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NURS 410 - NURSING RESEARCH EXAM 1
OUTLINE 1
Exam 1 outline: use Readings, Powerpoints, Class discussions
1) Organization structure what is it, why does it exist, what does it tell you?
Organizational structure defines how work is organized, where decisions are made, and
the authority and responsibility of workers. It provides a map for communication and
outlines decision making paths.
o Organizational designs are often classified by their characteristics of:
Complexity- concerns the division of labor, specialization of labor,
number of hierarchical levels, physical location (geographical
dispersion- the more dispersed an organization is, the greater are the
demands for creative designs that place decisions making related to pt
care close to the pt and consequently far from corporate headquarters) of
organizational units.
Formalization- degree to which an organization has rules (policies) that
define a member’s function. Often inversely related to the degree of
specialization and the number to professionals within the organization.
Centralization-location where decisions are made. Centralized= Top,
decentralized=bottom- at or close to the pt care level.
o Types of structures: Nursing organizations often combine characteristics of
several of these structures to form a hybrid structure.
Functional- arrange departments and services by specialty. Department
providing similar functions report to a common manager or executive.
Ex. would have VPs’ for each major function. Supports professional
expertise and encourages advancement. May result in discontinuity of pt
care services. Delays in decision making can occur is a silomentality
develops within groups. Issues that require communication across
messages.downloaded_by
,functional groups typically must be raised to a senior management level
before a decision can be made.
Service-line structures (sometimes called product lines)-functions
necessary to produce a specific service/product are brought together into
an integrated organizational unit under the control of a single manager or
executive. Ex. Cardiology service line. Benefits of this approach
include: coordination of services, expedited decision making process,
and clarity of purpose. Limitations include increased expense associated
with
duplication of services, loss of professional or technical affiliation and
lack of standardization.
Matrix- reflects both function and service in an integrated organizational
structure. The manager of a unit responsible a service reports to both a
functional manager and a service or product line manager. Ex. A director
of pediatric nursing could report to a VP for pediatric services (service
line manager) and a VP of nursing (functional manager). Enables a
timely response to the forces in the external environment that demand
continual programming and it facilitates internal efficiency and
effectiveness through the promotion of cooperation among disciplines.
Combines both a bureaucratic structure and a flat structure; teams are
used to carry out specific programs or projects. Superimposes a
horizontal program management over the traditional vertical hierarchy.
Nursing care is delivered in a teamwork setting or within a collaborative
model.
Flat- decision making is delegated to the professionals doing the work
(decentralized). The term flat signifies the removal of hierarchical
layers, thereby granting authority to act and placing authority at the
action level. Provides staff with authority to make decisions at the place
of interaction with patients is the hallmark.
-low level of formalization in relation to rules, with processes tailored to
meet individual consumer’s needs.
pg. 2
, A decrease in strict adherence to rule and policies allows individualized
decisions that fir specific situations and meet the needs created by the
increasing demands associated with consumerism, change and
competition.
-Has a potential for inconsistent decision making, loss of growth
opportunities, and the need to educate managers to communicate
effectively and demonstrate creativity in working within these
nontraditional structures.
Shared governance- goes beyond participatory management through the
creation of organizational structures that facilitate nursing staff more
autonomy to govern their practice.
-To be accountable, authority to make decisions concerning all aspects
of responsibilities is essential.
-The structure’s foundation is the professional workplace rather than
organizational hierarchy.
-Vests the necessary levels of authority and accountability for all aspects
of the nursing practice in the nurses responsibility for the delivery of care. 2) What are
Reflections of organizational culture?
-An organization’s mission, vision, and philosophy both shape and reflect
organizational culture. Organizational culture is the reflection of the norms or traditions
of the organization and is exemplified by behaviors that illustrate values and beliefs. -In
organizations culture is demonstrated in 2 ways that can be either mutually reinforcing
or conflict-producing. Is typically expressed in a formal manner via written mission,
vision and philosophy statements; job descriptions; and policies and procedures.
