Design of Health Care Organization

The main factors that influence organizational structure are those internal and external driving forces, which generally result in globalization and financial crisis. Thus, each company tries to build its own corporate structure that would lead the corporation to big revenues and high demands on the market. However, not every company is able to reach the aim due to geo-political aspects of the country and the type of business it is developing.

This essay is an attempt to conduct an organizational design of a typical Ukrainian state hospital. Ukraine is chosen due to its geographical position: it is a bridge between Russia and Poland; its internal and external factors are influencing the transition of health care sector from the Soviet Union times to be more Europeanized.

Organizational structure of any company affects the roles and relationships of both people involved in its operations and outsiders who can directly feel the climate of corporation once they become either ambulatory patients or those that are on in-patient treatment. Outdated structure can result in the lack of accountability of the corporation.

Corkindale notes about poor organizational design that can result “in a bewildering morass of contradictions: confusion within roles, a lack of co-ordination, slow decision-making… complexity, stress, and conflict” (2011). As it still happens in Ukraine, the associates at the top of the company are often very oblivious to the vital problems or postpone them for the undetermined period. Corkindale also mentions about the lack of materials on the topic of organizational design from both academics and consultancies (2011).

Every post-Soviet state hospital has its Charter, which contains information on its general provisions, legal position, its activities and properties, rights and responsibilities of the hospital, organizational structure and working procedures, management of the hospital and the responsibilities of its financial and economic activities, liquidation and reorganization of the hospital, and concluding provisions. However, the Charter does not reflect the strategy of the organization, in particular its position on the market.

All the companies want to lead but not in the case with the state hospitals as they do not have any competitors. The newest technologies and the most progressive methods of treatment are mostly used by private clinics, because they are smaller in structure and have less bureaucratic procedures, and it is much easier for them to respond quickly to any changes.

All the state institutions including hospitals are very bureaucratic, but since the population of Ukraine is mainly middle-class representatives, most of the patients have to choose state hospitals. On the one hand, such bureaucracy is positive, because medicine is free in Ukraine. Thus, citizens are registered upon their birth in that hospital, which is the closest to their residence address, and every neighborhood has its own therapist assigned. On the other hand, such a strong internal state system limits the progress of organizational health care system development; notwithstanding, the management of the hospitals tries to develop international relations by participating in international conferences, exchanges and internships, buying modern technologies and trying to apply international standards in their hospitals.

International communication is one of the main positive factors that influence the internal development of the health care institution to be more Europeanized; it develops and improves its processes. International experience exchange is also a very good method of motivation although it is hard to define whether it is internal or an external one. Doctors usually search for the programs they would like to participate and apply. There is no International Development Department to deal with such issues, and HR Department is more like a Soviet type of a trade union, which stimulates employees by providing New Year’s gifts, organizing the parties for the children of the workers and by giving small discounts for going to local health resorts.

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As we see, most of the internal processes in the hospital are mostly employees’ initiatives, and it is very hard to differentiate between internal and external motivation. The doctors want to develop and search for the development themselves, and the hospital, at the same time, creates the atmosphere for the need of such development and international communication. Moreover, those doctors that gained international experience are promoted by the hospital. They are advertised as the best employees and thus the image of the whole organization is growing.

The size factor is also important in the analysis of the company’s structure. Small organizations are less complicated in their structure. Thus, they remind organic systems very often (CliffsNotes, 2012). With its growth, however, the organization becomes more difficult to manage. A typical state post-Soviet hospital is largely structured, but that does not necessarily mean that it should have developed formal structure.

Our chosen hospital has strict and detailed rules, which dictate all of the work procedures. The communication inside of the hospital is hierarchical: with the authoritative instructions from superior to subordinate employees as the management carries the main responsibility and control over their employees, and fulfillment of the mission of the hospital. On the one hand, this type of structure should provide the organization to develop efficiently; on the other hand, there are nuances that block such potential to operate effectively.

Our hospital is on the maturity stage of development. As we know, during this phase, the organization becomes less innovative and generally interested in its expanding. The hospital is interested in being stable and secure with the only aim to gain more profit. Thus, innovations are not very much taken into consideration. One might think that this is a dying stage as there is no further development. Notwithstanding, in the case of our hospital, this stage has been prolonged since the collapse of the Soviet Union, and new push for changes and revival is inevitable for its further development.

Besides complicated internal structure, our hospital is responsible for reporting to various state institutions. Such accountability affects the operational services so they slow down their activities. Internal accountability influences the behavior of the organization positively as it helps the managers not only to keep things in order and save their time and effort but also to see their level of development and set the targets for future.

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Good management should not only include the evaluations of their personnel’s activities but also have to take into consideration the company’s internal and external factors. They are reflected in the planning of short and long-term activities, organizing various training for their personnel, leading the employees and controlling their activities.

External accountability to the state institutions is the formal reporting, which is mostly conducted because of the need to follow the state regulations. On the one hand, such information can be very useful for journalists and students, but on the other hand, the procedures to receive that information are very complicated. As a result, we have a lot of time and effort spent for the satisfaction of bureaucratic rules.

As we see, state health hospital has its own way of development, which is very low now. For this size of the company, there should be more initiative for the development of the personnel from the inside of an organization, especially when we consider its international development. When that happens, the employees will be more motivated, and that will bring not only more profit to the hospital, but the stereotype about the stagnation of post-Soviet state organizations of the developing countries will be broken.

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