Chapter II

ANALYSIS OF DATA

a. Analysis of the Organizational Structure

Organizational Analysis is defined as a process that assists businesses in
comprehending their performance, analyzing problem conditions and possibilities, and
developing a suitable action plan to improve company efficiency. It is a review of the
parts of the organization. The performance and conduct of an assessment of the
numerous external influences that affect organizational performance is an important part
of Organizational Analysis. It also includes assessing an organization's potential, as well
as its resources and skills. (Lakshmanan, 2021)

a.1. Level of Management

The term Levels of Management refers to the line that separates distinct
managerial levels within an organization. As the scope of the organization and
personnel grows, so does the number of management levels, and vice versa. The
various levels of management can determine an organization's chain of command, as
well as the degree of authority and often decision-making impact that all managerial
positions have. Management levels are often grouped into three major groups, each of
which directs managers to execute various functions (Duggal, 2023).
Malta Medical Center's Organizational Structure includes management levels
such as top-level management, middle-level management, and first-level management.
This level, often known as senior management or executive management,
consists of the organization's highest-ranking executives. They are in charge of making
strategic decisions, establishing organizational objectives, and assuring success. The
Board of Director, President, Hospital Administration, Chief Nurse and Chief of Clinics
are examples of top-level managers.
A hospital's long-term vision and growth depend on top-level management, which
sets the direction for service offerings, resource allocation, and expansions. They
handle policy changes with agility and intelligence, building a solid hospital culture in the
process. Their hierarchical structure, however, can occasionally cause a detachment
from frontline realities by slowing down decision-making and obstructing
communication. Even though they are strong in strategy and leadership, this
management level brings with it difficulties including possible disconnection and
communication hurdles. Hospitals must successfully strike a balance between
communicative and quick decision-making, as well as strategic oversight.
Middle-level managers are the Nurse Supervisor and Ancillary heads such as the
Human Resource Dept.,Laboratory Department,Ancillary Services, Billing Department,
Business Unit, Pharmacy Department, General Services, Accounting Department, Social
Services, Medical Record, Purchasing and Quality Assurance Dept. They serve as a link
between top-level management and first-level employees. They translate top
management's strategic decisions into actionable programs for their departments or
divisions. Middle-level managers manage and carry out these plans in order to fulfill the
organization's objectives.
Middle-level managers bridge upper management and staff, translating high-level goals
into actionable plans aligned with departmental objectives. They're hands-on, offering support
and guidance to frontline employees, ensuring smooth task execution and a positive work
atmosphere. Leading teams, they foster skill development and team unity, boosting productivity.
They also refine communication flow, aiding decision-making across levels. While pivotal for
coordination, middle management faces challenges like limited decision-making and potential
communication hurdles. Nonetheless, their effective utilization greatly contributes to a cohesive
and efficient work environment.
Lower-level managers of Malta Medical Center, often known as Head nurse and
staff nurses, oversee employees' operations and activities directly involved in producing
goods or providing services. They are in charge of ensuring that tasks are completed
efficiently and effectively in order to meet departmental objectives.
Low-level management in hospitals handles administrative tasks like paperwork,
scheduling, and data entry, ensuring smooth operations. They maintain records, manage
inventory, and oversee resources, contributing to efficient hospital functioning. Their direct
interaction with patients enhances the patient experience. However, limited decision-making
authority, workload pressures, and career growth constraints pose challenges that need
addressing for their effectiveness and satisfaction in the hospital setting.
Management is important because of its capacity to use resources properly,
streamline processes, and direct teams toward accomplishing organizational goals.
Effective management promotes innovation, adapts to changing market dynamics, and
assures effective resource allocation, ultimately increasing productivity and profitability.

