Report on Organisational Culture and Structure in Private Healthcare

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Health Care Environment
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Table of Contents
Introduction......................................................................................................................................3
Assignment Task 1..........................................................................................................................4
Conclusion.......................................................................................................................................9
Bibliography..................................................................................................................................10
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Introduction
The business environment of healthcare is divided into external and internal. Both environments
influence the facilities and resources of the organisation. Organisational culture demonstrates the
values, beliefs and behaviours that contribute to a business environment. The report will describe
the structure of a privately owned organisation. The organisational culture of the organisation
will be identified and explained here. The report will analyse the role of organisational structure
in influencing the culture.
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Assignment Task 1
1. Describe the structure of the organisation outlined below
The privately owned organisation has a hierarchical organisational structure. NHS is following
the same structure. The structure has a direct chain of command from top-level management to
bottom line employees (Diefenbach, 2013). Senior management of the organisation makes all
decisions on providing better services to adults with learning disabilities. The decisions made by
seniors are passed subsidiary levels. If the employees at the bottom line want to make a decision,
they request through chain commands. The hierarchical structure operates well in the privately
owned organisation, as it is only focusing on one service. The management can maintain tight
control over the quality, design and distribution of services. The key service provided by the
organisation is to serve adults with learning disabilities. The private organisation distributes a
specific marketing message that it wants to improve the lifestyle of disable people. The power in
the hierarchical organisational structure is centralised; the employees determine the authority
easily. Identifying the defined level of leadership within the workplace is easy. The management
gives the opportunity for availing promotion that motivates employees to work well.
The organisation faces some challenges due to the hierarchical organisational structure.
Communication among employees and supervisors is ineffective. The chance of conflict is more
in each department, as departmental heads make decisions benefitting their interest. The rise in
bureaucracy prevents the private organisation from dealing with change. The time for responding
to clients may be high.
Companies like NHS and British army have adopted a hierarchical organisational structure, as
they are dealing with a particular service. The hierarchy helps in establishing effective
communication channels between divisions, departments and employees. Additionally, these
organisations are owned by the Government, and the majority of power it provides to the
ministry of health and defence. Waterstones and Google rely on horizontal structure, as they are
dealing with different business models. The emphasis is given on empowering staff avoiding any
micromanagement. Employees required having more connection with managers and supervisors
for which this structure is being adopted.
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2. Identify and explain the organisational culture
The organisation’s culture includes norms, values, belief and behaviours. It is created to enable
employees to share a common value so that they can serve better to disable people. Charles
handy had developed four types of organisational culture including power, task, persona and
role. Organisations select a particular culture depending on the nature of business and
responsibilities given to employees. Power culture refers to a spider’s web with a spider located
in the middle of the web. It means the power is centralised and the business emphasises on
control and application of resources. The business depends on the people present in the centre.
Role culture enables employees to perform a particular role. Organisations are having functional
or hierarchical structure use role culture. In case of task culture, the management focuses on
teamwork. The particular culture is often associated with matrix structures. Person culture
emphasises on individualism.
Figure 1: Handy’s organisational culture
(Source: Cacciattolo, 2014)
The organisational culture followed in the privately owned organisation is role culture. As per
the CQC manager of the organisation, all members know their duties. They concern with the
organisational goals and values. The team sees itself effective and efficient. It indicates that the
private healthcare organisation emphasises on performing their own responsibilities. It is highly
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controlled, as organisational members aware of their tasks to be performed. Power is determined
concerning the individual position in the healthcare organisation. The particular culture is created
on a detailed organisational structure that comprises on a long chain of command. Employees
have delegated powers within the defined structure. As power derives from an individual’s
power, the business tends to face fewer issues.
According to Deal and Kennedy organisational culture is the way for doing various things. Two
marketplace factors have been identified that influence the cultural practices and patterns.
Degrees of risk and feedback speed are major elements influencing the decision-making
activities of the private healthcare organisation. Process culture is adopted in this organisation,
where risk is low, and feedback is slow. Myra Bell gives the opportunity to raise any issues in
the formal monthly meeting, but employees hardly do the same.
According to Edgar Schein, culture is directly influenced by various direct mechanisms such as
exemplary opinion, behaviour and status. The espoused culture concerns with rules of conduct,
values and standard (Mihaela and Bratianu, 2012). The healthcare organisation expresses its
objectives and strategies by conducting formal monthly meeting under the supervision of CQC
manager Myra Bell, which is a part of philosophy under espoused culture.
