CHAPTER THREE

ORGANIZATION AND
ORGANIZATIONAL STRUCTURE
 Objectives:

• At the end of this chapter, the student

should be able to:
• • Discuss systems theory and its
components
• Describe formal and informal
organizational structures
• Identify the four types of formal
organizational structures
 Cont:

• Describe the differences between

centralized and decentralized structures
• Discuss advantages and disadvantages of
each of the following organizational
structure: Pure line, line and staff,
functionalized line and staff; and matrix
• Explain the relationship between
responsibility and authority under ideal
circumstances.
• Identify the major components required
to deliver effective nursing care
• Discuss and compare each type of client
care delivery system
 Systems Theory

• Ludwig Von Bertalanffy introduced

general system theory several decades
age in an attempt to present concepts that
would be applicable across disciplines
and would be applicable to all systems.
The theory proposing that the sum of
part of the system
 Definition of the system

• A system may be defined as "sets of

elements standing in interrelation". All
systems have elements in common.
Societies, automobiles, human bodies and
hospitals are system The theory of open
system is part of a general system theory;
An open system is defined as a "system
in exchange of matter with its
environment,
 Cont:

• presenting import and export, building up

and breaking down of its material
components. Open systems theory
emphasizes the relationship between a
system and its environment and the
interrelationships of different levels of
system Systems are either closed or open.
Closed systems are self-contained and
usually can only be found in the physical
sciences.
 Organizational characteristics
• The first characteristic is input, or importation
of energy. Open systems import forms of
energy from the external environment. As, the
human cell receives oxygen and nourishment
from the blood stream, and organization
receives capital, human resources, material,
 Cont:

• The second characteristic is through put,

in which open systems transform the
energy and materials. Just as the human
cell transforms nourishment into
structure, an origination can create a new
product, process materials, train people,
or provide a service.
• The third characteristic is output. Open
systems export some product a
manufactured substances an inquiring
mind,
• Fourth, an organizations works as a
system of cyclic events. Organizational
activities occur over and over again in a
self-closing cycle, as the material that is
input is transformed and results in output,
 Organizational Structure

• An organization is a group of people

working together, under formal and
informal rules of behavior, to achieve a
common purpose. Organization also
refers to the procedures, policies, and
methods involved in achieving this
common purpose. Thus, organization is
both a structure and a process.
 Cont:
• Organizational structure refers to the
lines of authority, communication, and
delegation; can be formal or informal.
• Organizational process refers to the
methods used to achieve organizational
goals. An organization's formal structure
is in organizational chart that provides a
formal relations, functions and activities.
 Organizational Principles

• The principle of unity of Command: An

employee may interact with many
individuals in the course of the work but
should be responsible to with out
supervisor.
• The principle of Requisite Authority:
when responsibility for a particular task is
delegated to a subordinate, subordinate
must also be given authority over
resources needed for task
accomplishment.
 Cont:

• The Principle of Continuing

Responsibility: When a manager
delegates a function to a subordinate, the
manager's responsibility for that function
is in no way diminished.
• The Principle of Organizational
Centrality: Workers who interact with
the greatest number of other workers
receive greatest amount of work related
information and become most powerful in
organizational structure.
 Organizational Concepts

1. Responsibility- is the obligation to do, to

the best of one’s ability, the task that has
been assigned, or delegated. In any
organization, responsibility begins with
the overall objective of the organization.
For example, for nurses in a hospital,
service or patient care is the
responsibility.
 Cont:

2. Authority- the right of decision and

commands. An individual with authority
has the right to make decisions about his
or her own responsibilities.
Responsibility and authority are
delegated down the chain.
 Cont:

3. Delegation- is the process of assigning

duties or responsibilities along with
corresponding authority to another
person. Authority must be delegated with
the responsibility.
4. Accountability- is answering to
someone for what has been done. It is
related with responsibility.
 Centralization versus
Decentralization
• In a highly centralized organization, the
chief executive makes most decisions.
Decentralization is the allocation of
responsibility and authority for
management decisions downward
through the chain of command. In
centralized, decisions made at the apex
of the organization takes longer period of
time than decisions made at the lower
levels.
 Cont:

• The executive who will permit

supervisors to select staff, determine
staff schedule, institute working
improvements, evaluate goal
achievement, and recommend policy
change middle managers of opportunities
for professional growth.
 Types of Formal Organization
Structures
• Line Pattern/Relationship
• Line and Staff Pattern/Relationship/in an
Organization
• Matrix Organizational Structure
• Functional Line and Staff Pattern
 Team Nursing

• A dramatic change occurred after World

War II in the years between 1943 and
1945. The level and number of auxiliary
personnel began increasing, and the
professional nurse was assuming more
and more of the management functions.
Because of the changing configuration of
the work group
 Advantages

• Supports comprehensive care

• May increases job satisfaction
• Increases cost effectiveness
• Disadvantages
• Decreases personal contact with client
• Limits continuity of care
 Primary Nursing

• Primary nursing as a system of care

provided for a way to provide quality
comprehensive patient care and a
framework for the development of
professional practice among the nursing
staff. Primary nursing was a logical next
step in nursing’s historic evolution.
 Cont:

• By definition, primary nursing is a

philosophy and structure that places
responsibility and accountability for the
planning, giving, communicating and
evaluating of care for a group of patients
in the hands of the primary nurse.
Primary nursing was intended to return
the nurse to the bedside, thus improving
the quality of care and increasing the job
satisfaction of the nursing staff.
 Cont:

• Advantages
• May increase job satisfaction
• Improves continuity of care
• Allows independent decision making
• Supports direct nurse-client
communication
 Cont:

• Encourages discharge planning

• Improves quality of care
• Disadvantages :
• Increases personnel costs initially
 Case Management

• More recently, a new method of nursing

care delivery has evolved known as case
management. The American Nurses
Association (ANA) has defined case
management to be a system of health
assessment, planning, service
procurement and delivery, coordination,
and monitoring to meet the multiple
service needs of clients.
 Cont:

• Advantage
• Improves nurse responsiveness to clients
changing needs
• Improves continuity of care
• May increase nurse’s job satisfaction
• Disadvantage
• Increases personnel costs