Leadership test 3 chapter 12
it is important to be aware of how the formal structure affects all overall relationships and communications.
This is especially true because organizations change their structure frequently resulting in new communication lines and reporting relationships
committee should have an appropriate number of members, prepared agendas, clearly outlined tasks, and effective leadership if they are to be productive.
True
in healthcare organizations shared governance empowers decision-makers in this empowerment is directed at increasing nurses authority and control over nursing practice.
True
informal groups are present in every organization.. They are often powerful, although they have no formal authority. Informal groups determine norms and assist members in the socialization process.
True
organizational culture is the total of an organization's beliefs, history, taboos, formal and informal relationships, and communication patterns.
True
leadership roles associated with organized structure
1. Evaluate the organizational structure frequently determine if management positions should be eliminated to shorten the chain of command. 2. Encourages and guides employees to follow the chain of command and counseled employees as cool do not do so. 3. Supports personnel in advisory staff positions 4. Models responsibility and accountability for subordinates 5. Assist staff to see how their roles are congruent with and complement the organization's mission, vision, and goals. 6. Facilitates constructive informal group structure 7. Encourages upward communication 8. Fosters a positive organizational culture between workgroups and subcultures that facilitates shared values and goals 9. Promote participatory decision-making and shared governance to empower subordinates 10. Uses committees to facilitate group goals not to delay decision
first level managers
charge nurse, team leader, primary nurse, focus primarily on day-to-day needs at unit levels, short range operational planning, more often the communication flow is upward
top-level managers
chief nursing officer, chief executive officer, chief financial officer, look at organization as well as all external influences, strategic planning, communication flows from the top down
Decentralize decision-making
diffuses decision making throughout the organization and allows problems to be solved by the lowest practical managerial level
advisory staff positions
do not have inherent legitimate authority. Clinical specialist in in-service directors in staff positions often make the authority to accomplish a line relationship
external stakeholders
local business area colleges and universities insurance companies and HMOs community leaders unions professional organizations
top-level managers
look at the organization as a whole, coordinating internal and external influences, and generally make decisions with few guidelines or structures. Include the CEO or CNO
Internal stakeholders
may include the nurse in a hospital or the dietitian in a nursing home
groupthink
occurs when group members fail to take adequate risks by disagreeing, being challenged, or assessing discussions carefully.
Weber postulated three ideal types of authority or reasons why people throughout history have obeyed their rulers.
one of these, legal rational authority, was based on belief in the legitimacy of the pattern of normative rules and rights of those evaluated to authority under such rules to issue commands. Obedience, then, was owed to the legally established impersonal set of rules rather than to the personal ruler.
limitations of organization charts
organization chart show only formal relationships so what they can reveal about an institution is limited
Fayol 1949 suggested that an organization is formed when the number of workers is large enough to require a supervisor
organizations are necessary because they accomplish more work than can be done by an individual effort. Because people spend most of their lives in social, personal, and professional organizations, they need to understand how organizations are structured their formation, methods of communication channels of authority and decision-making processes
the term magnet is used to denote
organizations that were able to attract and retain professional nurses Mangus data's is not a prize or award rather it is a credential of organizational recognition of nursing excellence
Director of nursing
still used in some facilities to denote the CNL chief nursing officer is now used in many healthcare organizations to develop middle level managers.
many modern healthcare organizations continue to be organized around a line or line and staff design and many have attributes of bureaucracy; however, there is a movement toward less bureaucratic designs, such as ad hoc, matrix, and care centered systems
true
organizational culture should not confuse with organizational climate
true
organizational structure affects how people perceive their roles and the status given to them by other people in the organization
true
shared governance refers to an organizational design and empower staff nurses by making them an integral part of the patient care decision-making and providing accountability and responsibility in nursing practice
true
true false larger organizations benefit from decentralized decision-making
true
when assigning members to committee's cultural and gender diversity should always be a goal
true
unity of command means that each person should have only one boss to that there is less confusion and greater productivity
ttrue
middle level managers
unit supervisor, department had, director, focuses on integrating unit level day-to-day needs with the organizational needs, combining long-term and short-term planning, upward and downward with great centrality communication
The informal structure even has its own communication network known as
Grapevine communication is at the heart of the informal organization-it is conversations that occur in the break room, down the halls, during the carpal, and in between work that allows relationships of informal groups to develop
Max Weber
a German social scientist is known as the father of organizational theory. Generally acknowledged to have developed the most comprehensive classic formulation on the characteristics of bureaucracy, Weber wrote from the vantage point of a manager instead of that of a scholar. During the 1920s, Weber saw the growth of large-scale organizations and correctly predicted that this growth required a more formalized set of procedures for administrators. His statement on bureaucracy, published after his death, is still the most influential statement on the subject.
