Abstract
Organizational structure influences the service delivery of the organization. Different organizational structures are used in healthcare organizations. These include bureaucratic structure, matrix, flat structure and hybrid organizational structure. Common in most health organizations is the bureaucratic structure that uses a top-down approach of management. However, due to certain challenges, organizations are using a hybrid organizational structure, as it eliminates the problems of using a single organizational structure.
Bureaucratic Organizations
A bureaucratic organizational structure consists of four basic characteristics. According to Finkelman and Kenner (2013), division of labor is a distinguishing characteristic of bureaucratic organization. Division of labor involves the specialization of tasks. Each employee is assigned specific tasks. For instance, in a health organization, division of labor is evident from the different tasks that nurses, doctors and laboratory technicians perform on a daily basis.
A bureaucratic organization normally has a defined hierarchy as another distinguishing characteristic. A defined hierarchy clearly outlines the reporting relationship in the organization (Finkelman and Kenner, 2013). Employees are organized and ranked in order of their authority in the organization (Booyens, 2004). For instance, a nurse manager oversees all nursing aids and cleaning personnel.
Thirdly, a bureaucratic organization normally has detailed rules and regulations (Finkelman and Kenner, 2013). The organization management puts additional weight on the observance of policies and procedures, which are aimed to assist in decision-making. Thus, certain tasks usually have set out procedures in writing. Additionally, the policies can be applied when discipline an employee. Bureaucratic organizations are also characterized by impersonal relationships. Thus, a supervisor is required to ensure that subordinates do their tasks fully.
Matrix Organization
According to Roussel (2011), a matrix structure in an organization uses a horizontal program management, as opposed to a traditional vertical hierarchy, as is the case with bureaucratic organizational structure. Employees from different departments in the health organization may be assigned to a specific program or project. Thus, the employee reports to two supervisors, the program manager and the functional departmental head. According to Ellis and Hartley (2004), having two supervisors creates two directions for accountability and communication. Furthermore, in a matrix organization personnel with special expertise can be used as resource persons for other departments, which enhance the provision of knowledge in all these departments (Ellis and Hartley, 2004). For example, in large hospital organizations with financial services can be applied in various departments such as acute care and long-term care.
Flat Organization Structure
According to Roussel (2011), a flat organization structure is common in decentralized management. The authority in a flat organization structure is shifted from the top management and the main decisions made depend on the departments or divisions in the organization (Finkelman and Kenner, 2011). Therefore, different departments such as nursing, dietary or laboratory have special functions, which only can be performed through these particular divisions. Nursing care is offered through the nursing department, and nutrition care is handled through the dietary department (Finkelman and Kenner, 2013). In each department, complexity increases with the increase in the number of employees the manager supervises.
Hybrid Organization Structure
According to Yoder-Wise (2013), a hybrid organization structure combines several characteristics of a matrix, functional or flat organizational structure. In a hybrid structure, the functions that are of most important to the organization are decentralized whereas the less important functions are centralized. Therefore, functions such as nursing care or dietary care are decentralized to the respective departments whereas the administrative functions are centralized and handled by top management. With a hybrid structure, employees are able to work in areas in which they are well matched. Provision of services increases using a hybrid structure.
References
Booyens, S. W. (2004). Dimensions of nursing management. Landsdowne, Virg: Juta.
Ellis, J. R., & Hartley, C. L. (2004). Nursing in today's world: Trends, issues & management. Philadelphia, Penns: Lippincott Williams & Wilkins.
Finkelman, A. W., & Kenner, C. (2013). Professional nursing concepts: Competencies for quality leadership. Burlington, MA: Jones & Bartlett Learning.
Roussel, L. (2013). Management and leadership for nurse administrators. Burlington, MA: Jones & Bartlett Learning.
Yoder-Wise, P. S. (2014). Leading and managing in nursing. St. Louis, Mo: Elsevier Mosby.
