Healthcare Environment

Introduction

The healthcare environment of the healthcare organisation requires to be patient-friendly so that the service users are offered proper quality care needed by them for improving their health status. The organisational structure and culture are seen to play an effective role in managing the healthcare environment of the organisation as the staffs work accordingly to the way mentioned related to the culture and structure. In this assignment, the healthcare environment of “Road” is to be understood in respect to their organisational culture and structure to identify improvement to be made in the present work nature to ensure better care to the service users.

Structure of the organisation

“Road” is seen to be a supported scheme run for resolving health problems of homeless men and women who worked for the armed forces. The scheme follows a Horizontal organisational structure to offer support to the service users. As mentioned by Bergman et al. (2016), horizontal organisational structure involves two or three layers of governing bodies with less chain in commands to be followed. Generally, at the first layer of horizontal organisational structure is the manager or owner of the organisation; in the second layer is the team leader who reports to the owner and in later layers supporting employees and staffs of the organisation. In "Road", they follow a proper horizontal organisation structure as they are a smaller organisation and do not require many chains of commands to operate them as seen in case of hierarchical organisational structure. As asserted by Pettersen and Solstad (2015), the goals are more easily met in horizontal organisational structure as decision-making is executed quickly due to close working nature between higher authorities and the employees. This is seen in case of “Road” where the Frank, who is the manager of the organisation work closely with the staffs and helps them in decision-making for each aspect by actively working with them.

The Horizontal structure is also beneficial for "Road" because it helps to increase the flexibility of the organisation to adopt new changes within the organisation. As commented by Kerrissey et al. (2017), horizontal organisational structure helps to eliminate bureaucracy as people are communicating through vertical lines of business. This assists to facilitate effective communication within the staffs of the organisation resulting in better quality care to the service users. As argued by Nyström et al. (2015), in horizontal organisational structure there is lack of innovative ways in executing services as lower amount of experienced professionals are present to command ways to work. Thus, “Road” may face issues with implementing innovation in their services to offer better quality care to the service users.

Explaining the organisational culture

According to Handy’s model of organisational culture, there are four types of culture which are role, task, power and person. In “Road”, they follow the power organisational culture. As commented by Cacciattolo (2014), in power culture the control radiates from the centre meaning the owner or manager of the organisation. In “Road”, Frank who is the owner and manager of the scheme is seen to solely manage the employees in the organisation and decides what is to be done. Moreover, the decision-making regarding any aspect of care in “Road” is also taken with due permission and intimation to Frank by the employees. This informs that the power in the organisation mainly flows from the centre and thus it is evident that “Road” follows a power culture. As argued by Marques et al. (2018), role culture there is little scope for the experts to show power and staffs often have delegated authorities within a highly defined structure. In “Road”, no proper delegations of duties are seen for the employees and the employees collaboratively work to meet the care quality of the service users and here expert power is the key. Therefore, it evident they do not follow a role culture.

The task culture is the one in which team are formed for solving a particular problem (Shin et al. 2016). In “Road”, to solve a problem no separate teams are formed and the manager arranges meeting of all the staffs in the organisation to execute the decision-making for solving the problem. Moreover, the solutions to the problem are mainly decided by the manager and no team play is vivid in “Road”. This informs that they do not follow a task culture. As asserted by Nightingale (2018), in person culture people believe them to be superior on their own to make decisions. In "Road", the final decision-making to execute any task is made by the manager and all the staffs are required to execute any task by taking prior permission of the manager. This informs that individuals in "Road" do not believe them to be superior on their own and thus it does not follow a person culture.

Analysing the way organisation structure can impact on the organisational culture

“Road” by following the horizontal organisational structure creates work pressure for the manager (Frank) because there are few experienced hierarchical professional present in the organisation who follows this structure. Moreover, "Road" follows task culture in which the main decisions are made by the person who is at the centre, in this case, the manager. Thus, the condition leads the manager to be responsible for making all form of decision for “Road” to operate efficiently. As commented by Avgoustaki (2016), extensive work pressure often leads the manager to make the wrong decision as they could not differentiate between the right and wrong due to confused mental state regarding lot of responsibilities. This may negatively affect "Road" as it would lead them to fail to maintain proper quality of care for the service users due to confused decision-making by the manager to perform duties and services. As argued by Lin (2014), horizontal structure influences the task culture to be executed efficiently by making the managers make quick decision to resolve raised problem. Thus, according to this aspect, the manager at “Road” would be able to resolve problems at work in a quicker manner as the individual does not have to consult with large number of individuals to reach decision to solve the issue.

The horizontal structure leads the organisational culture to provide power among few employees to work efficiently (McCrink et al. 2018). This means that few employees would have increased tasks to perform for meeting the goals of the organisation. It is going to create work pressure among the employees as they require executing multiple tasks at the same time. As commented by Kapucu and Garayev (2016), horizontal structure influences the culture of the organisation to have few rules to execute work and little bureaucracy. This means that there would be less number of complex rules to follow by the employees at work helping them to execute their duties freely. The horizontal structure helps to build a collaborative working culture in the organisation with close relationship between the leaders and employees as there is little middle management to interfere (McCrink et al. 2018). This is beneficial for the employees as they would be able to directly inform about their needs and grievances to the leaders helping them to get quick solution for their problems at work. Moreover, this structure influences "Road" to have an autonomous and free working environment with greater satisfaction at work for the employees.

