ORGANIZING 2.

Chain of Command
• Is the form of every humans association The chain of command is depicted through lines
for the attainment of a common connecting various boxes in the organizational
purpose(Mooney 1939) chart, indicating who reports to whom. This
• Refers to the body of persons, methods, structure clarifies authority and accountability
policies and procedures arranged in a within the organization
systematic process through the delegation
of functions and responsibilities for the 3. Type of Work to Be Performed
accomplishment of purpose.
Each box is labeled with descriptions that specify
• Signifies an institution, administrative the type of work or function performed by that
body, or its personnel, or functional role or department. This characteristic helps
group, such as business, gov’t agency, or employees understand their responsibilities and
hospital, with a formal intentional the nature of the tasks expected from them.
structure of roles or position.
• The process of identifying and grouping 4. Grouping of Work Segments
thework to be performed, defining and
Organizational charts visually represent how
delegating responsibility and authority
work segments are grouped into departments or
and establishing relationships for the
units. This grouping can be based on various
purpose of enabling the people to work
criteria such as function (e.g., nursing,
most effectively together in
administration),
accomplishing objectives (Allen,2008)
5. Levels of Management
CATEGORIES OF ORGANIZATION
1. Types of Organizational Structures- The organizational chart illustrates different
(Functional Organization, Matrix levels of management within the organization,
Organization, Flat Organization, and Ad showing both individual positions and the
Hoc Organization) overall hierarchy.
2. Professional Nursing Organizations -
ORGANIZATIONAL DESIGN
(General Nursing Organizations,
Specialty Nursing Organizations, - it is a process used to improve the probability
Educational Organizations) that an organization will be successful and it is
3. Professional Nursing Organizations - the formal, guided process for integrating
(General Nursing Organizations, people, information and technology of an
Specialty Nursing Organizations, organization. It is critical aspect of creating
Educational Organizations) efficient, effective, and patient-centered
4. Collaborative Structures- healthcare systems
(Interdisciplinary Teams
WHY IT IS BEING USED?
CHARACTERISTICS OF AN • Enhancing Efficiency and Effectiveness
ORGANIZATION • Fostering a PatientCentered Approach
1. Division of Work
HOW IT IS DONE?
Each box in an organizational chart represents • -Assessment and Analysis
an individual or sub-unit responsible for specific
• Defining Goals and Objectives
tasks within the organization. This division of
• Choosing Right Structures
work allows for specialization, where each unit
• Implementing the Design
focuses on its designated responsibilities,
enhancing efficiency and effectiveness.
PRINCIPLES OF ORGANIZATIONAL TALL OR CENTRALIZED
DESIGN STRUCTURE
• Division of labor Characterized by a narrow span of control,
• Unity of command where supervisors are responsible for only a few
• Span of control subordinates. due to its vertical nature, this
• Authority and responsibility structure involves many levels of
• Contingency factor communication.

