Applied Sciences

Chapter 6


Objectives (1 of 4)

Define the basic management function of organizing and identify the steps in the organizing process.

Define the key concepts of hierarchy, chain of command, splintered authority, and concurring authority.

Differentiate between line and staff relationships and identify basic line and staff relationships.

Describe the dual pyramid organization arrangement found in healthcare authority patterns.

Objectives (2 of 4)

Identify the basic patterns of departmentation.

Introduce the concept of the matrix organization and define the applicability of this apparently contradictory concept.

Objectives (3 of 4)

Identify patterns of organizational flexibility: temps, outsourcing, and use of independent contractors and consultants.

Identify the principles involved in developing an organizational chart.

Describe the elements of a job analysis.

Introduce job descriptions, including their uses and the elements necessary in their development.

Objectives (4 of 4)

Describe the elements of the job rating and classification system.

Identify the content and uses of the management inventory.

Describe the role and activities of the professional practitioner as consultant.

Definition of Organizing

The process of grouping the necessary responsibilities and activities into workable units, determining the lines of authority and communication, and developing patterns of coordination.

Underlying Premises (1 of 2)

A common goal

Detailed plans

Need for clear authority-responsibility relationships

Reconciliation of power and authority elements

Underlying Premises (2 of 2)

Need for reduction of inevitable conflict

Reconciliation of individual needs with organizational needs

Preserving unity of command

Necessity of delegating authority

Process of Organizing

Goal recognition and statement

Review of organizational environment

Determination of structure needed to reach the goal

Determination of authority relationships and development of organizational chart, job descriptions, and support documents

Concepts and Principles

Authority-responsibility relationship

Scalar principle: chain of command

Unity of command

Principle of parity

Concurring authority


Effect of Split Reporting

Worker must balance two reporting relationships

Potential burnout when there is conflict between the two authority holders

Doubles the communication demands

Overcoming Problems of Splintered Authority

Managers pool their authority to make decisions and solve problems.

Refer the problem to a higher level for reconciliation.

Reorganize to eliminate splintered-authority situations.

Span of Control Determined by:

Type of work

Degree of worker training

Organizational stability

Geographic location

Flow of work

Supervisor’s qualification

Availability of staff specialists

Organization’s value system

Line and Staff

A LINE function provides service and directly advances the objectives of the organization.

A STAFF activity supports the line activity.

Functional Authority

The right of staff individuals to exercise a limited form of authority over the specialized function for which they are responsible, regardless of who exercises line authority over the employees performing the activity.

Line and Staff Interaction

Personal assistant to a line authority holder (e.g., “the assistant to . . . ”)

Specialized assistance (e.g., legal counsel)

Full department of specialized staff (e.g., architectural planning)

The Dual Pyramid

Common in healthcare organizations

Organization of medical staff as one track

Organization of administrative units as a second track

Each track with its distinctive authority-responsibility designations

Common Titles

Chief of staff

Chief of service

Department chairperson

Medical director

President of the medical staff

Departments May Be Established According to:

Function (common in healthcare)

Product (common in manufacturing)

Territory (common in outreach services)

Customer (common with large, specific-need groups)

Time (frequent with around-the-clock services)

Process (work procedures)

Number (of workers doing the same work)

Flexibility in Organizational Structure

Matrix pattern

Temporary departmentation

Temporary agency services


Contracted services


The Organizational Chart

Major functions, usually by department

Relationships of functions or departments

Channels of supervision

Lines of authority and communication

Positions (by job title) within departments or units


Job Description Content

Job title

Immediate supervisor

Job summary

Job duties

Job specifications

Uses of the Job Description (1 of 2)

Legal, regulatory, contractual, and accrediting mandates

Basis for job rating, classification, and wage and salary administration

Basis for categorization under Fair Labor Standards Law and Collective Bargaining


Uses of the Job Description (2 of 2)

Basis for orientation and training

Basis for performance evaluation, error correction, retraining requirements, and grievance determinations

Basis for determining eligibility for claims under workers’ compensation, OSHA, and similar programs

Sequence of Development

In preparation for development of new job descriptions or the revision of existing ones, the manager:

Carries out a job analysis

Prepares the new or revised job description

Applies the job classification criteria

Job Rating

Job rating elements include:

Complexity of duties

Error impact

Contact with patients and families

Degree of supervision received

Degree of required training

Mental and physical demands

The Management Inventory (1 of 2)

An overview of anticipated changes in the workforce

Manager gives particular attention to:

Known, planned retirements

Planned temporary leaves (e.g. military duty, family leave)

Promotional opportunities

The Management Inventory (2 of 2)

Cross-training capacity and needs

Phase out or consolidation of positions due to planned systems changes

The Credentialed Practitioner as Consultant

Consultative arrangements:

One time only

Initial survey with implementation of findings

Ongoing maintenance of project or program

The independent contractor

Importance of clear definition of relationship (e.g., IRS definitions)

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