Structure to fit goals, technology, workforce, & environment
• Goals & objectives
• Specialization & division of labor
• Coordination & control
According to Bolman and Deal, structure “is a blueprint for formally sanctioned expectations and exchanges among internal players and external constituencies.” (Bolman, 2013, p.46) When a structure is inadequate, difficulties result both between the internal players and the external constituencies. However, it is not as important to find the perfect structure, as it is to “putting people in the right roles and relationships” within the structure chosen. (Bolman, 2013, p. 45) When this happens, the structure will allow people to do their job well. The goal in my issue is to give safe and quality care to any mental health (MH) patient in our Emergency Department (ED). I have identified the following structural elements in my organization that are either driving forces or restraining forces toward this goal.
The first element is “vertical coordination.” (Bolman, 2013, p. 49) This vertical coordination in my issue is happening between external constituencies. Many area hospitals were diverting MH patients to our Level One Trauma Center, Harborview, overwhelming the Emergency Department. The elements in vertical coordination are “authority, rules and policies, planning and control systems.” (Bolman, 2013, pp. 51-54) The formal “authority” in this issue is WA State Central Region EMS and Trauma Council with Harborview Hospital being its leader. Harborview’s authority in King County has been established well before this issue arose. A top-down ap...
... middle of paper ...
...ing of people in our community by providing quality care in a collaborative environment.”
“Negative symbols perpetuate evil, just as positive symbols reinforce goodness. Symbols cut both ways.” (Bolman, 2013, p. 262) In the past I have worked for large organizations where whining and complaining was part of the culture and a very negative force. When looking at my issue through the symbolic frame, I can see were positive symbols have created a positive culture and are driving forces. I did not identify any restraining forces when looking through the symbolic frame.
Bolman, L. G., & Deal, T. E. (2013). Reframing Organizations (5th ed.). San Francisco, CA: Jossey-Bass.
Editorial: Washington must treat the mentally ill. (2013, October, 7). The Seattle Times. Retrieved from http://seattletimes.com/html/editorials/2021988414_mentalhealtheditxml.html
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