Name: Logeswarry K Vesupathy

Title: Reflection of My Organization and Management Structure and Culture

Nowadays, the organizations related to healthcare are facing many challenges due
to many factors such as poor patient satisfaction with the provided service, rapid
changes in technology and continuous increases of complex diseases and diagnosis
among patients. Therefore, the healthcare organizations placed many changes to
overcome the challenges or difficulties in managing the sector or the people
involving the organization. Relatively, the process of change is known to be a
common situation in various healthcare systems in many countries such as
redesigning of policy of management, reshaping of working and governing structure,
differ in leadership roles and introduction of new systems or infrastructures (Pomare,
et al., 2019). In my opinion, a healthcare organization design or structure and culture
plays important roles in forming an effective and successful management that
encompasses with high satisfaction level of employees, excellent workmanship and
with minimal work-related errors. In addition, Mannion & Davies (2018) stated in their
article that the culture in a healthcare organisation reflects the shared way of
thinking, feeling and behaving of the people in the organisation where the it is known
to be main reason for scandals in healthcare that can be improved with reformation
of culture as a recovery of the failures. Besides that, Winasti (2023) shares that
organizational structure in a healthcare organization permits in achieving designated
mission, vision or goals together emphasizes the delegation of roles and
responsibilities of the people in the organization that is synchronized to suceed the
organization’s aim.

Thus, I would like to use Kolb’s Reflective Cycle which is introduced by David Kolb’s
on year 1984 to reflect my experience working in two different organization and
management. Turesky & Wood (2010) highlighted in an article that Kolb’s Reflective
Cylce has been implemented widely in educational practices, for bussiness
management, organization development and also as a study for leadership traits and
skills. Additionally, I have decided to use this model to do my reflection because
Kolb’s Model focuses on experiental and comprehensive learning that accomodates
multiplicity of an individual along with personal development and growth throughout
their experience (Long & Gummelt, 2020). Kolb’s Reflective Cycle Model is a cyclical
process that consists of four stages which are Concrete Experience, Reflective
Observation, Abstract Conceptualisation and Active Experimentation. The Image 1
below shows the the cyclic process of Kolb’s Reflective Cycle.

Image 1

(Long & Gummelt, 2020)

Kolb’s Reflective Cycle Explaining My Work Experience with two different

Organizations and Management.

1. Concrete Experience (CE)

The first phase of the reflective cycle involves the description of my experience with
the two different organizations and managements. My first working experience is at
Penang General Hospital as a Senior Staff Nurse for eight years in the Cardiology
Department and currently I am working at Stonyhurst International School as a
School Nurse Manager. The vision and mission of the two organizations are as
shown below in Table 1.
 Organization Vision Mission
Penang General Hospital The organization carries 1. To facilitate and
the energy towards better enable the people:
health. i) Achieve their full
potential in health
ii) Appreciate health as
the most valuable asset
Stonyhurst International To develop men and For students will learn
School Penang. women for others who from each other, develop
lead a life of purpose, mutual respect and
driven by conscience, celebrate diversity
competence, compassion through a range of school
and commitment. and community events
and celebrations.
Table 1

The members of my first organization is consist of healthcare professionals such as

doctors, nurses, pharmacists and many more healthcare personnels who are based
as citizens of Malaysia from diversity cultures and ethnic groups. On the other hand,
my current employment place is consists of employees from various countries
especially from United Kingdom, France, Korea, and China together with local
citizens too. Besides that, organizational design which incorporates with structure
and culture are known to be significant elements in an organization which has a
major impact on the organizational behaviors of employees such as commitment and
level of satisfaction (Ghafar Ali & Hassan Helal, 2019). There are two types of
organizational design that I have been involved in each organization which are
bureaucratic organization structure implemented at Penang General Hospital and
matrix organization structure applied at Stonyhurst International School Penang.
According to Chalmers R (2023), organizational culture is also an important factor in
organizational structure, leadership and strategy where an effective organizational
culture will aid the employees to achieve goals and gives contenment in employees
careers or profession. Moreover, Competing Values Framework (CVF) is a tool used
for assessment of organization culture, where the framework consists two
dimensions that analyse of four types of ideal culture which are clan, adhocracy,
hierarchy, and market (Chalmers R,2023). Hence, there are two types of culture
been practised in the two organizations that I have been involved which are clan
culture and hierarchy culture.

