ORGANIZING

 ORGANIZATION
 Structure and process that allows agency to enact its philosophy and conceptual
framework to achieve goal
 ORGANIZING
 Process of establishing formal authority
 Involves :
1. Setting up the organizational structure
2. Determining the staff needed
3. Developing job description
ORGANIZATIONAL THEORY
 Max Weber – German scientist, Father of Organizational Theory
 Developed Bureaucracy theory
 Characteristics of the theory:
1. Clear division of labor
2. Well defined hierarchy of authority
3. There is impersonal rules and impersonality of interpersonal relationship
4. Systems of rules covering rights and duties of each position must be in place
5. Selection of employment and promotion is based on technical competence
ELEMENTS OF ORGANIZING
1. Setting up the organizational structure
2. Staffing
3. Scheduling
4. Developing job descriptions
ORGANIZATIONAL STRUCTURE
 The process by which:
1. Group is formed
2. Its channels of authority
3. Span of control
4. Lines of communication
CLASSIFICATION OF ORGANIZATIONAL STRUCTURE
I. FORMAL
1. Highly planned and visible
2. Provides framework for defining managerial:
a) Authority
b) Responsibility
c) Accountability
3. Roles and functions are defined and arrange systematically
4. Different people have different roles
5. Rank and hierarchy is evident
II. INFORMAL
1. Unplanned often hidden
2. Generally social
3. With shifting lines of authority and accountability
4. Had horizontal relationships
5. Composed of small groups of workers with similar interest
PURPOSE OF ORGANIZATIONAL STRUCTURE
1. Inform members of their responsibilities
2. Allows manager and individual workers to concentrate on specific roles & responsibilities
3. Coordinates all organizational activities
4. Reduces the chances of doubt and confusion concerning assignments
5. Avoids overlapping of functions
6. Shows to whom and for whom they are responsible
TYPES OF ORGANIZATIONAL STRUCTURE
A. TRADITIONAL STRUCTURE
1. LINE ORGANIZATION
 Each position has general authority over the lower position in the hierarchy
2. STAFF ORGANIZATION
 Advisory to the line structure with no authority to put recommendations into action
3. FUNCTIONAL ORGANIZATION
 Each unit is responsible for a given part of the organization’s workload

 Has clear delineation of roles and responsibilities which are interrelated

4. AD HOC DESIGN
 Modification of bureaucratic structure
 Use as temporary basis to facilitate completion of project within formal line of
organization
 A means of overcoming the inflexibility of line structure
 Use a project team or task approach
 Disbanded after a project is completed
5. MATRIX DESIGN( Network )
 Focus on both product and function
1. Function à all task required to produce the product
2. Product à end result of the function
 Has formal vertical and horizontal chain of command
6. SERVICE LINE
 Also called care-centered organization
 Overall goals are determined by the larger organization, but service line would decide
on the process to be used to achieve the goal
7. FLAT ORGANIZATIONAL DESIGN
 Remove hierarchal layers by flattening the chain of command and decentralizing the
organization
 More authority and decision making can occur where work is being carried out
ORGANIZATIONAL CHART
 Depict an organization’s structure
 A picture of the organization
 Defines formal relationship within the institution
 UNBROKEN SOLID LINES
 Shows relationship of lines of communication and authority
 Solid horizontal lineà represent communication between people with similar
sphere of responsibility and power but different functions
 Solid vertical lines between position denote :
 The official chain of command
 Formal path of communication and authority
 DOTTED OR BROKEN LINE
 Represents staff position
 Staff members provides information and assistance to the manager but has limited
organizational authority
COMPONENTS OF ORGANIZATIONAL CHART
1. DIVISION OF WORK
 Box represents the individual or sub-unit responsible for a given task of the
organization’s work load
2. CHAIN OF COMMAND
 Lines indicate who reports to whom and by what authority
3. TYPE OF WORK TO BE PERFORMED
 Indicated by labels or description for the boxes
4. GROUPING OF WORK SEGMENTS
 Shows the cluster of work group
5. LEVELS OF MANAGEMENT
 Indicate individual and entire management hierarchy
LEVELS OF MANAGERS
 TOP LEVEL MIDDLE LEVEL FIRST LEVEL

