NURS 6231 Week 3: Organizational Systems and Structures Part 1

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NURS 6231: Healthcare Systems and Quality Outcomes | Week 3

Within every health care organization exists a web of systems and structures that facilitate the delivery of patient care. This week, you begin to examine how the various components of an organization contribute to—and sometimes hinder—patient safety and quality. To that end, you compare a variety of frameworks that can be used to analyze an organization and, ultimately, improve performance.

As you proceed through this course, you will develop a comprehensive project related to quality improvement. This week, you begin to analyze an organization that will serve as the focus for your project.

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Learning Objectives

Students will:

  • Compare frameworks used to analyze organizations
  • Evaluate the effectiveness (usefulness) of frameworks to improve performance
  • Analyze the systems and structure of a health care organization*

*This learning objective will be assessed in Week 4.

NURS 6231 Week 3: Organizational Systems and Structures Part 1 essay assignment

Avedis Donabedian’s work generated a pivotal means of assessing organizational performance relative to structure, process, and outcomes. However, it is clearly not sufficient to view health care quality merely in terms of outcomes—the structures and processes that facilitate these outcomes are equally as important.

In this Discussion, you consider multiple frameworks that can be used to analyze an organization. As you proceed, consider how these frameworks allow you to examine the interplay of interdependent and related parts and processes that comprise the systems within an organization, as well as the arrangements or structures that connect these parts.

To prepare:

  • Investigate and reflect on the systems and structures of an organization with which you are familiar. Consider the following:
    • What is the reporting structure?
    • Who holds formal and informal authority?
    • How many layers of management are there between the frontline and the highest office-holders of the organization?
    • How are interdisciplinary teams organized?
    • How is communication facilitated?
    • How well integrated is decision making among clinical personnel and administrative professionals?
    • How are particular service lines organized?
    • Which departments, groups, and/or individuals within the organization are responsible for monitoring matters related to performance, such as quality and finances?
  • Select two of the following frameworks:
    • Learning organizations, presented in the Elkin, Haina, and Cone article
    • Complex adaptive systems (CAS), presented in the Nesse, Kutcher, Wood, and Rummans article
    • Clinical microsystems, presented in the Sabino, Friel, Deitrick, and Sales-Lopez article
    • Good to great, presented in the Geller article
    • The 5 Ps, presented in the ASHP Foundation article
  • Review the Learning Resources for each of the frameworks that you selected. Also conduct additional research to strengthen your understanding of how to use each framework to assess an organization.
  • Compare the two frameworks. How could each framework be used to identify opportunities to improve performance? In particular, how would you use each of these frameworks to analyze the organization that you have selected?

NURS 6231 Week 3: Organizational Systems and Structures Part 1 essay assignment

By Day 3

Post an analysis of the systems and structures of the organization you selected, sharing specific examples. Explain insights that you gained by comparing the two frameworks, and how each can be used to assess an organization, identify a need for improvement, and, ultimately, enhance the performance of an organization.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Compare the organizational structure of your colleague’s selected organization to your own.
  • Ask a clarifying question.
  • Select an attribute of the identified organizational structure and ask your colleague to elaborate on how this attribute is evidenced in their organization.
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