2. Relective Observation

I would like to explain the organizational design or structure of each organization that
I have assigned to. Firstly, the Penang General Hospital is known to be a
professional bureaucratic organization where it is a hierarchical form of organization
with assignment of precise work positions, specific roles or duties and process of
work to managers and employees using standards and protocols of the organization
(Andreasson, et al., 2018). Image 2 below shows an example of bureaucratic
structure that is similar to my organization.

Image 2

In the professional bureaucracy of the respective organization, the professional

workers consists of specialists or consultants, nursing managers or administrative
officers who are able to regulate their workmanship in succeeding the organizations
vision and mission. As an example, as a charge nurse, I was required to resolve
organizational problems involving nurses and also follow orders from senior
management such as specialists and consultants. A part from that, in my current
organization, the design that has been implemented is matrix structural organization.
Comparatively, Al Swaidi (2023) defines that matrix organization is functioned by
multiple stages of managerial accountability and representing neutralization of power
between projects and managers with employees. In addition, it is an organizational
structure that permits specialists from diverse functional departments to be assigned
with more than one tasks or responsibility that is led by the project manager. The
Image 3 below shows a similar example of matrix organizational design in my
organization.

Image 3

Based on the Image 3 above, I will be assigned with multiple projects regarding
medical affairs and safety of the students where I will discuss my tasks and roles
together products of my assignment with other department managers, project
managers, employees and with the Chief Operating Officer (COO) of my
organization.

Organizational culture is also vital for an organization to achieve success and in

maintaining well being of the employees. Principally, Penang General Hospital has
adapted the hierarchical culture where it is a custom that emphasizes on control
which is attained by monitoring, constructing and managing the organization
(Chalmers R, 2023). For example, the nurses in my department will be reporting to
the nursing managers and Head of Department of Cardiology. The Head of
Department of Cardiology has the highest authority and decides or make decisions
that the managers are accountable for applying and sharing with their employees.

Other than, my current organization has practiced the Clan culture that is also known
as group culture which highlights on forming and building strong and solid groups
and members with high level of commitment to influence and support peers in the
organization and acknowledge one another ideas and opinion in achieving goals
(Chalmers R, 2023). As for example, I as a School Nurse Manager work together
with the Head of Pastoral, Safeguarding Officer, School Counsellor and COO to
establish school health policies based on current health and safety guidelines and
protocols.

3. Abstract Conceptualization

In this phase of reflective cycle, I would like to compare the two types of
organizational structure and culture of the organizations together reflect on what
have I learned from my understanding and experience. Firstly, in a bureaucratic
organization, employees have high creativity level and a great self- direction
because the selected employees based on ideal level of qualification (Scot, 2021).
Scot (2021) also mentioned that in bureaucratic organization, there are job security,
good health benefits and rewards for dedicated employees. However, the
disadvantage of this design of organization are high work specialization with
repetitive routine, departmentalized and decentralised of authority.

A part from that, Al Swaidi (2023) mentioned in his article that the benefit of matrix
structural organization are it allows balance of authority and responsibility together
resolves the disintegration of functions and talents across the organizational
structure. Nevertheless, the weakness of this structure of organization are produces
dual line of authority, gives way for potential conflicts and allows decision making
process slower.

As well as, Table 2 below shows the advantages and disadvantages between clan
culture and hierachial culture of the organizations that I have worked with.

