Final dis
HSMP 3200
Division of Work
Remember, organizing means deciding how best to group the activities and resources of the organization to achieve its mission. Two of these principles are:
Division of Work or job specialization
Departmentalization or compartmentalization
These two major premises are the concern of the CEO in a smaller organization, or the COO in a larger one.
Division of Work
This refers to the degree to which tasks or functions within the organization are segregated (divided) into their respective component parts.
The objective of “division of work” methodology is to enhance efficiency in performing distinct functions or tasks.
Job Specialization
This is done by breaking down a task or function into smaller parts and having each part or step performed by a different individual
Result: each individual learns how to do her task exceptionally well = greater efficiency and higher production.
Easier to replace employees
Making a Nail involves 18 tasks
Without Specialization:
1 worker doing all 18 tasks yields approximately 20 nails a day
20 workers make 400 nails a day
With Specialization
20 workers make 100,000 nails a day
1 worker makes approximately 5,000 nails a day
What is your highest cost again?
Examples
Ophthalmologists specialize in different things like Lasik or retina surgery.
Home health’s may specialize in serving newborns or geriatrics.
Any others?
Departmentalization
The process of grouping various organizational activities (tasks, functions) into logical units (departments). Of course you already recognize that health care organizations are essentially a collection of “departments”
You might also think of all the “departments” that make up ETSU
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How is departmentalization achieved?
The basis for departmentalization can be any number of things, for example:
By function (e.g. business office, nursing unit)
By process and equipment (e.g. clinical laboratory)
By territory (geographic or physical location)
By customer (e.g. outpatient, children, women)
By time (e.g. multiple shifts in a hospital)
By product line (service specific)
Departmentalization by Function
You probably recognize this as the most common way of departmentalizing an organization.
Activities that are alike or similar and involve a particular function are placed together to create a department which is managed through a distinct chain of command.
Facilitates and enhances coordination
Facilitates in-depth skill development and allows for clearly defined career development.
Administrative alert: If a department is too large or complex it may limit the staff’s ability to develop efficient processes, result in routine and/or repetitive job tasks and in turn, increase worker boredom or lack of motivation.
Departmentalization by Process and Equipment
These are departments that operate sophisticated equipment and handle certain processes that require special installations, training, and expertise. (e.g. Radiology, Clinical Laboratory, Information Services)
Closely allied with departmentalization by function (e.g. Surgery, Nursing, Administration, Medical Records)
Departmentalization by Territory (Geographic Location)
Basis is defined geographic areas or sites
Some advantages
Places decision making close to where the work is done
Managers develop expertise solving problems unique to the location
Managers are familiar with their “local” customers and their problems
Some disadvantages
Duplication of effort and resources (e.g. separate billing systems)
Focus is on location's goals more than overall organization goals
Requires extensive rules or procedures to enable coordination and ensure continuity between locations
Departmentalization by Customer (Patient category)
Some advantages
Facilitates the attention to patient (customer) needs
Focus on a specific patient or condition type
Develops managers to become customer advocates
Some disadvantages
Conflicts over resource allocation
Restriction of problem-solving skills to a single patient type
Coordination problems between specialties or departments
Duplication of resources
Possibly pleases the customer but hurts the company
Centers of Excellence
This is simply a model for departmentalization that is a collection of specific functions, services, or product lines under the “umbrella” of a “Center of…”.
Fairly common examples: Woman’s Health Centers Cancer Treatment Centers Heart Health Centers
Kelsey- Seybold Cancer Center- Houston, Texas
Departmentalization by Time (work schedule)
Here, functions/activities are grouped by different working times called “shifts”
Most clinical departments
Maintenance, food services, security
Usually day, evening, or night shift.
Departmentalization by Product (output or service)
A department is responsible for a single product or group of closely related products (e.g. food, housekeeping or maintenance services.)
The emphasis is shifted from the function to the output, or product
An advantage
Department can be managed to gain economies of scale and the ability to leverage staff
A disadvantage
Can result in duplication of effort
You can mix and match: Hybrid Departmentalization
Optimizing organizational performance (your goal as an administrator) may require that you blend different methods of departmentalization.
Be aware of the advantages and disadvantages related to each method of departmentalization you are “mixing” together.
My mixing blunders: Social Service/Nursing, EVS/Maintenance.
Organizing a department from the supervisory level
This process is basically the same as for organizing the overall organization. Which, as you recall, is:
Grouping activities for purposes of specialization.
Assigning specific tasks and duties.
Delegating authority.
In effect, the supervisor is sub-dividing their department into what are often called “Sections”.
So , what is the ideal way to organize a department ?
There is no “one design fits all” answer.
The “ideal” organization is the most desirable for achieving stated objectives.
What is good for one department or supervisor may not be good for another department
At the same time,, trial and error (“try this then try that”) is not a good approach.
Why not?
It is important to ensure that the department’s goals are achieved through:
the proper organization of staff
coordination of duties and
efficient work flow
So , what is the ideal way to organize a department ?
Organizing Personnel
We have determined forming a sound structure comes first,
The next priority is to organize the people to fill this structure
If the department structure is planned around existing personnel, existing shortcomings are perpetuated
Example of a New Department in a New Organization
You are part of a 90 bed SNF start-up. Initial plans are to fill 25 beds, then 60 beds by first year. After that an expansion for 90 beds will be added. These are not LTC patients, rather short term rehab patients. How will you organize:
-Administration
-Social Services/Admissions
-Nursing
-Dietary/Dietician
-EVS
-Maintenance
Traditional structure
This is the most common form of organization design
Vertical hierarchical relationships. Each employee reports to one superior
Matrix structure
This organizational structure adds Cross-departmental connections
Matrix structures work well for
Complex, high-technology organizations such as healthcare often need to create project teams to focus resources and special talents for a given time on a specific project
And they affords top-level management an additional way to delegate and decentralize across traditional organization lines of authority.
Remember the example of Kelsey-Seybold?
Matrix organization
The basis for the matrix organization is an endeavor to create synergism through shared responsibility between project and functional management.
Suppose a CEO has 3 major
projects to get out in the next
year: EMR’s, pharmacy barcode,
and accreditation. They could
assign these projects to 3
different project managers and
establish a matrix org. for each.
Organizational Charts
A graphical illustration of an organizational structure at a given time.
“A snapshot of the organizational structure”
Benefits of Organizational Charts
Analysis might uncover structural faults and duplications of effort, complexities, or other inconsistencies
Offers a simple way to acquaint new members with the organizational makeup and with their fit into the entire structure
Assist in developing better lines of communication and operational relationships
Limitations of Organizational Charts
Organizational changes must be recorded speedily, or they are of little practical use
Information they give is limited
Displays only formal authority relationships
Individuals may confuse authority relationships with organizational “rank” or status
Some charts are so detailed/complex they end up confusing the employees
Types of organizational charts
Vertical chart
An organizational chart that shows the different levels of the organization in a step arrangement in the form of a pyramid
Horizontal chart
An organizational chart that reads from left to right, stressing functional relationships more than hierarchical levels
Circular chart
An organizational chart that depicts the various levels in concentric circles rotating around the top-level administrator, who is at the hub of the wheel
Inverted pyramid chart
An organizational chart featuring the chief administrator on the bottom and others farther up (What does this sound like?)
Traditional Vertical organization
Horizontal Organization
Circular Organization Chart