An Organizational Structure and Nursing Leadership - Research Paper Example

Organizational structure and nursing leadership/management and risk: This paper is an attempt to study the Organizational structure and nursing leadership and the management of risk. Leadership is probably the most widely researched area of organizational dynamics. This plays a crucial role in influencing the organizational structure and its culture. It has an important bearing on communication and also on the nature and quality of decisions to overcome the risk. Structure of an organization provides the frame work for accomplishing the work of the organization. Structure is essential for the efficient and effective management of work, power and control. The general goal of nursing is to deliver service that is caring, high quality and cost effective. Nursing leaders are faced with a complex, turbulent and constantly changing health care environment to manage 2. Organization's vision and mission act as guidelines for strategy formulation. The process of strategy formulation involves articulating a vision for the organization translating the vision into a mission that defines the organizations purpose, converting the mission into performance objectives, detailing each objective into specific goals, and formulating tactics and strategy for accomplishing the goals. Mission statement is the philosophy of business and services to build the image of the company in terms of activities currently pursued by the organization and its future. (Huber 2006). 3. Organizational structure or unit: The organization structure is a pyramid organization with seven levels in hierarchy. The communication channels are complex with a detailed reporting structure. It appears to be a centralized organization structure because of the multiple levels. There are two identified staff positions, the medical director and the financial director. Organization structure serves to provide order, distinction and framework for attainment of goals. Nurses control behavioural variations among individuals, direct flow of information, determine employee positions and provide an efficient work flow. Traditionally nursing organizations have been bureaucratic. To be successful in a health care reform climate, nursing organization must change to become more effective, efficient, innovative and flexible structure that respond quickly to dynamic and turbulent environment. A pure bureaucratic model does not help an organization function with optimum efficiency. As this organization is having different layers it is typically pyramidal. One positive aspect of this structure in our company is that it provides an opportunity for high level of interaction between the manager and the subordinates under manager's control. (Nagelkerk & Huber 2006). 1. Clearly differentiate between organizational climate and organizational culture. Include in your discussion whether your organization /unit has a climate that reflects its mission statement and values: Organization culture and organization climate are the two important factors that are needed to be taken into consideration in the heath care organization. Organization culture is concerned with the nature and beliefs and expectations whereas organizational climate is an indicator of whether those beliefs and expectations are being fulfilled. Organization climate is a set of characteristics which helps to describe the organization from another organization. "These characteristics are seen as relatively enduring and as influencing the behaviour of people in the organization". Basically organization climate reflects a person's perception of the organization to which it belongs. Organization climate is very important factor to be considered in studying and analyzing organizations because it has profound influence on the outlook, well being and attitudes of organizational members and thus on their total performance. In this company organization climate is wedded to mission statements and vision that it effectively utilizes it resources both human as well as non human so that the climate is good. This climate is said to be highly favourable when the existing management techniques such as that all the employee's goals in our organization are perfectly matched to the ideals of the organization. Organizational climate that reflects its mission statement and values in our organization plays a vital role in the survival. If our organization does not have mission and values it might result in the failure of our firm since its short run actions can be counterproductive to the organizations long run purpose. The external environment such as the size and location of the building, the weather or the place of our organization also affects our organization climate. As all the employees in our organization are performing their job in a relatively clean, quite and safe environment they will have a favourable perception of the organization climate. In our organization value system are fairly discernible where certain kinds of behaviour are rewarded and encouraged and certain kinds of behaviour subjects an individual to formal sanctions. As our organization is a tall organization formal value system is communicated to our employees through rules, regulations and policies. As ours is a health care organization involving employees and the patients we have created positive social relations and interaction within our organization. The creation of a climate where happy family atmosphere prevails is appropriate as also the organizations climate with premium on certain degree of freedom. In order to build a sound organization climate managers are trying to understand their people in our organization. Importance was given to job performance in general and building an overall climate conducive to values and mission statement. The organization climate also represents the philosophy and goals of those who joined to create the organization. As it is a formal organization where all the employees are treated with respect and understanding it will have certainly a different climate than one which is very cold and impersonal. (Crafford & et al 2006). 