HIERARCHAL SYSTEMS FLAT OR DECENTRALIZED

STRUCTURE
ORGANIZATIONAL HIERARCHY - refers to
the structured arrangement of different levels of Feature few levels and a broad span of control,
management and authority within an decision - making is spread among many people,
organization. making communication easy and direct. This
structure shortens the administrative distance
• Executive level between top and lower levels, Facilitates fast
• Managerial level problem - solving and response Encourages
• Supervisory level workers to develop their abilities and autonomy.
• Operational level
TYPES OF ORGANIZATINAL
REASONS OF ORGANIZING STRUCTURES
• Clarity and Structure LINE OR BUREAUCRATIC
• Accountability and Responsibility Bureaucratic organizational designs are often
• Efficiency and Productivity referred to as line structures or line
• Employee Satisfaction organizations, while those with staff authority
• Coordination and Collaboration are known as staff organizations. These
• Control and Monitoring structures are commonly seen in large healthcare
facilities and are typically modeled after Weber’s
ORGANIZATIONAL STRUCTURE original framework for effective organizations.
A process in which a group is formed
including its authority, responsibility and HOC DESIGN
accountability (ARA), span of control and lines The ad hoc design is an adaptation of the
of communication. Organizations consist of bureaucratic structure, often used temporarily
both formal and informal structures. within a formal line organization to complete
specific projects. This design helps address the
FORMAL STRUCTURE rigidity of line structures, enabling professionals
Formal structure, through departmentalization to manage the growing volume of information
and work division, provides a framework for effectively.
defining managerial authority, responsibility,
and accountability. MATRIX STRUCTURE
A matrix organization structure is designed to
INFORMAL STRUCTURE focus on both product and function. Function is
The informal structure typically develops described as all the tasks required to produce the
naturally as a social network among employees. product, and the product is the end result of the
function. The matrix organization structure has
PATTERNS OF ORGANIZATIONAL a formal vertical and horizontal chain of
STRUCTURE command.
SERVICE LINE ORGANIZATION STAFFING
Similar to the matrix design is service line Process of assigning competent people to fill the
organization, which can be used in some large roles designated for the organizational structure
institutions to address the shortcomings that are through recruitment, selection, and
endemic to traditional large bureaucratic development.
organizations. Service lines, sometimes called
care-centered organizations, are smaller in scale WHY IS IT IMPORTANT?
than a large bureaucratic system 1.Getting qualified and skilled people into the
team.
FLAT DESIGN
2.Roles become clearer and the workload works
Flat organizational designs are an effort to
remove hierarchical layers by flattening the become lesser.
chain of command and decentralizing the 3.There is an improvement in the morale and job
organization. In flattened organizations, there satisfaction
continues to be line authority, but because the
organizational structure is flattened, more 4. It helps the organization diversity its talent
authority and decision making can occur where profile and hence aids with company growth.
the work is being carried out
STEPS IN STAFFING
ORGANIZATIONAL RELATIONSHIPS 1. Determine the number and types of personnel
A. Chain of Command- the line of authority needed (manpower planning)
and the responsibility that flows
2. Recruit personnel
throughout the organization.
B. Unity of Command Principle- each 3. Interview
employee is accountable to only one
supervisor. 4. Induct or orient personnel
C. Scalar Principle- A clear chain of
5. Job offer
command brings the management to its
focus. STAFFING PATTERN
D. Span of Control- number of employees
A plan that articulates how many and what kind
that a manager handles. ·Tall Structure -
of staff are needed by shift and day to staff a unit
narrow span of control. ·Flat Structure-
or department.
wide span of control.
E. Delegation- process of giving authority to PATIENT CLASSIFICATION SYSTEM
subordinates to act and make decisions in This is a method of grouping patients according
an assigned task. to the amount and complexity of their nursing
care requirements, of nursing time, and skill they
5 RIGHTS OF DELEGATION
require.
1.Right Task
LEVEL 1 “SELF CARE OR MINIMAL
2.Right Circumstance
CARE”
3.Right Person Take a bath on his own, feed himself, and
perform his activities of daily living Patients
4.Right Supervision
about to be discharged Average amount of
5. Right Direction and Communication nursing care hours per patient per day is 1.5
LEVEL 2 “MODERATE CARE OR DISADVANTAGE
INTERMEDIATE CARE”
• Can be very costly
Need some assistance in bathing, feeding, or
ambulating for shorts periods of time Extreme FUNCTIONAL NURSING
symptoms of their illness must have subsided or Task-oriented method wherein a particular
have not yet appeared semi-conscious and nursing function is assigned to each staff
exhibiting some psychosocial or social problems member. The key idea was for nurses to be
Average nursing care hours per patient per day assigned to task not to patients.
is 3.
ADVANTAGES
LEVEL 3 “TOTAL COMPLETE OR
INTENSIVE CARE” • Very efficient to deliver nursing care
Completely dependent upon the nursing • Accomplish a lot of task in a small
personnel With vital signs checked more than amount of time
three times per shift, may be on continuous • Staff members do only what they are
oxygen therapy, and with chest or abdominal capable of doing
tubes Require close observation at least every 30 • Least costly
minutes for impending hemorrhage, with hypo
DISADVANTAGES
or hypertension and/or cardiac arrhythmia The
nursing care hours per patient per day is 6. • Care of patient become fragmented and
depersonalized
LEVEL 4 “HIGHLY SPECIALIZED • Patient do not have one identifiable nurse
CRITICAL CARE”
• Very narrow scope of practice for RNs
Need maximum nursing care Need continuous • Leads to patient and nurse dissatisfaction
treatment and observation Various medications,
IV; vital signs every 15-30 minutes; hourly TEAM NURSING
output. There are significant changes in doctor’s The goal of team nursing is for a team to work
orders and care hours per day may range from 6- democratically. Team members possessing the
9 more. skill needed by the individual pt, and team leader
has accountability for all the care.
NURSING CARE MODEL
Refers to the manner in which nursing care is ADVANTAGES
organized and provided. It depends on the
• Each member’s capabilities are
philosophy of the organization, nurse staffing
maximized so job satisfaction should be
and client population.
high
CASE METHOD/ TOTAL PATIENT • Patients have one nurse (TL) with
CARE immediate access to other health care
The first type of nursing care delivery system. providers
The nurse is responsible for all aspects of care of DISADVANTAGES
one or more patients.
• Requires team spirit and commitment to
ADVANTAGES succeed
• Consistent in carrying out the nursing • RN may be the team leader one day and
care plan a team member the next
• Patient needs are quickly met • Care is still fragmented with only 8 or 12
• Relationship based on trust is developed hour accountability
PRIMARY NURSING CARE performance descriptions used primarily for the
purpose of:
A decentralized delivery mode, more responsible
and authority is placed with each staff nurse. a. Recruitment
ADVANTAGES b. Placement and transfer
• Increased satisfaction c. Guidance and direction
• More professional system
• RNs more satisfied because they continue d. Evaluation of performance
to learn e. Reduction of conflict and frustration
DISADVANTAGES f. Avoidance of overlapping of duties
• Only confines a nurse’s talents to a g. Facilitation working relationships with
limited number of patients outside bodies
• Can be intimidating for RN’s who are less
skilled and knowledgeable h. Serves as basis for salary range

