Running head: ORGANIZATIONAL STRUCTURE DESIGN
Organizational Structure Design
Susan Cody
National University
Healthcare Leadership
HCA 670
Dr. Joann Harper
October 19, 2014
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ORGANIZATIONAL STRUCTURE DESIGN
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Organizational Structure Design
Kaiser Permanente is the nation’s largest not-for-profit integrated health care delivery
system. Founded in 1945, the organization has more than 164,000 employees and 15,100
physicians serving more than 8.6 million members. Kaiser Permanente has a health care delivery
system committed to preventative care and the empowerment of members to maximize their
Total Health-mind, body, and spirit. (Lofgren & Cantu, 2010) This paper will discuss a few of
the issues related to Kaiser Permanente’s organizational structure and culture.
Culture and Organizational Structure
The organizational structure of the Patient Care Services at Kaiser Permanente Hospital
in San Diego is complex and dynamic. The structure is hierarchical with the Senior VicePresident and Executive Director at the top of the chart. The Chief Nurse Executive reports to the
Senior VP, with a Nurse Scientist and a Nurse Champion reporting to the CNE. Directors for
Medical-Surgical, Maternal/Child, Periop, PCS Ops, and Quality/Safety are aligned in the
hierarchy. (Appendix)
Kaiser Permanente (KP) has also adopted a shared leadership structure. Shared leadership
involves the combining of official and unofficial leaders to develop positive outcomes. (Pearce,
Wassenaar, & Manz, 2014) Shared leadership requires simultaneous and ongoing influences to
secure a mutual outcome. When this process is shared across behavioral approaches, structural
boundaries, and organizational forms, the results are positively remarkable. (Pearce, Wassenaar,
& Manz, 2014) KP has achieved this culture by developing committees and councils lead by
nurses and other health care professionals. The Staff Nurse Council is central to all activities and
assists in helping to facilitate collaborative methods that promote clinical effectiveness
throughout the organization. (Nursing Pathways, 2011)
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Shared leadership provides greater transparency, and it balances concerns for various
stakeholders. This process also taps into the knowledge, experience and capacities of
organization members, thereby promoting responsible leadership. (Pearce, Wassenaar, & Manz,
2014) Empowerment is another strong aspect of leadership. Empowerment includes job
enrichment, self-managing work teams, and being able to control the general quality and
constant improvement of care. (Hossein, Saleh, Iman, & Jaafar, 2012) KP San Diego (KPSD)
has been focusing on developing a culture of collaboration among all health care workers. This
approach has increased staff morale, job satisfaction, and motivation, and has promoted
interpersonal relationships and increased ownership that provides a sense of worth within the
organization.
Environment of Support for Client-Centered Care
KPSD has adopted a model of care that places the patient, member, and family at the
center of the caring wheel. KPs mission is to provide extraordinary nursing care, every patient,
every time. To achieve this KP is currently focusing of increasing the professionalism of nurses,
providing patient and family-centered care, and by increasing compassion, teamwork,
excellence, and integrity among all health care staff. Patient-centered care improves patient
outcomes by reducing medical errors, increasing patient satisfaction, and reducing employee
turnover. For Kaiser Permanente to achieve this goal it must shift from institutional and
physician-focused care that emphasize professional roles and hierarchies to patient-centered care
that emphasizes clients’ needs and preferences. (Nursing Pathways, 2011)
The power of information is what motivates followers to comply and meet the needs of
the organization. (Sullivan & Decker, 2009) Communication and meaningful information
resolves most organization problems efficiently and quickly. Success is dependent on the ability
ORGANIZATIONAL STRUCTURE DESIGN
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and knowledge of the management team to support the decision-making processes and
implement significant change. Implementing cultural changes, increasing the value of
innovation, and participative decision-making processes should be a fundamental goal of any
health care organization. (Jbilou, Landry, Amara, & El Adlouni, 2009) At KPSD, middle
management is responsible for delivering effective communication to the front-line staff. This is
achieved at staff meetings, daily knowledge exchange in staff huddles, staff in-services, and by
engaging staff to participate in committees, councils, and Unit Based Teams. By empowering
these groups to enhance patient care and staff satisfaction, KPSD has created a valuable
organization that continues to THRIVE. (Lofgren & Cantu, 2010) While the KPSD
organizational chart is basically a mechanical one in outline, it is required to also remain organic
in its ability to respond to changes in regulations, and to the culture of the employees and
members. (Shahabadi & Pourkiani, 2014)
KPSD is an organization that recognizes the need for a strong infrastructure that includes
open communication and the need for recognition and reward. KP continues to develop skills to
manage and motivate staff by enhancing various talents in an organization, while maintaining an
organizational structure that has much to offer to attain number one as health care provider in
Southern California.
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References
Hossein, R. D., Saleh, P. A., Iman, A. M., & Jaafar, A. (2012, August). An analysis of the
empowerment level of employees and its relation to organizational factors. International
Journal of Business and Social Science, 3, 15. 255-263.
Jbilou, J., Landry, R., Amara, N., & El Adlouni, S. (2009). Combining communication
technology utilization and organizational innovation: evidence from Canadian healthcare
decision makers. Journal of Medical Systems, 33, 4. 275-286.
Lofgren, D., & Cantu, D. (2010). THRIVE. Marketing Health Services, 30, 3. 8-11.
Nursing Pathways (2011). The nursing strategy. Kaiser Permanente. Retrieved on Oct 8, 2014
Pearce, C. L., Wassenaar, C. L., & Manz, C. C. (2014). Is shared leadership the key to
responsible leadership? The Academy of Management Perspectives, 23, 3. 278-288.
Shahabadi, M. E., & Pourkiani, M. (2014, September). Explanation of the relationships between
different types of organizational structure and strategic capabilities of employees:
descriptive analysis. Kuwait Chapter of the Arabian Journal of Business and
Management Review, 4, 1. 96-106.
Sullivan, E. J., & Decker, P. J. (2009). Effective leadership and management in nursing (7th ed.).
Upper Saddle River, NJ: Pearson Prentice Hall.
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Appendix
Patient Care Services (PCS) Organizational Chart
Sr VP & Executive Director
Nurse Champion
Nurse Scientist
Director
Med/Surg/C.C.
Manager
2W/Oncology/Float
Manager
2NS
Manager
DOU/Dialysis
Manager
CCU/ICU/SDU
Manager
5N/S Med/Surg/PIC
Manager
5W/Tele/Stroke
*
Chief Nurse Executive
Director
Quality/Safety/Education
Director
Maternal/Child
Director
Perioperative
Director
PCS Ops/Service
Manager L&D
Manager Zion OR
Manager
Staffing
WOCN
Manager
Post Partum/Nsy
Manager Zion
Peri-Anesthesia
Nursing Office
Nursing
Education
Manager
SPD
House
Supervisors
Manager
SCN/Pediatrics
Manager
Otay Mesa
Manager
Garfield Surg Ctr
Support Services
Personnel
Project Manager I
Patient Education I