2. Discuss how your organization's structure, climate and culture facilitate or hinder the development of each of the following: (a) Communication channels (300 words) (b) Nursing leadership (300 words) (c) Nursing care delivery system (300 words) a) Communication channels: In a health care organization communication is a continuous human function. It is very much important like breathing or cardiac functioning. The relationship between the nurse and the client is important for all nursing practice. It is built on interpersonal or personal communication that take place in a specific setting. Effective communication between nurse and client is a learned skill rather than natural process. Communication process of nurse and client in a health care unit goes through the following areas. Health care problems of clients are identified through proper communication. After first sitting the client feels very much cared. The family members or others are included in the communication process. Health teaching will be conducted. Health promotion and preventive care will be delivered. Communication is basic to human life. Without proper communication people would not be able to learn, to direct their lives in the society. An important element of communication is the communication channel. It is the medium or carrier of the message. It can be television, voice or written words, touch etc. Every communication has a sender and a receiver. The sender is the person who is sending the message and purpose of communication will be translated into a code .Organizational culture and climate plays a very important role while communicating with the client. Communication can be through language or nonverbal signals, such as gestures, facial expressions, or body gestures. Nonverbal communication can express positive thought through touch, facial expression, and eye contact. Effective communication network promotes the culture and organization climate in the health care unit. The process of understanding the translated code is called encoding. There will be a receiver for the message and he should be able to understand or decode the message. Feedback occurs after the decoding of message. Feedback means the receivers response to the message. Relationship between nurse and client is an informal contractual one and it involves values and right. Employee satisfaction in any organization is highly depends upon the communication channel. Because of increased consumerism in the health care, health maintenance organizations has an effect on nursing advocacy and communication. Advocacy means to act as an advocate for client and decisions are supposed to be taken by the professionals. Another mode of communication technique is therapeutic communication. It allows nurses to understand the cognitive changes whenever they occur, so the inferences will be free from personal bias. (Craven & Hirnle 2006, p.367). b) Nursing leadership: Leadership is very important in nursing. A leader interacts with group members to influence, motivate, and to improve the performance of his or her subordinates. Likewise a nurse leader inspires others, improves their abilities, bring out their best, builds on their strength etc which refresh their commitment toward nursing. Nursing leadership improves the performance of employees in the health care unit. The mission of any health care activity is to carry out humanistic health care and which will reflect the goals of the organization. Nursing manager must deal successively with three dimensions. They are the job- the task has to be done, the mission- the goal of the organization and the Interpersonal relationships- the people who do the job. The success and effectiveness of any organization largely depends on their abilities to share knowledge and develop staff. Leadership is the key factor in today's nursing administration. Leadership demands us to have a healthy self esteem and self confidence in our roles and the ability to share that on an interpersonal and group basis. The nurse leader should be a role model in her action which will motivate others to achieve their potential. A nursing leader uses power and influence to act as a mentor and to produce followership in others. He or she is able to nourish and support others because of his or her understanding of self, and the working environment. Dysfunctional responses which threaten the nursing are increased boredom, complaints, mistakes, sabotage, job dissatisfaction and burnout. For constructive organizational change to take place we must do the following. Diagnose the problem Understand the etiology of the problem Make a decision on treatment approach It is like we should not give antibiotic