Potential changes to be made in the organisation

The changes to be made is by following the Lewin’s Change model which informs initially perceiving what changes is to be made, then implementing the change and lastly freezing the change executed (Manchester et al. 2014). In here, the changes are already identified for “Road”. One of the potential changes to be made in “Road” is that the owner requires appointing an assistant manager who can take care and make decisions for the scheme to operate effectively in absence of the manager. As mentioned by Gray et al. (2016), assistant managers assist the manager in making an effective decision for properly running the organisation. Thus, appointing an assistant manager is going to help Frank, the manager with the opportunity to discuss his decision-making with another experienced professional to reach right and better resolution for the organisation. This is going to reduce the responsibility of Frank at work to some extent as the assistant manager would be able to share a few of his duties to assist him to efficiently operate the scheme. The other potential change required is the appointment of new staffs in the organisation so that the responsibilities of care and managing the organisation can be distributed and the work pressure on the present employees is eased. As per the scenario, there is only 1 cleaner present to clean the large area with all 16 flats which are quite a burden for the person. Thus, appointing an extra cleaner to support in cleaning activities is going to reduce the work burden on the present staff. Moreover, it is going to ensure a better-cleaned environment of the organisation helping the service users to live in a proper healthy manner. These two changes are to be made permanent and the post of the assistant manager and increased number of cleaner is to be offered as full-time as per the theoretical understanding from Lewin’s change model.

Conclusion

The above discussion informs that "Road" is a scheme as well as an organisation which offers health care to homeless people who are ex-army men and women. The organisation follows horizontal structure due to which they have few rules and hierarchies to follow and the decision-making is quite quick regarding solving any issues. The organisation follows power culture because its manager acts as the centre power who directs others regarding the way employees are required to work within the organisation. The organisation required to appoint an assistant manager and increase the number of employees like number of cleaner to ensure a better health environment and quality care for the service users.

References

• Avgoustaki, A., 2016. Work uncertainty and extensive work effort: The mediating role of human resource practices. ILR Review, 69(3), pp.656-682.
• Bergman, C., Dellve, L. and Skagert, K., 2016. Exploring communication processes in workplace meetings: A mixed methods study in a Swedish healthcare organization. Work, 54(3), pp.533-541.
• Cacciattolo, K., 2014. Understanding organisational cultures. European Scientific Journal, ESJ, 10(10).pp.90-112.
• Gray, C.P., Harrison, M.I. and Hung, D., 2016. Medical assistants as flow managers in primary care: Challenges and recommendations. Journal of Healthcare Management, 61(3), pp.181-191.
• Kapucu, N. and Garayev, V., 2016. Structure and network performance: Horizontal and vertical networks in emergency management. Administration & Society, 48(8), pp.931-961.
• Kerrissey, M.J., Clark, J.R., Friedberg, M.W., Jiang, W., Fryer, A.K., Frean, M., Shortell, S.M., Ramsay, P.P., Casalino, L.P. and Singer, S.J., 2017. Medical group structural integration may not ensure that care is integrated, from the patient’s perspective. Health Affairs, 36(5), pp.885-892.
• Lin, L.H., 2014. Organizational structure and acculturation in acquisitions: Perspectives of congruence theory and task interdependence. Journal of Management, 40(7), pp.1831-1856.
• Manchester, J., Gray-Miceli, D.L., Metcalf, J.A., Paolini, C.A., Napier, A.H., Coogle, C.L. and Owens, M.G., 2014. Facilitating Lewin's change model with collaborative evaluation in promoting evidence based practices of health professionals. Evaluation and program planning, 47, pp.82-90.
• Marques, I., Willis, S.C., Schafheutle, E.I. and Hassell, K., 2018. Development of an instrument to measure organisational culture in community pharmacies in Great Britain. Journal of health organization and management, 32(2), pp.176-189.
• McCrink, K., Caldera, C. and Shaki, S., 2018. The early construction of spatial attention: Culture, space, and gesture in parent–child interactions. Child development, 89(4), pp.1141-1156.
• Nightingale, A., 2018. Developing the organisational culture in a healthcare setting. Nursing Standard, 32(21), pp.53-63.
• Nyström, M.E., Hansson, J., Garvare, R. and Andersson-Bäck, M., 2015. Locally based research and development units as knowledge brokers and change facilitators in health and social care of older people in Sweden. Evidence & Policy: A Journal of Research, Debate and Practice, 11(1), pp.57-80.
• Pettersen, I.J. and Solstad, E., 2015. Vertical and horizontal control dilemmas in public hospitals. Journal of health organization and management, 29(2), pp.185-199.
• Shin, Y., Kim, M., Choi, J.N. and Lee, S.H., 2016. Does team culture matter? Roles of team culture and collective regulatory focus in team task and creative performance. Group & Organization Management, 41(2), pp.232-265.