Identify Organizational Structure and Function

Identify Organizational Structure and Function Order Description Chamberlain" rel="nofollow">in College of Nursin" rel="nofollow">ing: NR-534- HEALTHCARE SYSTEMS MANAGEMENT Identify Organizational Structure and Function (graded) Thin" rel="nofollow">ink of a healthcare organization that you are most familiar with and thin" rel="nofollow">ink of its organizational structure. Describe this structure or use of combin" rel="nofollow">inations of structure (lin" rel="nofollow">ine, matrix, service lin" rel="nofollow">ine, ad hoc, or flat). Give an example of how decision makin" rel="nofollow">ing occurs and identify if this is centralized or decentralized. Is this best practice? Nursin" rel="nofollow">ing Services Delivery Theory (NSDT)—An Open System Several systems theories discovered in" rel="nofollow">in the literature, in" rel="nofollow">includin" rel="nofollow">ing open systems, chaos, and multiple types of adaptive theories, may assist in" rel="nofollow">in leadin" rel="nofollow">ing nursin" rel="nofollow">ing services (Rose, 2013). The open systems approach will be our focus here, as we look at how healthcare organizations meet their needs in" rel="nofollow">in various areas. Some of the areas that leaders deal with daily are fin" rel="nofollow">inance, quality, and regulatory requirements. Systems can be closed or open. A closed system has in" rel="nofollow">inputs and outputs within" rel="nofollow">in distin" rel="nofollow">inct barriers; most often, these barriers are from the in" rel="nofollow">internal organizational environment. The closed system is seen as an entity wherein" rel="nofollow">in all the components for functionin" rel="nofollow">ing are within" rel="nofollow">in the system; there are no in" rel="nofollow">inputs or outputs from the external environment. Historically, healthcare has been considered a closed system. An open system is seen as an entity that is in" rel="nofollow">interactive with its environment, bein" rel="nofollow">ing sustain" rel="nofollow">ined by the in" rel="nofollow">inputs and outputs of the system. In open systems, there is a hierarchy in" rel="nofollow">in which smaller systems in" rel="nofollow">interact with each other dynamically to support goals or accomplish tasks (Sullivan, 2011). Some of the smaller units of the healthcare system in" rel="nofollow">include highly specialized areas such as the emergency department and the in" rel="nofollow">intensive-care unit; the laboratories and central processin" rel="nofollow">ing; and human resources and fin" rel="nofollow">inancial management. An open organization becomes more complex as more specialized units are developed and function within" rel="nofollow">in it. In an open system, all the units are in" rel="nofollow">interdependent. Leaders have a broad overview and understandin" rel="nofollow">ing of the system within" rel="nofollow">in which they work as well as a detailed view of the areas within" rel="nofollow">in their sphere of in" rel="nofollow">influence. The healthcare open system functions to create patient care, diagnosis, and treatment for patients, and provide all the in" rel="nofollow">intricacies to support this goal. Inputs, Throughputs, Outputs, Cycles of Events, and Negative Feedback In NSDT, there are four main" rel="nofollow">in components that nurse leaders must consider in" rel="nofollow">in their daily work; these are in" rel="nofollow">inputs, throughputs, outputs, cycles of events, and negative feedback. The in" rel="nofollow">inputs are the people, materials, resources, and in" rel="nofollow">information. The people are all those who are in" rel="nofollow">internal and external to the system, in" rel="nofollow">includin" rel="nofollow">ing staff and patients. Materials mean those items that are required to complete the organizational goals of care delivery, such as supplies and devices. The resources are related to fundin" rel="nofollow">ing sources such as in" rel="nofollow">insurance, government, grants, loans, and donations. Information is vast, rangin" rel="nofollow">ing from the overall climate of the external environment to the details related to a specific patient (Meyer & O’Brien-Pallas, 2010). Throughput is what is manipulated and changed to affect us reachin" rel="nofollow">ing our goal. Throughputs can be as simple as a nursin" rel="nofollow">ing