UNIT 3 ORGANIZATION OF

NURSING ADMINISTRATION
Structure

3.0 Objectives
3.1 Introduction
3.2 Basic Concepts of Organization
3.2.1 Significance of Organization
3.2.2 Meaning
3.2.3 Characteristics
3.2.4 Importance

3.3 Functions of Organization

3.4 Principles of Organization and Their Application
3.4.1 Principles of Organization
3.4.2 Organization Chart

3.5 Types of Organization

3.5.1 Authority Relationships
3.5.2 The Line Relationship
3.5.3 The Line and Staff Relationship
3.5.4 Organizational Structure
3.5.5 Formal and Informal Organization

3.6 Organization of Hospital

3.6.1 Definition of a Hospital
3.6.2 Classification
3.6.3 Functions of a Hospital
3.6.4 Policies of the Hospital
3.6.5 Hospital Utilization
3.6.6 Health Team and Committee

3.7 Let Us Sum Up

3.8 Key Words
3.9 Answers to Check Your Progress
3.10 Further Readings

3.0 OBJECTIVES
After studying this unit, you should be able to:
• explain the meaning of organization;
• state the importance of organization chart;
• explain the principles of Organization;
• define line and staff authority;
• distinguish between informal and formal organizations;
• enumerate the functions of a hospital;
• explain the meaning of hospital utilization; and
43
• the role of health team.
Nursing Administration and
Management 3.1 INTRODUCTION
In unit 1 of this Block you have gained a basic understanding about the concept of
administration and management, its nature, scope, purpose and its functions and
principles in unit 2.
We have also discussed planning as an administrative function in more details in
Unit 2, because of its prime and utmost importance. In this unit we are devoting
ourselves to the discussion of organization and organizing as planning is translated
into action through organization. You can, therefore, well appreciate the crucial role
of organization and the need for a separate section for its discussion. You may
recollect that we have introduced organizing as the second administrative function
under section 2.4 in unit 2 of this Block. We want you to relate your learning of the
above section to the present discussion.

3.2 BASIC CONCEPTS OF ORGANIZATION

Now you willleam basic concept of organization.

3.2.1 Significance of Organization

Organization is extremely important to any enterprise. An organization is the
systematic bringing together of interdependent parts to form a unified whole through
which authority, coordination and control may be exercised to achieve a given
purpose. It facilitates administration, encourages sound, balanced growth and
diversification, provides for best use of human beings and stimulates creativity.·

3.2.2 Meaning
Dictionary - method of dividing up work,
- body of person organized for some end or work.
- to frame and put to working order.
"Organization is a group of people whose activities are consciously coordinated
towards a common objective or objectives"- By Chester Bernard
"Organization is a formal declared pattern of relationships established in
government by law and by top management" - By White.
"Organization is a process of grouping the necessary responsibilities and activities
into workable units, determining the lines of authority and communication and
developing patterns of coordination."
"It is conscious development of role structures of superior and subordinate, line and
staff. "
The word "Organization" may convey at least three meanings:
Firstly it may refer to the activity of management in arranging people, tasks, and
resources in the most orderly and efficient manner.
Secondly it may also name the arrangement itself, the outcome of the organizing
activity.
Thirdly it may describe any numb~r of business, behavioural and humanist
concepts.
Perhaps we may now define organization as a "group of people working together
and with each other towards achievement of the common goals". It may also be
defined, as "organization is a process of weeding together a framework of positions
which can be used as a management tool fer the most effective pursuit of the goals
44
of an enterprise."
Koontz and 0' Donnel have described organization "Essentially as the creation Organization: of Nurting
Administration
and maintenance of an intentional structure of role."

• From the above definitions it is clear that:

i) Any organization must have defined goals or objectives and
ii) The functionaries shall endeavour to achieve those goals and objectives.
In another sense Organization is thus the structure of duties and activities
necessary for the conduct of or operation of activities without which the
organizational objectives cannot be achieved.

• The organization must:

i) Reflect objectives and plans ofthe organization.
ii) Reflect the authority available to various categories of managers
belonging to different management levels.
iii) Reflect its environment in terms of infrastructural facilities and work
culture.
iv) Be manned with trained and appropriate people, commensurate with their
job requirements.

• Thus you find that Organization has four connotations viz. i) as an

administrative function, ii) as a system, iii) as an operation and iv)as a result:
i) As an administrative function broadly, organization is a process of
identification and grouping of activities with determination and
establishment of authority relationships for these groups of activities as
well as arranging for men, materials, machines and money.
ii) As a system, organization consists of many interrelated and
interdependent subsystems; each system and subsystem has the
components of :

a) Input: Human resources, material resources, information and energy serve as

input.

b) Throughput: The methods through which functions are carried out.

c) Output: The actual outcome.

d) Management component: The system sees that the desired outcomes are
obtained.
Illustration: Patient care system in a hospital ward has a subsystem of
administration of medications to the indoor patients. This subsystem has:

• Doctors and Prescription of the attending doctors;

Nurses assigned to the patients and assigned for ~ as input
Administration of medications.

• Actual procedure of drug administration to the

concerned patients
-----=----= as throug hput
---=-
• Concerned Patients actually taking the medicines as
prescribed in the right dose, right time and right manner. =======- as output

• Determining whether the concerned patients have actually received the

medications through record as management review asking patients, observing
patients' progress towards recovery
iii) In an operational and restricted sense, organization is involved with
determination and defining of duties and responsibilities of the personnel
and establishment of interrelationship between the various activities within
45
the organization(s).
Nursing Administration and iv) As a result of the function of organizing or organization we have an
\1anagement
organization which is a group of people working together to accomplish
the laid down common objectives or goals within a defined and specific
framework.

Check Your Progress 1

1) Fill in the blanks:
"
Orga:r:ization can be conceived of
i) as an administrative .
ii) as a system consisting of many interrelated and interdependent

ill) as a of the function and

iv) in an sense, organization is concerned with determination
of duties and of the and establishment of
interrelationship between the various .
2) An organization reflects the following essential features:
i)
ii)
ill) .
iv) ........................... ' ~ .