a.1.1 Line and Staff Authority

A line authority structure is a typical hierarchical structure in which authority runs
in an uninterrupted line from the top to the bottom of the organization. The line
organization is centered on attaining the organization's key goals and objectives, such
as production, marketing, and income. There is a clear chain of command in a line of
authority, where everyone reports to their immediate superior, and decisions are made
by those at higher levels (Bragg, 2023). Moreover, in a line authority, line managers are
responsible for achieving the primary goals and objectives of the organization,
On the other hand, staff authority refers to a level of authority granted to
individuals or departments within an organization that provides advice, support, and
specialized knowledge to assist line or operational units in accomplishing their goals.
Unlike line authority, which involves direct decision-making and control over operations,
staff authority doesn't have the power to make final decisions or give orders but serves
in an advisory or support capacity (Bragg, 2023).
The distinction between line authority and staff authority is determined by the
persons to whom the authority is granted. Line authority is connected with decision-
making power in normal operations, whereas staff authority is related to specialist work
that gives help to line personnel. While line authority can be found in many sorts of
organizations, staff authority can only be found in a few, particularly large ones (Dili,
2019).
In Malta Medical Center they both utilize Line and staff authority. The Top-level
management is responsible for settling the overall direction of the organization and also
holds ultimate authority over lower-level management. The Staff Authority of Malta
Medical Center is made up of the Health Service Manager and the Medical Director or
Chief Clinic, who provide guidance to those with line authority. Staff authority is
responsible for improving line personnel's efficiency in carrying out their assigned
activities and accomplishing organizational objectives.
In the Emergency Department, clear line authority aids rapid responses during
crises, optimizing care and resources, potentially saving lives. However, this authority's
rigidity can hinder adopting new treatments, causing delays and impacting patient
outcomes by limiting flexibility in embracing innovative approaches.
In Malta, specialized staff authority swiftly addresses outbreaks by leveraging
their expertise. However, conflicts can emerge between staff authority, such as IT
specialists suggesting new technology, and line managers' decisions, causing delays
and impacting operational efficiency. Balancing these influences is crucial for hospitals
to leverage expertise while aligning with broader goals and strategies.

a.2 Authority, Responsibility, and Accountability of Personnel

Authority
The flow of authority is always downhill. It is the authority granted to a manager
or leader to act and make decisions within defined parameters in order to achieve
organizational goals. The manager and the individual receiving the delegation share
authority. Without authority, an organization cannot function (Dunham, 2023).
An example of downward communication would be sharing policies and
procedures within the company, ensuring that everyone is aware of the guidelines they
must follow by ensuring the uniformity of the shared information. For instance, Jake G.
is a Chief Nurse. He wants to amend a policy to say that all employees must not use
cellphones during the shift. He passes on that information to the head nurse, who tell
the employees of the policy change (Study.com, 2019)

Responsibility
The act of carrying out a certain task is referred to as responsibility, and it
imposes an obligation on those who are regarded accountable. When a task is
delegated, the management and the person receiving the delegation share
responsibility for completing the assignment (Dunham, 2023).
An example of that is the responsibility of a Chief Nurse, they establishes and
directs the nursing model; reviews and evaluates administrative and clinical nursing
procedures within the hospital; directs and oversees the development and
implementation of clinical and operational policies, procedures and standards, including
quality assurance activities, for assigned areas; initiates changes as needed (Vidal,
2023)