in" rel="nofollow">intervention and other provisions of services (Meyer & O’Brien-Pallas, 2010). Outputs are those thin" rel="nofollow">ings that in" rel="nofollow">include any products generated (perhaps through research), materials created (such as a new device or drug), and services provided. One clear service that is provided as an output is the volume of patients that are cared for. One product is the revenue that is generated within" rel="nofollow">in the organization. Systems cycles are those regular and periodic events that ensure best practices, highest quality, and patient safety such as adherence to regulatory demands (Meyer & O’Brien-Pallas, 2010). Other cycles in" rel="nofollow">include in" rel="nofollow">infection-control data and monitorin" rel="nofollow">ing, review and updatin" rel="nofollow">ing of policies and procedures, and addressin" rel="nofollow">ing patient-satisfaction surveys. Negative feedback has high appreciation from nursin" rel="nofollow">ing leaders because this is a mark of the degree to which their sphere of in" rel="nofollow">influence is meetin" rel="nofollow">ing organizational expectations (Meyer & O’Brien-Pallas, 2010). Negative feedback occurs through evaluation of performance in" rel="nofollow">indicators for the organization and those people and specific units functionin" rel="nofollow">ing within" rel="nofollow">in it. An example of how the NSDT works within" rel="nofollow">in the organization is seen by observin" rel="nofollow">ing a nursin" rel="nofollow">ing unit’s activity. The patient arrives for care, leadin" rel="nofollow">ing nursin" rel="nofollow">ing staff to in" rel="nofollow">input the delivery of services to promote the output of improved patient health. Along this path, there may be necessary changes in" rel="nofollow">in room assignment or areas of care; these changes would be throughput, and durin" rel="nofollow">ing this change, there may be negative feedback if the patient and family do not appreciate the change. It is through the use of the NSDT and consideration of healthcare as an open system that leaders gain" rel="nofollow">in in" rel="nofollow">information and in" rel="nofollow">insight in" rel="nofollow">into how to respond to daily events that brin" rel="nofollow">ing barriers and challenges to the organization’s function and meetin" rel="nofollow">ing the goals for patient-care delivery. System Unit Interdependence Leaders must keep the organizational goals firmly in" rel="nofollow">in min" rel="nofollow">ind as they work within" rel="nofollow">in the organization creatin" rel="nofollow">ing changes (throughput) to improve the output. Daily staffin" rel="nofollow">ing of the organization in" rel="nofollow">in which staff assignments are adjusted across units is a keen example of how throughput is used, demonstratin" rel="nofollow">ing the in" rel="nofollow">interdependence of systems units on each other. Consider the oncology unit with the need for two registered nurses due to high patient volume. The goals of the organization must be met, in" rel="nofollow">includin" rel="nofollow">ing delivery of high-quality, safe patient care to all patients on the oncology unit. Leaders evaluate staff competencies and change (throughput) the nursin" rel="nofollow">ing care assignments of two registered nurses from one area to another. If this shortage of nursin" rel="nofollow">ing personnel becomes an ongoin" rel="nofollow">ing situation, the organization will adapt by hirin" rel="nofollow">ing additional registered nurses in" rel="nofollow">in a supportive role for the oncology patient population. Leadership will evaluate the department performance, and should the number of patients decrease, the oncology registered-nurse staff would shift to accommodate the needs in" rel="nofollow">in another area (throughput). A cycle of events for this particular oncology unit may occur seasonally if there is an in" rel="nofollow">influx of population such as in" rel="nofollow">in a college town or a city where the weather is pleasant durin" rel="nofollow">ing a harsh win" rel="nofollow">inter. Feedback will be obtain" rel="nofollow">ined from staff and patients and, if negative, additional adjustments will be made by the leadership team. Thus nursin" rel="nofollow">ing services delivery is a dynamic in" rel="nofollow">interplay of in" rel="nofollow">inputs, throughputs, outputs, cycles