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N471: Practice of Nursing V > Organizational Structure and Strategic Planning > Flashcards

Organizational Structure and Strategic Planning Flashcards

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1
Q

Why bother having organizational structure

A

it helps ID roles and expectations

allows arrangement of the work group to maintain command, reinforce authority, and provide a formal system of communication

Designs foster the organizations survival and success

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2
Q

Organizational Design

A

Process of aligning an organizations structure with its mission

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3
Q

Formal Organizational Structure

A

emphasis on organizational positions and formal power

Framework for providing managerial authority, responsibility and accountability

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4
Q

What things are present in formal structrure

A

roles and functions defined

people have different roles

rank and hierarchy are evidence

ex: manager –> nurse –> nurse assistant

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5
Q

Informal Organizational Structure

A

focus on naturally forming social network of employees and their relationships

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6
Q

What things are present in informal structure

A

typically based on camaraderie

rely on the informal structure if the formal structure becomes ineffective

“grapevine” communication within the informal group

ex: nurse to nurse colleagues

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7
Q

Classical Theory of Organizational Structure (1900s)

A

Founder: Max Weber

Bureaucracy design - the ideal, intentionally rational, most efficient form of organization

“Efficiency through design”

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8
Q

4 Elements of Classical Theory of Organizational Design

A
  1. Division and Specialization of Labor - dividing work reduces number of tasks each employee must do ==> increased efficiency and improved organizational product occur as a result — Also, a manager can standardize work for greater control
  2. Chain of Command
  3. Organizational Structure
  4. Span of Control
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9
Q

Chain of Command

A

Hierarchy of authority and responsibility within the organization

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10
Q

Line Authority

A

linear hierarchy chain of command

things go up and down a chain

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11
Q

Staff Authority

A

Advisory Relationship in the chain of command without formal control over another

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12
Q

Unity of Command

A

Differs from line authority

A solid vertical line where one person/one boss exists and everyone reports to them

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13
Q

3 Levels of Management from Highest to Lowest

A
  1. Top Level (Board of directors, CEOs, Administrators)
  2. Middle Managers (Nursing supervisors, Dept. Heads)
  3. First Level Managers (Team Leaders, Charge Nurses, Primary Care Nurses, Case Managers)
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14
Q

Span of Control

A

Number of people reporting (direct reports) to any one manager

Determined by the amount of people designated to respond to this manager

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15
Q

What happens if a managers span of control is too wide

A

Too many people report to the same manager thus delaying decision making

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16
Q

What happens if a managers span of control is too narrow

A

too few people are reporting to the same manager resulting in inefficient, top heavy organization

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17
Q

“Tall” Organization

A

Complex Organization with numerous departments, highly specialized and differentiated, and authority is centralized

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18
Q

“Flat” Organization

A

Less complex organization where authority is decentralized and several managers supervise large work groups

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19
Q

Stakeholders

A

Entities that play a role in the organization’s health and performance

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20
Q

Internal Stakeholder Examples

A

nurses

Other hospital staff

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21
Q

External Stakeholder Examples

A

managed care providers

nursing homes

schools of nursing

chamber of commerce

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22
Q

Every organization should be viewed as being…

A

part of a greater community of stakeholders

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23
Q

Centrality

A

Where a position falls on an organizational chart and the degree of communication of a particular management position

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24
Q

What position has most centrality

A

middle managers

they have a broader view of the organization up and down

decisions are made by these few managers at the top of the chart

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25
Q

Scalar Chain

A

Decision making hierarchy (or pyramid)

it is a chain of all supervisors from top management to the person at the lowest rank indicating who makes decisions

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26
Q

Centralized Decision Making

A

Top Down Decision making

one or a few individuals make decisions from the top of the scalar chain pyramid

decision making is rapid

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27
Q

Decentralized Decision Making

A

allows problems to be solved by the lowest management level

decision making may be delayed if several levels get involved so this may help that

it prevents delays from having to go all the way to the top

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28
Q

The larger the organization, the greater the need for ___ decision making

A

decentralized

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29
Q

Gang Plank

A

middle managers that make decisions in decentralized decision making

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30
Q

Advantages of using an Organization Chart

A

maps lines of decision making authority

helps people understand assignments

reveals to managers and personnel how they fit into the organization

contributes to sound organizational structure

shows formal lines of communication

Basically - shows who is in the chain of command and who to report to, and know what their own role in the chain of command is

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31
Q

Disadvantages of an Organization Chart

A

does not show informal structure of organization

does not indicate DEGREE of authority held by each line position

difficult to keep up to date, may show ho-w things should be rather than how they are

may confuse authority with status

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32
Q

Types of Organizational Structures

A

Functional Structure

Line Structure

Ad Hoc Design

Matrix Structure

Service Line Organization

Flat Designs

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33
Q

Functional Structure

A

employees are grouped by specialty/function, similar tasks performed by the same group (ex: all nursing tasks fall under nursing, dietary in dietary etc)

centralized form of decision making - one person is calling the shots

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34
Q

Line Structure

A

Bureaucratic Design

Used in LARGE health facilities

authority, responsibility, and relationships are defined

things flow top to bottom - DECENTRALIZED (Middle managers make some decisions)

