Organization Type and Structure
The selected organization is a private hospital that is privately owned by a non-profit organization, and that is privately funded through payments of the services offered to the patients as well as by insurers. The hospital has three core elements that are effectively integrated to promote quality patient care, and these are a governing body, highly trained medical staff, and competent staff members. The governing body is made up of the Board of Directors. The Board of Directors are the ones that make up the executive body which manages the hospital organization. The members have both business and healthcare background along with skills and knowledge necessary in fulfilling their roles in the hospital. Their responsibilities include establishing the laws and policies regarding the management of the institution. In general, the board is ethical, financially and legally responsible for the day-to-day operations of the hospital.
The Nurse Manager explained that the organizational structure of the institution is made up of several layers with the hospital administrator at the top of management, then followed by the department managers and then managers tailored to the various activities carried within the hospital. The leading theory of management used in the hospital is the matrix management where the leaders emphasize overlapping areas of responsibility. Unlike the traditional linear management structure, matrix management promotes cross-functional teamwork hence bringing people together from different departments with the objective of fulfilling the organization's strategic goals. The organization combines both functional and product departmentalization, and this is to mean that it continuously seeks to get the advantages of project lines and functional lines creating a direct relationship between departments. According to the Nurse Manager, this helps the institution to be more responsive since there is an easy exchange of information between groups to encourage efficiency, and collaboration hence promoting quality care. Additionally, this results in a more efficient utilization of resources.
The mission of the hospital is to create a difference in the lives of people via excellent patient care. The primary focus of the institution is on establishing itself as the leading hospital that offers seamless, and all-inclusive patient care of the highest quality and that are based on particular values. In the same vein, the organization focuses on creation and maintenance of value for the people, patient, and the associated shareholders. The hospital has five core values, and these are quality, compassion, respect, collaboration, and foresight. It is from these values that the hospital can identify its primary strategic goals.
The vision of the hospital is to become a global leader in value-based healthcare. This organization's management understands that in the healthcare business when a hospital offers the best quality experience to the patients, most of the programs work efficiently. The objective patient-focused approach and the goal of value creation delineate the organization as more than just a profit-making machine. Instead, the vision communicates the centrality of the clientele in the service provision. In line with the vision, the healthcare practitioners in the institution are determined to their best and achieve the highest quality of care of the patients and the community around it. Sticking to this vision will ensure that the hospital becomes the choice for patients and the staff while being a prominent community member recognized for meeting the needs of the society through excellent wellness programs and quality patient care.
Factors Impacting Upon Management/Practice at The Organization
One of the leading roles of a nurse manager is to know and understand the various types of budgets in a healthcare institution such as operating, and cash expenditure. The operating budget refers to the primary budget that the nurse leader manages, and it relates to personnel and supply costs. The nurse manager, therefore, has the responsibility of maintaining the nursing budget to ensure that there is no misuse of available resources. Lack of coordinating these costs leads to increased costs and inefficiencies at the hospital. According to the interview, the manager mentioned that budgeting is part and parcel of patient care because it directly affects the level of care and its provision as well. Fiscal allocation plays an integral role in the management of the organization because it determines the availability of resources and degree of quality that the institution will offer. In the interview, the manager elucidated that, "Many people fail to understand the real meaning of budgeting and thus when they hear about the term budget the first thing that comes to your mind is 'money' which is not the case. Budgeting involves having explicit knowledge concerning the allocation of funds, resource, and staff. All these promote the quality practice and should be keenly assessed regularly." In turn, this helps in ensuring that the staffs have all the necessary tools that will make their work easier and support the clients on a daily basis. Therefore, according to the manager, knowledge of resource allocation helps in general cost management, promotion of quality care and achieving the strategic goals.
Model of Resource Allocation
The hospital manager allocates the resources mainly based on the objectives. This is accomplished by assessing the degree of need and giving it the priority. The manager referred to this model as the resource-allocation-in-response-to-need. This is then split into function types such as time, and resources. Fiscal budget is usually set up based on the pressing needs such as the drugs that are running out, the number of staff that needs to be paid, enhancements that can be improved to enhance quality and the number of associated stakeholders. These are mainly cost functions. Unlike the time function, this is often given much attention because it affects the operation of the hospital in numerous ways. For example, if there is a shortage of beds, the creation of the fiscal budget should mainly focus on how to buy more beds and create more space to allow more patients to be admitted while ensuring that there is quality service offered to the customers.