3.2.3 Characteristics
The discussion in the foregoing paragraphs clearly bring out the characteristics of
an organization, which are:
i) Group of people
ii) Common goals or objectives
ill) Division of work
iv) Vertical and horizontal relationship
v) Chain of command with laid down channels of communication
vi) Group dynamics.
An organization's existence is the result of a group of people working together
consciously for realizing a common objective or objectives. For the harmonious
functioning of the organization, the rest of the four characteristics i.e. division of
work vertical relationship - the relationship between the supervisors and the
subordinates and horizontal relationship- the relationship between different
departments and divisions, chain of command or flow of authority from the higher
to the lower levels of management in the hierarchy as well as group dynamics form
inherent features of an organization as basically organizations are groups of people.
Group dynamics is interpreted as the interactions that take place between the
individuals and the groups within the organization, based on their values, needs,
sentiments, attitudes, beliefs, and interests. This social, self-generating and dynamic
interactive process gives rise to informal groups which render a dynamic element to
the organizational functions.
Resources: The objective of every organization involves transforming resources
to achieve results. The principal resources used by organization are: people
(human resources), capital, materials, technology and information.
Dependence on environment refers to the relationship to the outside
environment. Term environment includes economic conditions, customers, labour
46
unions, government regulations, competing organizations, social attitudes and values ..
We may summarize the characteristics of a good organization as follows: Organization: of Nurting
Administration
1) The structure should be clearly defined so that employees know where they
belong and where to go for assistance.
2) The goal should be to build the fewest possible management levels and have
the shortest possible chain of command. This eliminates friction, tress, and
inertia.
3) The unit staff need to be able to see where their tasks fit common tasks of
the organization.
4) The organizational structure should enhance, not impede the communication.
S) The organizatio.ial structure should facilitate decision making that results in the
greatest work performance.
6) Staff should be organized in a manner that encourages informal groupseo
develop a sense of community and belonging.
7) Nursing services should be organized to facilitate the development of future
leaders.

3,2.4 Importance
As has been stated in unit 1 of this Block, organization as a function translates the
plan of the establishment into action. Thus the importance of organization can be
enumerated as indicated below:
i) Assists administration in gearing the human, material and financial
resources towards fulfillment of the objectives of the enterprise.
ii) Provides the structure within which the functions of planning, staffing,
directing, coordinating and controlling are performed.
iii) Helps in growth and development of the establishment, in planning for
need based change through appropriate division and allotment of work.
iv) Makes optimum use of all resources, determines needs for innovative and
new technologies in terms of cost effectiveness and accomplishment of
objectives of the establishment.
v) Encourages individual growth and development of personnel according to
individual potentials through job enrichment, training and participation from
them.
vi) Invites creative and innovative ideas to working through adopting human
relations approach. Also once the authority, responsibility and accountability
are determined for each worker, a person is required to work on hislher own
which helps in confidence building, creative thinking and motivation.
The basic importance of organization lies in the fact that it provides the
platform for excellence in performance as without a proper structure of
organization, best and good performance can never emerge.

Check Your Progress 2 •

1) Enumerate the characteristics of Organization .

•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• A ••••••

47
Nursing Administration and
Management 2) Mark 'Y' or 'N' against the following statements, 'Y' if you consider it as
'correct' and 'N' if you consider it as 'incorrect'.
i) Organization effects balance within the organization. (Y IN)
ii) Organization hinders creativity. (YIN)
ill) Organization stands in the way of organizational growth
and development. (YIN)

3.3 FUNCTIONS OF ORGANIZATION

Functions of the organization structure are:
i) Providing well defined authority relationships and delegation of authority.
In unit 1 of this Block we have defined authority as the right to do or the
right to command others to do. Please refer to the same.
Delegation is defined as assigning authority to a person who thereby
assumes the right to perform a task including decision-making task and is
accountable for the task.
Authority in an organization may be defined as the right to command
people within the organization and use organizational resources for
performance of tasks and activities within the framework of the organizational
policies, rules, regulations and procedures.
Illustration: A teacher in a school of nursing has the authority to initiate
disciplinary action against an erring student but cannot take disciplinary
action; this is to be taken by the admitting authority according to the existing
policies of the particular school. As such she can warn the student and initiate
action only without implementing any disciplinary action.
ii) Develops and describes channels and patterns of communication
between the management and the workforce, between supervisors and
subordinates, between the divisions and departments within the organization.
iii) Decides and identifies decision making centers within the organization
for different decision areas and communicates the same to all concerned.
iv) Effects balance within the organization by allocating resources according to
priority, organizational objectives and plans prioritizing activities within the
organization.
v) Encourages creativity and innovation through clear-cut authority
relationships and inviting participation from those having potentials.
vi) Provides opportunities for growth and development of the organization
through capacity building, maintaining a constant level of quality performance
and consciously making efforts to meet the needs and demands of the
changing economic and environmental climate.
vii) Adapts to change, makes use of available and cost-effective new
technologies that are beneficial for the organization; encourages operational
research and studies to obtain prior and valid information on the changing
requirements and consequent modifications necessary in the organization
structure.

3.4 PRINCIPLES OF ORGANIZATION AND

THEIR APPLICATION
The guidelines which are required to the followed in planning and designing an
effective and efficient organization structure are referred to as Principles of
48
organization. A principle refers to a basic or elementary truth. The principles of
organization suggest only the working rules conduct which with experience seems Organization: of Nurting
Administration
to have validated (white). The administrator must know the principles and apply
them with judgment in terms of the immediate situation.
Let us explain these principles briefly:

3.4.1 Principles of Organization

1) Principle of Objective: An establishment or an enterprise exists to achieve
certain laid down objectives i.e. every organization and every part of the
organization must be an expression'of the purpose/objective, it is essential that
the organizational objectives are formulated in clear, unambiguous, achievable
and measurable terms/statements, which should be understood by all
concerned.
2) Principle of Specialization: This means that entire job or work of the
enterprise is differentiated into various parts or sub-parts, which is then
assigned to individuals according to their expertise, qualification and
experience. The activities of'every member, as far as possible, should be
confirmed to the performance of a single function.
3) Principle Hierarchy: i.e. control of higher over the lower. It consists in the
universal application of superior-subordinate relationship through a number of
levels of responsibilities reaching from top to the bottom of structure(). An
organization is like a pyramid, broadest at the base and tapering towards the
top. In this pyramid there is hierarchy. This is also known as the scaler
process.
This is the characteristic of an organization which explains the levels of
authority to which people are assigned in the organization. Infact, it reflects
who is accountable to whom, for what work. And his or her efforts are being
controlled and directed by whom. •
4) Principle Unity of Command: An employee should receive orders from one
superior only, should it be violated, authority is undermined; discipline is in
jeopardy or disturbed and stability threatened (Foyol).
5) Principle of Span of Control: It is the number of subordinates or units of.
work that an administrator can effectively control and supervise. This depends
upon two factors i.e. type of activity carried out in the organization and how
experienced is the superior officer/manager himself. Shorter the span of
control, greater will be the contact and hence effective control. No person
should supervise more than five or at the most.
6) Centralization vis Decentralization: Centralization stands for concentration
of authority or near the top; decentralization, on the other hand, denotes
dispersal of authority among a number of individuals or units. Neither
centralization nor decentralization can be accepted as absolute principles.
Administrators have to either compromise between the two principles, or else
each case has to be decided on its own merits according to concrete factors of
the situation for example, formulating policy is centralization whereas
implementation of policy is decentralization.
7) Delegation of Responsibility: Delegation is a process of assigning
responsibility and authority to a eo-worker or subordinate and ensuring his
accountability. This means conferring of specified authority by a higher
authority to subordinate subject to his right of supervision and control,
.Responsibility must correspond with authority.
Advantages- delegation serves as a vehicle for coordination.
1) It develops an increased sense of responsibility and efficiency.
2) Reduces executives burden. 49
Nursing Administration and 3) Minimizes delay in decisions
Management
4) Is conducive for effective control
5) Permits subordinates development.
Limitations- Unfamiliarity with art of delegation.
1) Incapacity of subordinates.
8) Principle of Continuity: Reorganization is a continuous process in every
enterprise/undertaking specific provision should be made for this.
9) Principle of Communication: A good communication is essential for
effective interaction that paves way towards achieving the organizational
objectives. A two-way communication flow from top to bottom levels and
from bottom to top levels is a prerequisite in any organization.
10) Principle of Balance: This principle implies that there should be a semblance
between the various parts and various functions within the organization.

