Organizational Structure and Culture
Siatta Krah
University of Phoenix
Senior Practicum: Leadership and Management
NUR492
Susan Waterbury
January 5, 2016

Organizational Structure and Culture
Organizational structure is important and essential to every organization; structure integrates the goals and mission of the organization, size, technology, and the environment. The goal, mission, and size of the organization determine the structure of the organization (Sullivan, 2013). The structure of the organization directs leadership roles, communications amongst staffs and clients. In this paper I will discuss my organization’s structure and how it creates an environment of support for client-centered care, the use of information systems, communication methods, and a decision making-ability with culture and organizational structure. I will also discuss the issues of power and control as well as organizational leadership, care delivery system, and how the generational differences influence my organization culture.
The Influence of Generational Differences
Currently, I am employed at Daughters of Israel Rehabilitation Center and Nursing Home, this facility is a sub-acute and long-term care facility. The framework for this facility organizational structure is functional structure. According to Sullivan (2010), in the functional structure, employees are grouped in the department by specialty with similar tasks being performed by the same group. In a functional structure, all nursing tasks fall under nursing services; the same is true for other functional areas. Our facility has administration, non- nursing or medical personnel’s, and then departments: nursing, rehabilitation, social services, dietary, housekeeping, maintenance, etc. All of these departments work independently and collaboratively to serve our patients and family. Organizational structures divide roles and departments into independent groups and allow each department to communicate formally and informally. Daughters of Israel is a not for profit subacute and long-term care facility, we serve Medicare and Medicaid patients, because of our organizational structure there are generational differences that influence the organization culture. Therefore, management needs to recognize these differences because they influence recruitment and retention. Dittmann (2006) did a study of Patterson work on generational differences at the work place and noted that Patterson believes it is still important to observe and take note of interaction between members of different generations, especially since conflict between individuals in different generations or age categories in the workplace may keep ideas, plans, and products from advancement. "A lack of understanding across generations can have detrimental effects on communication and working relationships and undermine effective services.' According to Sherman (2006), nursing workforce is made up of four different generations; generational diversity, including workforce differences in attitudes, beliefs, work habits, and expectations, has proven challenging for nursing leaders. I have observed in my workplace these four generations: Mature generation, the Baby Boomers, Generation X, and the Millennials sometimes described as the Net generation or generation Y (Sherman, 2006). Learning to understand how each of these generation communicates and problem solve is essential to every organization.
Communication
Communication is very important in every organization especially in healthcare since our patients’ lives and wellbeing are dependent on us. According to Sullivan (2010), the functional structure has several weaknesses. Coordination across function is poor. Sometimes we experience some of these weaknesses. Communication amongst the different generations is difficult due to beliefs and upbringing. Utilizing effective communication strategies such as sensitivity to communication, honoring preferences of each group can help bridge the gap. Making sure that communication is understood by everyone create a unique solution that appeals to each generational system. Daughters of Israel departments’ heads and managers have a weekly meeting to discuss quality assurance, reports on care issues, and develop strategies to solve problems that have or may arise. Communication within upper management and middle management is effective. All salary employees have access to emails, and received frequent updates and followed ups from the medical director, administrator, and other upper management. The rest of the staff have to wait for bulletins or for their managers to inform them. As stated by Sullivan (2010), one of the weaknesses of functional organization structure is that decision-making responsibility can pile up and overload senior managers, who may be uninformed regarding the day-to- day operation. A classic example of this issue is when managers are asked to call family members regarding investigations that were conducted by the administration, and the outcome is unknown to the managers.