line structures
also called bureaucratic organizational designs referred to as line structures or line organizations those with staff authority may be referred to as staff organizations both of these types of organizational structures are from frequently a large healthcare facilities and usually resemble Weber's original design for effective organizations
Scalar chain
the decision-making hierarchy or peer meds where decisions are made within the organizational hierarchy
authority is defined as
the official power to act as the power given by the organization to direct the work of others. A manager may have the authority to hire, fire, or discipline others
management functions of organizational structure
1. If knowledgeable about the organization's internal structure, including personal and department authority and responsibilities within that structure 2. Facilitates constructive formal group structure 3. Provides the staff with an accurate unit organization chart and assist with interpretation 4. When possible maintain unity of command 5. Clarifies unity of command when there is confusion 6. Follows appropriate subordinate complaints upward through chain of command 7. Establishes an appropriate span of control 8. Strives to create a constructive organizational culture and positive organizational climate 9. Uses the informal organization to meet organizational goals 10. Uses committee structure to increase the quality quantity of work accomplished 11. Works, as appropriate, to achieve a level of operational excellence befitting an organization that would be eligible for magnet status or some other recognition of excellence 12. Continually identifies, analyzes, and promote stakeholder interests in the organization
advantages of organization chart
1. Maps lines of decision-making authority 2. Helps you to understand their assignments and those of their coworkers 3. Reveals to managers and new personnel how they fit into the organization 4. Contributes to sound organizational structure 5. Shows formal lines of communication
the 14 forces of magnetism for making hospital status
1. Quality of nursing leadership 2. Organizational structure 3. Management style 4. Personal policies and programs 5. Professional models of care 6. Quality of care 7. Quality improvement 8. Consultation and resources 9. Autonomy 10. Community and the hospital 11. Nurses as teachers 12. Image of nursing 13. Interdisciplinary relationships 14. Professional development
the optimum span of control
3 to 50 employees
nurses quickly feel as though they have many individuals to account to because healthcare often involves an interprofessional approach.
Additional individuals the nurse may need to be accountable to include in the immediate supervisor the patient the patient's family central administration in the position.
The organizational chart defined formal relationships within the institution. Formal relationships, lines of communication, and authority are depicted on the chart by unbroken solid lines.
Dotted or broken lines on the organizational chart represent staff positions because these positions are advisory staff member provides information and assistance to the manager by his limited organizational authority
factors to consider when organizing committees and making appointments
true
groupthink occurs when there is too much conformity to group norms
true
organizational structure is effective when the design is clearly communicated, there are as few managers as possible to accomplish goals, communication is facilitated, decisions are made at the lowest possible level, informal groups are encouraged, and future leaders are developed.
To
a bureaucracy, as proposed by Max Weber, is characterized by a clear chain of command, rules, and regulations, specialization of work, divisions of labor, and impersonality of relationships.
True
an organization chart depicts formal relationships, channels of communication, and authority through line-and-staff positions, scalar James, and span of control.
True
organizational culture is a system of symbols and interactions unique to each organization. It is the ways of thinking, behaving, and believing that members of a unit have in common.