Check Your Progress 3

1) Enumerate any six principles of organization.

2) Define span of control.

3) What are the factors that determine the span of control?

We shall now proceed to discuss organization chart.

3.4.2 Organization Chart

It is one of the tools that may be usefully employed to understand the organization
structure of an enterprise.
What do we Understand by an Organization Chart
An organization chart is the diagrammatic representation of the different positions in
the hierarchy of an institution, showing the channels of communication and the
formal lines of authority among these positions. In other words it gives the
executives and the employees or the managers and the subordinates a bird's eye
view of i) the relationships between the various departments and divisions, ii) as
well as those that exist between the different positions in the management levels
and the grass root level employees in an enterprise. It also provides an opportunity
to all- from the top-level administrators to the workforce, to understand their
positions, roles, and to whom they are accountable or answerable. It has, therefore,
to fulfil! the following characteristics:
i) Must be a diagrammatic presentation;
ii) Must denote the principal lines of authority between the different positions
within the enterprise;
iii) Must show the interrelationship between various functions and authority
positions;
iv) Must denote the channels of communication between the various positions
50 and between the executives and the subordinates.
Advantages of Organization Chart Organization: of Nurting
Administration
i) It serves as a tool fo! the management, in that it enables each employee to
understand how hislher position fits into the total organizational set up and he/
she relates to others in the organization.
ii) This serves as a tool to the individual employees, as through this clearcut
graphic portrayal each employee understands to whom he/she has to report
and receive instructs from, limits ofhislher authority, hislher accountability and
who are hislher associates.
iii) It serves as an important guide to the new employees.
iv) It provides the platform for classification of personnel and of evaluation
systems.
v) It has a significant role in detecting deficiencies and inconsistencies.
Limitations of Organization Chart
Organization chart is an important tool of administration, but it alone cannot make
an organization effective. Its limitations may be enumerated as follows:
i) It fails to show the informal relationships within the organization, which play a
vital role in organizational functions.
ii) It does not denote the quantum or the degree of authority vested in particular
positions and consequently the extent of accountability built in these positions.
iii) It does not have provisions for updating without disturbing the entire setup
because or the rigidity of relationships introduced in the organization chart.
iv) It only denotes the relationships and channels of communication which should
exist but not what actually exists.
v) If an organization chart is faulty, it may cause misunderstariding and confusion,
defeating its purpose. It might bring in a conflict between the organizational
members, because it gives rise to a feeling of superiority and inferiority among
them.
An illustration of an organization chart is given below:

~ ~ ~
1) Dy.Director Nursinq 2) Dy.Director Nursing 3) Dy.Director Nursing
(Educationt Training) (Hospital Slrvice) (communlty Service)

1) Assistant Director 2) Assistant Director 3) Assistant Director

Nursing Nursing Nursing
(Education & Training) (Hospital Service) (Community Service)

~ ~ ~
Principal Chief Matron/Matron District Public Health Nurse

~ ~ ~
Sister Tutor Assistant Matrpn Health Supervisor(Female)

~ ~ ~
PHN Sister Health Worker (Female)

~
Staff
Fig. 3.1: Organization Chart 51
 ~ursing Administration and
"rtanagement
Check Your Progress 4
1) Enumerate the characteristics of an organization chart.

2) Match the items of Column "A" with those of Column "B":

Column A Column B
i) Organization Chart a) Must be a diagrammatic
representation. representation.
ii) An advantage of organsation b) Top level management.
ill) Limitation of organization chart c) Serves as a tool for management.
iv) Characteristic of organization d) Denotes formal relationship and
chart. channels of chart. Positions.
communication between e) Does not show informal
relationships.

3.5 TYPES OF ORGANIZATION

Types of Organization: Before we go on to discuss the types of organization, it is
necessary for you !o understand.
3.5.1 Authority Relationships
• In the preceding sections, we have discussed the organization structure and
we have talked about the principles of organization. In these sections, you
have come across the term authority relationships. What is meant by authority
relationships? You know that definition of authority by now. The relationship or
the pattern of formal relations that exist between different positions having
various authority - viz. authority inherent in a line position, delegated
authority, authority by virtue of professional expertise etc. within the
~ganization structure is referred to as authority relationships.
When an organization structure is designed the authority relationships must be
clearly defined. There are three types of authority: these are line authority, staff
authority and functional authority and functional authority.
• Line Authority: Refers to the authority of those positions within an
organization which have the authority, responsibility and accountability for
achieving the main objectives of that organization. Line works at the direct
accomplishment of programme/ organizational objectives and is assisted by
staff and auxiliary services. For example, it consists of carrying forward the
goals of nursing department through a chain of command.
• Staff Authority: Refers to the authority of those positions within the
organization which are there to provide advice and service to the line positions
in fulfilling the objectives of the organization. Staff authority is like an advisory
body which provides specialized advice but does not command, staff positions
are not vested with delegation of responsibility- accountability triad staff
independently and collaborately collect and analyze the information and
present their findings/opinions to the director, but they are dependent on the
line personnel to accept and utilize or reject their proposals.
• Functional Authority: Relates to authority & those positions within an
enterprise which are there for specific functions, irrespective of departments
or divisions within the organization.
In a planned organization structure the authority relationships have to be
clearly spelt out and defined. Based on their relationship, we find different
types of organization within, the planned organization structure. These are
52
mainly formal and informal organization.
By formal organization is meant the patterns of behaviour and relationships that is Organization: of Nurting
Administration
deliberately and legitimately planned for members of an organization. This is also
known as structural organization. Emphasis here is on charts and manuals.
By informal organization is meant the whole pattern of actual behaviours- the way
members of the organization really do behave- in so far as these actual behaviours
do not coincide with the formal plan. This is also known as functional organization.

