School of Nursing and Midwifery
400846 Building Organisational Capacity in Health Care Autumn 2021
|Unit Name:||Building Organisational Capacity in Health Care|
Essay: Short critical analysis
Type of Collaboration:
This is a formal academic essay (see essay writing guidelines on the vUWS site under ”
APA referencing is required and all ideas are to be acknowledged, using this referencing style (see style guide under assessment tab.
Assessment 1: Short Critical Discussion Paper
Aim of assessment: This first assessment requires students to critically discuss the organisational structure of the Chifley District Hospital ( CDH) in the following case study.
The module 1 readings are the framework for this assignment and are the support theories for the next two modules
Case Study The Chifley District Hospital, a 130 bed community hospital situated in the outer suburbs of Sydney, has provided general acute medical, surgical, obstetric and emergency services to the local community.
Over the last 10 years, the population of the area has increased significantly to include a much larger proportion of young families and a significant number of retirement villages.
The hospital has reviewed the needs of this growing community and is changing its range of services in response to that review.
To deal with these changes the CDH has a plan to redevelop the hospital facilities and restructure the organisa- tion to provide a focus on the health needs of the growing population and to provide a number of specialty services including cancer, paediatric, cardiovascular, renal, trauma, aged care and community services.
The bed number will increase to 300, with an increase in the capacity for community based clinics in the specialty services.
·The Vision statement of the hospital is to Provide health experiences that are able to respond to the changing needs of the community.
·The stated mission of the restructured hospital is to provide highest quality, specialist health care in partnership with patients, carers, the community at large and other health care providers.
·The overall strategic goals of the new organisation are to develop high performing, multidisciplinary teams within the specialist services in order to provide high quality, patient-centred care that is effective, eﬀicient and able to respond to the changing health needs of the population.
Currently, CDH has a traditional, functional (bureaucratic) organisational structure but the management team is reviewing alternative organisational structures which might better suit the changing internal and external environ- ments of the organisation and have the potential to improve communication and collaboration across teams and accountability for resource utilisation, quality of care and patient outcomes.
END OF CASE STUDY INFORMATION
Assignment 1 Instructions:
After reading the case study above use the course materials and essential readings to develop a short (1500 word), critical essay-style paper that discusses the strengths and limitations of the current organisational structure in relation to the vision, mission and goals of the Chifley District Hospital (CDH).
Students are required to identify an organisational structure that might better support the vision, mission and goals of the CDH, detailing the strengths and weaknesses of this new organisational structure and why it might be a better fit for this hospital.
With high expectation from the healthcare organizations and increasing demands for meeting the healthcare need of the population, the healthcare facilities or hospital need to function with best of the efficacy. For obtaining desired functioning and achievement, an organization has to define its vision, mission and objective. The organizational structure has a direct relationship with the structure of an organization as the way of functioning helps achieve the desired goals. The essay critically analyse the weakness and strength of the organisation structure of The Chifley District Hospital. The essay also proposes an alternate organisational structure that might better support the district hospital's vision, mission, and goals.
Background information of the hospital
The Chifley District Hospital is a 130-beded community hospital situated in outer suburbs of Sydney's, providing medical and emergency care to the community. With a growing community and changing needs, the organisation intends to increase to 300 bed with the expansion of the specialty · The Vision statement of the hospital is to provide healthcare experiences responding in accordance to the changing needs of the community with the mission to provide the highest quality, specialist health care in partnership with patients and the community at large and other health care providers. The new organisation's overall strategic goals are to develop high performing; multidisciplinary teams to meet the increasing need of the people. Currently, the hospital has a traditional, functional (bureaucratic) organisation, but the management team intent to explore alternative organisational structures for better changing internal and external environments of the organization.
Critical evaluation of the current organisation structure
Bureaucratic organisations function in an environment where there is stability in the nature and the minimal scope of technological changes in routine. The organisations working on the function structure are primarily centralised and have a very well defined hierarchy of function, authority and control. The whole process is standardised with productivity, and efficiency is defined as per the set standards and protocols (Verburg et al., 2018). ·The hospital's Vision statement is to Provide health experiences that can respond to the changing needs of the community; however, the bureaucratic organisation has rigid in nature with most f the task and jobs are strictly defined, and there is little space for flexibility and providing feedback. With such an organisation structure where the scope of reintroductions is little, achieving vision for meeting the changing health needs would be complex (Bahadori et al., 2017).
