Review and summarize the organizational model and structure for your employer/organization or that of an allied health organization in your chosen field. What features of the model work well and contribute to overall performance of the organization? Which features do not work well, or do not work at all? If you had the authority to do so, what elements of your organizational model would you change, and why?
The functional model's key strength is specialization. It fosters deep expertise within departments. A dedicated finance department ensures accurate billing and revenue cycle management, while a specialized quality assurance team can focus on improving patient safety metrics. This clear division of labor prevents redundancy and confusion, as each department has a well-defined role. The hierarchy provides a clear chain of command, which is critical for making rapid decisions in a high-stakes environment like a hospital. In times of crisis, like a mass casualty event, this structure ensures a clear flow of information and directives, which contributes to the overall performance and safety of the organization.
The primary drawback of this model is its tendency to create silos. Departments often operate independently with limited communication or collaboration, leading to inefficiency and a lack of a holistic view of the patient experience. For example, a nurse might identify a patient need, but due to a communication gap between nursing and social work departments, the patient's need for community resources goes unaddressed. The rigid hierarchy can also inhibit innovation. Staff on the front lines, who have the most direct contact with patients, may find it difficult to communicate ideas for improvement to upper management, creating a disconnect between leadership and daily operations.
If I had the authority, I would implement a hybrid or matrix model to improve cross-functional collaboration.
Create Interdisciplinary Teams: I would establish standing interdisciplinary teams focused on specific patient populations or care pathways (e.g., a team for stroke patients or a team for pediatric oncology). These teams would include members from nursing, physical therapy, social work, and physicians. This would break down departmental silos and promote a more patient-centered approach.
Empower Frontline Staff: I would decentralize some decision-making authority and empower frontline staff to address problems as they arise. This could be done through shared governance committees where nurses and other staff have a direct voice in policy and practice changes. This would not only improve morale but also lead to more agile and effective problem-solving.
Invest in Communication Technology: I would invest in a secure, integrated communication platform that allows all members of a patient's care team to share information and updates in real-time. This would eliminate fragmented communication and ensure everyone is working from the same page, ultimately improving the quality and safety of patient care.
A typical large healthcare system, like the one I'm familiar with, operates on a functional organizational structure. This model groups employees based on their specialized functions, such as nursing, finance, human resources, and medical specialties (e.g., cardiology, oncology). At the top is a CEO, followed by a C-suite of executives (CFO, COO, CNO), with multiple layers of directors, managers, and staff beneath them. Within the clinical divisions, there is often a matrix structure, where a nurse, for example, reports to a nurse manager for day-to-day operations and a charge nurse for specific patient care tasks. .