Issue is it can produce monotony and alienate workers while restricting upward communication

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35
Q

Ad Hoc Design

A

modification of bureaucratic structure

used temporarily to facilitate project completion and provide flexibility

project teams usually - and they usually disband once project complete

allows professionals to handle large amounts of information

may result though in decreased loyalty to parent organization

contains both self contained and functional units – usually result of growing organization

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36
Q

Matrix Organization

A

both horizontal and vertical chain of command!!!

fewer formal rules and fewer levels of hierarchy - but slows decision making due to information sharing and potential overload of middle manager

can produce confusion and frustration for workers due to Dual Authority

integrates product and functional structure into one overlapping structure

different managers are then responsible for function and product

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37
Q

Focus of matrix organization is on both…

A

product and function

38
Q

Service Line Organization

A

used in large organizations to address shortcomings that occur in large traditional bureaucratic organizations - smaller in scale than large bureaucratic systems

All functions needed to produce a product or service (i.e. healthcare) are grouped together into self contained units (primary, oncology, etc)

Decentralized in Structure

Preferred by large, complex organizations as there is rapid response in an unstable environment

Used when organizations require frequent adaptation and innovation

like a chain

39
Q

Strengths of Service Line Organization

A

easy coordination across function (nursing, dietary, etc)

reduced role conflict

client satisfaction is usually high

easy coordination

40
Q

Weakness of Service Line Organization

A

possible duplication of resources

lack of in-depth technical training and specialization (who do I report to?)

services operate independently and often compete

department of nursing may not even be shown on organizational chart

41
Q

Flat Organizational Structure

A

remove hierarchal layers by flattening the scalar chain and decentralizing organization

continue to have line authority, but more authority and decision making occur where the work is actually being carried out

tends to maintain characteristics of bureaucracy

Centralized decision making - might make workload slower since middle management is not helping make the decisions

42
Q

Centralized Decision Making

A

decision making at the top of an organization

a few managers at the top of the hierarchy make decisions (top down communication)

decision making can be rapid

43
Q

Decentralized Decision Making

A

decision making diffused through the organization

problems solved by the lowest practical managerial level

problems solved at the level they occur

44
Q

Organizational Climate

A

perceived characteristics of the organization (physical attributes, organizational structure, lines of communication, policies)

“the mood”

45
Q

Organizational Culture

A

values and behaviors that contribute to the unique psychological and social environment of the organization

norms, traditions, and rituals within an organization (what are the rules?) - uniforms or scrubs, when is report given, is tardiness tolerated, etc

46
Q

How does organizational culture differ from organizational climate

A

differs from organizational climate (how people perceive the organization) - people in the same organization may have different perceptions about the same organization

47
Q

Shared Governance

A

Nurses at every level play a role in decisions that affect nursing throughout the organization

based on the philosophy that nursing practice is best determined by nurses

nurses gain control over practice, efficiency, and accountability is improved; feelings of powerlessness mitigated (pushes against medical model)

nurse managers move out of traditional industrial roles and uinto collegial roles

48
Q

Participatory Management

A

lays the foundation for shared governance

others are allowed to participate in decision making

allows nursing staff at the unit level to participate in decisions like practice counsel and various types of committees to help make decisions at the bigger level for a variety of issues like professional practice or QI

49
Q

What sort of decision making is made in shared governance and participatory management

A

decentralized decision making

50
Q

Magnet Hospitals

A

AANC looks a the nursing practice culture and outcomes and can recognize hospitals as such to put voice back into nursing staff to be autonomous as a profession

51
Q

What are some characteristics of Magnet Hospitals

A

well qualified nurse executives in a decentralized environment, with organizational structures that emphasize participatory management

autonomous, self governing, self managing climates

flexible staffing

adequate staffing ratios

clinical career opportunities

professional practire culture

52
Q

Strategic Planning

A

process of long range and ongoing planning for the future or an organization

guides the direction of the organization

53
Q

How far ahead does strategic planning plan

A

3-7 years ahead

54
Q

Considerations when Strategic Planning

A
  1. Values - beliefs or attitudes of the organization
  2. Vision - described goals
  3. Mission - broad, general statement of the organization’s reason for existence
  4. Philosophy - written statement reflects the values, vision, and mission
  5. Goals - specific statements as to what is to be achieved

Extra: Stakeholders, Regulatory Bodies, and things outside the organization influencing it

55
Q

What sort of things does strategic planning look at

A

follows objectives and specifies actions

ID’s personnel responsibility for each activity (meetings, etc)

projected cost

criteria for meeting goals

expected date of completion

current status of the organization

56
Q

___ follows planning as the second phase of the management process

A

Organizing

57
Q

Organizing Phase

A

relationships are defined, procedures are outlined, equipment is readied, tasks are assigned