Beyond formal documents and verbal descriptions given by administrators and
managers, organizational culture is also represented in day-to-day experience of staff
and pts. To many it is the lived experience that reflects the true organizational culture.
-When there is a lack of congruity between the expressed organizational culture and the
experienced, confusion, frustration and poor morale often result.
pg. 3
, -Organizational culture can be effective and promote success and positive outcomes, or
it can be ineffective and result in disharmony, dissatisfaction, and poor outcomes for
pts, staff, and the organization.
3) What determines an organizations strategic (long term) plan?
It is designed to encompass the organization’s emphasis on mission statements,
etc. Develop procedures/operations to actualize their envisioned future. 4) Know how
to read an organizational chart (what does it tell you)?
Functional (pg. 147), service-line (pg. 148), matrix (pg. 149), flat (pg.150)
-The horizontal dimension of an organizational chart, the graphic representation of
work units and reporting relationships, relates to the division and specialization of labor
functions attended by specialists. ----Hierarchy connotes lines of authority and
responsibility.
-Chain of command is a term used to refer to the hierarchy and is depicted in vertical
dimensions of organizational charts.
-Span of control refers to the number of subordinates a supervisor manages. For
budgetary reasons, span of control is often a major focus for organizational
restructuring. -Organizational charts usually indicate line positions through the use of
solid lines and staff positions through the use of broke lines.
5) Why are so many hospitals focusing on redesign and restructuring (position, structure),
what is the motivation?
Redesign is a technique to analyze tasks to improve efficiency. Save resources? Fulfill
mission statements?
Restructuring is a technique to enhance organizational productivity.
• Society as whole is changing (economic, social and demographic)
• Changes are being made in both facility design and care delivery systems as efforts are
made to reduce cost while striving to meet or exceed consumer expectations and
improve patient outcomes.
• Competition for patients is also a factor.
• Consumerism: consumer demands that care be customized to meet individual needs
• Changes in technology: mainly information technology that provides means of
customizing care
pg. 4
o
NURS 410 - NURSING RESEARCH EXAM 1
OUTLINE 1
Exam 1 outline: use Readings, Powerpoints, Class discussions
1) Organization structure what is it, why does it exist, what does it tell you?
Organizational structure defines how work is organized, where decisions are made, and
the authority and responsibility of workers. It provides a map for communication and
outlines decision making paths.
o Organizational designs are often classified by their characteristics of:
Complexity- concerns the division of labor, specialization of labor,
number of hierarchical levels, physical location (geographical
dispersion- the more dispersed an organization is, the greater are the
demands for creative designs that place decisions making related to pt
care close to the pt and consequently far from corporate headquarters) of
organizational units.
Formalization- degree to which an organization has rules (policies) that
define a member’s function. Often inversely related to the degree of
specialization and the number to professionals within the organization.
Centralization-location where decisions are made. Centralized= Top,
decentralized=bottom- at or close to the pt care level.
o Types of structures: Nursing organizations often combine characteristics of
several of these structures to form a hybrid structure.
Functional- arrange departments and services by specialty. Department
providing similar functions report to a common manager or executive.
Ex. would have VPs’ for each major function. Supports professional
expertise and encourages advancement. May result in discontinuity of pt
care services. Delays in decision making can occur is a silomentality
develops within groups. Issues that require communication across
messages.downloaded_by
,functional groups typically must be raised to a senior management level
before a decision can be made.
Service-line structures (sometimes called product lines)-functions
necessary to produce a specific service/product are brought together into
an integrated organizational unit under the control of a single manager or
executive. Ex. Cardiology service line. Benefits of this approach
include: coordination of services, expedited decision making process,
and clarity of purpose. Limitations include increased expense associated
with
duplication of services, loss of professional or technical affiliation and
lack of standardization.
