Organizational

Structures
A Report By
Charmaine D. Dela Cruz
ADVANTAGE L IM IT A T IO N
S S
Maps lines of decision- •Shows only formal
making authority relationships
Helps people •Does not indicate
understand their degree of
assignments and authority
coworkers •May show things as
Reveals to managers
they are supposed
to be or used to
and new personnel be rather than as
how they fit into the they are
organization •Possibility exists
Contributes to sound of confusing
organizational authority with
structure status
Shows formal lines of
Organizational
Structures

Bureaucratic/Line Structure
Line and Staff Structure
Functionalized Line and Staff Structure
Service Line Organization
Flat Organizational Design
Adhocracy Organizational Models
Bureaucratic/Line
Structure
This is the kind of structure that has a very
specific line of command.
The approvals and orders in this kind of
structure come from top to bottom in a
line.
Suitable for smaller organizations like
small accounting firms and law offices.
Allows for easy decision making, and also
very informal in nature.
Have fewer departments, which makes it
decentralized.
Line and Staff Structure
Appropriate for small companies
•

Helps to identify a set of guidelines for the

people directly involved in completing the
organization's work.
•

This type of structure combines the flow of

information from the line structure with
the staff departments that service, advise,
and support them
Functionalized Line and
Staff
 Structure

Classifies people according to the function they
perform in their professional life or according
to the functions performed by them in the
organization.
Functionalized Line and
Staff
 Structure

The organization chart for a functional based
organization consists of Vice President,
Sales department, Customer Service
Department, Engineering or production
department, Accounting department and
Administrative department.

Service Line Organization
Also called “care-centered organizations”
•

Used in large institutions to address endemic

shortcomings of traditional large
bureaucratic organizations.
•

The goals is set by the large organizations but

the service decides on the process to be used
to achieve goals.

Flat Organizational
Designs
Is an effort to remove hierarchical layers by
flattening chain of command and
decentralizing the organization.
Many managers resist
Flattened Organizational Structure
ADHOC DESIGN
A modification of bureaucratic structure
Used on a temporary basis to facilitate
completion of a project within a formal line of
organization.
Uses a project team or task approach, usually
disbanded after project is completed.
Matrix Organizational Structure
Designed to focus on both product and
function
Has a formal vertical and horizontal chain of
command
Less formal rules and fewer levels of hierarchy
May CONFUSE and FRUSTRATE workers
because of its dual hierarchical design
 PRESIDENT

Functiona Manager
l
Vice President Nursing Services
Vice PresidentVice
Finance
President Human Resou

Product Manager

President Pediatric
Manager
Services
of Nursing Pediatrics

ident Maternal and

Manager
Women’of
s Services
Nursing Women Services

e President Oncology
Manager
Services
of NursingOncology Services
Matrix
Organizational
Structure
PROJECT MANAGEMENT
Is the discipline of planning,
•

organizing, securing and

managing resources to bring
about the successful
completion of specific
engineering project goals
and objectives
COLLEGIAL
MANAGEMENT
Also referred as European-style management
Restrictrics monocractic authority by
maintaining a balanced division of power
among top management groups
The “directors” represent functional areas
It is the “board” that make policies and
decisions

Shared Governance

Most innovative and idealistic or organizational
structures
Alternative to bureaucratic organizational
structure

 CHIEF NURSE ADMINISTRATOR
Clinical Nursing Practice Administrative
Services

Nurse Educator
ed Nurse Organization
Quality Control
Infection
Nurse
Associate
Control Nursing
Nurse Administrator
Director of Nonclinica

C Professional
O Performance
M (standards,PR)
M Quality Assurance

SHARED GOVERNANCE MODEL

I Infection Control Clerical
Clinical Nursing Division Services
Coordinators
T Patient Care
T (Policies, procedures)
E Knowledge and Staff
E Development Personnel Service
S (continuing
education/research)
Nursing Opportunities
(retention, recruitmentPrimary
) Nurse Case Managers Budget and Suppli
Nonclinical
(support staff, budget,
equipment specifications)
Information Syst
Ancillary Nursing Staff

Shared Governance
 NCBH Nursing Organizational
Framework Organizational Structure

ip Pr
h a
e rs il Co ctic
a d nc un e
Le Cou cil
Pr
of Coordinatin
es
si g
on Council
a lD
ev lity il
el
o ua unc
pm Q o
en C
ta
lC
ou
nc
il

Sample nursing council in a shared governance model

Participatory
Management
Foundation for shared governance
•

Implies that others are allowed to participate in

decision making over which someone has
control.
•

Thus, the act of “allowing” participation

identifies the real and final authority for the
participant.
SELF-GOVERNANCE

Places autonomy, authority, and control for
services to clients with the professionals
providing care.
Corporate Model
A corporation is a group of people who act
as one body.
Corporations may be private or public;
proprietary or non-for-profit
For nursing service to be a corporate entity, it
must be able to sustain its own activities
without dependence.

Inter-organizational
Relationships
Health care organizations have been forming
relationships with one another to survive the
increases competition for resources.

Horizontal integration occurs when
organizations provides the same or similar
service. (e.g. one provides laundry service
while the other provides dietary service for
both organizations.

Inter-organizational
Relationships
Vertical Integration – is an arrangement among
dissimilar but related organizations to
provide a continuum of care.
•

(e.g. affiliation of a health maintenance

•

organization with a pharmacy, hospital, home

care, and long term health facility.
MERGERS
Means that one organization will join its asset
with another .
2000s
•

Top 10 M&A deals worldwide by value from 2000 to


2009:
Rank Year Purchaser Purchased Transaction
value ( in
2 2000 Glaxo SmithKline Beecham
75
mil, 961
. USD )
Wellcome Plc .
6 2009 Pfizer
Plc . Inc . Wyeth 68 , 000
8 2002 Pfizer Inc . Pharmacia 59 , 515
Corporation
Health Care Networks
Health Preferred Individual Physicial Hospital Management
Maintenance Provider Practice Organization Service
Organizations Organization Association (PHO) Organizations
(HMO) (PPO) (IPA) (MSO)
Associationsof Groups of Provides Allows a Provide
health care health care insurance hospital and medical
professionals and
facilities that professionals coverage, medical staff practice
provides a health and hospitals health care to have joint management,
care package for that services managed care physician
a fixed sum of contractswith rates, and contracts. recruitment,
money that was the employer , bill a fee for informations
paid in advance
for a specific
insurance services. system, billing
period of time company and and collection
other third- system, quality
party payer to monitoring,
provide health and other
care to a services.
group.
Integrated Healthcare
System

Main objective is to keep people healthy at the
lowest cost setting when necessary.
•

Improving healthcare outcomes and reduce

health care cost while improving patient
satisfaction.