Mechanistic Structure and Decision Making in Health Care Organizations

This article discusses the mechanistic organizational structure in health care organizations. It explains the advantages and disadvantages of this structure and its impact on decision making. The article also provides an example of a health care organization that uses this structure.

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MECHANISTIC STRUCTURE AND DECISION MAKING IN HEALTH CARE
ORGANISATIONS

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Introduction
A mechanistic organizational structure is a based on the hierarchy where senior level
management makes the organizational decisions. Strategic decision making involves the crafting
of the organizational mission, vision, goals, values as well as the objectives of the company. It
also unfolds when a company wants to alter these components (Kazemi & Alavi, 2017). A
company must entail in strategic decision making to continuously shape its future and maintain a
sharp competitive edge. An organizational structure allocates responsibilities and duties to
employees in the organization. One of the perfect examples of organizations that use the
mechanistic structure is the healthcare providing institutions.
Discussion
A mechanist's organizational structure is similar to bureaucracy. Max Webber developed the
current administration based on strict hierarchy and defined rules (Weber, 2015). It gets
characterized by high centralization and formalization as well as complexity. Information flow
follows formal channels.
The fundamental concepts used by a healthcare facility using a mechanistic organizational
structure include; division of labor, highly hierarchical, member task specialization and a
hierarchical structure (Thompson, 2017).
Employees in health care services such as registered nurses (RNs) and Medical Doctors (MDs)
get given particular job descriptions aligning with their responsibilities and duties. They are
alienated to change resistance, rigidity; hence they are unfavorable for companies which embrace
innovativeness and quick decision making as well as implementation. They delimit the
entrepreneurial spirit and discourage the application of individual initiatives on the nurses (RNs)

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and Medical Doctors (MDs). A person's autonomy and self-determination typically get lowered
by this model of organizational structure leading to lower levels of significant employee
motivation towards the job assigned.
Despite all these shortcomings, when it's in a suitable environment, it can give a good outcome
to the health institution. Its most significant advantage is efficiency. The healthcare facility that
intends to minimize costs and maximizes efficiency fits well in this particular structure.
An excellent example of a healthcare firm that uses a mechanistic organizational structure is the
Royal Children's hospital in Australia (www.rch.org.au) It gets characterized by high
formalization based on rules, centralization, and hierarchy. All departmental heads in the
hospitals report to the top management of the hospital. Decision making in the hospital gets done
by the senior management of the institution and strategies are communicated downwards.
Strategic decision-making process involves the charting of long-term goals as well as longer-
term visions and mission. The health organization may decide to alter or make changes to its
strategy. The course of action in any organization relies on strategic decisions. In healthcare
firms that use a mechanical organizational structure, strategic decision making roles are vested in
the top management which constitutes of the executives of the hospital management. It's the role
of the firm's senior management to make very accurate strategic decisions. Communications
concerning the processes flow from top to bottom, within the organization. Top management
makes critical decisions based on rules, procedures, and policies of the firm.
A mechanistic organizational structure makes decision making quick because there is the
absence of many consultations. Only the critical corporate management gets consulted in the
long-term or short-term decision making. The decisions made are directly communicated from

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top to bottom. Healthcare providing firms which use this type of structure must be operating in
stable environments.
The implementation of a decision made in health organizations that use such type of
organizational structure gets implemented slowly because the employees were not part of the
think-tanks in such decisions. Large medical firms that utilize the mechanistic structure rarely
require changes through decision making because they operate in stable environments. The
employees may tend to adapt slowly to change. In such organizations, strategic decisions that
lead to the change in the organizations have a high chance of being impacted easily. Resistance
to change might be impossible because there are set principles and procedures to be followed
making the implementations easy to be actualized (Daft, 2015).
The other consequence of a mechanistic organizational structure in a hospital is that only top
management issues orders and asses result on the employee performance and organizational
performance. It also makes decisions on the course of action on the improvement measures that
need to be taken to meet organizational goals, objects and the vision and mission of the
organization (Romiszowski, 2016).
This type of organizational structures builds its basis on a very long chain of command as well as
a vertical structure which implements decisions to be ineffective in firms located in unstable
environments. Registered nurses and medical doctors play a minimal role in the strategic
decision-making process of such organizations.

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In conclusion, hospitals that operate using mechanistic organizations structures are those that
work in stable environments. Decision making roles get vested to the top management officials
in the facility. Decision making is quick and easy in such firms.

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References
Daft, R. L. (2015). Organization theory and design. Cengage Learning.
Kazemi, M., & Alavi, S. B. (2017). A Theoretical Framework for Several Antecedents of Shared
Leadership in Corporate Board Contexts. Iranian Journal of Management Studies, 10(4),
751-781.
Romiszowski, A. J. (2016). Designing instructional systems: Decision making in course planning
and curriculum design. Routledge.
Royal Children's hospital. Retrieved 31st June 2018 from www.rch.org.au
Thompson, J. D. (2017). Organizations in action: Social science bases of administrative theory.
Routledge.
Weber, M. (2015). Bureaucracy. In Working in America (pp. 29-34). Routledge.