Additionally, other resources are allocated based on the urgent needs. The manager highlighted that the institution suffers the same as other healthcare organization regarding the shortage of nurses. Therefore, it has been essential that the staffs are hired and trained depending on areas or departments that there are shortages. Besides, the management strives to teach the available team concerning teamwork that can fit within the matrix structure of management. This allows easy management of the available staff while eliminating the cases of nurses' burnout that would deteriorate the quality of care as offered by the organization. Therefore, the nurse manager adopts the optimal utilization as the benchmark in allocating money, resources and workforce. As a result, it ensures that there are no cases of over or under allocation of resources.
Impact of Fiscal Changes On the Nurse Manager
When asked about the impact of fiscal changes on her role, the nurse manager responded that it is not as easy as it was before, and this is because there has been a decline in the reimbursements for the care that hospitals are promoting while at the same time there is a continuous increase in the number of uninsured patients. The impact of these changes thus puts the nursing managers in constant pressure to cut down the cost and hence it is integral to be sound about financial management. Most of the payments to the healthcare organization are from the insurance companies. Sometimes, some of the costs are never paid because of inadequate safety net. Studies reveal that around 47 million Americans do not have health insurance. This strains the work of the nurse managers, and they have to continuously follow up with the insurance companies so that all the care offered can be reimbursed in time to avoid insolvencies that might strain other resources such as workers.
Impact of Technological Changes on the Nurse Manager
Information and communication technologies have had massive implications for the management of healthcare organizations. The effect is evident in the fact that they promote patient-centered care and enhancing the quality of care (Rouleau, Gagnon & Cote, 2015). The manager agreed with this and added that "Technological innovation in nursing has played a significant role in the quality of care as offered by the institution. The one strength of technological innovation in my institution is the ability to educate the staff and the patient. It is from this reasoning that the organization has strived to embrace the technological changes in the industry. The manager has integrated the technology in almost all areas of operation as a way of enhancing inter-departmental communication and promoting collaboration. The manager encourages the staff to continuously teach the patients on how they can use the information and communication technologies in communicating with the nurses as well as keying and finding their relevant information. Though the nurse manager revealed that one of the challenges had been some of the nurses, have been adamant at accepting the technological changes but there are programs and teams in place that are continuously teaching them on how they can embrace the changes in all levels of operations.
Impact of Staffing and Legislative Changes on the Nurse Manager
The shortage of nursing staff across the world has affected nursing management in numerous ways, and the critical result has been on the relationship between management and the nurses, which in turn shapes the staffs' attitude and their retention (Nassar, Abdou & Mohmoud, 2011). The policymakers have been forced to enhance the professional development strategies for the nurse managers. The policymakers have invested in learning programs that aim at improving leadership and management skills, while at the same time executing an organizational change that can enhance the results. According to the interview, the nurse manager indicated that the changes in staffing and legislation mean that she has to mainly implement evidence-based factors to promote quality care and nurse retention. The management styles have had to change, and as a manager, she uses current theories regarding solving any management related issues. The interview revealed that style of management used by a nurse manager plays a vital role in encouraging the workforce empowerment, job satisfaction, and organizational commitment. The main reason why the hospital has managed to retain its best staff, and continue to attract more is because of the style of management, which is mainly transformational. The selected style used by the nurse manager seeks to promote equality and equity among the staff, as well as communication and interaction among the staff and management. It is because of this that the nurses in the organization appeared motivated in their different roles.
Challenges, Change, Conflict, Staff and Patient Diversity, Coping Strategies
The central concept that the nurse manager considered to be a challenge is performance management. Nurse managers are considered the leaders of the nursing team and they walk a fine line that separates the needs of the staff as well as that of the organization. It thus means that they must consistently act as the liaison between the two parties. One of the challenges associated with performance management affecting numerous managers is change and managing change and the conflict t...
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