Organizational Structures and Leadership


Most healthcare organizations do not operate in an informal manner. There are no ad hoc decisions or makeshift operations. It is essential for organizations to structure their functions and outline an order of authority to operate efficiently. Governance structures make it easy for staff to inquire and operate around the organization. For instance, if a staff member is in a practice dilemma, it becomes easy to consult the appropriate authority within the organization (Hartley, 2007).

There are formal and informal organization structures. Formal structures have plans, and are visible while informal structures are unplanned and hidden. The formal structures follow departments with division of labor that provides the framework for responsibility and accountability. Informal structures are social and have shifted lines of accountability. There are different types of organizational structures. They include matrix structure, divisional structure and functional structure (Marquis and Huston, 2012). The other types of organization structures are line, ad hoc, service line, flat, or a combination. Functional structures group each set according to function while divisional structure involves the setting of different divisions in different areas of operation. The matrix structure combines the attributes of functional and divisional structures. Line structures are bureaucratic. Ad hoc structures operate temporarily to complete the project while service lines are similar to matrices. Flat structures have devolution attributes where there is decentralization of decisions (Bellot, 2011).

I will review the American Hospital Association. The best description of the organization structure of this association is matrix. It combines the attributes of functional and divisional structures to discharge its mandate (American Hospital Association, 2013). The decision making process is central in this organization. The management board of the association is in charge of decision making. The board members make decisions for the organization. They are the major stakeholders while making the decision (Holden, 2005). Within the governance unit, the head of the department is in charge of decision making. He or she makes final decisions regarding operations in the unit. In centralized decision making, few managers in the top of the management hierarchy are in charge of decision making. Centralized decision making may increase the bureaucracy and time of decision making because managers with that responsibility operate in the top of the hierarchy (Madden, 2011). However, decentralized decision making diffuses the decision making process throughout the organization. This is advantageous because solutions to problems can be found in units or department.

Committees and task forces investigate important matters that may affect the organization. In addition, they may recommend appropriate actions to the management board (Collins, 1996). The organization councils in the organization are in charge of vetting the decisions of the management board that may have significant importance to the organization. Only individuals voted by members of the association are welcome to the council. This is relevant to formal leadership because it provides a defined line of responsibility and accountability. It also offsets informality leadership because it does not have room for makeshift decision making (Berggren and Carlstrom, 2010).

Formal and informal leadership structures have a big influence on decision making within this unit. The leadership structure determines the authority responsible for taking various decisions and the level on which decision must be taken. For instance, if a problem occurs in the human resource department, the leadership structure defines that the human resource manager is responsible for decisions (Downey et al., 2011).

From my experiences, I think that organizations should adopt formal and flexible leadership structures that allow for decentralized decision making. I would recommend my unit to review the decision making process in order to include every stakeholder within the department. Decentralization will improve decision making and bring members aboard in the management of the organization. Formal leadership structure contains a defined hierarchy and procedures while the informal structure does not have defined organizational hierarchy. However, the two relate closely because sometimes formal structure may incorporate aspects of informality in case of emergencies or minor decisions. In addition, informal organization may incorporate formality because the organizational culture defines the organization. For instance, the governance unit has a formal leadership structure. However, this does not come into consideration in making obvious and minor office decisions. The concepts of formal leadership structure are evident in the organization because of the presence of an organization chart that defines the management hierarchy. There are various departments in the organization that carry out different functions. Departments have certain responsibilities and are accountable to the organization in different matters. Informal structure is evident in the organization during minor decision making. The organization breaks from its central structure. Formal leadership structure concepts are evident in the governance unit because there is a departmental leader and other heads responsible for the operations of the unit. They are part of the organizational management. Informal concepts are evident when simple or random operations are in the hands of staff. In addition, the governance unit operates in accordance with the organizational culture. This may be invisible and inclusive of informal structure aspects (LaSala and Bjarnason, 2010).

In conclusion, it is evident that variations in healthcare such as the increase of patients in healthcare institutions can put pressure on decision making regarding healthcare. It is essential for healthcare organizations to have administrative structures that can provide solutions to promote patient care.

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