Organizational Theory

1. Reduction Theory
a. Division and Specialization of Labor- dividing the work reduces the number of tasks that each
person carries out, with the intent of increase efficiency by assigning repetitive tasks to
dedicated workers to improve the organizations product.
b. Organizational Structure- delineate work group arrangements based on the concepts of
departmentalization as means to maintain command, reinforce authority and provide a formal
communication.
Bureaucracy- management in which decisions and regulations are made by a complex network
of officials and administrators rather than by elected officials. Characterized by a hierarchical
structure, standardized procedures, and a focus on rules and regulations.
c. Chain of Command- depicted on a table of organization (Organizational Chart) through job titles
listed in magnitude of authority and responsibility. Those jobs that ascends to the top reflect
increased authority and represent the right and or power to direct the activities of those of
lesser rank.
d. Span of Control- addresses the issue of effective supervision expressed by the number of line
authority. Ex: physician oversees holistic approach, but specialist are called for subcomponent
parts.
2. Humanistic Theory as a bridge- people desire social relationships, respond to group pressure
and search for personal fulfillment in work settings. Hawthorne effects (Western electric
Company)-individuals cannot be coerced or bribe to do things they consider unreasonable.
3. Adaptive Theories-
a. System theory
Inputs-materials, money, equipment’s, human capital with particular expertise.
Throughputs- resources are transformed when processes are designed, animated and
coordinated with the mission of the organization in mind. (associated with access to care
and how patients enter and leave the hospital)
Output- create the goods and services desired.
b. Contingency Theory- enhanced when leaders attend to and interact directly with the unique
environment ( people, objects, regulators, competitors)
c. Chaos Theory- Small changes can lead to significant variations in patient outcomes. Nurses
can use this understanding to adapt to changing patient conditions and improve patient
care.
Organizational Structure
1. Functional Structure- Employees are grouped in departments by specialty, and groupings of
similar tasks are performed by group of like minded or trained individuals operating out the
same department.
2. Service-Line Structure-
Organizational Chart- a drawing that shows how the parts of an organization are linked. It depicts the
formal organizational relationships, areas of responsibility, persons to whom one is accountable, and
channels of communication.
 Line Staff- Illustrate the structure and hierarchy within a healthcare facility or nursing
department. Line positions (e.g., Nurse Managers, Registered Nurses) are directly involved in
patient care and have authority and responsibility for delivering healthcare services to patients.
Staff positions (e.g., Nurse Educators, Unit Secretaries, Infection Control Nurses) provide
support, expertise, and assistance to the line positions. They contribute to the overall
 effectiveness and quality of patient care but do not typically have the same direct patient care
responsibilities.
 Vertical Chart- hierarchical chart, displays the structure and hierarchy of a nursing department
or healthcare facility from top management down to the staff nurses and other healthcare
professionals. This type of chart illustrates the chain of command and reporting relationships
within the organization.
 Left to Right Chart- Displays the structure and hierarchy of an organization with positions and
reporting relationships aligned horizontally from left to right
 Circular Chart- Positions or departments are arranged in a circular or wheel-like pattern, with the
center typically representing the highest authority or core function

Organizational Culture- the customary way of thinking and behaving that is shared by all members of
the organization and must be learned and adopted by newcomers before they can be accepted into the
agency.
Culture- learned, shared, and transmitted. It is a combi¬ nation of assumptions, values, symbols,
language, and behaviors that manifest the organization's norms and values.
Cultural network -primary informal means of communication within the organization that carries the
corporate values and heroic mythology.
Gestures are a nonverbal form of communication.
Gossip is talk or rumors about others.
Jargon is specialized vocabulary or idioms specific to a way of work.
A joke is a funny anecdote.
Slang is a specialized vocabulary of idioms outside the standard language.
A signal is given by a gesture.
A slogan is a catchword or motto.
Stories may describe conflicts, heroes, or traditions.
Legend is the story of a saint or some wonderful event.
Myths are fictitious, traditional stories with a historical basis used to explain something.
A saga is a long story of adventure or heroic deeds.
Songs are poetry or verse that is sung.
Verbal forms of humor could be jokes, whereas visual forms could be cartoons posted on bulletin
boards.
Rituals are the day-to-day routines that show employees how they are to behave.
Policies and procedures clarify routines.
Inductions, promotions, planning retreats, and retirements are rituals that reinforce the values.
Ceremonies are extravagant rituals that give visible evidence of the agency's values.
Types of Culture:
William Schneider (1999)
1. Control culture - authoritative, conservative, impersonal, tough minded, realistic, systematic,
task driven, objective, and prescriptive.
2. Collaborative culture - adaptive, collegial, democratic, informal, participative, personal,
relational, supportive, and trusting; the leader functions as a coach, integrator, team builder, and
trust builder.
3. Competence culture -challenging, efficient, emotionless, formal, impersonal, intense, objective,
rational, and task driven; the leader is an assertive, visionary standard setter who recruits the
most competent people and then stretches them.
 4. Cultivation culture - attentive, emotional, enabling, humanistic, nurturing, people driven,
personal, promotive, and relaxed; the leader is a catalyst, cultivator, empowered, inspirer,
promoter, and steward.
Robert Cooke and Denise Rousseau (1987)
1. Positive culture members- proactive and interactive to meet their satisfaction needs. That
culture is based on humanism, affiliation norms, achievement, and self-actualization.
2. Passive-defensive and aggressive-defensive cultures people- protect their security and status in
reactive, guarded ways. Passive-defensive culture is based on conventional, approval,
dependent, and avoidance norms.
3. Aggressive-defensive culture -based on power, oppositional, competitive, and perfectionistic
norms. Leaders need to diffuse negativism in oppositional norms and act as role models for
desirable behaviors, encouraging a cultural transition to more positive norms.