3.5.2 The Line Relationship

It is the oldest and the simplest form of any organization. It is also known as the
military or scalar organization. The Army, for example is divided into Sections,
Platoons, Companies, Regiments, Brigades, Divisions, Corps, Commands and they
form the total Army. The section or group is placed under the command of a leader
who is the supreme of that section or group or unit and his words are final to the
subordinates. Louis A. Allen defines "Line functions are those where a superior
exercises direct supervision over a subordinate-an authority relationship in direct
line or steps."
In this type of organization the line of authority is straight and vertical and each
person/performer at the same level performs the same functions. In an enterprise
or an institution, the chief executive leads the entire organization. Here the
maximum authority rests on the top or highest levels of management and the
quantum of authority decreases in a step ladder fashion for the subsequent levels or
management in the hierarchy. The Line or straight or vertical line of authority
serves as the channel of: i) command, ii) Communication, iii) direction, iv)
coordination, v) control and vi) accountability.
The departments I divisions are formed depending upon the responsibilities involved
and work to be carried out by each department/division and each department and
each division is headed by a divisional I departmental head.
The following two figures will describe the line relationship in an organization.
Board of Director/Management

Chief .Executive
~
~
Manager
Administration

Supervisor Supervisor Supervisor Supervisor Supervisor

Staff Staff Staff Staff Staff.
Fig. 3.2: Line Relationship

Medical Superintendent

Nursing Superintendent

Deputy Nursing Superintendent

Assistant Nursing ANS ANS ANS

Superintendent(ANS) Medical Paediatric Outpatient
Surgical Division Division Division Division
••• ••• •••
Ward Sister (W/S) W/S W/S W/S
Surgical Medical Paediatric Outpatient
+
Staff Nurses(S/N)
+ + +
SINS SINS SINS
Surgical Medical Paediatric Outpatient

Fig. 3.3: Relationship in Hospital Nursing Services 53

Nursing Administration and There are possibilities that more sub-sections/divisions may exist under each
Management
branch. In this type of organization the direction follvows from the top, transmitted
through the managers to the supervisors and then to the workers or staff. The
hierarchy is maintained as per the figures shown. There is no scope for downward
to upward or upward to downward movement. The authority is the only in the chief
executive and what he describes, must be carried out. If one has to say something
to the lower level he/she can only approach the immediate boss and not anyone
above. In this type of relationship only immediate supervisor issues the command or
directive to the subordinates or staff: or only one superior issues command and the
number of persons is normally limited under one supervisor.
There are advantages or merits and disadvantages or demerits in this type of
organization. Let's list the merits first:

• Simplicity
• Unity of Control
• Better discipline
• Fixed responsibility: Responsibilities are well defined and persons are
accountable to some one in the line form.
• Prompt decisions: Because of chain of command, unified control and fixed
responsibilities, it is possible to take prompt decisions.
The demerits are:
• Lack of Specialization: this system does not provide any scope for employing
specialists.
• Overloading or over reliance: The departmental head is all in all of his
department/division in this type of organization.
• Inadequate Communication: There is no down to upward communication in
this type of organization.

The Functional Relationship: This is a system which follows the scientific

management system. Here the relationship may exist both horizontally or diagonally
between the two department heads. This is denoted by a dotted line in the
organization chart. The functional relationship in a higher level is well organized but
in a lower level it can perhaps be implemented or utilized in a limited way. Kuntz
and O'Donnell say, " well managed concerns recognize that functional authority
should be used sparingly and only where real necessity exists."

The Distinguish Between Line and Staff Functional Relationships: It is

considered to be a necessary principle in an enterprise.

The functions which are concerned with achievement of the main or chief
objectives of an enterprise are known as line functions. The functions which
support the line functions are staff functions. For instance in a maternity hospital,
the main objective is: Providing services to pregnant women during their antenatal,
intra-natal and postnatal period. For this one of the line functions would be
rendering antenatal care which includes registration, making out antenatal cards,
taking of height and weight or the pregnant women, taking their obstetric and
medical history, obtaining other relevant information, making detailed antenatal
examinations, screening for risk factors, administration of immunization against
tetanus, giving advice for diet, prescribing iron supplementation, imparting necessary
health education and so on in the antenatal clinic. These are line functions.

The staff functions for this would be ensuring adequate and timely availability of
equipment and supplies, availability of necessary records, supply of vaccines and
essential medicines, procuring the required manpower for rendering the services
etc. Thus personnel, supply and maintenance of equipment and supplies, finance
54
etc. are staff functions.
 Organization: of Nurting
3.5.3 The Line and Staff Relationship Administration

In order to strike a balance between the structural and functional organization, it is

believed that the best system to adopt in any progressive and elite organization is
the line and staff relationship / functions. Here there is a scope having experts and
advisers to advise the leader of the team wherever and whenever required. The
suggestions made by these experts are honoured and implemented by the manager
to the extent possible. The staff or workers are permitted to voice their views in this
type of organizations. Their views and concerns are appreciated, made note of, and
implemented, wherever necessary. However, the decision to implement these views
and suggestions within the department/division rests with the manager alone.
He / she remains accountable for the performance and also involves others in the
bargain. Thus, while maintaining the line type of organization it also takes care of
the staff and a co-ordination between / among the staff within hierarchical
framework makes a good organization.

Let us now examine the merits and demerits of Line and Staff functions: First we
shall talk about merits:

• Expert's advice becomes available to the Line Management.

• There is benefit of planned specialization.
• Line Managers get more time to devote to their own functions. This results in
greater efficiency.
• Chances of advancement of employees become better as more jobs become
available.
'~.
Following could be demerits of this type of functions:
• Staff need to assume Line authority and thus may become a cause of friction
between the two.
• Sometimes staffs do not give sound advice because the staffs are not
accountable for the results of implementation of the advice.
• Staffs fail to see the whole picture as they lack the mind of relating advice to
the task and objectives of the enterprise.
The following figure will illustrate a typical Line and StaffR~lationship:

Advisor ~ Specialist - - - - - ..• Chief Administrator •.. - Specialist - Advisor

I
in Hospital I
Hospital I
I
Management

r
I I

I-----------

All heads of Departments

l
Dy. Chief Nursing
r Dy. Chief
Surgery, Medicine (Administration) Superintendent (Finance and
Obstetrics and Gynaecology, Accounts)
Paediatrics etc.

N.B: Heads of departments of Surgery, Medicine etc. and Nursing Superintendent while acting as Line
Managers for their respective departments, act as specialized staff for advising in matters related to •
their respective disciplines like surgery, medicine, nursing etc .

.. shows staff authority

Fig. 3.4: Line and staff organisation

Considering today's economic conditions it can doubtlessly be said that it is essential

to have Line and Staff organization in large enterprise, whereas it may advisable to
have only Line organization for small scale enterprises. 55
Nursing Administration and Perhaps it may be mentioned that a combination of Line and Staff System, will be
Management
the most "SUITABLE & IDEAL" organization from all points of view, provided the
following matters are considered and incorporated in the system.

i) The organization must operate in terms of objectives and policies.

ii) Line must be educated to use functional departments properly.

iii) The line must overcome the resistance to change.

iv) The functional departments must be extremely proficient and efficient.

v) The line must keep the functional departments informed about their difficulties
and changes.

vi) The line must also make proper use of the functional department.