to a patient who is allergic to it. Therefore exact identification of the problem is essential. Self motivation is the drive which influences the profession to grow and leadership to be enhanced. And patient care to be achieved. (Baillie & et al 1989, p.2). c) Nursing care delivery system: Nursing is a major component of the health care delivery system and nurses constitute the largest employment group within the system. It is important for the development of organizational climate because it plays a major in the nursing care activity of any health care unit. Nursing services are very essential for patients suffering from various health problems. So nurses need to understand the nursing system effectively to deliver quality care for patients. Nursing: "Nursing is the process of recognizing, understanding and meeting the health needs of any person or society and is based on a constantly changing body of scientific knowledge". (Introduction to nursing and health care delivery system in India n.d., p.42). Nursing care delivery system is a systematic process of identification of patient's problems, finding solutions, assigning others to implement the solution and evaluate the effectiveness of the implemented solution. The nursing processes in a health care organization are as follows. 1. Assessment 2. Diagnosis 3. Planning 4. Implementation 5. Evaluation 1. Assessment:-This refers to a systematic collection of data, to assist in identifying needs and problems of the patients. 2. Diagnosis:-It is a clinical judgment about potential health problems and life processes. Data collected during assessment are critically analyzed and interpreted in this phase and conclusions are drawn according the patients problems. 3. Planning: - This means to develop a plan of action after a careful assessment. Strategies are developed to prevent, minimize or connect the problems identified in the diagnosis phase. 4. Implementation: - It is the act of implementing the planned activity to achieve the outcome. 5. Evaluation: - Evaluation means checking the progress of the nursing care, and revise it if needed. Advantages of Nursing Care Delivery System: 1. Helps create healthy environment to the patients. 2. Identification of actual cause behind health problem is possible. 3. Development of systematic and individualized nursing care. 4. Innovative nursing care solutions can be made. 5. Helps to increase nursing autonomy and to promote nursing accountability 6. To increase the effectiveness of nursing care. Changes in the organization's structure, climate and culture facilitate the organization to meet its challenges and it facilitates the overall development of the health care unit. (Introduction to nursing and health care delivery system in India n.d.). 1. Analyze and discuss the differences between Quality Assurance and Quality Improvement including in your discussion examples of how your health care organization addresses each area. Quality assurance refers to a program and the activities intended to guarantee or ensure quality of patient care, quality assurance throughout the production process by monitoring relevant measures and process that enable them to detect, correct and to prevent failures in the supplies to make the customers to meet the demand. Quality improvements are "the process that uses clinical and technical skills to produce a service. The focus is on whole systems not just on performance of individual practitioners." Ambulatory surgical nursing (Schick 2000, p.149). Our organization has continuously strived to improve the quality of the services provided by our organization in order to survive in the competitive market. So we make sure that the quality assurance and quality improvement are continuously implemented. It is disastrous to be complacent about quality. Every competitor in heath care is trying to do better than others and the customers have become more conscious and are always on the look out to go where another organization is providing a better heath care service. Quality is all pervasive and effects all the departments in our organization whether in radiology, cardiology, medical services etc. For a company to strive for excellence in quality assurance and quality improvement all the employees and the top management should have a strong belief and commitment in the services provided. So we are continuously improving the services for a better life of customers. Technology changes have been rapid and radical affording opportunities for better services. As it is now possible to use new and better health care technologies, we have decided to invest in such technologies and also we train all the employees in our organization in adapting to this new technology. As it became important to look for quality assurance in all the technology through which we are providing services to our customers it became imperative for us to train and develop our employees in a continuous process for the survival and progress. It is essential not only for our organization but also all other organizations. This way we will strive to provide quality assurance initiatives to improve the health of the customers. It is important intervention which focuses on establishing a place that encourages all the employees to perform well, thereby sustaining good services to customers and also profitability of an organization. Effective improvement in quality of services activities will