True
centralize decision-making
a few managers at the top of the hierarchy make the decisions and the emphasis is on top down control.
typically governance councils include
a nursing practice counsel a research Council a professional development or education Council a nursing performance improvement or quality Council and a leadership Council occasionally they may also have a retention Council
service line organization
also called service lines or care center organizations are smaller in scale them large bureaucratic systems the service line would decide on the processes to be used to achieve the goals
Span of control
also can be determined from the organization chart. The number of people directly reporting to anyone manager represents the manager span of control and determines the number of interactions expected of him or her.
flat organizational designs
are an effort to remove hierarchal layers by flattening the chain of command in decentralizing the organization. Thus a single manager or supervisor would oversee a large number of subordinates and have a wide span of control
First level managers
are concerned with their specific units workflow. They deal with immediate problems in the units daily operations, with organizational needs, and with personal needs of employers. They need good management skills
joint practice committees
are developed to assume the power and accountability for decision-making and professional communication takes on an egalitarian structure
stakeholders
are those entities in an organization's environment that play a role in the organization's health and performance or that are affected by the organization.
Weber was also credited with the development of the organization chart to depict an organization structure
because the organization chart is a picture of an organization the knowledgeable manager can drive much information from reading the chart. For example, an organization chart can help identify roles in their expectations.
middle level managers
coordinate the efforts of lower-level of the hierarchy and are the conduit between lower and top-level managers. Middle level managers carry out day-to-day operations but are still involved in some long-term planning and in establishing unit policies.
organizing
follows cleaning as the second phase of management process and is explored in this unit and organizing phase relationships are defined procedures are outlined equipment is readied and tasks are assigned
external stakeholders
for an acute care hospital might be the local school of nursing, home health agencies, and managed care providers who contract with consumers in the area
internal stakeholders
hospital employees physicians patients patient's families union shop stewards Board of Directors
participatory management
implies that others are allowed to participate in decision-making over which someone has control. Thus, the act of allowing participation identifies the real and final authority for the participant.
responsibility
is a duty or an assignment.
ad hoc design
is a modification of the bureaucratic structure and is sometimes used on a temporary basis to facilitate completion of a project within a formal line organization.
Matrix organization structure
is designed to focus on both product and function. Function is described as all of the test required to produce a product in the product is the end result of the function the matrix organization structure has a formal vertical and horizontal chain of command may be complex and communication and confusing
informal structure
is generally and naturally forming social network of employees. Education portal suggests that it is the informal structure that fills in the gaps with connections and relationships that illustrate how employees network with one another to get work done.
unity of command
is indicated by the vertical solid line between positions on the organizational chart. This concept is best described as one person one boss in which employees have one manager to whom they report to whom they are responsible.
Accountability
is similar to responsibility but is internalized thus to be accountable means that individuals agree to be morally responsible for the consequences of their actions
organizational culture
is the total of an organization's values, languages, traditions, customs, and sacred cows
Shared governance
one of the most innovative and empowering organizational structures, was developed in the mid-1980s as an alternative to the traditional bureaucratic organizational structure. Often described as a flat type of organizational structure the governance is shared among board members nurses physicians and management
centrality
or where a physician falls on organizational chart is determined by organizational distance
subcultures
organizations if large enough also have many different and competing value systems that create subcultures. The subcultures shaped perceptions, attitudes, and beliefs and influence how their members approach and execute their particular roles and responsibilities.
pathway of excellence designation
recognizes healthcare organizations and long-term institutions for positive practice environments where nurses excels. Organizations must undergo a thorough review process that meet 12 practice standards essential to an ideal nursing practice environment
traditionally, nursing departments have used one of the following structural patterns; bureaucratic, ad hoc, matrix, flat, or various combinations of these
the type of structure use in any healthcare facility affects communication patterns, relationships, and authority
Organizational structure refers to
the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions.
flattened organizations
there continues to be a line of authority but because the organizational structure is flattened more authority and decision-making can occur where the work is being carried out
disadvantages of line structures
they often produce monotony, alienate workers, and make adjusting rapidly altered circumstances difficult
formal structure
through departmentalization of work divisions, provides a framework for defining managerial authority, responsibility, and accountability.
