CASE STUDY OF CDH2 Organisational Structure of the Chifley District Hospital (CDH): A Case Study Introduction In this day and age, environmental changes spark a need to derive an organisational structure to accommodate the changing needs and demands. Rapidly growing communities require a modified healthcare organisational structure, which can provide advance and quality care to patients. In this case study, Chifley District Hospital (CDH) wants to review its organisationalstructureinordertoencounterthechangingcommunitydemand.Itis acknowledgedthatthemission,vision,andstrategicobjectivesofCDHcanbe operationalised by the formulation of a new organisational structure to help in better communication and maintaining a balanced internal and external environment. Therefore, this essay critically discusses the current structure of the CDH, identifies its strengths and weaknesses. It then focuses on the mission statement, vision, goals, and strategic objectives of CDH. Keeping in mind the needs of CDH then suggests a suitable organisational structure for CDH with an emphasis on the strengths and limitations of it. Discussion Current Organisational structure of CDH The current organisational structure of CDH is based on traditional, functional (Bureaucratic) organisational structure. This structure groups the departments according to their functions; that is, each department differs according to its specialty. Hospitals usually have laboratories, pharmacies, nursing services, doctors, surgery, and administrative staff. As CDH has a functional structure, it means that its department is differentiated in general medicine, surgical, obstetric, and emergency services. All of these departments report to one authority, such as Chief Executive Operations, and the decision making is centralised. Only one person or manager gets to make the decisions.
CASE STUDY OF CDH3 Same as others, this structural design has its strengths and weaknesses. The strengths of this structure lie in the independent working of each department. Each department has people performing common functions as they just focus on their tasks. It increases work efficiency and performance. Moreover, the authority is known. Same as strengths, there are certain weaknesses as well. The coordination and communication between departments are unsatisfactory. There is a lack of collaboration in each unit. Such functional units have a hard time dealing with changes. This can compromise patient care. Moreover, decision making is too focused on a single person. This leads to narrow mindedness rather than a broad horizon, in terms of decisions related to the organisation from a wider perspective (Courtney, Nash, & Montgomery, 2002). Therefore, it becomes necessary to restructure CDH's organisational design to accommodate all new changes. Importance of Organisational Vision, Mission, and Objectives When it comes to an organisational structure, mission, vision, goals, and objectives of that organisation are of utmost importance. The mission is a broader statement for a reason behind an organisation's existence. It defines the sole reason for the presence of that organisation. With this comes the vision; it defines where the organisation wants to be? What this organisation will achieve by and what will they accomplish by fulfilling their purpose? It is a short and precise statement to tell future endeavours and the key to successful change (Ferlie et al., 2016). In the last comes the goals and objects, basically the outcome of the whole mission and vision. The target that has to be achieved is defined in one by one goal to make it simple and authentic. It provides a course of action. The structure of an organisation is formulated according to vision, mission statement, and goals. The mission statement is the key feature for the functioning of a complex and dynamic organisation. When health care organisations are structured or restructured, it helps in overcoming all the challenges and respond efficiently to those challenges such as budget
CASE STUDY OF CDH5 More Suitable Organisational Structure The Chifley District Hospital (CDH) is a community hospital with a capacity of 130- beds. It has been providing several services to the local community, such as medical, surgical, obstetric, and emergency services. However, its population has a significant increment in the proportion of young families and retirement villages in the last ten years. This triggered the need for the hospital to review its current status and take new measures to fulfil the demands of the population, and include more services, such as pediatric, cardiovascular, renal, oncology, trauma, old age care, and community services. It will expand the community-based clinics and increase the number of beds up to 300. Themanagementiscurrentlyconsideringnewwaystoalternatethepresent organisational structures, which will be more effective for the changing needs. For this purpose, the divisional product/market design seems to be more suitable, as it fulfils the mission, vision, and objectives of CDH. It is also known as product-line structures, service- integrated structures, or service-line structures (Marquis & Huston, 2009). This design divides the clinical services according to specific patient needs and conditions. The services are divided into different divisions on a broader level, and then, with further grouping in these divisions, it is basically a multidisciplinary design. Thisorganisationalstructureismoreeffectiveandappropriateforthenew requirements of the community and changing the external and internal environment of the organisation. Each department specialises in specific services as well. The same activities are assigned to these self-contained units. Staff will specialise in their units as well flow of information is maintained. Moreover, this design is decentralised in terms of decision making. Each clinical service decides on its own, and then further discussion with the CEO can happen. This gives more time to the upper management for planning and formulating
CASE STUDY OF CDH6 strategies (Westphal, 2005). This helps in maintaining the internal environment of the organisation. Similarly, such organisations have their resources aligned to the ever-growing and changing demands of the environment. It provides a quick response to the patient's needs. This helps in balancing the external environment. Divisional and product/market structure has a better way of communication and collaboration. Due to specialised tasks, collaboration within each service unit is easier and effective. However, this design also helps in communication across different units. For example, a nurse may work as a pediatric nurse, but her functional area falls into nursing. This will require coordination among other departments, as well (Cornelis et al., 2019). Thus, resulting in better communication and collaboration among different service lines, such as nursing, pharmacology, and laboratory, etc. Furthermore, this structure aims to increase accountability and utilisation of resources by decentralising decision making and increased involvement of medical health providers and nurses (Harris, 2005). It provides the nurses and health professionals to lead the management. Enhanced cooperation and focus on teamwork results in the quality care of the patient. It helps in the maintenance and fulfilment of patient need. This is why Divisional and product/market structure seems more suitable for CDH, as they plan to increase their departments along with high performing multidisciplinary teams with special services. Although this structure has its drawbacks, such as competition between departments for resources, giving more importance to departmental goals rather than the organisation and independentworkingofeachunit.Nevertheless,theselimitationscanbecateredby enhancing communication across departments and prioritising organisational goals. Conclusion
CASE STUDY OF CDH7 Considering all of the above, Chifley District Hospital (CDH) wanted to cater to the growing demands of the community and institutionalise a way that can withhold its services. Untilnow,itwasfunctioningontraditional,functional(bureaucratic)organisational structure. However, with the change in mission, vision, and objectives of the CDH, a different and more suitable structural design was needed. For this purpose, divisional and product/market structure has been proposed as it seems that this structure might encounter the dynamics of the internal and external environments of the organisation, have a better solution for the enhancement of effective communication and strong collaboration across teams, and resource utilisation in a more responsible way, along with the no-compromise in care of the patient and providing quality service.
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