Type of Culture Advantages Diadvantages

Hierachial 1. Assurance of good
career path and
promotion.
2. Efficient
communication and
leadership skills.
3. Delegation of roles and
authority.
Clan 1. Increases productivity
1. Process of decision
making slower.
2. Departmental
dissatisfaction.
3. Difficult in making any
new changes.
1. Inability to express
 and growh in an disagreement or
organization. dissatisfaction.
2. Good communication 2.Inadequate authority.
skills. 3. Posibility for work
3. Enhances working abuse.
flexibility.

Table 2

Thus, working in both type of organizations has pros and cons during my working
experience which enables me to adapt each style of organization and work
professionally.

4. Active Experimentation

During the final stage of reflective cycle, I would like to discuss on any changes or
modifications I would like to implement or suggest for future practice. Firstly, I would
like to suggest to implement the Lean Six Sigma technique in both organizations as
this technique implemented for continuous improvement in quality related problems
or issues which aid any healthcare organizations to enhance operations, cost
effective and improve quality of operations in an organization (Vashnavi & Suresh,
2022). On the other hand, in the organization which practices bureaucratic structure,
I would like to suggest for conducting emotional intelligence training among the
employees as the employees in this type of organization may have poor attitude of
work due to repetitive work routine with no work flexibility provided( Kuye &
Akinwale, 2020). This intervention will aid in creating awareness among employees
to manage their emotions and increases personal and management satisfaction.In
addition, both type of structural organization should play an important role in creating
a conducive work environment for workers to motivate the employees to perform
better which increases the productivity and quality of an organization. Lastly, in order
to create a successful working culture in an organization, the management should
practice to review employees performance continuously by assigning with a mentor
and monitor organizational structure to ensure relativity of work and open for any
area of improvement (Al Swaidi , 2023).
As a conclusion, an organization has the power to select the most suitable and
effective organizational structure or design to achieve the desired goals by
considering strength and weakness of each structure.

References

Al Swaidi , S. . J., 2023. Innovative Business Development in Healthcare: Using

Matrix Organizational Techniques. NILES Journal for Geriatric and Gerontology,
6(1), pp. 319-332.

Andreasson, J. et al., 2018. Professional Bureaucracy and Health Care Managers

Planned Change Strategies: Governance in Swedish Healthcare. Nordic journal of
working life studies, 8(1), pp. 23-41.

Chalmers R, B. G., 2023. Organizational Culture. s.l.:StatPearls Publishing.

Ghafar Ali, D. K. A. & Hassan Helal, D. W. E. S., 2019. Impact of the organizational
design on the organizational behaviors of nurses among healthcare sectors. IOSR
Journal of Nursing and Health Science (IOSR-JNHS), 8(6), pp. 63-81.

Long, E. M. & Gummelt, G., 2020. Experiential Service Learning: Building skills and
sensitivity with Kolb’s learning theory. Gerontology & Geriatrics Education, 41(2), pp.
219-232.

Mannion, R. & Davies, H., 2018. Understanding organisational culture for healthcare
quality improvement. BMJ, Volume 363, pp. 1-4.

Pomare, C. et al., 2019. Organisational change in hospitals: a qualitative case-study

of staff perspectives. BMC Health Services Research, 19(840), pp. 1-9.

Scot, A., 2021. Bureaucracy: advantages and disadvantages. International Scholars

Journal; Global Journal of Sociology and Anthropology, 11(2), p. 1.

Turesky, E. & Wood, D., 2010. Kolb's experiential learning as a critical frame for
reflective practice. Academic Leadership, January.8(3).

Vashnavi, V. & Suresh, M., 2022. Modelling of readiness factors for the
implementation of Lean Six Sigma in healthcare organizations. International Journal
of Lean Six Sigma, 11(4).

Winasti, W. B. H. &. v. M. F., 2023. Hospital Organizational Structure and

Information Processing: An Entropy Perspective. Entropy (Basel, Switzerland), 25(3),
p. 420.