to achieve designation as a system, the system must not only retain the 14 forces of magnetism required for individual organizations, they must also demonstrate empirical modeling of five key components
transformational leadership structural empowerment exemplary professional practice new knowledge innovation and improvements empirical quality results
There is an inverse relationship between the span of control and the number of levels and hierarchy in the organization the narrower the span the greater the number of levels in organization
true
Unity of command is difficult to maintain and some large healthcare organizations because the nature of healthcare requires an interprofessional approach
true
authority, responsibility, and accountability differ in terms of official sanctions, self directedness, and moral integration
true
but in reality the optimum span of control depends on various factors such as the nature of the job, the managers abilities, the employees maturity, the task of complexity, and a level in the organization at which the work occurs
true
centrality refers to the location of a position on an organization chart where frequent and various types of communication occurs
true
current research suggests that changing an organization structure is a manner that increases autonomy and work empowerment for nurses will lead to more effective patient care
true
employees was relatively small organizational distance can receive more information than those who are more peripherally located
true
iin centralized decision-making, decisions are made by a few managers at the top of the hierarchy. In decentralized decision-making, decision-making is diffuse throughout the organization, and problems are solved at the lowest practical managerial level
true
in general the larger organization the greater the need to decentralize decision-making
true
magnet designation is conferred by the ANC to healthcare organizations exemplifying well-qualified nurse executives in a decentralized environment, with organizational structures that emphasize open, participatory management. Magnet designated organizations demonstrate improved patient outcomes at higher staff nursing satisfaction and organizations that do not have magnet status
true
shared governance requires a substantial and long-term commitment on the part of workers in the organization
true
the entities in an organization's environment that play a role in organizations health and performance, or which are affected by the organization, are called stakeholders
true
the informal structure also has its own leaders. In addition, it also has its own communication channels, often referred to as the great find
true
the stated aim of shared governance is the empowerment of employees within the decision-making system
true
too many committees in an organization is a sign of a poorly designed organizational structure
true
limitations of organization chart
1. Shows only formal relationship 2. Does not indicate degree of authority 3. Are difficult to keep current 4. May show things as they are supposed to be or used to be rather than as they are 5. May defined roles too narrowly 6. Possibility exists of confusing authority with status
because committees communicate upward and downward and encourage the participation of interested or affected employees, the assist the organization and receiving valuable feedback and important information
1. The committee should be comprised of people who want to contribute in terms of commitment energy and time 2. The membership have a variety of work experience and educational backgrounds. Composition should however ensure expertise sufficient to complete the task 3. Committee should have enough members to accomplish assigned task but not so many that discussion cannot occur. 68 members of the committee are usually ideal 4. The tasks and responsibilities including reporting mechanism should be clearly outlined 5. Assignment should be given I had a time with clear expectations that assigned work will be discussed at the next meeting 6. All committee should have written agendas and effective committee chairperson
Regardless of what table organizational structure is used, certain minimum requirements can be identified:
1. The structure should be clearly defined so that employees know where they belong and where to go for assistance 2. The goal should be to build the fewest possible management levels and have the shortest possible chain of command. This eliminates friction, stress, and inertia 3. The unit staff need to be able to see where their tasks fit into common tasks of the organization. 4. Organizational structure should enhance not be communication 5. Organizational structures and facilitate decision-making that result in the greatest work performance 6. Staff should be organized in a manner that encourages informal groups to develop a sense of community and belonging 7. Nursing services should be organized to facilitate the development of future leaders
Characteristics of bureaucracies
1. There must be a clear division of labor (all work must be divided into units) 2. A well-defined hierarchy of authority must exist in which superiors are separated from subordinates 3. There must be impersonal rules about impersonality of interpersonal relationships. In other words, bureaucrats are not free to act in any way please. 4. A system of procedures for dealing with work situations 5. A system of rules covering the rights and duties of each position 6. Selection for employment and promotion is based on technical competence
Assessing the organizational culture
1. What is the organization's physical environment? 2. What is the organization social environment? 3. How supportive is the organization? 4. What is the organizational power structure? 5. How safe is a organization? 6. What is the communication environment? 7. What are the organizational taboos? And who are the heroes?
people need to be aware that informal authority and lines of communication exist in every group, even when they are never formally acknowledge.
True
subunits of large organizations have a culture of these cultures meet support or be in conflict with other cultures in the organization.
True