Essential features of line staff organization as well as line organization and

functional organization are:

Positions Refers to positions Refers to positions of advisory and service

vls-a-vis responsible and accountable capacity for providing advice and service
objectives for attainment of the main 'to the Line fqr realizing theorganizational
or prime objective(s) of the prime objective(s) of the8bjectives.
organization

Experts and No experts with specific Experts with specific expertise are available
Expertise expertise are there to advise line officials.

Specialization Not based on planned Based on planned specialization

specialization

Elimination No scope of friction as no Chances of friction are there between the of

friction staff position or official Line and Staff Officials
between Line exists.
and Staff

Sharing of Credit goes to key officials Staff and Line Officials share the credit.
Credit holding key p,0sitions in tre
Line. '

Line of authority Line ofauthotity is vertical Line of authority is functional

diagonal and or stor straight

Unity of Command Is present Is not present as grass root level

Workers receive instructions from
Line as well as Functional bosses

Generalist Line managers are Functional managers are

Vs Specialist generalists specialists in their respective fields

Maintenance of Strict discipline is Loose discipline exists.

Discipline maintained.
Suitability Suitable for small scale Suitable for large scale and
organization complex organization

Check :Your Progress 5

1) Define: Line authority, Staff authority and Functional authority.

56 ......................................................................................... , - .
 • Organization: of Nurting
2) Enumerate the merits of Line Authority. • Administration

3) . Enumerate the merits and demerits of Line and Staff Authority.

3.5.4 Organization Structure

Overview
We have given a basic idea, about the meaning, characteristics and the importance
of organization in the preceding paragraphs. We hope you have been able to grasp
the idea that: i) Organizing is the second administrative function which is
considered to be a process of creating a structure or platform where various
people can work together to attain their common objectives effectively, ii) These
people work together and combine their efforts consciously and harmoniously
towards attainment of the common goals of the establishment which is termed
organization also.
Minimum Requirement
.
of an Organization Structure
Minimum requirement of an organizational structure are clarity, economy, direction
of vision, decision-making, stability and accountability, and perception and self-
renewal.
Operational Principles:
• Organizational needs derive from the statements of mission and objectives and
from observation of work performed.
• Organizational design and structure develop to fit organizational needs so that
people perform and contribute to achieving the work of the division of nursing.
• A formal organizational should be flexible and based on policy that promotes
individual contributions to the achievement of organizational objectives.
• A formal organization is efficient when it promotes achievement of objectives
with a minimum of unplanned costs or outcomes.
• A formal organization should build the least possible number of management
levels and forge the shortest possible chain of command. This eliminates stress
and levels of friction, slack, and inertia.

The organization structure should indicate:

i) Well defined relationships (vertical, horizontal and lateral) of all categories of
staff belonging to all levels of management as well as the workforce ..
ii) Well-defined duties and responsibilities of all categories of personnel - both
management and workforce.
iii) Hierarchical relationship between the supervisors and the subordinates within
the establishment.
iv) Assignment of tasks to individuals, divisions and departments.
v) Coordination of activities and tasks.
vi) Policies, rules, regulations, procedures and methods for performance of tasks
and activities as well as for evaluation of performance. 57
Nursing Administration and
Management -
3.5.5 Formal and Informal Organization
You may recollect that we mentioned about formal and informal organizations at the
. beginning of this section. We shall give you a basic idea about these now. As the
name suggests the distinction between these two types of organization is on the
basis of formal or informal groups and planned or unplanned structure. In addition,
the purpose i.e. the reason for which these types of organization exist vary. In order
to understand these two types of organizations you have to transfer your learning of
organization - its definition as well as its structure to this area. Let us then start
with the:
Definitions
Formal Organization: Formal Organization is that organization which comprises
groups, deliberately and consciously created by the administration of an enterprise
by means of the organizing process for accomplishing the laid down objectives of
that enterprise.
By formal organization is meant the patterns of behaviour and relationships that is
deliberately and legitimately planned for members of an organization. This is also
known as structural organization. Emphasis here is only on charts and manuals.
In other words formal groups only constitute the formal organization.
Informal Organization: By informal organization is meant the whole pattern of
actual behaviours-the way members of organization really do behave - in so far as
these actual behaviours do n~t coincide with the formal plan. This is also known as
functional organization.
Formal Organizations have three basic types of formal groups- viz.
i) the Command Group consisting of a manager and his subordinates within his
span of control,
ii) the Work Team comprising individuals who perform together on a particular
job or jobs, and
iii) the Committees comprising groups constituted within the organization by the
Management with delegated authority for particular functions. Decisions in a
Committee are always taken by the Committee members as a whole, which is
the unique characteristics of a committee.
Characteristics
Characteristics of a formal and informal organization in respect of the following
aspects are:
Subject Formal organization Informal organization

Origin Formal organizations Informal organizations emerge

comprising formal groups
are conscious and
deliberate creations by the
enterprise management.
• formal organization .
Purpose Formal organizations exist
for realizing the
organizational goals.
Structure Here the structure is
formally designed with clear
definition of authority
relationships, well defined
positions and roles.
58
spontaneously out of social
interactions within the formal'
organizations; for an informal
organization to come up, it is
essential that there exists a
The informal organization exists
for the social and psychological
interaction of the members of
the formal groups,
Here there is no formal design
of the structure; instead, these
organizations have unwritten
rules which serve as guidelines
in accordance to which the
members behave.
 Organization: of Nurting
Subject Formal organization Informal organization Administration

Activities Focus round the Activities are not specified and

organizational objectives;
are well classified,
differentiated and well
defined.
Membership Each member of a formal
organization belongs to a
particular structured work
group within the formal
groups, having one superior
in a line authority.
Behavioural Each member has to maintain
Norms the prescribed behavioural
norms in their work situations,
maintaining discipline,
decorum and code of ethics.
Orientation Is towards efficiency, quality
of performance, achievement
of organizational goals and
cost-effective organizational
operations.
are dependent on psycho-
social, socio-political and
socio-cultural factors.
There is no rigidity. The
members join particular
informal groups on account of
friendship, need for affiliation,
assistance, protection and
communication. Proximity
and attractions are also factors
that prompt formal group
members to join informal
groups.
Informal groups have their own
norms in the form of rewards and
punishment through which these
groups have a social control over
their members.
Is towards individual members"
satisfaction and focus round
groups cohesiveness, affiliation
and friendship.

