Sanford Medical Center Organization structure

Nursing Leadership and Management

The hospital is well recognized and has been named a top 100 Heart hospital and top 100 hospitals nationally. The organization also has a nationally ranked children's hospital that has newborn and pediatric intensive care services. Sanford Medical Center is a level II trauma center that is supported by AirMed transport services that cover a three-state area. The services offered within the facility include:

• 3D Mammography

• Allergy & Immunology

• Behavioral Health

• Breast Health

• Cancer/Oncology

• Children's/Pediatrics

• Dermatology & Cosmetic Services

• Diabetes & Endocrinology

• Ear, Nose & Throat

• Emergency Medicine

• Family Medicine

• Neurology

• Ophthalmology

• Cardiology

• Palliative care

• Laboratory and Pathology

• Surgery

• Radiology

Sanford Medical Center is a not-for-profit rural health facility. The facility does partner with the community to bring health and healing to the people living and working across its region. At the core of the facility is ensuring that healthcare benefits reach the communities broad needs. The facility does offer discounted or free medical services to patients who the facilities eligibility requirements. The community care program was developed to ensure that healthcare services are available for all who need irrespective of financial position. Sanford Medical Center has partnered with local and national organizations that serve the community to offer healthcare awareness, prevention, education, fundraising, and research for healthcare issues affecting the community.

The mission of Sanford Medical Center is a dedication to the work of health and healing builds upon its vision of improving the human condition through exceptional care, innovation, and discovery (Sanford Health, n.d). The facility's philosophy is that health care services are a community asset (Sanford Health, n.d). Therefore, there is need to have long-term partnerships between the facility and the community. The administrative structure of Sanford Medical Center includes a Board of Trustees that comprises of community leaders who are all volunteers. The board members are selected for their expertise and experience in various areas in the health care system. The facility also has an executive committee responsible for patient care activities. Finally, the facility has a hospital administrative unit that comprises of a chief administrator and numerous assistants.

The organization uses a matrix reporting structure because each person reports to two bosses or managers. Each of the managers has a responsibility in a different area of responsibility ensuring that there is no overlap in the reporting and responsibility assignment (Goetsch & Davis, 2014). For example, Sanford Medical Center is managed by a CEO, who is charged with the day-to-day running of the facility. The CEO reports to the Executive Vice President, and to the President of Sanford Health. This clearly indicates that the organization uses a Matrix Reporting structure. Matrix reporting staff members are not lined up using functional, product, or geographic lines they are lined up using both. This ensures that the management of the organization can reap the benefits of both systems. Matrix reporting is mostly used by large organizations that have a cross business group, or any other form or working structure that does not follow the traditional vertical business unit.

Sanford Medical Center is managed by the Sanford Health, which currently has 43 hospitals, and about 250 clinics located in nine states and three counties. This makes it the largest health system in the United States. Therefore, there is a vast knowledge readily available to all employees of Sanford Medical Center. The facility is a teaching hospital, and it has partnered with the local universities to offer on the job training and teaching to nurses and doctors. This is a positive for the facility because there are numerous students willing to assist and offer services to the needy within the community and the hospital. The community will always receive the necessary healthcare assistance. Sanford Medical Center is a not-for-profit facility, which means it is able to subsidise some of its charges in order to deliver on its mission of health and healing. By partnering with the local community, the facility has been able to identify the members of the community who desperately need health care services and do not have the necessary funds to foot the hospital bills. Being managed by a large parent company ensures that the hospital will continue growing and there are additional facilities that would be added to the hospital when the need arises. The facility is working on becoming a level I trauma center, which would boost its image and demonstrate its capability to the community and the nation. Receiving the level I trauma and pediatric center will offer the facility the requisite recognition and improvement of the services offered.

Some of the limitations of the facility include the parent company has a huge number of employees that makes it hard to manage and address all the employee grievances. With a large organization, management is hard pressed to only address the issues that are overly vital for the success and image of the organization. Therefore, some of the employee issues might go unsorted. The organization makes use of a matrix reporting structure, which puts a heavy toll on the employees especially because they have to report to two different bosses and they have two very different responsibilities. The use of the matrix reporting structure results in confusion with the employees because they might be uncertain of who is their boss, or when they should report to a particular boss.

The nursing care delivery system used at Sanford Medical Center is team nursing. Team nursing is a nursing delivery system that a group of nursing professionals offers total patient care to a group of patients in acute care or inpatient setting (Rantanen, Pitkanen, Paimensalo-Karell, Elovainio, & Aalto, 2016). This model of care came about as a response to the nursing shortages due to the World War II and nurses leaving hospitals. The nursing team will comprise of a team leader or charge nurse, registered nurses, and nurse aides. The charge nurse is normally responsible for assigning patients to team members, and they should be knowledgeable of all the patient information and care plans. Nurses are assigned patients, and they are required in turn to delegate the responsibility to the nurse aides who are within their scope of practice. A team would be responsible for a maximum of six patients within the facility. Working within a team allows the team members to identify, plan, implement, and evaluate the appropriate course of care. The main goal of team nursing is that a group working together towards a common goal is more suited to deliver quality care to the patient. The facility developed the team nursing care delivery system in order to provide the best quality of care for the patient by using the capabilities of each team member. Team nursing also offers a clear line of the organization, and each nurse is aware of whom they report and take order from.

The charge nurse would analyze the patients under her care and determine who is best suited to take charge of each patient. There could be an overlap to ensure that each patient receives the requisite care. The charge nurse would then distribute the responsibilities to the registered nurses in her team. Each nurse would peruse through their patient care plan and notes and establish the appropriate nurse aides. The nurse aides are charged with caring for the patients and reporting to their respective nurse. At no time can a nurse aide report directly to the charge nurse. The nurse aides comprise of licensed and unlicensed nursing staff. They are normally nurses in training, and they fit well within the facility since this is a teaching hospital. The reports generated or provided by the nurse aides are then communicated to the charge nurse by the registered nurses. The reports will contain patient analyses, patient outcomes, and recommendations for further care. The charge nurse would compile the reports are provide them to the nursing manager.