of events, and negative feedback. Why NSDT Is Important Although the use of the NSDT seems to organize the work within" rel="nofollow">in the environment, there contin" rel="nofollow">inue to be many variables that impact the ability to ensure consistency in" rel="nofollow">in delivery of nursin" rel="nofollow">ing services. These variables in" rel="nofollow">include the patients who are different ages, genders, cultures, degrees of illness, and degrees of needs. Some tools are available to leaders who strive to create the steady state for patients and employees, but often there is more chaos than consistency. Usin" rel="nofollow">ing the NSDT as a foundational component, leaders can focus on both the global and sub-units of the organizational system. The NSDT allows leaders to measure and evaluate nursin" rel="nofollow">ing services through observin" rel="nofollow">ing the actual work completed rather than usin" rel="nofollow">ing data that may not offer both quantitative and qualitative perspectives. Unlike the closed system, open systems described through the use of the NSDT are energetic, in" rel="nofollow">innovative, and dynamic in" rel="nofollow">in the approach to nursin" rel="nofollow">ing services. Applyin" rel="nofollow">ing the NSDT with nurse-sensitive in" rel="nofollow">indicators supports leaders to lead and manage the process of nursin" rel="nofollow">ing within" rel="nofollow">in the organization (Meyer & O’Brien-Pallas, 2010). Emotional Intelligence in" rel="nofollow">in Leadership As leaders use the NSDT to gain" rel="nofollow">in in" rel="nofollow">information and in" rel="nofollow">insight within" rel="nofollow">in their organizations, it becomes important for these leaders to manage their behaviors and communication in" rel="nofollow">in a manner that is appropriate for their roles. In order to ascend to the highest levels of leadership, in" rel="nofollow">individuals must be able to view, know, and reflect on their behaviors and communication patterns related to the impact on others. There are five components to emotional in" rel="nofollow">intelligence. These are (a) self-awareness, (b) self-regulation, (c) motivation, (d) empathy, and (e) social skills (Taft, 2013). Self-awareness is the component that identifies the degree to which the leader knows him- or herself. This is the ability to know what you are feelin" rel="nofollow">ing and how these feelin" rel="nofollow">ings may translate in" rel="nofollow">in facial expression, body language, and verbal communication and how others in" rel="nofollow">in the environment will in" rel="nofollow">interpret and respond to you. Leaders with high self-awareness demonstrate humility and appreciation. They are keenly aware of their strengths and weaknesses. How can you achieve high self-awareness? Keep a journal of your thoughts and in" rel="nofollow">interactions durin" rel="nofollow">ing the day that in" rel="nofollow">includes reactions of others to you. Fin" rel="nofollow">ind a method that will allow you to respond rather than react. Some techniques to encourage respondin" rel="nofollow">ing in" rel="nofollow">include countin" rel="nofollow">ing to 10, excusin" rel="nofollow">ing yourself for a moment, or askin" rel="nofollow">ing for a meetin" rel="nofollow">ing or the opportunity to give an answer at a later time. Self-regulation requires establishment of acceptable response patterns that in" rel="nofollow">include (a) careful and measured non-emotional responses (no cynicism or sarcasm); (b) makin" rel="nofollow">ing measured decisions; never rushed or with an emotional response; (c) universal or neutral approach to all people regardless of status, race, gender, etc.; and (d) never compromisin" rel="nofollow">ing personal, organizational, or professional values. How can you achieve high self-regulation? Leaders must draw the lin" rel="nofollow">ine designatin" rel="nofollow">ing where they can and cannot compromise; to do this, leaders must clarify their values and those of their profession. A good way to do this is to ask yourself what your code of ethics is. Knowin" rel="nofollow">ing where you stand ethically will support ethical and moral decision makin" rel="nofollow">ing. Another way to achieve self-regulation is through self-accountability. Leaders must be accountable for their actions; stop blamin" rel="nofollow">ing others, the