Accountability
Accountability is the act of being held accountable for one's actions and
judgments. Accountability is an individual's duty to report formally to his superior about
the work he performed in order to fulfill the responsibility, and every employee should be
held accountable for jobs allocated to them in order to be able to finish that job
according to the criteria set by the higher-ups (Dunham, 2023).
An example is asking a staff member to clarify a documentation error is an
illustration of healthcare-related responsibility. Answering to an insurance company or
addressing people' health concerns in a public forum are two other instances of
responsibility (Boyles, 2020)
In Malta Medical Center, the President Dr. Warner C. Camarao holds the highest
position and is the one who is in charge of making the final decision regarding the
overall management of the hospital together with the CEO as the top-level
management. When a task is delegated, the management and the person receiving the
delegation share responsibility for completing the assignment. In Malta Medical Center
the top-level management is responsible for determining what work needs to be done,
while the middle-level management receiving the delegation is responsible for
determining how the assignment should be executed. Then the first-level management
is accountable for accomplishing the task.
The board of directors, comprising the CEO or general manager, has distinct
duties in a business setup. They're tasked with appointing the CEO or general manager
and assessing the business's overarching direction and strategies. Meanwhile, the CEO
or general manager oversees staff hiring and daily business operations. Problems arise
when these boundaries blur, causing conflict if directors intervene in daily affairs or if
management involves itself in high-level policy decisions outside its scope. The board of
directors appoints officers within its ranks. The primary role is the president or chair,
followed by the vice-president or vice-chair who steps in when the president is absent.
These roles are held by board members. Additionally, there's usually a secretary and
treasurer, possibly combined. These positions involve specific duties and can be filled
by a board member or an external appointee. Selection is often based on willingness
and qualifications, although seniority might influence the process. Each board may have
its unique approach to these appointments (Boland&Hoftstrand, 2021)
The hospital administrator holds authority over the overall management, policies,
resource allocation, and procedures of the hospital. Their role is pivotal in guiding the
hospital's direction, making strategic decisions, and ensuring policy enforcement to
meet organizational goals. Responsibilities include effective financial management,
staffing supervision, compliance with healthcare regulations, and implementing
strategies to improve patient care. The administrator is accountable for the hospital's
outcomes, including success, patient outcomes, staff well-being, and financial stability.
The Chief Nurse is responsible for supervising nursing operations, making policy
and staffing decisions. They provide leadership and guidance to nursing staff, ensure
compliance with regulations, and are held accountable for patient care outcomes and
the overall performance of the department. The Chief Nurse has the authority to
introduce a new post-operative patient monitoring protocol. They decide on staffing,
nurse training, and implementing updated monitoring equipment for better surgical
patient care. If the protocol leads to better outcomes like reduced complications, the
Chief Nurse is responsible for these positive changes. They report these results to
hospital management. Conversely, if challenges arise or expected improvements don't
happen, the Chief Nurse is accountable. They must address issues transparently and
make necessary adjustments to the protocol.
The Nurse Supervisor manages a particular unit, guiding nursing personnel and
ensuring excellent patient care. They have control over their shift, handling staff
responsibilities, upholding protocols, and addressing any arising concerns. As a front-
facing leader, they're responsible for their unit's results and conduct during their shift,
reporting important incidents and swiftly managing obstacles to maintain effective
operations and top-tier care. The Nurse Supervisor directs the night shift in a surgical
unit, overseeing staffing and ensuring quality care for post-operative patients. During an
unforeseen rise in patients, they promptly reallocate responsibilities to manage the
situation effectively without compromising care standards. When a medical crisis arises,
they take charge, leading the nursing team in providing immediate aid and collaborating
with other medical staff. After the shift, they summarize the night's occurrences,
incidents, and patient progress in a report for higher management evaluation. This
highlights the Nurse Supervisor's leadership in shift management, adept handling of
emergencies, and accountability in reporting and patient well-being.
The Head Nurse manages a designated nursing department, overseeing both
staff and patient care. They control nursing operations, assign tasks, and ensure
compliance with protocols within their unit. Responsible for supervising staff, they guide
patient care, maintain standards, and address challenges as they occur. As a senior
authority, they're answerable for their department's results, reporting noteworthy
incidents, and promptly resolving issues to maintain effective operations and excellent
patient care. The Head Nurse supervises a hospital's medical-surgical unit, overseeing
nursing staff and ensuring patient care standards. Faced with a sudden patient increase
from an outbreak, they quickly adjust duties to handle the rise while maintaining care
quality. In a critical patient emergency, they lead immediate care and coordinate with
other medical personnel. They compile a detailed report on events, patient conditions,
and challenges encountered, submitted for higher management assessment. This
showcases the Head Nurse's control over staff, ability to handle crises, and
responsibility for reporting incidents and ensuring patient well-being within their unit.
The Staff Nurse is primarily responsible for providing direct patient care within
their designated duties. They administer medications, monitor patients, and adhere to
care plans under the supervision of senior nursing staff. Their duties involve delivering
attentive care, collaborating with the healthcare team, precisely recording patient data,
and supporting patients' needs. They are responsible for following care protocols,
ensuring high-quality care, and promptly notifying changes in patient conditions to
facilitate effective healthcare management. A Staff Nurse in a hospital's surgical unit
delivers direct care to post-operative patients, administering medications, monitoring
vital signs, and aiding patient recovery. They collaborate with the healthcare team,
accurately document patient details, and promptly communicate any changes in patient
conditions to higher-ranking nurses or physicians. In an emergency or if complications
arise, they swiftly alert the medical team, implement protocols, and provide necessary
assistance. This showcases the Staff Nurse's pivotal role in patient care, adherence to
protocols, and quick response to ensure effective healthcare delivery.