MODULAR NURSING (DISTRICT

NURSING)
CONTENTS OF JOB DESCRIPTIONS:
Modification of team and primary nursing. A
1. Job Title – position and necessary
geographical assignment of patient that
qualification
encourages continuity of care by organizing a
group of staff to work with a group of patient in 2. Job relationships – degree of supervision , line
the same locale. and staff responsibilities and reporting
mechanisms imposed on the worker
ADVANTAGES
3. Performance or Job Description – catalogue of
• Useful when there are a few RN’s
the assigned tasks and responsibilities of the
• RN’s plan their care worker
DISADVANTAGES
EMPLOYEE DISCIPLINE
• Paraprofessionals do technical aspects of A process that organizations use to enforce rules
nursing care and standards of behavior among their
employees.
FORMULA TO DETERMINE
STAFFING PATTERNS PURPOSES OF EMPLOYEE DISCIPLINE
Determining Nursing Care Hours 1. Creates order and smooth transition
- This method involves calculating the number during shifts and breaks.
of nursing care hours required per patient. 2. Helps nurses to perform their tasks better.
3. Provides direction for delinquent
Formula = No. of hours of nursing care X No. employees.
of patients
PRINCIPLES OF DISCIPLINE
JOB DESCRIPTIONS - Discipline should be done privately,
Specifications of duties , conditions, and promptly and consistently.
requirements of a particular job prepared - It should be progressive in nature.
through a careful job analysis. Also called as - It should be preceded with counseling.
- Disciplinary procedures should be instituted frameworks essential for effective decision-
with extreme caution. making and leadership

DISCIPLINARY PROBLEMS
Poor Role Clarity and Job Descriptions

When roles and responsibilities are not clearly

defined, staff may overstep boundaries, neglect
duties, or experience role confusion.

Failure to Follow Policies and Procedures

When staff deviate from protocols or guidelines,

it reflects poor discipline and organization

CONFLICT AMONG STAFF

Interpersonal conflicts and lack of team
cooperation can hinder organization and overall
effectiveness.

DELEGATION PROBLEMS
Inappropriate or poor delegation—either
assigning tasks to unqualified staff or
micromanaging—can lead to frustration,
inefficiency, and poor team dynamics

STEPS FOR PROGRESSIVE

DISCIPLINE
- Verbal warning
- Written warning
- Final written warning
- Suspension
- Termination

TOOLS FOR TERMINATING STAFF

- Inform the HRD for terminating staff
- State the offending behavior and the reason
for termination
- Explain the proposed termination process
- Termination must have the approval of
higher authorities
- Arrange the employee to be escorted out
- Report back to the HRD and administration

MEMORY AID
A memory aid refers to any tool, technique, or
method used to help leaders and managers retain
and recall key information, concepts, or