Organizational Structure and Performance in Public Health

Introduction: Structure and Performance in Public Health

Various studies have been conducted in an attempt to establish how the organizational structure of enterprises in the private sector affects business performance. There is, however, an equally important need to assess how the performance of entities in the public sector is affected by organizational structure — particularly in the realm of public health. Alongi (2015), the author of a study titled A Case Study Examination of Structure and Function in a State Health Department Chronic Disease Unit, observes that most of the available literature on this subject largely focuses on how public health departments function in their efforts to positively impact the health and wellbeing of the populations they serve. For this reason, the relevance of establishing how the functioning of public health agencies is affected by changes in organizational structure cannot be overstated. This is especially important given that the effective functioning of these agencies results in better health outcomes for the populations being served. Alongi (2015) specifically elected to focus on a state health department's chronic disease prevention and control unit, seeking to establish how the unit's operational aspects are impacted by the way it is structured.

Collaboration as a Driver of Organizational Effectiveness

Although Alongi (2015) is categorical that her study design limits her ability to establish causality, she indicates that the chronic disease unit's effectiveness was indeed influenced by several elements of her conceptual model. Of particular interest is collaboration, which has been defined in this context as "working internally and externally for the purpose of leveraging resources to maximize effectiveness and efficiency" (Alongi, 2015, p. e16). The author points out that one approach found to improve efficiency was the chronic disease unit's collaborative culture, which encouraged individuals to pursue learning opportunities — specifically peer-to-peer learning — and to reach out to prospective advisers.

Collaborative approaches were found to be complemented by the structure of the unit. It is important to note, however, that collaboration was supported by the structure particularly when there was close physical proximity between collaborators, and when the alignment of content and task expertise played a role. Several collaborative initiatives believed to facilitate effectiveness were cited in the study. In both public agencies and private entities, collaboration is instrumental in promoting problem-solving, since in a collaborative setting, knowledge and skills are more likely to be shared and combined for better outcomes. Even at the team level, experience levels differ, and a collaborative framework can be especially beneficial in overall problem-solving efforts. Organizations structured to enable people to work together toward common goals tend to be more effective in achieving them.

Conclusion: Implications for Public Health Organizational Design

In the final analysis, the findings of the Alongi (2015) study are instrumental in that they provide crucial insights into the creation of organizational structures that can be deemed highly efficient in various state health agency settings, as well as in the private sector. The overall goal of state health agencies and departments is the improvement of population health, and an organizational structure that is highly efficient can be a powerful tool in achieving that goal.

References

Alongi, J. (2015). A case study examination of structure and function in a state health department chronic disease unit. American Journal of Public Health, 105(S2), e15–e22.

Bolman, L. G., & Deal, T. E. Reframing organizations. Jossey-Bass.