3. Analyse how the structure of this organisation can impact the culture of the organisation
Positive impacts
The hierarchical organisational culture is compatible with the role culture. It directs nurses and
support workers to behave in a way that is compatible with the organisational norms and values
of serving disabled people. Individuals are given with clear roles, and they know whom to report
in the structure. Employees with specific skills have the power to perform the related task
without supervision, and this improves productivity and efficiency of the healthcare organisation
(Ojo, 2012). The clear channels of communication established by the hierarchical structure make
workers receive policy direction and daily assignments from the manager directly. Employees do
not confuse whom to report, as they are aware of their immediate reporting manager.
Negative impacts
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The negative impact of hierarchical structure on the culture is that employees are not flexible to
share new ideas to the manager. Employees do not raise any issues for which Myra Bell cannot
understand the problems faced by them. Additionally, the team is lacking in creativity for which
it does not want any changes in the way of performing work. This may influence the
organisation’s long-term effectiveness due to limited skills and expertise.
The outcomes for adults with learning disabilities can be improved by empowering staff and
embedding new skills within them. The team is lacking in conveying information to each other
through suitable communication channels. The manager should allow employees to use Daniel
Goleman’s emotional intelligence by embedding five ingredients such as self-motivation, self-
awareness, empathy, emotional control and handling relationship.
4. Identify two potential changes this organisation could make to improve this provision
The staff team comprising support worker, nurses and others stated that they are already
effective and do not want to change how they are performing. The healthcare organisation may
not resist changes in this way.
The organisation may apply Kotter’s change management model to identify the ways through
which people come across during the transformation process. Creating urgency for highlighting
potential threats and developing guiding team will let the manager to complete the initial stage of
the change successfully (Cook, 2015). As the members are not ready to change, their
involvement and acceptability are necessary for managing, leading and applying changes.
Lewin’s change model is another effective framework to draw analysis of the organisation’s
ability to adapt and deal with the change process. The first stage of this change model is
unfreezing, where people require strong support from the management. Therefore, Myra Bell
should take time from the busy schedule, supervise nurses, and support workers for embracing
change. The middle stage is changed in which workers shall be motivated to input new ideas and
raise issues. The last stage is refreezing, where the organisation shall measure success by taking
feedback from workers (Manchester et al., 2014). The following two changes can be carried out
for improving the provision.
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The privately owned healthcare organisation can adopt a transformational leadership style to
improve the care provision for adults with learning disabilities. The healthcare manager needs to
create a vision of innovation that will make changes in healthcare provision. Inspiring nurses and
support workers can be effective in transforming the service into quality care. This would make
workers stay focused and come with organisational issues that they are facing without staying
silent.
The healthcare organisation can bring changes in its system by appointing an assistant manager,
who will oversee the work of nurses, support workers and others. Myra Bell remains busy due to
more paperwork. Therefore, the assistant manager can monitor and supervise the work of
employees in the absence of Myra Bell. Regular supervision of the new assistant manager can
motivate and inspire people to work more effectively.
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Conclusion
The study concludes that the organisation has a hierarchical structure. The culture followed in it
complements the structure. The positive and negative influence of the hierarchical structure has
been discussed. The change was identified by applying Lewin and Kotter’s change model. The
employees need to bring changes in their work behaviour and raise issues for overall
development of the organisation. The mixture of task and role culture can be effective for the
private organisation.
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Bibliography
Cacciattolo, K., 2014. Understanding organisational cultures. European Scientific Journal,
ESJ, 10(10).
Cook, N.D., 2015. Crisis management strategy: Competition and change in modern enterprises.
Routledge.
Diefenbach, T., 2013. Hierarchy and organisation: Toward a general theory of hierarchical social
systems. Routledge.
Maduenyi, S., Oke, A.O., Fadeyi, O. and Ajagbe, A.M., 2015. Impact of organisational structure
on organisational performance.
Manchester, J., Gray-Miceli, D.L., Metcalf, J.A., Paolini, C.A., Napier, A.H., Coogle, C.L. and
Owens, M.G., 2014. Facilitating Lewin's change model with collaborative evaluation in
promoting evidence based practices of health professionals. Evaluation and program
planning, 47, pp.82-90.
Martinez, E.A., Beaulieu, N., Gibbons, R., Pronovost, P. and Wang, T., 2015. Organizational
culture and performance. American Economic Review, 105(5), pp.331-35.
Mihaela, V. and Bratianu, C., 2012. Organizational culture modeling. Management &
Marketing, 7(2), p.257.
Mohelska, H. and Sokolova, M., 2015. Organisational culture and leadership–joint
vessels?. Procedia-Social and behavioral sciences, 171, pp.1011-1016.
Ojo, O., 2012. Influence of organizational culture on employee work behavior. International
Journal of Contemporary Business Studies, 3(11), pp.46-57.
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