The functional structure's advantage is the adherence, and compliance assurance from the employee with proper follow of code of conduct. This can assure the mission achievement of providing quality care as there is continuity of performance and operation in the hospital working through the functional structure (Verburg et al., 2018).. The current organisation structure has some benefits of being a bureaucratic function as it has a clear line of authority and hierarchy within the different department. This allows the maximum output from each department when they have predefined services to offer. This type of structure is also able to limit the expenditure and increase the efficiency of utilising the maximum out of the available resources to deliver better quality services to the patients; however, in contrary, it cannot be denied that in such type of structure, the healthcare professionals become isolated and very limited information is shared (Bahadori et al., 2017). The interdepartmental and interprofessional collaboration to provide integrated care becomes impossible as other departments are entirely unaware of other departments' functioning. In such type of organisation, the responsibility of achieving the organisational goals is not shared but largely dependent on the decision made by the senior management where the lower in hierarchy employees are supposed to follow the instructions (Pettersen & Solstad, 2015). Hence, it is a managerial level-derived function that may allow efficiency, but ownership and achievement share are lacking (Zanganeh Baygi & Seyedin, 2013). This, in some instances, is demotivating to the staff working with the patients. For example, there is no provision of providing feedback, and most of the higher management is unapproachable for freedom of expression. The organisation structure is an effective tool for interactions within the organisation. It acts as the basis for the distribution of the specialist's responsibilities in the hospital's ecosystem. These types of organisations are primarily focused on professional training and development (Alongi, 2015).
Clinical and non-clinical departments should keep in touch and share the working experience to establish the necessary partnership as the hospital intent to achieve in their mission. These departments should have the liberty to their experiences to maintain high-quality services through continuous improvement in the system. The cohesion and cooperation between different department and services can ensure safety and quality in treatment (Pettersen & Solstad, 2015). The demand of the healthcare needs are changing; hence lack of communication between the partners may cause wastage of time and resources; for example, no intercommunication between the radiology department and the orthopaedic department can increase the waiting time for the patient, contrary to this if smooth flow information could be established it ensures better, speedy and safe treatment option. Hence, a functional organisation is correct in terms of changes and innovation, resistance to eth environmental changes, and autonomy (Alongi, 2015).
Through the analysis, it can be understood that functional organisational structure has some advantages and disadvantages. The authority and responsibility identification is a critical essential component to achieve the organisational goal (Zanganeh Baygi & Seyedin, 2013). However, with changing environment, organisations such as community hospitals should adopt a more flexible structure that can accommodate changes as per the need and technology (Pettersen & Solstad,2015). The hospital needs to increase lateral communication for making the operation smooth and goal-oriented. The current structure is mechanistic and inhibits the employee's potential, and creates a barrier.
Alternative to current organization structure
The hospital's expansion plan needs to fulfill multiple tasks based on the technological process, total quality management, human resource, and advocacy (Nigam et al., 2014). Team building, designing and restructuring should be considering to follow up with changing demands continuously. In today's era, treatment is not just providing medication but also several aspects, including culture, m region, intrapersonal relationship, and sharing perspectives. Hence in comparison to the traditional organisational structure, the hospital requires a flat and organic structure to provide quality-based services to the expanding community (Green et al., 2017). Contrary to the functional organisation having multiple supervisors, managers, and directors, the flat organisation has easy accessibility to the leader; hence, functioning is more flexible and goal-oriented. This structure is more productive and less hierarchy oriented. Each member of the hospital is valued rather than intimidating seniors.
With respect to the economic, demographic and social context, the healthcare system needs to innovate interlaced with the organisational redesign and integrated network system, significantly when the community needs are expanding (Nigam et al., 2014). The continuous and changing consumer with global impact required adaptive organisations that include resources as a systemic part of the decision making, as the vision of the hospital after the expansion is to provide high performance through multidisciplinary teams within the specialist services flat organisation can provide the interdisciplinary structural empowerment in daily clinical practices. An organisation, especially a hospital, is a stressful working environment to provide the highest quality, specialist health care in partnership with patients, carers, the community at large and other health care providers (Van et al., 2016). Stakeholder must take an essential role in internal governance. However, this structure has certain drawbacks; a flat organisation structure can sometimes become a source of confusion as role and responsibilities are not well-defined, which is not suitable for organisations like hospitals where super-specialised functions from healthcare professionals are required (Fiorioet al., 2018). Along with role confusion, a flat organisation can lead to a conflict of interest and difference of opinion as the level of authority is not defined. The flat organisation may also result in extra costs as there might be duplication of role mismanagement due to an undefined working system (Van et al., 2016).
In conclusion, the hospital needs to achieve its mission, vision, and goal to meet the community and individuals' needs. The current functional organisational system has few merits and demerits that need to be evaluated by the higher management as hospital structure is required to achieve the organisation's mission and goal. In contrast, the goal and mission of the organisation decide the structure of the organisation. Ownership, authority, intrapersonal relationship is essential components to achieve the described goals, mission and objective of the community hospital, which is possible with the more flexible approach as in a flat organisation. As suggested by Van et al., 2016 to meet the expanding demands of community with mos flexible and patient oriented approach organization need to adopt the flat organizational structure.