a.2.1 Centralization & Decentralization

Centralization is defined as the concentration of decision-making power in a few
hands. All key decisions and activities at the lower level, as well as all subjects and
actions at the lower level, must be approved by top management. Decentralization, on
the other hand, is the systematic delegation of control at all levels of management and
throughout the company. In a decentralized organization, senior management retains
power over critical decisions and policy formulation for the entire organization. The
remaining authority may be delegated to middle and lower management levels (Jenuja,
2023). The amount of authority allocated to the lowest level determines the degree of
centralization and decentralization.
The Malta Medical Center employs a dual approach, utilizing both centralized
and decentralized decision-making methods. While the Hospital Administration retains
the ultimate responsibility and authority to address significant problems or concerns,
employees across various levels possess the autonomy to resolve minor issues or
make decisions benefiting their departments without direct involvement from higher
management.
Centralization in decision-making ensures swift responses and consistency in
policies, optimizing resource use and fostering a unified approach. Yet, its rigidity can
hinder adaptability and innovation. Top-down control might delay responses to market
changes, create bottlenecks, and disengage lower-level employees, impacting creativity
and morale. Balancing centralization with autonomy is vital for efficiency and innovation,
allowing organizations to benefit from control while encouraging adaptability and
engagement.
Decentralization empowers employees and drives innovation by distributing
decision-making authority across various levels. This cultivates ownership,
accountability, and adaptability among staff, fostering a dynamic and competitive
organization. It enables quicker responses to local challenges and encourages creativity
through participative decision-making, resulting in a diverse range of perspectives and
streamlined operations. However, it may lead to inconsistencies in policies and
strategies, posing challenges in coordination and alignment with the organization's
goals. Balancing decentralized decision-making with cohesive organizational objectives
is essential to harness its strengths while maintaining alignment across the
organization.

a.2.2 Levels of Decision-Making

A decision-making process is a set of processes that an individual goes through
to identify the best alternative or course of action to satisfy their needs (Burns and
Brush, 2023). This entails weighing the advantages and disadvantages of many options
and selecting the optimal alternative to attain the desired result. Decision-making in
management is about behaving in a way that fulfills corporate goals and objectives
(Davis, 2023).
There are two types of decision-making processes in management: centralized
and decentralized. In Centralized decision-making, strategic planning, goal formulation,
budgeting, and talent deployment are often carried out by the senior leader or
leadership team or the top management, while the lower level follows the upper
management's instructions and policies. In contrast, formal decision-making power is
divided across numerous individuals or teams in decentralized organizations, and top
management leads and supports the lower levels (Bililies, 2020).
Centralization in decision-making streamlines processes, ensuring quick
responses and consistent policies. This efficiency proves crucial in critical situations,
fostering agility and control over resource allocation. Yet, its rigidity might stifle
adaptability and innovation. Top-down approaches could slow responses to market
changes and create bottlenecks, impacting competitiveness. Also, disengagement
among lower-level employees due to limited decision-making might hinder creativity and
morale. Balancing centralized control and flexibility is key to optimizing efficiency while
nurturing innovation and engagement at all levels.
The hospital's top management team, including the President, Board of Directors,
Chief Nurse, and Chief of Clinics, collaborates to centralize patient care protocols.
Recognizing the need for a unified approach, they support a proposal from the Chief
Nurse and Chief of Clinics. This leads to the formation of a task force, overseen by
these leaders, aiming to streamline care procedures and resources. Despite initial
pushback, their guidance and resource allocation drive the adoption of standardized
protocols. This centralization ensures consistent care practices, fosters teamwork
across departments, and ultimately enhances the hospital's patient care standards, all
guided by unified top-level leadership.
Decentralization empowers lower-level employees, fostering accountability and
innovation. It enables quick responses to local challenges and encourages diverse
perspectives, driving creativity. However, it can lead to inconsistencies in policies and
resource allocation, causing coordination challenges and divergent strategies.
Achieving a balance between decentralized decision-making and organizational goals is
essential for leveraging its strengths while ensuring alignment across the organization.
In an effort to improve patient care, the hospital restructures its nursing
management by creating independent units, each headed by a lead nurse within various
wings or floors. These lead nurses are empowered to make decisions about patient
care protocols and staffing within their units. With specialized training and effective
communication, they work closely with frontline staff to tailor care plans to suit the
unique needs of their units. This shift towards decentralization encourages a more
adaptable and personalized approach to patient care, empowering nurses to actively
contribute to better outcomes and a more fulfilling patient experience across the
hospital.
Malta Medical Center makes both centralized and decentralized decisions. A
hybrid model combines both centralized and decentralized, it gives employees more
authority, which can lead to higher motivation and job satisfaction. Furthermore, to
increase healthcare provision and quality, policymakers must strike a balance between
these two methods.

