Organizational Structures and Leadership

In most health care settings, it is unlikely that you would hear the terms “ad hoc” or “matrix” as you walk down the hallway. Although it is helpful for any organization to delineate pathways of responsibility and authority in an organizational chart, the lived experience of these structures is most apparent through the inquiries and behaviors people share everyday.

In your own workplace, you may find yourself wondering, who should I turn to when I have a practice dilemma? or Where can I go to learn more about this issue? These questions speak to the intricacies of formal and informal organizational structure and leadership.

To prepare:

• Review the information presented in Chapter 12 of the course text. Focus on the information about formal versus informal structure as well as the types of organizational structures.
• Consider the overall structure or hierarchy of your organization or one with which you are familiar. Which organizational structure best describes your organization—line (or bureaucratic), ad hoc, matrix, service line, or flat? Note: It is possible to have a combination of structures in one organization. Is decision making centralized or decentralized in this organization?
• What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and informal leadership.
• Reflect on how decisions are made within a specific department or unit. Which stakeholders provide input or influence the decision-making process? Assess this in terms of formal and informal leadership.
• To support your analysis, consider your own experiences and investigate these matters by speaking with others at the organization and reviewing available documents. Be sure to consider how the concepts of formal and informal structure and leadership relate to one another and are demonstrated in the organization and in the particular department or unit.

Post on or before Day 3 a (1) depiction of your organization’s formal structure, indicating whether it is best described as line, ad hoc, matrix, service line, flat, or a combination. (2) Describe how decisions are made within the organization and within one department or unit in particular, noting relevant attributes of centralized/decentralized decision making. (3) Explain the influence of formal and informal leadership on decision making within this department or unit

REQUIRED RESOURCES

Readings

• Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application(8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
  • Chapter 2, “Classical Views of Leadership and Management”
    
    The information introduced through this chapter relates to this week’s Discussion, and will also be referred to in future weeks of the course.
  • Chapter 3, “Twenty-First Century Thinking About Leadership and Management”
    
    This chapter examines new thinking about leadership and management and how this may influence the future of nursing.
  • Review Chapter 12, “Organizational Structure”
• Allmark, P., Baxter, S., Goyder, E., Guillaume, L. and Crofton-Martin, G. (2013), Assessing the health benefits of advice services: using research evidence and logic model methods to explore complex pathways. Health & Social Care in the Community, 21, pp. 59–68. doi:10.1111/j.1365-2524.2012.01087.x
  
  This manuscript examines causal pathways between the provision of advice services and improvements in health. It may also be useful to commissioners and practitioners in making decisions regarding development and commissioning of advice services.
• Downey, M., Parslow, S., & Smart, M. (2011). The hidden treasure in nursing leadership: Informal leaders. Journal of Nursing Management, 19(4), 517–521.
  Retrieved from the Walden Library databases.
  
  Informal leaders can have a strong impact in the workplace. This article explores the value informal leaders can provide.
• Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., & Charns, M. P. (2014). Leadership for Evidence-Based Practice: Strategic and Functional Behaviors for Institutionalizing EBP. Worldviews on Evidence-Based Nursing, 11(4), 219-226. doi:10.1111/wvn.12044
  
  Except from Abstract: Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization.

Media

• Laureate Education, Inc. (Executive Producer). (2012a). Diverse organizational structures. Baltimore, MD: Author.
  
  Note: The approximate length of this media piece is 7 minutes.
  
  This week’s media pieces further explore the structure of the three organizations presented in Week 1. The experts provide additional insights into how the structure of the organization influences nursing practice and patient care.