The Significance of Vertical Organizational Structure in Healthcare Systems

Introduction

In the healthcare system, organizational structures are very vital in all sectors and health care is not an exception. Having in mind that they deal with human lives in their hands which is extremely sensitive, they ought to carry out all their functions very precisely thus executing very high-quality services every hour and every day. With this kind of requirement, the most suitable can only be the vertical organizational structure. This way there are many layers of management to ensure that no worker can throw the system off and also to ensure that all the tasks are carried out exactly and correctly. Also in it, are a majority of the workers operating with very specific, narrow and roles that require very low authority.

The healthcare management is in charge and their main duty is to ensure that every worker in the whole team is doing what they are supposed to do and doing it with the utmost integrity to ensure that the healthcare facility is running as it is supposed to. They generally are mandated to oversee the day–to–day activities taking place in the given facility.

Also, any given healthcare fraternity has a culture. This organizational culture is a collection of traits that make an organization unique or traits that define an organization. It is comprised of values that govern the workers, the expectations that they align to as they carry out their duties, and practices that guide and inform all their actions at any given time. This paper is aimed at discussing the healthcare fraternity precisely the managerial roles, organizational structure, and culture.

Scenario 1: the role of the healthcare manager.

Healthcare managers work together with other health care professionals to ensure that the services that are provided directly to the mental health patients are efficient and of high quality (Andreasson et al., 2016, pp.219-227). Quality management is of great importance in the healthcare sector. The managers are responsible to check and ascertain that the mental health patients are being given healthcare that is efficient and of high quality.

This is achieved by ensuring that healthcare is accessible to all patients with mental health issues at any given time (Aggarwal et al., 2019, pp.180-182). It should also be appropriate, in that patients suffering from mental health issues must access the right treatment and medication as the manager is there to ensure this happens (Gopee et al., 2017). They also ensure that the health care services are affordable. In this case, managers ensure that the fees allocated for the treatment is fair enough to accommodate the average population.

Quality also dictates that the managers should ensure that the care given to patients is safe. This implies that when patients go for treatment when they have psychological issues they should be able to feel safe in the hands of the medical professionals since they have proof of a record of patient safety in the healthcare facilities. To effect this the manager is supposed to keep track of how the professionals handle the patients as they carry out the procedures in mental health to maintain consistency when it comes to patient safety.

Healthcare managers are also tasked with staying abreast of the new laws, regulations, and changes that happen in the healthcare sector to properly inform the professionals under him/her effectively and in good time Buchbinder et al., (2019). Thereafter make sure the changes are implemented and complied with adequately. According to Kuma et al (2016, p.20) change management is a major concern when it comes to healthcare systems.

The ability of a healthcare facility to change, adapt, and evolve seamlessly is the most suitable competitive advantage it has over the rest. Effective management of change demands that all the team players be moving together and in unison with each member performing their roles with integrity kahm et al (2019). The managers need to ensure that the frontline workers are well updated and equipped to effect the changes taking place as they are the pointy of direct contact with the mental health patients (Sandahl et al., 2013). They need to fully understand these changes for them to explain the current procedures to the patients and guide them without causing commotion and confusion.

The healthcare managers are also supposed to effectively manage the finances of the healthcare facility. This includes managing overhead costs, patient hospital fees, and billing (Zietlow et al. 2018). Like any other organization, healthcare facilities also highly depend on effective financial management. It is the work of the managers to ensure that the financial goals of their facilities are met (Roberts et al. 2016). They establish strong financial management plans and this enables the organization to provide efficient healthcare to mental health patients. The managers can do this successfully by carrying out several responsibilities which include; Evaluation and planning. This entails assessing the financial effectiveness and overall operations of the healthcare facility which makes the managers be able to plan for the future of the healthcare facility (Linnander et al. 2017). This evaluation helps the manager to establish the gaps in terms of the operations and can see if the mental health care equipment is effective and properly functioning to take care of the patients. If not make plans to buy better equipment in the future.

The managers also make long-term investment decisions. According to Lamé et al. (2020), in this case, they assess the need to invest in for instance bigger wards for psychiatric patients, and how well it will serve the patients in question and can figure out if it will be good to invest in that particular project. According to (Hunter and Murray, 2017), the managers also lead the finance team in financing projects. They do so in acquiring grants, fundraising, loans and they also use internal funds.

