Organizational analysis in healthcare settings

Nursing Leaderships Role:

KEY' FACTORS in ORGANIZATIONAL ANALYSIS

The objective of this work is to research and examine the healthcare setting or to identify the factors that are necessary for consideration within the organization by the individual in a nursing leadership role as to structural effectiveness of the organization as specifically related to nursing staff.

Nursing leadership in an organization is responsible to oversee and direct the provision of healthcare by nursing staff in an efficient and effective manner. Because the largest healthcare provider group in the entire healthcare system is comprised of Nurses those in Nursing leadership positions understand that "staffing and other workplace issues remain critically important"(Nursing Leadership, Organization and Policy, 2006) in the delivery of efficient and effective healthcare. A recent study made identification of "the need for further work on strategies that address generational differences, such as recruitment and retention issues related to work-life balance expectations, full-time employment opportunities,; and specific education and mentoring needs that support the transition of new nurses into a complex work environment." (Ibid) Nursing care has been shown to have a great impact on patient safety and on the quality of care that patients receive.

I. ORGANIZATIONAL STRATEGIES

Specific strategies exist in the organization that promotes the attraction and retention of quality nursing staff. The first among these is the creation of a work environment "that foster[s] professional accountability" through the elimination of "stringent rules" and which allows the nurses the "flexibility to act on their expert judgment to solve patient care issues" [which] provides the encouragement of autonomy in the organization. (Upenieks, 2003a; as cited by (Cook, Hiroz & Mildon, 2006) Secondly it is important to "encourage the participation of nurses in receiving, updating, and initiating policies and procedures founded on evidence-based practice and research (Batson, 2004; Gleason-Scott, Sochalski & Aiken, 1999; Robinson, 2001; as cited by NHRSU, 2006) Listed next is the necessity to "Implement a decision making structure for nurses such as shared governance (Kramer & Schmalenberg, 2002; as cited by Cook, Hiroz & Mildon, 2006) Additionally, the NHRSU states that nursing leadership should "Ensure, strong, visible nursing leadership at both the organizational and unit levels (Hinshaw, 2002; as cited by Cook, Hiroz & Mildon, 2006)

II. 'KEY' FACTORS in ORGANIZATIONAL ANALYSIS

Throughout the literature reviewed in this study runs a common thread related to organizational effectiveness and the analysis of organizations which is the factor of nursing staff turnover. The work of Alexander, Bloom and Nichols states that: "To be effective organizations must maintain members willing and able to perform the work necessary to produce the output of the organization. High rates of turnover affect the basis of organizational control by eliminating the normative foundation on which control is exercised." (1991) in this work Alexander, Bloom and Nichols cite the statement of researchers in 1981, specifically Price and Mueller who state that: "Norms specifying work to be done cannot be obeyed unless an organization can maintain its members." (1991) This leads to a "diversion of resources from basic production into controlling membership, a process counter-productional to organizational effectiveness." (Hage & Aiken, 1974; as cited by Alexander, Bloom and Nichols, 1991) the NHRSU 2006 Factsheet further states that it is necessary to "nurture the clinical competence" of nursing staff citing the work of Kramer & Schmalenberg (2002) as well as it being important to "improve access to opportunity structure, such as information and resources" citing the work of Upenieks (2003a); Gleason-Scott (1999); and Sochalski, & Aiken (1999). It has been shown through research to be critical that the organization make the provision of support for the nursing staff in terms of their education and provisioning career support as well through making time and financial allocations to provide the necessary support system in which the nursing staff may advance their education and hence their career. (Cook, Horz & Mildon, 2006; paraphrased citing the work of: Robinson, (2001 and Hinshaw (2002) Additionally falling within these provisions of support are time and financial allocations for "research, special projects and publications (Kramer & Schmalenberg, 1988; as cited by Cook, Horz, & Mildon, 2006) the research fact sheet includes the necessity for organizations to "Support a 'bias toward action' (Kramer & Schmalenberg, 1988; as cited by Cook, Horz, & Mildon, 2006); and to "Enhance nurse-staffing rations (Hinshaw, 2002; as cited by Cook, Horz, & Mildon, 2006) and lastly to provide encouragement among the nursing staff and physicians within the organization to collaborate among one another. (Robinson, 2001; Hinshaw, 2002; as cited by Cook, Horz, & Mildon, 2006)

III. OUTCOMES for ORGANIZATIONS WITH THESE CHARACTERISTICS

Cost-Benefit Analysis

The cost-benefit analysis of the organizational outcomes in organizations that adhere to the foregoing organizational characteristics are that these organizations are able to "attract and retain nurses, and hence reduce turnover, which may significantly impact on overall organizational costs (Jones-Schenk, 2001; Upenieks, 2003a; as cited by Cook, Horz, & Mildon, 2006)