Exam #1: Organization Structure Flashcards
Organization Structure
- Communication
- Authority
- Formal Relationships
Chain of command
Formal paths of communication and authority
Unity of command
Reporting to one person
Span of control
The number of direct reports
Organizational Chart Position/Levels
- Board of Directors
- Advisory committee
- CEO/President
- Executive Leadership (CFO, COO, CNO)
- Directors (Senior Managers) -> Assistant Director of Nursing
- First-level Managers (Managers, Charge Nurses)
- Nurses, LPN’s, CAN’s, unit secretaries
Board of Directors
Responsible for direction of where the organization is going.
Advisory committee
- Group of people who have something to contribute to help move organization in a direction.
- They have no power/authority but will make suggestions.
CEO/President
- Top of the organization.
- They answer to board of directors.
Executive Leadership: CNO
- Responsible for nursing department.
- Their job is to have a vision for the nursing department.
- Their thinking is big, asks “how do we move forward”.
- The person who is ultimately responsible for implementing guidelines.
Executive Leadership: COO are responsible for
- Housekeeping staff
- Axillary staff
- Maintenance
- Etc.
Directors (Senior Managers)
- Have more than 1 unit under their belt.
- Help get a little more specific with what their department needs to do and then share that with managers to implement on each separate floor.
First-Level Managers: Managers
- Get direction from directors of what is to happen on their unit.
- All gives information to the directors about what they need to do their job.
Charge Nurse
Day-to-day working of the unit, more working on the floor
Shared Governance
- Gives nurses control over their own practice, allows for shared decision making at a faculty level
- Ex: if the Director of ICU wants to get new IV pumps, the nurses on the floor are best for input on what kind of IV pumps to get
- Ex: All policies and procedures of nursing school are a result of faculty not just the dean.
Advantages of Shared Governance
- More accountability
- More control over work environment
- Improves job satisfaction
- Decreases turnover rate
- Improves recruitment abilities
- Nurses become more fiscally responsible
Disadvantages of Shared Governance
decisions not congruent across all units
Organizational Culture
How the unit carries out care; shared beliefs
Organizational Climate
How the employees perceive an organization; individual and vary among employees.
Magnet Status
- Developed by American Credentialing Center (ANCC)
- Recognition for hospitals w/ well qualified nurse executives and an organizational structure that emphasizes open, participatory management
- Improved patient outcomes and higher staff nurse satisfaction -> more access to professional development
- Lengthy process, Awarded for 4 years
- Not available in Nevada
How to qualify for Magnet Status
- Hospital must submit an application and undergo a multiday onsite evaluation
- Presence of ALL 14 Forces of Magnetism (basically a perfect hospital)
- Lengthy process, takes years to form, and requires a lot of money
Managerial levels/roles
- Upper Level (Executive Leadership): CEO, COO, VP of Nursing, DON
- Middle Level (Senior Managers): directors, supervisors, assistant DON
- First Level: charge nurses, head nurse, nurse manager
Upper Level Management
- Look at the organization as a whole including external forces
- Most communication is top down although some upward
- Focus on strategic planning
- Ex: budgeting for each department, achieving magnet status, long term goals
Middle Level Management
- Roles in several things, such as overseeing departments, budgeting within departments
- Looking at everything in more broad of a view.
- Ex: replacing new vents and getting new hospital beds for the department
First Level Management
- Focus on day to day activities
- Long and short term planning
- Lots of communication up and down
- Looks at more specifics
- Ex: inventory, performance improvement activity
Patient Care Delivery Model: Total Patient Care
-Complete care for a group of patients
-1 nurse assigned to a group of patients
Ex: ICU
Patient Care Delivery Model: Functional
-Tasks are assigned
-1 nurse assigned to give meds, another nurse assigned to do vitals, etc.
Ex: Psychiatric setting (mental health charge), med surg nurse
Patient Care Delivery Model: Team Nursing
- Lead nurse uses a group of workers to provide care
- RN, LPN, CNA all work together
- CAN be responsible for ambulating, documenting I&O, bed bath, under stable and normal conditions.
Patient Care Delivery Model: Primary Nursing
- Nurse has 24 hr responsibility for each patient
- Nurse sleeps at hospital
Committees
- Have a defined purpose
- Functions: advisory, communication, problem solving, improve services
Standing orders
- Always going to exist
- Ex. Pharmacy, therapeutics
Ad how
-We want to do something and gather a group together to get this task done. -Once task is accomplished, there is no more group.
Stakeholders
- Individuals or groups who have interests in what the organization does. -They may or may not have power or influence
- Internal v external
- Ex: As a student of the SON, I am an internal stakeholder for the SON.