organization, and the situation. Facin" rel="nofollow">ing errors, challenges, and barriers earns respect and admiration from others. Lastly, practice calmness. Monitor your behavior the next time you feel yourself becomin" rel="nofollow">ing anxious. How are you actin" rel="nofollow">ing? Do you get quiet or do you scream? Practice breathin" rel="nofollow">ing. This may seem silly, but often we do not take full, even breaths in" rel="nofollow">in situations that are difficult; breathin" rel="nofollow">ing helps to keep you calm. To relieve stress, express it in" rel="nofollow">in a manner that is acceptable. An acceptable manner is to write down everythin" rel="nofollow">ing that you would like to say, then file it away, never to be read by anyone but you. Motivation can come from others or can be created within" rel="nofollow">in yourself. The best leaders have high standards and clear goals. These people are focused on achievement. How do you get yourself more motivated? To get more motivated, you need to reexamin" rel="nofollow">ine what you love about your job. If you are strugglin" rel="nofollow">ing with even one thin" rel="nofollow">ing, begin" rel="nofollow">in with somethin" rel="nofollow">ing concrete such as “I love that I get paid for the job I do”; “I love that I receive a great in" rel="nofollow">insurance plan”; “I love that I earn vacation time”; and so on. If you are a leader, recall the whys that led you to origin" rel="nofollow">inally apply for the position. The use of the whys is a valuable technique to reevaluate performance. Completin" rel="nofollow">ing this process helps to fin" rel="nofollow">ind the issues that are creatin" rel="nofollow">ing problems and discover possible solutions. Take a look at an example below: Prin" rel="nofollow">int Shuffle Why am I unhappy? Because I was reprimanded for missin" rel="nofollow">ing a deadlin" rel="nofollow">ine. Card 1 of 5 View each term then click "Flip Card" to see the defin" rel="nofollow">inition. Previous Card Flip Card Next Card Empathy is a critical component in" rel="nofollow">in the demonstration of emotional in" rel="nofollow">intelligence. Empathy is the quality in" rel="nofollow">in which the leader has the ability to see the issue or concern from the other person’s poin" rel="nofollow">int of view. This component requires leaders to be fair in" rel="nofollow">in dealin" rel="nofollow">ing with all staff, to step up and give positive and negative feedback, and to listen carefully to the concerns of others. Leaders who are empathetic earn respect and gain" rel="nofollow">in the loyalty of their staff. How can you learn to be more empathetic? Thin" rel="nofollow">ink of a time when you were in" rel="nofollow">in conflict over an issue. Of course, it is easy to justify your poin" rel="nofollow">int of view, but now reverse the roles (just as you might in" rel="nofollow">in a debate class). What are the strengths of the other person’s argument? What makes that argument valid? How might this person’s problem solution effect the needed change? Another strategy to alert the leader to empathy is to attend to the body language of the person that they are engaged with. Is the person crossin" rel="nofollow">ing his or her arms, in" rel="nofollow">indicatin" rel="nofollow">ing that he or she is closed? Is the person failin" rel="nofollow">ing to make eye contact (remember to consider culture here)? Does the person smile as a negative response is given, in" rel="nofollow">indicatin" rel="nofollow">ing in" rel="nofollow">incongruence? Lastly, be sure to acknowledge feelin" rel="nofollow">ings that you observe and hear from others. Some examples in" rel="nofollow">include seein" rel="nofollow">ing a sad face when you advise a staff member that you will not be able to grant requested vacation time. A leader who sees the sad face should state, “I can see that you are sad that I cannot grant your vacation time.” Allow the person to speak and share his or her feelin" rel="nofollow">ings. Social skills are the last of the emotional in" rel="nofollow">intelligence components. The best leaders are open to hear the positive and negative and embrace the opportunity to be advised of these types of situations. These leaders are expert managers of change and conflict resolution. Leaders with the best social skills understand that when they are in" rel="nofollow">in their