a.3 Differentiation of Activities

In a hospital setting, differentiation of activities involves organizing and dividing
tasks among various departments and specialized units to ensure effective and efficient
healthcare delivery. The structure of a hospital is designed to accommodate the diverse
needs of patients, medical professionals, and support staff (Van Der Ham et al., 2021).
Along with secondary clinical laboratory services and a pharmacy, Malta Medical
Diagnostic Center began offering professional medical care in the areas of adult
cardiology, internal medicine, and pediatrics. Later on, x-ray and ultrasound facilities
were introduced, along with specialists in diabetes (Dr. Lowel M. Amoguis), OB-
Gynecology (Dr. Ana Riza Parreno), and ENT (Dr. Danilo R. Legita). In 2016, MMCI
opened a skin clinic, which is run by Dermapathologist Dr. Maricar Lacuesta and
reconstructive surgeon, Dr. Hector Nazareno. MMCI currently has 48 authorized beds
available for admission. The following facilities provide out-of-hours specialized
consultant consultations: Emergency Room, Renal Dialysis Unit, Operating Room,
Delivery Room, Level 1 X-ray, Pharmacy, Secondary Laboratory, Dental Clinic, and
Skin Clinic.
Employee specialization within departments enables them to become experts in
their particular fields, resulting in higher quality and more effective service delivery. It
also makes it easier for teams or people to divide up work so that each member may
concentrate on a task that best suits their expertise. This strategy can give companies a
competitive edge, make process scaling easier, and increase output overall. Overall
productivity increases when activities become more differentiated from one another. In a
business environment, differentiating one's activity can have advantages as well as
disadvantages.Specialization, effectiveness, creativity, and satisfaction with work are
the advantages. Workers can concentrate on assignments that align with their
competencies, fostering specialization and proficiency in particular domains.

As workers grow more skilled at their specialized duties, differentiating activities

can increase efficiency and output. Teams with specialized members may encourage
creativity as they concentrate on becoming experts in their field and offering fresh
concepts and solutions. Roles that match an employee's interests and talents may
make them happier, which could improve morale and reduce turnover. On the other
hand, the disadvantages are problems with coordination, risk of redundancy, flexibility,
and communication. Specialization may lead to a breakdown in communication across
various functional areas, which could impede information flow within the company.
It might be difficult to coordinate different specialized tasks, which increases the
risk of bottlenecks and delays in the process as a whole. An excessive focus on
differentiation could result in labor-intensive procedures or repeated efforts across
departments, driving up expenses without delivering appreciable benefit. Highly
differentiated organizational structures may be less able to handle tasks that call for a
cross-functional approach or to adjust to changes. In actuality, the success of an
organization depends on striking the correct balance between distinction and
integration.