Examples Chief Nursing Unit supervisor Charge nurse

Officer Department Team leader
Chief Executive head Primary nurse
Officer Director
Chief Financial
officer
Scope of Organization as Focus on Primarily on day-to-
responsibility a whole as well integrating unit day needs at unit
as external level day-to- level
influences day needs with
organizational
needs
Primary Strategic Combination of Operational
planning focus planning long term and planning
short range
planning
Communication Top-down Upward and Often upward
flow downward

ADVANTAGES AND LIMITATIONS OF ORGANIZATIONAL CHART

ADVANTAGES LIMITATIONS
Maps lines of decision making authority Shows only formal relationships
Helps people understand their assignment and Does not indicate degree of authority
their coworkers
Reveals to managers and new personnel how Show things as they are supposed or used to
they fit into the organization be rather than as they are

Contribute to sound organizational structure Possibility exist of confusing authority with

status
Shows formal lines of communications
PRINCIPLES OF ORGANIZING
1. UNITY OF COMMAND
 Responsible to only one superior
 One person/one boss à employee have one manager to whom they report and to whom
they are responsible
 Indicated by vertical line between position on the organizational chart
2. SCALAR HIERARCHY/CHAIN OF COMMAND
 Authority and responsibility flow in clear unbroken lines from highest to lowest position
 Those having the greatest decision making responsibility are located at top , those with
least responsibility at he bottom
3. HOMOGENEOUS ASSIGNMENT/DEPARTMENTATION
 Workers performing similar assignment are group together for a common purpose
4. SPAN OF CONTROL
 Number of workers that a supervisor can effectively damage
 Top level – 1:6 of supervisor
 Base – 1:10
5. EXCEPTION PRINCIPLE
 Recurring decisions handled in a lower level managers
 Problems involving unusual matters referred to higher level
6. DECENTRALIZATION/PROPER DELEGATION OF AUTHORITY
 Process of conferring specified decision making to the lower level of organization

ORGANIZATIONAL CULTURE
 A systems of symbols and interactions unique to each organizations
 The way of thinking, behaving and believing that the members of a unit have in common
 The total of an organization’s :
 Values
 Language
 Traditions
 Customs &
 Sacred cows
 How employees perceive an organization
 The view of the organization by an individual
REQUIRMENT FOR EFFECTIVE ORGANIZATION
 STRUCTURE should:
 be clearly defined à employee know where they belong where to go for assistance
 enhance and not impede communication
 facilitate decision making that results in the greatest work performance
 Goals should be build the fewest possible management levels and have the shortest
possible chain of command
 Staff should be organized in a manner that encourages informal groups to develop sense of
community and belonging
 Nursing service should be organized to facilitate development of future leaders
STAFFING
 Process of determining and providing the acceptable number and mix of nursing personnel to
produce a desired level of care to meet the patient’s demand
 Purpose: to provide nursing unit with appropriate and acceptable numbers of workers to
perform the nursing task required
FACTORS AFFECTING STAFFING
 Type, philosophy and objective of hospital & nursing service
 Population served
 Number and severity of illnesses of patient
 Availability and characteristics of nursing staff
 Administrative policies- rotation, weekends & holiday duty
 Standards of care desired
 Layout of various nursing units and resources available within the department
 Population served
 Number and severity of illnesses of patient
 Availability and characteristics of nursing staff
 Standards of care desired
 Layout of various nursing units and resources available within the department
 Budget
 Professional activities and priorities in non patient activities
 Teaching program expected hours of work/annum of employee
 Pattern of work schedule
 PATIENT CARE CLASSIFICATION SYSTEM A method of grouping patient according to the
amount and complexity of the nursing care requirement and nursing skill and time required
 CLASSIFICATION:
 Level I: Self Care or Minimal Care
o Can take a bath on his own
o Perform ADL on his own
o Patient about to be discharge
o Non=emergency cases
o Do not exhibit unusual symptoms
o Requires little treatment
 Level II: Moderate or Intermediate Care
o Needs assistance in bathing, feeding or ambulating for short periods of time
o Extreme symptoms have subsided or yet to appear
o Have slight emotional needs
o With IVF or BT
o Semi-conscious
o Have some psychosocial or social problem
o Periodic treatment, observation
 Level III: Total, Complete or Intensive Care
o Completely dependent on nursing personnel
o On continuous
LEVELS OF CAREO2 therapy
NCH NEEDED /DAY RATIO OF PROF. TO
o With chest or abdominal tubes NON-PROFESSIONALS
o Requires close observations
 Level IV: Highly Specialized Critical Care
o Needs continuous treatment & observations
LEVEL I 1.5 55:45
o VS q 15 minutes
o Hourly
LEVEL II I&O 3.0 60:40

