Management process – Organizing

Definition of Organization

1- The term organization refer to " any collection of persons, materials, procedures, ideas or facts so managed & ordered that in each case the combination of parts makes a meaningful whole that at achieving organization objectives.

2- In other words the process of organization implies the arrangement of human & nonhuman resources in an orderly fashion to make a meaningful whole that accomplishes organizational objectives.

Organizational Chart  Structure

Definition: an organization is a collection of people working together under division of labor and a hierarchy of authority to achieve a common goal.

– the organizational structure should provide an effective work system, a system of communication identity to individuals and to the organization…. and should consequently foster job satisfaction.

– Agencies contain both formal and informal structures.

– Formal structure appears on the organization chart.

– Informal structure comprises personal and social relationship that don’t appear on the organization chart (it is based on personal relationship rather than positional authority)

– Formal relationship between people in various position in the organization.

– They shown who supervises whom & how various jobs& departments are linked together to make achieve coordinated system.

– Main channels of communication (downward, upward , horizontal, and diagonal)

– Downward flow of authority (orders & commands) from superior to subordinate to = chain of command.

– Upward flow of communication (accountability) from subordinates to superior.

– Horizontal flow of communication between employees of the same level.

– Diagonal communication flow between employees of different level have different functions (e.g. between nursing station and pharmacy )

– In a chart solid lines denotes lines of command (line of authority) whereas dotted lines denotes counseling or advisory line.


Types of Normal Organizational Structures:

– A formal structure describes position, task responsibility and relationship.

– Most nursing departments utilize one of the following structural patterns.

1. Line organization

2. Functional structure

3. Dual Structure

4. Self-contained unit structure

5. Matrix Structure


1- line organization:

– Most common structure in health care facilities.

– Line positions can be shown either horizontal or vertical unbroken line

A. Horizontal unbroken line:

– represents communication between individual with similar spheres of responsibility and power but different functions


B. Vertical Unbroken Line:

– represents communication between individuals with different positions.

– Those having the greatest decision-making and authority are located at the top, and those with the least at the bottom.


2- Functional Structure:

– Employees are group in departments by task.

– Similar task in the same group … similar group in the same departments … and similar departments report to the same manager.

– All nursing task are under nursing service and the same is true for other functional areas.


• Use resources efficiently.

• Do not duplicate tasks.

• Simplify training because common tasks are grouped together.


• coordination across function is poor and difficult.

• Response time is slower


3- Dual Structure:

– separates technical and administrative responsibilities.

– It has one hierarchy for technical professionals who make technical decisions and control technical matters … and another administrative hierarchy for supervisory management who make decisions about issues such as personnel and budget.


– Give equal status to technical and administrative managers


4- Self-contained unit structure:

– All functions needs to produce a product or service are grouped together in an autonomous division.

– Large health care organizations that acquire a smaller clinic may operate it as a self-contained unit.


– high client satisfaction can be achieved.

– High coordination across function occurs ( employee collaborate with other unit functions to meet unit goals and reduce conflict.


– divisions operate independently and often compete each service line which is independent has its own nursing staff and compete with other service lines.


Matrix Structure:

– This structure has a formal vertical as well as horizontal chain of command.

– Separate executives are responsible for each side of the matrix.

– Heads of department report to both the functional and product manager.


– Motivation to staff members.

– Strong contact between staff of different divisions


– Need excellent interpersonal skills for involved managers.

– Dual authority can be frustrating and confusing.

– Time consuming because frequent meetings are required to resolve problems and conflict.


How to keep Organized ?

– Every plan should be flexible enough to allow for changes if the need arise, So if rearrangement of duties become necessary, you need to evaluate the situation, change as a little possible in order to minimize confusion and chance for error.


Help Your Team to keep organized by:

– Giving each person time and opportunity to pal the work.

– Have all necessary supplies available.

– Avoid interrupting your team except emergency.

– Encourage and help each member to improve his work habit.

– Help team to evaluate their work.

– Evaluate the effectiveness of you plan.