The healthcare managers are also to create work and shift schedules for the healthcare workers. This applies to both the professionals that are in direct contact with the patients and also those with administrative duties. They are responsible for making sure that there are professionals ready to take care of the patients in every way (Von et al., 2016). This ensures that there are no patients that get stranded in hospitals without being attended to simply because a healthcare worker is not at the right place at the right time (Roberts et al. 2016, pp. 11-14). It also works well for the medical team in that it reduces burnout as they are always relieved by their peers and have time to rest and get ready to attend to patients in their next shifts.

It is also the responsibility of the healthcare managers to ensure that organized records of the facility's services are kept (Kruse et al., 2017, pp. 1-9). This is for instance the records on the number of beds that the mental health patients have occupied at a particular point in time. This helps the facility in sorting the patient out on arrival in terms of admission rather than waiting to frustrate patients later.

Scenario 2: how organizational structure impacts organizational culture

The organization structure is what governs the behavior of employees in a specific organization, of which the behavior is referred to as the organizational culture which depicts the way things are and have always been done in that particular organization Ahmady et al., (2016,pp. 455-462). This is a case of a small community hospital that has joined the Age UK. Age UK is a charity organization that takes care of the aged. These two organizations have different structures in that the community hospital operated under a hierarchical organizational structure whereby every entity is subordinate to another (Ahmady et al., 2016). It means that in this particular hospital there is a singular power at the top of the hierarchy which is the overall and the subsequent levels of power are beneath it (Grynko et al 2020). On the other hand, the Age UK has a divisional organizational structure whereby each organizational function is grouped into a division and each division is independent of the others. Patri and Suresh (2017, pp.251-272) explain that each division is an entity on its own and has its necessary resources for example they have its finance department, IT, and so on.

Due to the community hospital having a hierarchical organizational structure they have had a culture that goes in line with the hierarchy structure. This culture is known as the task culture. Task culture is characterized by having well organized teams that are of the same vision and goal which is working tirelessly together to overcome the challenges that are presented to them and meeting their targets effectively as a team Gillam, Stephen, and Paul, (2021,p.20-25). In such a culture there is so much need for effective team work in matters like empathy, active listening, as well as compassion. In such a structure the team mates normally interact and collaborate in the most effective way. On the other hand, in the small community hospital operates on the power culture. This kind of culture is whereby power is only placed in the hands of several people in the organization who have the authority to make decisions (Handy, 2019, p.113). The people in authority are entitled to a lot of special privileges at the workplace that others don’t. In the hospital the responsibilities have higher security and a lot of predictability according to (Handy, 2019, p.113). In the power culture, subordinates have no choice but to abide by the instructions given by the superior workers.

For the hierarchical structure, levels of authority and responsibility are defined such that whatever the highest person in the hierarchy says is final and instructions cannot be given by another person in the lower levels of the hierarchy (Azzolini et al., 2018,p.6-8). All the healthcare professionals in that particular hospital know who they report to and it cannot be otherwise and therefore in case something comes up concerning specific projects, they know who to talk to. In this kind of structure, there are very clear paths and chances of rising from one rank to another (Rider et al., 2018). The healthcare officials work with utmost motivation intending to be promoted from one level to another.

Bringing the Age UK on board will come with some disadvantages to the culture that has been existing in the community hospital previously mentioned as the power culture. In this case, the cost of setting up and maintaining the divisions will be high to the community hospital that is used to spending lesser money on their structure (Sow, 2017). It may be so difficult for the two organizations to take advantage of the economies of scale unless all their purchases are integrated and this also means inconveniencing the hospital as it has always had its way of making purchases. According to Willis et al. (2017) cases of inefficiency might arise especially since having many divisions in the Age UK, a lot of inefficiencies is witnessed for having a lot of functional areas as opposed to when there is only one centralized functional area and in this case, patients may suffer.

According to LaGuardia et al. (2021), there may be the effect of rivalry at work as it is witnessed in organizations with a divisional structure unlike in the hospital where the professionals at the same level in the hierarchy have camaraderie (Ismael, 2021). Having the divisional structure on board will make it difficult for the professionals in the hospital to transfer skills as they normally do. Strategic focus may be affected as in the Age UK every division has its strategic direction and sometimes it differs from the one for the whole organization. In the hospital where there is a hierarchical structure, the strategic direction is one and that can affect the daily operations. For Age UK there is a lot of accountability in their organizational culture as the approach makes it easier to assign responsibility for actions and results. Every division in this case has its management that looks out for the best interest of the division. The managers can make decisions very quickly if need be for the sake of the divisions and the organization at large as they are allowed by the divisional structure (Giri, et al. 2019). These divisions can make their own independent culture regardless of what the other divisions are doing. It can yield faster responses from the clients (Green and Shapira, 2018).

