2.1 Organizational Structure
Systems Theory and Health Care
As nurses we know that the success of our patient-centered care interventions is dependent upon many factors. All too often, despite extensive planning and hard work, a patient care intervention fails to lead to the intended results. Factors beyond our control, and often beyond our knowledge, change the intended outcomes. This is typical of events in a complex adaptive system.
So how can we be successful leaders if we cannot predict what will happen when we attempt to guide others? Perhaps a review of the first two principles of the complex adaptive system will provide an answer to this question. The first principle, which is focused on using the lens of complexity, and the second principle, which describes good enough vision, provide us with clues on how to lead others within the complex adaptive health care system. Organizations and nurse leaders acknowledge that they cannot control change, and thus they do not try to control every aspect of organizational change. Successful health care leaders attempt to give a general sense of direction to employees, rather than focus on specific details. Next, leaders also encourage employees to develop innovative responses that best meet their individual strengths and needs and meet the healthcare system’s ultimate goal of quality patient care. Leaders cannot predict all the factors that will influence the final results of change activities, but by following these principles, they know that the final response will be what is best suited to the environment, or healthcare system, and the needs of the individual.
Learning Exercise 2.1.1
What are we talking about when we speak about systems theory in a health care organization? For a deeper understanding, watch this video titled “System Theory of Management” (7:37) by Nguyen Thanh Thi, then answer the following questions:
- What are the three basic system types? Describe each type.
- What type of system is a hospital?
- What is synergy? What is entropy?
There are three fundamental concepts that, when applied to our individual organizations, can transform the way we provide health care. For additional information, watch this video titled “Systems Thinking and Complexity in Health: A Short Introduction” (5:02), then complete the following exercises:
- Define the three fundamental concepts that can transform the way we provide health care.
- Give an example of how each concept can make a difference to health care provision.
Organizational Culture
Organizational culture is often referred to in healthcare organizations, but there is a lack of consensus on what it actually is, how it influences behaviors and if leaders can change the culture (Watkins, 2013). In a social media platform, Watkins facilitated a discussion on perceptions of organizational culture and later published a synthesis of responses in Harvard Business Review (Watkins, 2013), As you can see from the variety of responses compiled in Table