lead to the development of a healthy, satisfied customers and also efficient, adaptive and profitable organization. However if we have not been able to properly implement quality assurance and quality improvement it might destroy the harmonious relationship between the organization goodwill and the customers. Thus clearly it is essential of us to implement quality assurance and quality improvement and it the responsibility of every organization to see that it is followed continuously and no failure occurs in the process. All the employees in our organization are given appropriate responsibilities and sufficient powers to accomplish their tasks and achieve the objectives of the organization. Considerable time is spent on all the employees to facilitate all round development of the organization. This creates a shared sense of responsibility and accomplishment among all the employees in the health care services and also helps them to motivate to do better services for the customers. 2. Discuss how the communication channels in your organization facilitate (or not) the accountability associated with managing quality and risk: Communication is essential for achieving managerial and organizational effectiveness. Without communication employees will not be aware of what their co-workers are doing, will not have any idea about what their goals are, how to manage the quality and risk and will not be able to assess their performance. In the absence of communication employees will not be able to give instructions to their subordinates and will not receive information about the quality needed to be taken care of or the risks involved. Similarly, they may not be well placed to develop plans and to take decisions. Good communication channel helps our employees become more involved in their work and develop better understanding of their jobs. Unless the key goals relating to quality and risk are communicated to employees they will not work in that direction. If the services we are providing to the customers are not good enough it can invite negative feedback from the customers which may help in improving the services provided but may also sometimes harm the development of the organization in the long run. So we should take care of the communication channel for improving the quality of services. Our organizations have appointed various managers in different department as required at any point of time and made available appropriate information to make sound decisions. We follow a interactive communication channel as the communication channel is large which will help our employees to coordinate the work to achieve the overall organizational objectives. Conclusion: Leadership is the ability to influence people and drive them towards the achievement of goals. This study on organizational structure and nursing leadership/management and risk helps to give a clear picture on the important mission statement and values needed to achieve the overall objectives of the organization. It shows a well designed organizational structure that facilitates coordination among the activities of employees and enables the organization to accomplish its goals and objectives through quality assurance and quality improvements. Another important element of the study of this organization is the communication channel. It is important that flow of information relating to decision making is maintained well so that quality of service improves and also manage the risk that would arise. Appendix1: organization chart: (Nagelkerk & Huber 2006, p.78). Appendix II: mission statement and vision: Mission statement: Vision statement: (Huber 2006). References Baillie V K, & et al 1989, Effective nursing leadership: a practical guide, Jones & Bartlett Publishers. Crafford, A, & et al 2006, Industrial psychology: fresh perspectives, Pearson South Africa, viewed 16 May 2009, http://books.google.co.in/booksid=V5UGnfHwkmwC&pg=PA115&dq=difference+between+organisational+climate+and+organisational+culture&lr=&ei=Zn4NSoKZA4HgkwT8uMHcCQ#PPA116,M1 Craven, R F, & Hirnle, C J 2006, Fundamentals of nursing: human health and function, Lippincott Williams & Wilkins. Huber, D 2006, Leadership and nursing care management, Elsevier Health sciences, viewed 16 May 2009, http://books.google.co.in/booksid=MgSgz-qmlQEC&pg=PA224&dq=Mission+Statement+and+Values+Statement.++in+nursing&ei=NAsNSu2FMoGckASk2-zcCQ#PPA224,M1 Introduction to nursing and health care delivery system in India n.d., viewed 16 May 2009, http://www.textbooksonline.tn.nic.in/Books/11/Nursing-EM/Vol1/Unit_2.pdf Nagelkerk, J, & Huber, D 2006, Study guide for leadership and nursing care management, Elsevier Health sciences, viewed 16 May 2009, http://books.google.co.in/booksid=Bv11dHC72S8C&pg=PA76&dq=Organisational+Chart+to+show+the+chain+of+command++in+nursing&ei=jAANSrbWL4SmkAS-iqmKDg#PPA78,M1 Nagelkerk, J, & Huber, D 2006, Study guide for leadership and nursing care management, Elsevier Health sciences, viewed 16 May 2009, http://books.google.co.in/booksid=Bv11dHC72S8C&pg=PA76&dq=Organisational+Chart+to+show+the+chain+of+command++in+nursing&ei=jAANSrbWL4SmkAS-iqmKDg#PPA78,M1 Schick, L 2000, Quality improvement: definitions of quality, Elsevier Health Sciences, viewed 16 May 2009, http://books.google.co.in/booksid=dixpEL1mVugC&pg=PA149&dq=differences+between+Quality+Assurance+and+Quality+Improvement+in+health+care+organisation&ei=xRENSs7QC4PWkATRiLHnCQ#PPA149,M1 Read More