Module:1

Organization structure and Administration of Hospital

Hospital Pyramid: An Organizational structure

Organizational chart, Preparation of chart-activity analysis,

decision analysis, relation analysis

An organizational chart is a visual representation of the division and coordination of work

within an organization or department within an organization. The food service department’s
organizational chart should be reviewed and revised at least once a year or whenever changes
are made in the department’s structure.
It illustrates :
 relationships among units and lines of authority through the use of boxes and
connecting lines.
 the unbroken line of authority that extends from the top of the organization to
the lowest subordinate and clarifies to whom and how information and
discussions should flow.
 the characteristics of the larger organization and its units. For example, the
organizational chart in Figure 6.3 shows how the various positions in one type
 of food service department relate to each other and to the administration of the
hospital.
The following items are depicted on an organizational chart:
• Chain of command: The solid lines in Figure 6.3 demonstrate that the upper
levels of the organization are linked to each of the lower levels through a defined
set of relationships. Authority is the right to perform or command. Managers are
given authority to direct the operation of the food service department, and with
this authority the manager can give orders or directions and expect them to be
obeyed or followed.
• Unity of command: Each employee is linked by a vertical line to only one
supervisor. This ensures that each employee reports to, and is accountable only to,
his or her immediate superior, an unbroken line of authority. When the unity of
command is broken, the employee usually has to cope with conflicting demands
from several supervisors.
• Departmentalization: The organizational chart also shows how jobs are
grouped into those that have common tasks that can be coordinated by a
supervisor. For example, Figure 6.3 shows that the food service department is
split into three units: nutrition care services, food procurement and production,
and nonpatient operations. Each unit is further divided into areas of
specialization.
•Lines of communication: In addition to showing the chain of command,
organizational charts show how information should flow through the
organization. Solid lines in all the flow charts shown (see Figure 6.1 and figures
6.3 through 6.9) indicate both the flow of authority and the flow of formal
communication among different positions in the chart. Broken lines show that
information must also flow outside the chain of command. For example, in Figure
6.3, although the assistant directors of nutrition care services, food procurement
and production, and nonpatient operations do not supervise each other, they must
communicate and coordinate their efforts to ensure efficient operation of the whole
department. In addition, the broken line in Figure 6.3 between the medical staff and the
food service director indicates that the medical staff advises the food service department
on the most appropriate service for particular patients but does not have direct authority
over the department.

 Span of control : Span of control refers to the number of employees each

manager must supervise directly. In a large organizational structure (see Figure
6.3), each manager tends to have a narrow span of control, whereas in a less
complex structure (see Figure 6.6), each man ager’s span of control is wider.
i. A tall organizational structure (Figure 6.3) is multi-reporting layers within the
organization, giving span of control to three assistant directors.
ii. A flat organizational structure (Figure 6.5) has fewer layers of supervisors and
subordinates.
iii. The wider or larger the span, the more efficient the organization.
 iv. The wide span of control speeds up decision making, increases flexibility,
empowers employees, and allows employees to get closer to customers.
Employee training is necessary in a wide span of control.

For
example, Figure 6.3 represents five management levels: CEO, vice president of operations, food
service director, food service assistant directors, and managers. A large organization such as this has
what is called a tall organizational chart. Smaller organizations tend to have what is called a flat
structure because they have fewer levels of management.
Figure 6.4 is an example of an organizational chart for a small health care institution. Small
hospitals and extended care facilities, particularly those in small communities or rural settings,
hire a dietetic consultant or part-time regis tered dietitian. A dietary manager has responsibility
for the day-to-day supervision of the food service department in such institutions.

The organizational chart for a small food service department

Figure 6.6 illustrates two levels of management within a much larger food service department.
Although the functional–hierarchical structure has been credited with contributing to the large
economic growth.
Preparation of Organizational chart:
According to Peter Drucker, an organization structure can be charted out by using three types
of analysis.

Organization Chart
Activity Analysis Decision Analysis Relation Analysis
•Determining activities •Determining how far in • Defining manager’s role in
the future, a decision will relation to his contribution to
•Listing according importance show its effect goals
ever
•Grouping interrelated unitary •Impact of decision on • Interaction with other
ones together other activities or people.
function

•Depending on ethics
How often decisions are
taken

Activity Analysis:
Activity analysis for an organizational chart involves examining the tasks, roles,
responsibilities, and interactions of individuals within an organization. It aims to understand
how work is distributed, how decisions are made, and how communication flows. We can
conduct activity analysis by:
 Task Analysis: Identify the key tasks and activities within each department or team. This
helps understand the specific roles and responsibilities of each position.
 Role Clarification: Ensure that each position in the organizational chart has a clearly
defined role and set of responsibilities. This helps prevent confusion and duplication of
effort.
 Communication Flow: Analyze how information flows within the organization. This
includes both formal communication channels (such as emails and meetings) and
informal channels (such as conversations and social networks).
 Decision-Making Processes: Examine how decisions are made within the organization.
This includes identifying who has the authority to make decisions, how decisions are
communicated, and how feedback is solicited.
 Efficiency and Effectiveness: Evaluate the efficiency and effectiveness of the
organizational chart in achieving the organization's goals. This includes identifying any
bottlenecks or inefficiencies that may exist.
By conducting activity analysis on an organizational chart, organizations can gain
insights into how work is performed, identify areas for improvement, and optimize their
structure to better achieve their objectives.
 Decision analysis involves evaluating how decisions are made within an organization and
identifying ways to improve decision-making processes. It can be done by:

Decision-Making Roles: Identify the key decision-makers within the organization. This
includes individuals at different levels of the hierarchy, as well as cross-functional teams or
committees involved in decision-making.

Decision Criteria: Determine the criteria used to make decisions. This may include factors
such as cost, quality, time, and risk.

Decision Processes: Analyze the processes used to make decisions. This includes
understanding how information is gathered, analyzed, and used to inform decisions, as well
as the steps involved in the decision-making process.

Decision-Making Tools: Identify the tools and techniques used to support decision-making,
such as decision matrices, cost-benefit analysis, and scenario planning.

Decision Outcomes: Evaluate the outcomes of past decisions to identify patterns or trends.
This can help improve future decision-making by learning from past successes and failures.

By conducting decision analysis, organizations can improve the effectiveness and

efficiency of their decision-making processes, leading to better outcomes and organizational
performance.

Relation analysis in an organizational chart involves examining the relationships between

different individuals or departments within an organization. This analysis can help identify
communication channels, reporting structures, and dependencies. Some key aspects of
relation analysis are:
Reporting Structure: Analyze the formal reporting relationships within the organization.
This includes identifying who reports to whom, and understanding the hierarchy and chain of
command.

Communication Channels: Identify the formal and informal communication channels

within the organization. This includes understanding how information flows between
different levels and departments.

Collaboration: Analyze how different departments or teams collaborate and work together.
This includes identifying cross-functional teams and understanding how they are structured
and managed.
Dependencies: Identify dependencies between different parts of the organization. This
includes understanding how the work of one department or team impacts the work of others.

Decision-Making Processes: Analyze how decisions are made within the organization and
how different individuals or departments are involved in the decision-making process.

By conducting relation analysis, organizations can gain insights into how different parts of
the organization interact and collaborate, identify potential bottlenecks or areas for
improvement, and optimize their structure to enhance communication and efficiency.