The organisational structure is generally depicted in a diagrammatic form the conventional organisation chart is a line or scalar chart, showing each layer of the organisation in sequence.
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In drawing the organisation chart, certain general conventions have to be followed. Generally, line authority and line relationships are indicated by solid lines and staff and advisory positions by broken or dotted lines.
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There are two major kinds or organisational charts the master chart and the supplementary chart.
The master chart depicts the entire organisation, showing all departments and major positions of authority.
The supplementary chart for a department gives specific details for the organisational pattern for that unit and the linkage of authority in the direct chain of command from highest authority to that derived by the department chief.
An organisation will have as many supplementary charts as there are departments or units. The supplementary charts depict each individual job title and the number of positions in each section.
Advantages and Limitations of Organisational Charts:
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There are following advantages in using organisation charts:
1. Managers can review it to determine any inconsistencies and complexities in the organisational structure, as it depicts major lines of decision-making and authority.
2. An organisation chart may be used to orient employees, as to where they fit into the organisation, where each job fits in relation to other jobs in the department.
3. The chart is a useful tool in managerial audit; managers can review such factors as the span of control, crossed lines of authority. Managers can assess current practice with the original plan of job assignment and determine where the discrepancies now exist.
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4. The chart conveys information about the chain of command, supervisory relationship, channels of communication, and lines of decision making.
Organisation is a dynamic concept:
Therefore, there are also certain limitations in the rather stale structure presented by the organisation chart.
1. Besides the formal lines of authority, important lines of informal communication and significant informal relationships cannot be shown.
2. The chart may become obsolete easily if not periodically updated on occurrence of change in organisational pattern.
Nevertheless, the importance of organisational charts cannot be underestimated although some experts are not in favour of organisational charts.
“Good organisations are living bodies that develop muscle to meet challenges. The organisation chart should never be formalised and printed because a chart demoralises people.
When there is need to reorganise, such need would not be frequent, it should be undergone about with precision and speed of surgery well-planned and swiftly executed”.
Understanding an organisation is easier if there is an organisational chart describing the structure of the system, with authority-responsibility relationships depicted as clearly as possible and written job descriptions prepared for all key functionaries.
Matrix organisation:
Looking at the differences in task complexity within the hospital, departments performing routinised activities (CSSD, laundry, kitchen) have more task-oriented workers, more formalised structure than those having different levels of task complexity (wards, ICU, laboratory) who are informally structured and more interpersonally oriented.
Experts in the hospital field have recognised that complex tasks and highly skilled professional workers call for a colleague participatory structure, while the repetitive tasks performed by semiskilled and unskilled workers call for a hierarchical formalised structure.
At one extreme are the physicians with their loose organic structure and at the other end relatively unskilled workers of housekeeping, dietary, laundry and maintenance, with more hierarchical centralised supervision. Nurses and skilled technicians fall in between.
The colleague structured medical staff structure, coupled with hierarchically controlled nonprofessional departments is fundamentally the appropriate form of organisation for a hospital, given the tasks it is faced with.
Nevertheless, a difference of opinion still exists among two major schools of thought: (i) those who consider the formal organisation with its associated hierarchical authority structure as superior, and (ii) those that differ as to the degree to which procedures should be specified hierarchically and imposed on organisation’s members.
Contingency Theory:
However, a third school of thought considers that a hierarchical or a participatory approach to organisational management should vary according to the circumstances, especially the complexity of the tasks being performed.
Called the “contingency or situational theory of management”, the essence of the theory is that for simple tasks, having the workers report to one boss is efficient but boring for the workers and inflexible in adapting to changes; for difficult tasks a participatory approach is more efficient.
“Matrix organisation” is one such special kind of problem-solving organisation concept, designed to solve problems that cannot be solved by conventional subsystems and processes.
Drawing from the larger, formal parent organisation the men, machines, procedures and techniques this process integrates them into a temporary group or force with the objective of solving a complex problem that formal organisation and routine method cannot solve.
Its chief characteristic is extra organisation, within the existing formal organisation that is ad hoc, temporary, single problem-oriented task force.
The process groups together persons of multiple skills and disciplines. Upon completion of its task, the special group dissolves and its members revert to their normal functional activities.
Matrix organisation is defined as the existence of both hierarchical (vertical) coordination through departmentation and the formal chain of command, and simultaneously lateral horizontal coordination across departments.
A cardiac emergency team is the simplest example of a matrix organisation in many a hospital and relevant to other medical and nonmedical responses in a hospital.
The intern, emergency nurse, resident physician/cardiologist, medical assistant, ECG technician, cardiac emergency all come together from within their designated locations, merge into a team, accomplish the task of resuscitation, and then melt away back into their respective task/departments.
Conclusion:
Organisational structures which are personality oriented so as to satisfy the egoistic needs of the owners and promoters can never prove to be useful in the long run.
Similarly, it should not be fashion oriented, such as having only a certain number and levels of positions without justification of needs.
It should be a means to an end rather than an end in itself, and should never be rigid because one type of organisational structure may be appropriate now but may not be so in course of time.
Considering the difficulties of hospital organisation and numerous factors that influence it, the various dimensions of the organisation that characterise effective hospital organisation are summarized.