a.4 Span of Control

In organizational management, the term span of control refers to the number of
subordinates or employees that a supervisor or manager can effectively manage. In a
hospital setting, the span of control is particularly relevant in determining the
management structure and hierarchy within the organization. The span of control can
vary based on the size of the hospital, the complexity of its operations, and the specific
needs of the patient population (Rogers, 2020).
Dr. Warner C. Camarao, the center's owner, president, and medical director, is
the only person in overall charge of the Malta Medical Center. His wife, Rosanne
Alarcon Camarao, is a nurse by profession who has held positions as a nurse,
secretary, receptionist, and medical records officer. The span of control's range of Malta
Medical Center is extremely wide since the hospital’s administrator holds authority over
the overall management, policies, resource allocation, and procedures of the hospital.
The administrator is accountable for the hospital's outcomes, including success, patient
outcomes, staff well-being, and financial stability.
 There are advantages and disadvantages to having a wide range of control in
organizational management. The advantages include empowerment, flexibility, cost
savings, and efficiency. A wide span reduces the number of management groups,
facilitating quicker decision-making and more effective communication. Lesser labor
costs and lesser overhead are the results of having fewer managers. It makes it
possible to respond to changes in the corporate environment with more flexibility and
agility. With more freedom and accountability, workers could feel more driven and
empowered.
However, downsides include overworked managers, difficulties with
communication, the possibility of mistakes, and restricted progress. Having a lot of
subordinates can overwhelm managers, which could result in less monitoring and
direction. Communication channels may get strained as the distance increases, making
it challenging to maintain effective and clear communication. Decreased supervision
raises the possibility of mistakes or misinterpretations during decision-making. With less
face-to-face time spent with supervisors, there may be less opportunities for staff
development and mentorship. The right amount of control relies on a number of
variables, including the type of job being done, employee skill levels, and the
organizational structure and culture.
The optimal span of control in a hospital also depends on various factors,
including the hospital's goals, the complexity of medical services provided, and the need
for effective communication and coordination. Striking the right balance between a
manageable span of control and maintaining efficient operations is crucial for the overall
effectiveness of the hospital's management structure (Ruffin et al., 2023).

b. Channels of Communication
Communication is an important tool to have interpersonal connection with
others.Communication channels are the means by which individuals talk and interact
with one another. Understanding which channels the institution uses will aid you in
determining the appropriate way of communication to be done in various situations in
the workplace (Krosel and Helbert, 2022).
In an organization, the channel of communication can be oral or written. This
can be through writing letters, sending emails, conducting meetings, phone calls or
voicemail and text messages which are used to relay messages within the organization.
(Vogel, 2023).

b.1. What is the usual direction of information flow?

Malta Medical Center (MMC) is an established organization in which the
communication flows in a downward, upward and diagonal direction.
The flow of information in downward communication is from the top-level to the
bottom-level. This is an established form of communication in companies that aids in
coordinating a variety of activities at different levels of the hierarchy (Turner,2023).
The upper management relays instructions, announcements, new rules and
strategy, and performance feedback to the subordinates. The head delivers the
information down to the chain of command through emails, and memos ensuring that
the messages conveyed are concise and easy to understand to decrease the likelihood
of misinterpretation and to build a more transparent and open communication culture
inside the institution.
In upward communication, the flow of information is from the low-level employees
to upper management. The lower-level employees directly communicate with upper
management to provide feedback, suggestions or complaints regarding the day-to-day
activities of the institution (Birt,2023). In relaying concerns, subordinates follow the
chain of command. First, the concern will be addressed to the head nurse, if the head
nurse needs advice, the nurse supervisor will be tapped, then the nurse supervisor will
tap the chief nurse, and then the chief nurse will approach the hospital administration.
Through this, employees will have the freedom to express their complaint or
suggestion to the upper management which gives them a sense of importance. Thus
build a positive work environment and would enhance the employee’s work
performance(Team, 2023b).
In addition, diagonal communication is also used. In this form of communication,
employees in different levels and departments interact with each other. This sort of
communication is frequently required when activities or projects need departmental
collaboration or when information must be disseminated across organizational levels
(Soni, 2023). The MMCI practiced open communication wherein for example the head
nurse can directly communicate with the hospital administration and other departments.
Despite the fact that this communication may differ from the regular line of
command, it is fast and efficient in information transmission to its intended recipient,
allowing the problems to be addressed and resolved directly. Through diagonal
communication, stronger relationships can foster between individuals at different levels.
As people interact more freely, they build professional connections that can enhance
teamwork and collaboration (Rigg, 2023).

b.2. How is downward communication accepted?