Informal Organizations

i)
..
Characteristics of an informal organization in terms of the following are:
Origin: Informal organizations emerge spontaneously out of social interactions
within the formal organizations; for an informal organization to come up, it is
essential that there exists a formal organization.
ii) Purpose: The informal organization exists for the social and psychological
interaction of the members of the formal groups.
iii) Structure: Here there is no formal design of the structure; instead, these
organizations have unwritten rules which serve as guidelines in accordance to
which the members behave.
iv) Activities: Activities are not specified and are dependent on psycho-social,
socio-political and socio-cultural factors.
v) Behavioural Norms: There is no rigidity. The members join particular
informal groups on account offriendship, need for affiliation, assistance,
protection and communication. Proximity and attractions are also factors that
prompt formal group members to join informal groups.
vi) Orientation: is towards individual members' satisfaction and focus round
group cohesiveness, affiliation and friendship.

Check Your Progress 6

1) Define Formal and Informal Organizations.

59
Nursing Adptinistration and 2) Place a 'v" mark against the most appropriate answer under each statement:
Management •
i) All of the following are applicable in case of a Line Organization except:
a) Line authority is vertical and straight.
b) Line organization is suitable for large scale organizations,
c) Line organization maintains strict discipline.
d) Unity of command are present
e) Line managers are generalists.
ii) A line and staff organization:
a) Refers to positions of advisory and service capacity to provide
advice and service to the line.
b) Based on pl~rllled specialization.
c) Provides a platform for sharing of credit by both staff and Line
Officials.
d) All of the above. •
e) Only a) and c)
iii) A Functional Organization is characterized by all 'except':
a) Functional and diagonal authority •
b) Functional managers are generalists.
c) Unity of command is not there.
d) Strict discipline is not maintained.
e) Suitable for large-scale organizations.
3) Fill in the blanks:
i) The three basic types of formal groups are ,
and .
ii) A formal organization's activities focus round the organizational objectives
and are well ." and well .
iii) In an . , the orientation is towards group
cohesiveness, affiliation and friendships.
iv) The negative features of an informal organization may be:
Resistance to , informal leaders' attitude towards .
of : and spread of .

3.6 ORGANIZATION OF HOSPITAL

Definition like all social organizations hospitals grew of a necessity. The health
needs of the people were to be met. It is the resultant effect of a felt need that had
to be catered to; this is relevant even today. Hospital is an institution for delivery of
•
health care in the modem world.

3.6.1 Definition of a Hospital

The word 'Hospital' is derived from the Latin word 'hospitalis', which comes from
'hospis', meaning a host.
"The hospital is an integral part of a social and medical organization, the function of
which is to provide for the population complete health care, both 'curative' and
'preventive' and whose out-patient services reach out to the family and its
environment; the hospital is also a center for the training of health workers and
biosocial research" (WHO Expert Committee on Organization of Medical Care,
60
1957).
Today hospital means an institution in which sick or injured persons are treated as Organization: of Nurting
Administration
well as healthy persons are helped to prevent, promote and maintain an optimum
level of well being.

A modem hospital is an institution, which possesses adequate accommodation and

well qualified and experienced personnel to provide services of curative, restorative,
preventive and promotive character of the highest quality possible to all people
regardless of race, colour, creed or economic status. It conducts educational and
training programmes for the health personnel particularly required for patient care
and hospital services. It also conducts research assisting the advancement of
medical services and hospital services and conducts programmes of health
education.

3.6.2 Classification
Hospitals have been classified in many ways.

According to Ownership/Control
On the basis of ownership or control, hospitals can be divided into four categories,
viz., Public Hospitals, Voluntary Hospitals, Private Hospitals and Corporate
Hospitals.

i) Public Hospitals are those run by Central Government, State Government or

local bodies on a non-commercial basis. These hospitals may be general
hospitals or specialized hospitals or both. General hospitals are those which
provide treatment for common diseases whereas specialized hospitals provide
treatment for specific diseases like infectious diseases, cancer, ailments of eye,
E.N.T., etc.

ii) Voluntary Hospitals are those, which established "andincorporated under the
Societies Registration Act run by voluntary organizations on a non-commercial
basis. A board of trustees usually manages such hospitals. The main sources
of their revenue are, public and private donations and grant-in-aid from the
Central Government, State Government, and from Philanthropic Organizations,
both national and international. Thus, voluntary hospitals are run on a 'no
profit, no loss' basis.

iii) Private hospitals are generally owned by individual or a group of people. These
are run on a commercial basis.

iv) Corporate Hospitals are run by limited companies formed under the
Companies Act. They can be either general or specialized, or both.

Classification According to Clinical Basis

According to classification Hospitals are classified as general or specialized
hospitals. In a general hospital, patients are treated for all kinds of diseases but in a
specialized hospital, patients are treated only for those diseases for which that
hospitals has been set up, such as Cardiac Diseases, Tuberculosis, Cancer, etc.

Classification According to Length of Stay of Patients

A hospital may fall into a category of either long-term or short-term (now known as
chronic care or acute care hospital respectively) according to diseases and
treatment provided.

Classification According to Teaching or Non-teaching Status

A hospital may have a Medical College attached to it, when it is called a teaching
61
hospital. A hospital without a Medical College is termed as a non-teaching hospital.
Nursing Administration and
Management
3.6.3 Functions of a Hospital
i) The primary function of a hospital is the provision of medical care to a
community.
ii) To be a center for education of all types of health professionals.
iii) To be a center of research.
Despite these varied functions, exaggerated importance must not be .!!iv~nto the
place of hospital in a scheme of community health care.
Though hospital's appearance may be impressive, mere provision of hospital beds is
no substitute for environment, preventive and domiciliary health services.

3.6.4 Policies of the Hospital

Policies are guide to action. Policies supply the standard guidelines for planning to
act inline with legal requirements and to achieve the desired goal. Policies help the
executive keep his activities within a prescribed framework of action.
, A Policy is a verbal or written basic guide to action that is adapted and followed
by a manager.' Terry
Policies refer to a broad general statement of expected actions that serve as a
guide to managerial decision-making or to supervise the performance of
subordinates.
A clearly defined polity is a pre-requisite to good administration.
In a hospital the policies are framed considering the objectives of the hospital and
should explicitly explain the derived action intended by the management. Primary
obligation of a hospital is to provide efficient service to the patients and to the
community.
Policies for a hospital will include those related to

• Personal policies.
• Purchase of equipment and supplies
• Medical Services
• Nursing Services
• Dieting Services
• Employee welfare policies.
• . Staff Development
• Maternal Management
• Fiscal Management

3.6.5 Hospital Utilization

The term 'hospital utilization' denotes the manner in which a certain community
makes use of its resources or the manner in which certain cornmunits utilizes the
hospital.