Having the Age UK on board which has the task culture will affect the hospital’s way of operation in that Age UK is not used to bureaucracy and can implement innovations and important changes on their own at the division level, they may end up being slowed down as everything goes through a process step by step up the hierarchy but eventually the task culture will dominate the institutions as they will be easily making decisions owing to the fact that they do not need a lot of steps to effect any changes they might require. This will prove to work best as compared to the mode of operations in the power culture that at times causes delays. The power culture operates in a way where in case any manager has differences or is partial to one staff member or another, workflow seems difficult and can cause unrest among others (Mannion and Davies 2019). The hierarchical structure may cause a lack of collaboration in the organization as there might be competition for power witnessed in the workers instead of them working together for the sake of the advancement of the company. Having a hierarchical structure may cause the employees on the lower levels to feel unworthy to bring their contribution as they are used to doing in the divisional organization. The management also may be affected in that hierarchical structures make their managers feel entitled and territorial in that they don't want their subordinates working for other managers which is not the case when it comes to divisional structures (Green and Shapira, 2018). The employees in the Age UK might find it so difficult to increase their internal innovation in that if they have ideas they should first pass through their immediate supervisor and if the ideas are rejected by the supervisors they can't go any further (Radujković and Sjekavica, 2017, pp.607-615). This slows down the growth of the organizations as ideas only come from one source. Joining the two facilities will cause the cultures the workers have to clash and might take a longer time to adjust and properly integrate.

Scenario 3: different organizational structures in business, health, and social care organization

Having the best organizational structure is the best decision that can be made when beginning any given organization. Choosing the best structure will have a lot of positive implications in the long run because having a poor organizational structure results in confusion among the employees, poor decision-making among the managerial team and it trickles down to poor production (Galván, 2019). Apart from the hierarchical and divisional organizational structures, there are three others which are as follows.

The functional organizational structure. This is the traditional structure that has professionals grouped based on their area of specialty provided they do similar tasks. This is for example all the accountants are placed in one group to work together in the finance department (Hülscher, 2019). All the activities of this particular organization are governed by the chief executive officer. The merits of this kind of structure are that the organization permits division of labor and permits specialization. In this organization the workers can share responsibilities amongst themselves and are also allowed to only do what they have prowess in. all employees understand that they are working together in their departments but with the sole aim of growing the organization. It eliminates duplication in that it is very clear on the departments and no department can do the job of the other. This design can enhance coordination and there is control within the departments. The demerits of this structure are; employees may lose sight of the organization as a whole because of always focusing on their work at the department. According to (Radujković and Sjekavica, 2017) each function or department works as a stand-alone unit and therefore there is no accountability for the rest of the organization. It can also lead to poor communication and coordination across the functions. It also results to lack of understanding across the departments and they often do neglect the company goals by only focusing on the department’s ones.

The matrix structure. This is a combination of structures. It may be in the form of combining product and geographical divisions or functional and divisional structures. It has its advantages which include, in case there is a conflict of interest in the organization the matrix enhances the decision making. Here there is direct contact that replaces bureaucracy. It develops its managers by increasing their involvement in decision-making. Here the advantages of different structures are combined and it works best for the institution (Rider et al., 2018). The disadvantages here are that it may take more time to make a decision, this kind of structure can confuse matters job and task responsibilities. This kind of structure can cause bureaucratization.

Divisional organizational structures are used by most of the large companies across the globe. This makes it easy for there to be autonomy among the groups that are within the organization. It has various advantages like it is easy to effectively assess the divisional results and act accordingly. If the division is unproductive it can be closed down. Also every division can make decisions for itself without any form of interference. There is also easy expansion as in whenever there is a new product in the company a new division can be introduced. Its disadvantages are it might be expensive as it has more employees, it can also cause rivalries among the divisions, and inefficiencies can arise as employees may not have a strict oversight.

In conclusion, the choice of an organizational structure highly affects how the employees work and this generally affects organizational production. Once I open a healthcare facility (Vineyard Healthcare) hierarchical structure is best suited as it is very well organized to ensure that the healthcare workers stick to their duties and report to the relevant persons to avoid confusion at work and enhance a smooth flow in the day to day operations of the facility.

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