Question

A great way for leaders to begin solving problems with organizational structure is to ask three important questions:

1. Is the problem the structure, or is the problem the way leadership is managing the structure?
2. Does the structure of the organization match the organizational mission, vision, and goals?
3. Has the design of the organization been compromised due to accommodating various employees?

• Answer the three guiding questions above to determine how a solution to the structure could be reached.
• What questions would you add to this list?
• How would your proposed question(s) benefit the organizational structure?

Answer 1

Organizational structure changes can be a result of several factors. The healthcare organization I previously worked for underwent a structural change. The company owned two hospitals in the same small town and decided they needed to merge the two facilities into one due to the financial strain of maintaining both locations within five miles of each other. Finally, they completed an expansion and remodel of one hospital and closed the other hospital. The new hospital opened in the summer of last year and I am experiencing the organizational structure shifting first hand.

In the organization, leadership is struggling with managing the new organizational structure well because the changes have not been presented well or the employees are not being supported well enough to understand the impact of these changes. High turnover in upper management has left the company functioning less than ideal. For example, changes are proposed and a plan for implementing these changes are decided upon. Then, part way through implementation, a key manager or director leaves the company. Thus, the other managers and directors are left to pick up the slack. From what I have experienced, more often than not, the company is not replacing the missing manager but gives the responsibilities to another person. This happened in my department. My manager left and now my peers and I are reporting to a manager over a completely different department. This transition was not communicated well and most of my co-workers were left unsure who to go to for help with the daily operations.

When considering such a large change to the organization, the mission, vision, and goals of the company should be the foundation to any decisions made. The company should be looking at those three factors to decide if the change is in line with how the company should function. I believe this company is trying to re-think and re-vamp the way they carry out their mission and, in that respect, these changes seem to be in alignment with their mission, vision, and goals. The closing of one facility was financially responsible which ultimately affects the care provided to their patients by facilitating improved, cohesive care for the patient.

The hospital has the challenge of being in a smaller populated city where there is the need for specialized doctors but not enough for a full-time position. Without these specialty doctors, the population would be forced to drive more than one hour to the nearest hospital to have these procedures performed. The organization will do almost anything to secure a physician. This compromise damages the company by straining financial resources and making other employees within the company feel less important. Physicians have the ability to use their position to choose what they want to do, rather than being on board with the mission and vision of the company. Because they are catered to, they tend to not follow back-of-house policies such as using the IT systems. If changes are going to be accepted, the company needs all of its employees on board and to reinforce policies, no matter the position.

The problems I see can be summed up in the term “Change Management.” All of the changes going on in my company are not being managed well. Most of it can be remedied with direct communication from senior leadership and managers, and positive reinforcement of policies. The organization is not operating as one company with one goal. The lack of good communication has caused disjointedness and this disconnection is impeding the organizational change they are trying to implement.

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