Matrix- reflects both function and service in an integrated organizational
structure. The manager of a unit responsible a service reports to both a
functional manager and a service or product line manager. Ex. A director
of pediatric nursing could report to a VP for pediatric services (service
line manager) and a VP of nursing (functional manager). Enables a
timely response to the forces in the external environment that demand
continual programming and it facilitates internal efficiency and
effectiveness through the promotion of cooperation among disciplines.
Combines both a bureaucratic structure and a flat structure; teams are
used to carry out specific programs or projects. Superimposes a
horizontal program management over the traditional vertical hierarchy.
Nursing care is delivered in a teamwork setting or within a collaborative
model.
Flat- decision making is delegated to the professionals doing the work
(decentralized). The term flat signifies the removal of hierarchical
layers, thereby granting authority to act and placing authority at the
action level. Provides staff with authority to make decisions at the place
of interaction with patients is the hallmark.
-low level of formalization in relation to rules, with processes tailored to
meet individual consumer’s needs.
pg. 2
, A decrease in strict adherence to rule and policies allows individualized
decisions that fir specific situations and meet the needs created by the
increasing demands associated with consumerism, change and
competition.
-Has a potential for inconsistent decision making, loss of growth
opportunities, and the need to educate managers to communicate
effectively and demonstrate creativity in working within these
nontraditional structures.
Shared governance- goes beyond participatory management through the
creation of organizational structures that facilitate nursing staff more
autonomy to govern their practice.
-To be accountable, authority to make decisions concerning all aspects
of responsibilities is essential.
-The structure’s foundation is the professional workplace rather than
organizational hierarchy.
-Vests the necessary levels of authority and accountability for all aspects
of the nursing practice in the nurses responsibility for the delivery of care. 2) What are
Reflections of organizational culture?
-An organization’s mission, vision, and philosophy both shape and reflect
organizational culture. Organizational culture is the reflection of the norms or traditions
of the organization and is exemplified by behaviors that illustrate values and beliefs. -In
organizations culture is demonstrated in 2 ways that can be either mutually reinforcing
or conflict-producing. Is typically expressed in a formal manner via written mission,
vision and philosophy statements; job descriptions; and policies and procedures.
Beyond formal documents and verbal descriptions given by administrators and
managers, organizational culture is also represented in day-to-day experience of staff
and pts. To many it is the lived experience that reflects the true organizational culture.
-When there is a lack of congruity between the expressed organizational culture and the
experienced, confusion, frustration and poor morale often result.
pg. 3
, -Organizational culture can be effective and promote success and positive outcomes, or
it can be ineffective and result in disharmony, dissatisfaction, and poor outcomes for
pts, staff, and the organization.
3) What determines an organizations strategic (long term) plan?
It is designed to encompass the organization’s emphasis on mission statements,
etc. Develop procedures/operations to actualize their envisioned future. 4) Know how
to read an organizational chart (what does it tell you)?
Functional (pg. 147), service-line (pg. 148), matrix (pg. 149), flat (pg.150)
-The horizontal dimension of an organizational chart, the graphic representation of
work units and reporting relationships, relates to the division and specialization of labor
functions attended by specialists. ----Hierarchy connotes lines of authority and
responsibility.
-Chain of command is a term used to refer to the hierarchy and is depicted in vertical
dimensions of organizational charts.
-Span of control refers to the number of subordinates a supervisor manages. For
budgetary reasons, span of control is often a major focus for organizational
restructuring. -Organizational charts usually indicate line positions through the use of
solid lines and staff positions through the use of broke lines.
5) Why are so many hospitals focusing on redesign and restructuring (position, structure),
what is the motivation?
Redesign is a technique to analyze tasks to improve efficiency. Save resources? Fulfill
mission statements?
Restructuring is a technique to enhance organizational productivity.
• Society as whole is changing (economic, social and demographic)
• Changes are being made in both facility design and care delivery systems as efforts are
made to reduce cost while striving to meet or exceed consumer expectations and
improve patient outcomes.
• Competition for patients is also a factor.
• Consumerism: consumer demands that care be customized to meet individual needs
• Changes in technology: mainly information technology that provides means of
customizing care
pg. 4