– Decide whether the work had been completed on time.

– Determine if yours are satisfied with the care are received.

– Determine your team member’s satisfaction.


Organizing and delivery of nursing care:

– Nursing care delivery system refers to the manner in which nursing care is organized and provided.

– Effective delivery of nursing care promotes efficiency in an organization through high productivity and adequate staffing.

– Effective delivery of nursing care helps in increasing job satisfaction.

– The type of patient’s care delivery system used reflecting the organization structure, philosophy, it also depends on nursing staffing.


Types of nursing care delivery systems:

A- Case Method:

– Involves one-to-one nurse patient ratio.

– One nurse is responsible for caring for one patient and providing all the care required.

– The responsible nurse reports to the head nurse.

– Although this approach is expensive, it continues to be used in critical care units.


– Based on holistic philosophy of nursing.

– The nurse is fully responsible about the patient and gives him full accountability.

– Direct contact with the patient.

– Continuity of patient’s care.

– Good nurse-patient relationship.

– Allow the nurse to coordinate patient’s care (authority).


– Lack of educational development.

– Very expensive.


B. Functional Method:

– Fragmented approach, focuses on task and procedure.

– Tasks are assigned to various personal based on complexity and required skills.

– Each staff is responsible only for assigned task …. One nurse for medication …. An other one for dressing …. An other one for vital signs ….

– The charge nurse is responsible for coordinating the activities and report to the nurse manager.


– Based on task-oriented philosophy of nursing.

– Not expensive in comparison with case method.

– Efficient because tasks are completed in reasonable amount of time.

– Staffs do only what they are able to do and trained to do.

– Helpful in critical shortage of nurses / emergency.


– Fragmented nursing care.

– Patients do not know their nurses.

– Nurses do not have enough time to communicate with patients.

– There is a little time for psychological care.

– Deals with patients in a mechanistic way rather than humanistic.

– Poor job satisfaction.

– Reflects bureaucracy and centralized organization.


C. Team Method:

– Based on group philosophy.

– Reflect decentralization …attempt to support goal action through group action.

– The team leader is responsible for managing the care of group.

– Working with the team leader various qualified personnel, they report to the team leader, who then report to the head nurse.

– The team leader assigns personnel based on qualification and client needs.

– The team leader is responsible for planning and evaluating the nursing care provided by the team members.

– The nurse manager remains responsible for major management, decisions, communication and coordination.


– High job satisfaction.

– Nurses have enough time to communicate.

– Patients know their nurses.


– Required efficient team leader skills.

– Rotation of team leader is frustrating.


D. Primary Method:

– Reflect decentralized structure and based on comprehensive philosophy.

– A primary nurse is assigned to care for group of patients 24hrs a day through their stay in the hospital.

– He has 24hrs responsibility for assigned patients.

– Responsible for assessing, planning, implementing and evaluating the nursing care.

– Associate nurse carry out the plan of care when the primary nurse is not available.

– The nurse manager is responsible for assigning primary nurses, coordinating the activities of primary nurse on all shifts and assigning associate nurses for periods when primary nurses are of duty.

Advantages :

– Provide satisfaction for nurses and patients.

– Nurses get self esteem for providing complete nursing care.

– Good communication between patients and nurses.

– Increase accountability and facilitate continuity of care.

– Efficient method which decrease the number of people in the chain of commands. (reduce error).

– Patient know their nurses and times they are available.

Disadvantages :

– Primary nurse confines a nurses talents to her own patients, other patients can’t get benefit.

– More professional staff and fewer non-professional staff are required for successful implementation.

– Complicates doctors rounds because no single nurse in the unit knows al the patients.

Related posts:

Posted in Nursing Management Tagged with: ,

FaceBook Page

(function(i,s,o,g,r,a,m){i[\'GoogleAnalyticsObject\']=r;i[r]=i[r]||function(){ (i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o), m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m) })(window,document,\'script\',\'\',\'ga\'); ga(\'create\', \'UA-69237529-7\', \'auto\'); ga(\'send\', \'pageview\');