organization, or even in" rel="nofollow">in the public domain" rel="nofollow">in, they are on stage. Everyone looks to the leader to demonstrate appropriate behaviors at all times. The leader sets the tone for all those who are under his or her sphere of in" rel="nofollow">influence. For example, if you are the chief nursin" rel="nofollow">ing officer and you have a bad temper and treat your division directors poorly, then it will be expected that this is appropriate organizational behavior. Thus the division directors will tend to demonstrate bad temper and treat the leaders who report to them poorly, and so on. How can you improve your social skills? Leaders should take advantage of educational experiences that offer in" rel="nofollow">interactive opportunities. The topics of these educational experiences should be conflict resolution, communication, and how to give well-deserved praise and rewards to others. Workin" rel="nofollow">ing toward competency in" rel="nofollow">in each of the five areas of emotional in" rel="nofollow">intelligence will guide those who wish to be in" rel="nofollow">in leadership roles and those who are in" rel="nofollow">in leadership roles to perfect their ability to gain" rel="nofollow">in respect and loyalty and move staff effortlessly through change (Taft, 2013). Leader as Change Agent The majority of a leader’s role is to ensure that staff and patients are satisfied, that quality care is achieved, and that new in" rel="nofollow">innovations are adopted that have a positive impact at the unit, the division, and the organization level. The completion of these tasks requires change. The role of the leader is the role of the change agent (Porter-O’Grady & Malloch, 2015). A leader’s goals should mirror those that have been identified as a standard of excellence, such as the Magnet Recognition program of the American Nurses Credentialin" rel="nofollow">ing Center (ANCC, 2014), a part of the American Nurses Association. The vision of the Magnet recognition program identifies the delivery of nursin" rel="nofollow">ing to be based on knowledge and expertise. Magnet recognition is based on core prin" rel="nofollow">inciples and adaptability and aims for contin" rel="nofollow">inuous in" rel="nofollow">innovation and discovery. The model for Magnet recognition consists of five components: (a) transformational leadership practice; (b) organizational empowerment; (c) flawless professional practice; (d) attain" rel="nofollow">inment of new knowledge, improvement, and implementation of in" rel="nofollow">innovation; and (e) practical outcomes (AACN, 2014). Those attendin" rel="nofollow">ing to the Magnet standard of excellence must also have a broad view that encompasses all organizational levels. In addition to these components, the standard has the overarchin" rel="nofollow">ing expectation that nurses work to the full scope of their practice; have autonomy; are encouraged to make bedside decisions; engage in" rel="nofollow">in collaboration related to the work environment; have support for ongoin" rel="nofollow">ing professional and academic education; and pursue development within" rel="nofollow">in their career goals, in" rel="nofollow">includin" rel="nofollow">ing leadership and clin" rel="nofollow">inical expertise. Leaders who follow a standard for excellence will be creators of opportunity, use evidence to base all decisions, and have a clear and articulated vision. Leaders will encourage the professionals whom they lead to ask questions and consider takin" rel="nofollow">ing risks related to in" rel="nofollow">interactions with others and proposin" rel="nofollow">ing alternate care actions. Additionally, these leaders are not found in" rel="nofollow">in offices but are among their staff; visible, roundin" rel="nofollow">ing, communicatin" rel="nofollow">ing, and accessible. Informal leaders can be highly effective in" rel="nofollow">in the role of staff champion for these types of changes and support formal leaders to achieve their goals. However, goal achievement related to change requires a carefully guided process to ensure understandin" rel="nofollow">ing, acceptance, and adoption of the change as a part of new practice and workflow. Summary Combin" rel="nofollow">inin" rel="nofollow">ing the concept of the NSDT and emotional in" rel="nofollow">intelligence within" rel="nofollow">in the function of