Care Delivery System
Patient -centered care is our goal at Daughters of Israel, though it has not been said to employees but it is implied the care delivery system we practice. The care delivery system with primary caregiver is the kind of system we use to provide care. All of our patients have primary nurses on each shift with the primary therapist, social workers, and dieticians. The premise of the care delivery system with primary caregiver is that it enables patients to know who is responsible for coordinating their care within each discipline. The patient and family become familiar with each discipline and know who to speak to if and when problems arise. What I have observed about this type of care delivery system is that patients know their primary caregiver by name and patients are treated as individual not by room or ID number. The implementation of this care delivery system placed the responsibilities, emotional safety, improved patient experience, and patient outcome directly with the primary caregiver; effective communication is also promoted amongst the interdisciplinary team (Creative Health Management, 2016).
The use of information system
In the last few years, health information has played an important role in how healthcare is provided to our patients. According to Health IT. gov., Health information technology (health IT) can potentially increase and sustain patient safety through the use of information in the electronic health record (EHR). The use of health IT can make it easier for healthcare providers to share critical information about patient and patient could have easier access to their individual medical records. There has been a tremendous reduction in medication and transcription errors since we change over to electronic medical records. We currently use Sigmacare a software that is easy to use for the younger generation, and due to the support from our IT department older generations are getting more comfortable using it. We are paperless in our facility, so it has made it easier to access patient laboratory and diagnostic information, consultations, and progress noted from both physicians and nurses.
Decision-making within the organization
We are a multi-disciplinary facility working as one unit for our patients wellbeing. Issues in each department are investigated and resolved by the department heads, but ultimately all decisions that affect the facility are finalized by the administrators. We have a board of directors who influence bigger decisions. Managers do not influence or make decisions but are told to inform staffs on their units of the decisions. There is not an issue of power; every department head knows his or her limitations.
Siatta,
Your paper meets most of the requirements per the rubric. You have some interesting content. I would like to have read more about how a functional structure is implemented and whether it’s effective. Did you run your paper through Writepoint by Grammerly prior to submission. Some of the comments are not applicable, but there are some corrections that could have been made prior to submission. Please review APA formatting in regard to headings and reference page. The introduction had a good thesis statement, but both the introduction and conclusion need further development.
Susan
Content10 points possible | Points available | Points earned | * Introduction | 1 | 1 | * Identifies type of organizational structure | 1 | 1 | * Describes how structure creates an environment of support for patient-centered care | 1 | 1 | * Describes use of information systems within culture and organizational structure of agency | 1 | 1 | * Describes use of communication methods within culture and organizational structure of agency | 1 | 1 | * Describes use of a decision-making ability within culture and organizational structure of agency | 1 | 1 | * Identifes informal and formal reporting lines while looking at issues of power and control, as well as who real leaders are in organization | 1 | 1 | * Describes how social and cultural influences of community integrate into delivery of care in your organization | 1 | 1 | * Describes how generational differences influence organizational culture of the workplace | 1 | 1 | * Recommendations and conclusion | 1 | .5 | Format5 points possible | Points available | Points earned | * Follows rules of grammar, usage, and punctuation * Has a structure that is clear, logical, and easy to follow * Consistent with APA guidelines for formatting and citation of outside works | 5 | 4 | Total | 15 | 13.5 |

References
Better Information Means Safer Health Care (2015). Retrieved from https://www.healthit.gov/patients-families/better-information-means-safer-health-care
Creative Health Management (2016) An essential part of achieving strong quality and a great patient experience is a care delivery system that facilitates exemplary care. Retrieved from http://chcm.com/solutions/primary-nursing/ DITTMANN, M. (2006) Generational differences at work: A psychologist studies ways to help traditionalists, baby boomers, gen Xers and millennials work better together, despite their generational differences. Vol 36, No. 6. Retrieved from http://www.apa.org/monitor/jun05/generational.aspx
Sherman, R., (May 31, 2006). "Leading a Multigenerational Nursing Workforce: Issues, Challenges, and Strategies." OJIN: The Online Journal of Issues in Nursing. Vol. 11, No. 2, Manuscript 2. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume112006/No2May06/tpc30_216074.html
Sullivan, E. (2010) Effective Leadership and Management in Nursing 8ed. Retrieved from University of Phoenix Ebook Collection