Factors Influencing Hospital Utilization

The manner in which a certain community utilizes the hospital and the extent of
such utilization are influenced by many factors that depend on the social, economic,
educational, and cultural characteristics of the people and on the attitudes and
special habits of the medical profession. With regard to the letter, it may be
presumed that the doctor orders or advises admission to a hospital primarily for
medical reasons; however, this is not always the case. Very often people
themselves influence the decision for or against hospital admission, e.g. in the less
62 developed countries, fear of the hospital may be a strong argument against hospital
 admission, whereas in more sophisticated communities, the hospital "habit" may be Organization: of Nurting
Administration
such that a person may bring pressure to bear on the attending physician for
admission to the hospital, even though there may not be objective reasons for this
course of action. Because of the rising cost of hospital care, studies need to be
. carried out to identify the directions in which economy may be affected without
influencing the quality of care.
The following are some of the factors that affect the utilization of a hospital:
Factors influencing hospital utilization can be classified into either extra-mural factor
i.e. without the hospital or intra-mural factor, i.e., within the hospital.

i) Extra-Mural Factors
Availability of Hospital Beds: larger the number of available hospital beds in the
community, the larger the volume of hospital utilization (especially in economically
developed countries). They are the result of factors linked to socio-economic
development such as better health education, increased health consciousness, larger
protection by social security, higher standards of living leading to increased demand
for medical care.

Service Coverage and Bed Distribution: This depends on the geographic

distribution of hospital beds rather than on total number of beds, and an even
geographic distribution increases hospital utilization by making the hospitals more
available to people. On the other hand, a large number of beds concentrated in
urban areas may still mean a low admission rate for the country as a whole, as a
large sector of the rural population may not be able to take full advantage of the
hospital because of the distance involved.

Age of the Population: A population with high life expectancy (and consequently a
higher proportion of aged persons) tends to raise the volume of hospital utilization.
The effect of age on utilization index is reflected in the person hospitalization rate
and in the average length of stay per person.

Means of Communication: The modes of transport available for the community to

reach the hospital and tlie traveling distance are likely to influence the hospital
utilization.

Morbidity and Mortality Ratio: Hospital utilization is greatly influenced by the

morbidity pattern of the community. The sporadic increased demand due to an
outbreak of disease and the day-to-day morbidity pattern both determine, to a large
extent, the type and volume of hospital admissions.

Availability of Extra-mural Medical Services: The type, extent and quality of

extra mural medical services affect hospital utilization in various ways, e.g. a well-
organized domiciliary health service can reduce the load on the hospital. An
important role is played by the outpatient department, e.g., a good out-patient
department with diagnostic facilities may greatly reduce the number of admissions
to the hospital.

Housing: The current trend of families to live in smaller houses or apartments has
a definite influence on hospital utilization. The combination of shortage of space and
shortage of home help is an important factor in the demand for hospital admission.
This is particularly true with regard to the elderly, who often cannot be kept at home
when sick.

Supply of Physicians: The number of doctors in a country influences hospital

utilization in a number of ways, e.g., in areas with a very small supply of doctors,
the admission rate' tends to be low, as large sectors of population have no access to
medical practitioners and much illness remains undetected. As the number of
doctors' increases, more cases of illness are detected and the hospital admission
63
rate rises.
Nursing Administration and Existence of Proprietary Hospitals: The proprietary hospital is also selective in its
Management
admission policy, usually receiving minor or curable cases. Therefore, complicated
cases are mostly referred to general hospitals.

ii) Intra-mural Factors

Hospital's physical layout / internal organization: The greater the amount of
segmentation within a hospital, the lesser the degree of utilization, as shown by the
bed occupancy rate and the turnover interval, e.g., earmarking beds for particular
diseases or putting them at the sole disposal of particular consultants would
influence hospital utilization.
Methods of Payment for Hospital Services: There are two methods of payment
for hospital services: direct and indirect. In the former, payment is made directly by
the utiliser of the hospital services, in the latter, services are paid for through
prepaid programmes, e.g., C.GH.S./ E. S. I. , sickness insurance, third party
payment etc. Hospital utilization is greatly influenced by the method of payment.
Hospital "Bottlenecks": Another important factor in hospital utilization connected
with the hospital itself, is what might be termed "hospital bottlenecks" or, in other
words, the efficiency of the hospital's supportive services: X-ray department,
laboratory services, O.T. services etc. Shortage of personnel, space or equipment in
these departments result in prolonged average hospital stay and a lowering of
admission rate. Improved efficiency in these departments increases the admission
rate, and, consequently, decreased hospital stay of the patients. Similarly, the
administrative services, such as the admission and discharge procedures, may act
as bottlenecks and adversely affect the efficiency of the hospital.
Medical Customs and Social Patterns: The customs or attributes of the medical
profession affect hospital utilization, e.g. early ambulation results in a lower average
stay in the hospital. The demand on hospitals is also affected by the social and
cultural patterns of the community, e.g., people not corning to hospital even when
needed.
Research and Training: Hospitals with programmes of research and / or training
tend to be more selective in their admission policy.
The work and importance of a hospital ought not to be measured in terms of beds;
the average length of stay, occupancyrate, and admission rate are all part of the
picture. The hospital's activity should also be related to the number of patients
examined and treated as in-patient or outpatient in the rehabilitative services or
under home care. The hospital of the future should have fully developed extra-
mural services and a reduced number of beds.

3.6.6 Health Team and Committee (Role of Committee in

Hospital/Organization)
We shall now briefly discuss the role of committees in an organization.
Committees can be formed for many reasons i.e. to resolve a particular problem for
a particular period (adhoc committees), permanent Committees like Finance
Committee, Personnel Selection Committee, Establishment Committee to deliberate
upon and resolve issues on a regular basis (Standing Committees). The committees
facilitate in taking a mutually acceptable decision within the periphery of the
committee's pow,r. Take for example a committee on procurement of computers,
which shall normally have supervisors from user division, finance and materials.
These persons will look into the needs, advantages and disadvantages of procuring
the number and types of computers to be procured and they shall also lock into the
justification of procuring the same from a particular firm. The compatibility of the
computer to be procured with the needs of the division shall be analyzed and then a
64 decision taken. This ensures the involvement ofrespective supervisors in the
committee. The committees are formed within the organization in order to facilitate Organization: of Nurting
Administration
smooth movement of the various operations in the organization and is a part and
partial of any established institution I organization.
Some of the important advantages of committees are:
i) They can often produce a better decision than can one person working alone.
ii) They are extremely useful in coordinating plans and transmitting information
throughout the organization.
iii) The motivational value they create among the members can result in both
enthusiasm and support for their decision.
Some disadvantages include:
i) They can be a big waste of time and money.
ii) Sometimes they are used for making decisions that are best handled by an
individual manager.
iii) When a deadlock is reached, the decision of the committee is sometimes a
compromise that produces a truly inferior result.
iv) Some members may use this platform towards a negative influence.
However if the supervisor manages the committee meetings properly and usefully it
can be advantageous and drawbacks can be minimized. For holding successful
committee meetings following guidelines are useful and helpful.
i) Make certain a meeting is really necessary to achieve the objectives;
ii) Develop an agenda and send it out to the concerned persons in advance;
iii) Give careful consideration to those being invited to the meeting;
iv) Give the meeting your undivided attention;
v) Be prepared adequately;
vi) If participation by the members is important, be prepared to ask the right
questions or initiate discussion in order to stimulate discussion and involvement;
vii) Keep to the agenda to the extent possible;
viii) Conclude the meeting by summarizing the highlights including actions to be
taken;
ix) Have the proceedings correctly recorded lminuted.