leaders sets the stage for dynamic, professionally satisfyin" rel="nofollow">ing work for staff and leaders and provides patients with motivated expert nurses who are proactively engaged in" rel="nofollow">in seekin" rel="nofollow">ing the best practices that align with the needs and desires of the patient. Leadership is the toughest job that nurses will ever love and the most rewardin" rel="nofollow">ing to see staff develop, patients flourish, and professionalism become the norm. Becomin" rel="nofollow">ing the leader who can accomplish these many duties with the consistency that is demanded in" rel="nofollow">in the organization takes time and practice. Change is the one constant that is at all organizational levels and offers immediate learnin" rel="nofollow">ing opportunities for staff, potential leaders, and current leaders to gain" rel="nofollow">in mastery of this dynamic and important process that is a key to success (Porter-O’Grady & Malloch, 2015). Reference Marquis, B. L. & Huston, C. J. (2014). Leadership roles and management functions in" rel="nofollow">in nursin" rel="nofollow">ing: Theory and application. (8th ed.). Philadelphia, PA: Lippin" rel="nofollow">incott, Williams & Wilkin" rel="nofollow">ins. • Chapter 2: Classical Views of Leadership and Management • Chapter 3: Twenty-first Century Thin" rel="nofollow">inkin" rel="nofollow">ing about Leadership and Management • Chapter 12: Organizational Structure Battilana, J. & Gasciaro, T. (2013, Jul-Aug). The network secrets of great change agents. Harvard Busin" rel="nofollow">iness Review. lin" rel="nofollow">ink to article Jayanthi, A. (2013). Usin" rel="nofollow">ing an in" rel="nofollow">input-throughput-output model to min" rel="nofollow">inimize cost, in" rel="nofollow">increase value. Becker’s Control & Clin" rel="nofollow">inical Quality [onlin" rel="nofollow">ine]. lin" rel="nofollow">ink to article Johnson, V., Wessel, T., & Johnson, K. (2013). Buildin" rel="nofollow">ing collaboration between CNOs and direct-care nurses. American Nurse Today [onlin" rel="nofollow">ine], 8(1). lin" rel="nofollow">ink to article Krueger, D. L. (2013). Informal leaders and cultural change. American Nurse Today [onlin" rel="nofollow">ine], 8(8). lin" rel="nofollow">ink to article Lee, T. H., & Hall, K. W. (2010). Turnin" rel="nofollow">ing doctors in" rel="nofollow">into leaders. Harvard Busin" rel="nofollow">iness Review, 88(4), 50-58. lin" rel="nofollow">ink to article American Nurses Credentialin" rel="nofollow">ing Center (ANCC). (2014). Magnet recognition program overview. Retrieved from https://www.nursecredentialin" rel="nofollow">ing.org/Magnet/ProgramOverview Meyer, R. M. & O’Brien-Pallas, L. L. (2010). Nursin" rel="nofollow">ing services delivery theory: An open system approach. Journal of Advanced Nursin" rel="nofollow">ing, 66(12), 2828–2838. Porter-O’Grady, T. & Malloch, K. (2015). Quantum leadership: Buildin" rel="nofollow">ing better partnerships for sustain" rel="nofollow">ined health (4th ed.). Burlin" rel="nofollow">ington, MA: Jones & Bartlett Learnin" rel="nofollow">ing. Rose, M. R. (2013). Theories of organizational and social systems: Utilizin" rel="nofollow">ing systems theory in" rel="nofollow">in evaluatin" rel="nofollow">ing a case management governmental organization. University of Wisconsin" rel="nofollow">in—Human Services Today [onlin" rel="nofollow">ine]. Retrieved from https://www.uwosh.edu/hst/?p=501 Sullivan, T. (2011, Sept.). Embracin" rel="nofollow">ing complexity. Harvard Busin" rel="nofollow">iness Review [onlin" rel="nofollow">ine]. Retrieved from https://hbr.org/2011/09/embracin" rel="nofollow">ing-complexity/ar/1 Taft, S. H. (2013). Emotionally in" rel="nofollow">intelligent leadership in" rel="nofollow">in nursin" rel="nofollow">ing and healthcare. In L. Roussel (Ed.), Management and leadership for nurse admin" rel="nofollow">inistrators (pp. 59–86). Burlin" rel="nofollow">ington, MA: Jones & Bartlett Learnin" rel="nofollow">ing. Page or paragraph numbers must be in" rel="nofollow">included with quotes per APA. See APA re how to format references and in" rel="nofollow">in-text citations i.e. capitalization issues and use of the ampersand versus the word ("and"). Includin" rel="nofollow">ing at least one in" rel="nofollow">in-text citation and matchin" rel="nofollow">ing reference. Check for grammar and spellin" rel="nofollow">ing