Downward communication is referred to as any form of communication from a
higher-up to a lower-level employee. This kind of direction of communication is often
directive (Sullivan, 2012). It involves transmitting messages vertically to the bottom level
of the organization. While commands typically follow the organizational hierarchy and
originate at the top levels, ensuring effective downward communication can pose
challenges. However, utilizing respectful language and crafting unambiguous
communications can help address these issues and increase efficacy. It is essential to
create clear and concise messages that are easy to understand while avoiding
ambiguous language that can confuse.
As per Malta Medical Center, the information flows downward as major decisions
are made by the Board of Directors, and the human resource department head is
responsible for disseminating the announcement to the entire organization by releasing
memorandums through the use of the Internet and personal interactions. However,
varying levels of experience, knowledge, authority, and status between the sender and
the recipient can lead to potential misunderstandings or misinterpretations. As a
preventive measure, top-level announcements are initially communicated to middle-
level managers and department heads for inclusivity and contextual understanding.
Once the department heads and their respective teams have been informed of the
matter, the human resource department head shall make an official announcement to
the entire organization.
With the measures, inclusivity, and proper dissemination of information, as a
result, the messages and directions from upper management are well accepted.

b.3. How accurate is upward communication?

Upward communication is the process by which company employees
communicate and share their thoughts and feedback with higher-level management.
This direction of communication occurs from staff to management or from lower
management to middle or upper management. Upward communication often involves
reporting pertinent information to facilitate problem solving and decision making
(Sullivan, 2012) Upward communication is a process that allows employees to share
their feedback and thoughts with higher-level management. It plays a vital role in
shaping the workplace culture, as it gives employees a voice and a way to share their
ideas. This plays an important role in the culture of the company, as it gives the
employees an actual voice and paradigm for sharing their thoughts. Upward
communication is a prevalent response to requests for information, opinions, or actions
communicated downwards.
The Malta Medical Center follows a well-defined chain of communication.
Upward communication is a prevalent response to requests for information, opinions, or
actions communicated downwards. It plays a critical role in keeping management
informed of new developments, performance levels, and other pertinent issues that
require their attention. Staff members can raise their concerns and issues via
communication letters or messaging platforms on the internet connecting to the
appropriate person, as the center of open and transparent communication. Upward
communication often comes in response to downwardly communicated requests for
information, opinions, or actions. It helps to alert management of new developments,
levels of performance, and other issues that may require their attention. In the nursing
department in Malta Medical Center, staff nurses can direct their concerns to senior
staff nurses, who in turn report to the head nurse, and ultimately to the nursing
supervisor and chief nurse. The organization values the head nurses' suggestions,
problems, and weekly reports, viewing this as a more efficient way to communicate and
resolve problems in a timely manner.
Errors and confusions are common in relaying messages. An example of this is
the distortion of messages along the way resulting in lowering of accuracy. Fear of
superiors could hinder the accurate delivery of information. Upward communication is
only received as moderately accurate due to the possible circumstances.

C. Is there an informal organization resisting the formal one?

Informal organization builds when individuals in a company come together due to
common interests and social networks (Nasrudin, 2022). Informal organization are
commonly found in every institution because as humans, social interactions are innate.
Thus, informal groups were initiated in MMCI and friendships were built with colleagues.
Currently, there is no material available to confirm the existence of an informal
organization resisting the formal one in MMCI.
 In informal organizations, social contacts can occur between members of the
same hierarchical level or between members of various levels and departments
(Demerits, 2019). For example, Every day, the human resource personnel and
members of the sales team get together for lunch. People from multiple departments
and administrative levels may participate in this unofficial lunch group, which promotes
cooperation and companionship beyond their official positions and thus, this can
increase employees morale, improve communication and enhance teamwork which
benefits the organization (Vedantu, 2023).
However, challenges may arise, there could be a resistance of informal
organization to the formal one, if members of the group become resistant to change. For
instance, staff members of several businesses organize celebrations and get-togethers
for holidays. There will be opposition if the administration tries to forbid these kinds of
social gatherings without permission (Demerits, 2019).