58
Q

Organizational structure refers to what

A

the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions

59
Q

Legal Rational Authority

A

concept for bureaucracy

Based on a belief in the legitimacy of the pattern of normative rules and the rights of those elevated to authority under such rules to issue commands

60
Q

Obedience is owed to…

A

the legally established impersonal set of rules rather than to a personal ruler

this is the type of authority in bureaucracy

61
Q

Max Weber’s Characteristics of Bureaucracies

A

Defining Characteristic: Bureaucracy is an institutional method for applying general rules to specific cases, thereby making the actions of management fair and predictable

Division of Labor Present

Well Defined Hierarchy of Authority

Impersonal rules and Impersonality of Interpersonal Relationships - prevents bureaucrat’s from acting in any way they want

System of procedures for dealing with work Situations

System of rules covering the rights and duties of each position must be in place
Selection for employment and promotion is based on technical competence

62
Q

Authority (Staff) Positions

A

No inherent legitimate authority

63
Q

Unity of Command

A

one person./boss in which employees have one manager to whom they report and to whom they are responsible

difficult to maintain in some large healthcare organizations because the nature of health care requires and interprofessional approach

It is the lines connecting positions on a chart

64
Q

Span of Control

A

the number of people directly reporting to any one manager

65
Q

Too many people reporting to a single manager does what? Too few results in what?

A

too many = delay decision making

too few - inefficient, top heavy organization

66
Q

Centrality refers to …

A

the location of a position on an organizational chart where frequent and various types of communication occur

67
Q

Line Structures/Staff Organizations basically refer to…

A

bureaucratic organizational design

68
Q

Ad Hoc Design

A

modification of the bureaucratic structure and is sometimes used on a temporary basis to facilitate completion of a project within a formal line organization

it is a means of overcoming the inflexibility of line structure

69
Q

Matrix Organization

A

designed to focus on both product and function

vertical and horizontal chain of command exists

70
Q

Function

A

all the tasks required to produce a product (ex: patient outcome)

71
Q

Product

A

end result of the function(s)

72
Q

What would be an example of the product manager and functional manager of the manager of nursing on a pediatric unit

A

Product Manager: VP Of Pediatric Services

Functional manager: VP of nursing services

73
Q

Service line Organizations are also called

A

care centered organizations

smaller in scale than large bureaucracies
overall goals are determined by the large organization but the service line decides what processes are used to achieve the goal

74
Q

Flat Organizations ___ Decision Making

A

Decentralize

  • allows multiple middle managers to spread decisions out
75
Q

Organizational Culture

A

the total of an organization’s values, language, traditions, customs, and sacred cows (those few things present in an institution that are not open to discussion or change)

76
Q

Organizational Culture is a system of…

A

symbols and interactions unique to each organization. it is the way of thinking, behaving, and believing that members of a unit have in common

77
Q

8 Distinct Organizational Culture Styles

A

Caring
Purpose
Learning
Enjoyment
Results
Authority
Safety
Order

78
Q

Caring Culture Style

A

focuses on relationships and mutual trust

79
Q

Purpose Culture Style

A

exemplified by idealism and altruism

80
Q

Learning Culture Style

A

exemplified by exploration, expansiveness, and creativity

81
Q

Enjoyment Culture Style

A

exemplified by fun and excitement

82
Q

Results Culture Style

A

exemplified by achievement and winning

83
Q

Authority Culture Style

A

defined by strength, decisiveness, and boldness

84
Q

Safety Culture Style

A

defined by planning, caution and preparedness

85
Q

Order Culture Style

A

focused on respect, structure, and shared norms

86
Q

Organizational Climate

A

how employees perceive an organization

87
Q

Participatory Management Implies..

A

that others can participate in decision making over which someone has control

88
Q

5 Model Components Required for MAGNET Status

A

Transformational leadership

Structural Empowerment

Exemplary Professional practice

New knowledge, innovation, and improvements

Empirical quality results

(These 5 grew from an original 14 forces)

89
Q

14 Foundational Forces of Magnetism for Magnet Hospital Status

A

Quality of Nursing leadership
Organizational Structure
Management Style
Personnel policies and programs
Professional models of Care
Quality of Care
Quality Improvement
Consultation and Resources
Autonomy
Community and the Hospital
Nurses as teachers
image of nursing
interdisciplinary relationships
professional development

90
Q

Pathway to Excellence

A

program emphasizing supportive practice environments

shared governance structure valuing nurses contributions in everyday decisions

to earn this designation you must meet 12 practice standards essential to an ideal nursing practice environment

91
Q

Because committees communication up and down and encourage the participation of interested or affected employees…

A

they assist the organization in receiving feedback and important information

also a goal for committee forming should be cultural and gender diversity

92
Q

Groupthink

A

group members fail to take adequate risks by disagreeing, being challenged, or assessing discussion carefully

manager needs to be a part of a committee to prevent this

N471: Practice of Nursing V (11 decks)

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