LEVEL III 4.5 65:35

KLEVEL IV 6.0 70:30

7 or higher 80:20
o Significant changes in Doctor’s order
PERCENTAGE OF PATIENT AT VARIOUS LEVEL OF CARE/TYPE OF HOSPITAL

TYPE OF MINIMAL MODERAT INTENSIVE HIGHLY

HOSPITAL CARE E CARE SPECIALIZED
CARE CARE

PRIMARY 70 25 5 -

SECONDAR 65 30 5 -
Y
TERTIARY 30 45 15 10

SPECIAL 10 25 45 20
TERTIARY

COMPUTING FOR NUMBER OF NURSING PERSONNEL NEEDED

 Ensure that there is sufficient staff to:
 Cover all shifts
 Off duties
 Holidays
 Leaves
 Absences
 Time for staff development
COMPUTING FOR NUMBER OF NURSING PERSONNEL NEEDED
RA 5901: Forty-Hour Week Law
 Employees working in 100 bed capacity and up will work only 40 hours a week
 Applied also to employees working in agencies with at least 1 million population
 Employees working on less than 100 bed capacity or in agencies located in the community with
less than 1 million population will work 48 hours a week
STAFFING FORMULA
1. Categorize the number of patients according to the levels of care needed.
 Multiply total number of patient by % of patient at each Level of Care
 250 patients x .30 = 75 patients needing minimal care
 250 patients x .45 = 112.5 patient needing moderate care
 250 patients x .15 = 37.5 patients need intensive care

 250 patients x .01 = 25 patients needed highly specialized nursing care

2. Find the number of NCH needed by patients at each level of care per day
 A. find the number of patients at each level by the average number of NCH
needed/day
B. get the sum of NCH needed at various level
 75 patients x 1.5 NCH needed at Level I = 112.5
 112.5 patients x 3 NCH needed at Level II = 337.5
 37.5 patients x 4.5 NCH needed at level III= 168.75
 25 patients x 6 NCH needed at Level IV = 150
total 768.75 NCH/day
3. Find the total NCH needed by 250 patients per year
 total NCH needed/day x total number of days in a year
 768.75 x 365 days/year = 280,593.75 NCH/year
4. Find the actual working hours rendered by each nursing personnel per year
 8 hours x 213 working day/year = 1,704 working hours/year
5. Find the total number of nursing personnel needed
 A. total NCH per year = 280,593.75 = 165 TNP
working hrs/year 1,704
Find the number of reliever
 B. total Nsg. Personnel x 0.15 (For those working 40 hours a week) = 165 x 0.15 = 25
 total Nsg. Personnel x 0.12 (For those working 48 hours a week)
 Add no. of relievers to no. of nursing personnel needed
 165 + 25 = 190 nursing care personnel needed
Distribute by shift
 124 nurses x .45 = 56 nurses on AM shift
 124 nurses x .37 = 46 nurses on PM shift
 124 nurses x .18 = 22 nurses on night shift
Distribute nursing attendants/ shift
 66 nursing attendant x .45 = 30 nsg. Attendant AM shift
 66 nursing attendant x .37 = 24 nsg. Attendant PM shift
 66 nursing attendant x .18 = 12 nsg. attendant