Check Your Progress 7

1) Enumerate the demerits of committees .

.........................................................................•........................................

2) List the general guidelines for holding a successful committee meeting.

65
Nursing Administration and
Management 3.7 LET US SUM UP
Do you think you can recapitulate what we have discussed in this unit? Sure you
can; even so, we are doing so for you. In discussing the basic concepts of
organization we have said:

The organizing function - - - - Results in - - - - - - - - - ORGANIZATION

• Identification &
Grouping of activities
Group of People
Performing together
to Attain Laid down
• Establishment and
common Objectives
definition of authority
relationships.

We discussed the organization structure, the principles of organization and types of

organization in the successive sections. These can be summed up as:

I Group of people
Organization 1----. working together
I I
for achieving common
Hasa goals.

Principles of Guide Structure

I1----- ••.Networks or pattern of
Organization Planning of I I Formal Relationships
between various parts/
units of the organization
Types or Design

~
Functional Divisional

Project I I Matrix

Fig. 3.5: Diagrammatic presentation of Organization structure

There are fourteen principles which guide the planning of the organization structure,
of which 'span of control' (erspan of supervision, or span of management) has a
crucia! role. The organization chart and manuals have also been discussed briefly.

In types of organization, the types-viz. the Formal and Informal Organizations have
been discussed. Figures below sums up what we have discussed in this unit.

In Units 1, 2 and 3 you have been given an idea about the basics oJi"adrninistration
and organization.

66 We shall now move on to discuss about supervision in Unit 4 of this Block.

 Organization: of Nurting
Administration
Organizing Results in Formal gives rise to Informal
function Organization Organization

Group of People for

common goals

~
Principles
Guide in
planning of
I
I
Structure
I .
I
~ ~
May one, two May one, two Dependent
- have
have orall or all on situational
three below three below demands
~
~ + •••
LO LSO FO

LO = Line Organization
LSO = Line and Staff Organization
FO = Functional Organization

Fig. 3.6: Organization at a glance

3.8 KEY WORDS

Chain of Command The line of authority running from the top to the
bottom of the formal organization.
Communication is the process through which messages,
information and attitudes are exchanged with one
another.
Functional Authority is that authority which emerges out of functional
expertise.
Grapevine Refers to an informal communication network for
sending messages usually on a one-to-one basis
and orally, that exists through a formal
orga~zation.
Line authority is the authority that flows directly from a superior
to asubordinate.
Organization Structure The authority and accountability relationships that
exist between different positions within a formal
organization, clearly denoting who is to report to
whom and who is accountable to whom.
Span of Control Refers to the number of subordinates that a
manager or a supervisor can effectively
supervise. This is also known as span of
management and span of supervision.
Staff authority is the authority that is vested on the advisory Staff
67
to advise Line managers.
Nursing Administration and Systems An arrangement and set of relationship among
Management
multiple parts operating as a whole (ECO-03
IGNOU)
Unity of Command Refers to a principle, which says that every
subordinate should have only one supervisor.

3.9 ANSWERS TO.CHECK YOUR PROGRESS

Check Your Progress 1
1) i) function; ii) subsystems; iii) result; organizing; iv) operational;
responsibilities; personnel; activities.
2) i) Objectives and plans of the organization;
ii) Authority available to various categories of managers;
iii) Environment of the enterprises;
iv) Manning of the enterprise with appropriate people.

Check Your Progress 2

1) i) Group of people
ii) Common goals or objectives
iii) Division of work
iv) Vertical and horizontal relationship
v) Chain of command with laid down channels of communication.
vi) Group dynamics.
2) i) Y
ii)· N
iii) N

Check Your Progress 3

1) i) Unity of objectives
ii) Di vision of work and specialization
iii) Definition of Jobs
iv) Distinguishing between line and staff functions
v) Chain of command
vi) Unity of command.
vii) Principle of Adequate Authority
viii) Unity of Direction
ix) Exception principle
x) Span of supervision
xi) Balance principle.
xii, Principle of communication
xiii) Principle of continuity
xiv) Principle of flexibility
2) Span of Control or Span of Supervision refers to the number of subordinates/
persons; a manager or a supervisor / superior can effectively supervise.
3) i) Time and attention spans
ii) Personality and energy spans
68
. iii) Span of knowledge
 iv) The nature of the activities and tasks being performed. Organization: of Nurting
Administration
v) The capabilities of supervisees.
vi) The degree of decentralization

Check Your Progress 4

1) i) Must be a diagrammatic representation;
ii) Must denote the principal lines of authority between the different positions
within the enterprise;
iii) Must show the interrelationship between various functions and authority
positions;
iv) Must denote the channels of communication between different positions
and between the executives and the subordinates.
2) i) d)
ii) c)
iii) e)
iv) a)

Check Your Progress 5

1) i) Line authority: Refers to the authority of those positions within an
organization, which have the authority, responsibility and accountability for
achieving the main objectives of that organization.
ii) Staff authority: Refers to the authority of positions within an organization,
which are there to provide advice and service to the line positions in
fulfilling the organizational objectives.
iii) Functional authority:Relates to authority of those positions within an
enterprise which are there for specific functions irrespective of
departments or divisions within the organization.
2) Merits of line organizations are:
i) Simplicity; ii) Unity control; iii) Better discipline; iv) Fixed
responsibility; v) Flexibility
3) Line and staff organization

Merits
i) Expert's advice becomes
available to the line Management
ii) Benefit of planned management
is there
iii) Line managers have more time
to devote to their own functions
leading to greater efficiency
iv) Chances of advancement of
employees become available.
Demerits
i) Staff tend to assume line
authority and thus may become a
cause of friction between the two.
ii) Sometimes staff do not give sound
advice, not being accountable for
the results of the
iii) Staff steal credit although line
mana gers plan and give
direction through sheer hard work
and intelligence.
v) Staff fail to see the whole picture
relating advice to the tasks and
objectives of the enterprise.

Check Your Progress 6

1) i) Formal Organization is that organization which comprises groups
deliberately and consciously created by the administration of an enterprise
by means of the organizing process for attaining the organizational
69
objectives.
Nursing Administration and ii) Informal Organization is a spontaneously formed grouped people; who
Management
meet and interact regularly drawing its group members from the formal
groups on the basis of their psycho-social needs.
2) i) b
ii) d
iii)b
3) i) Command Group Work Team; Committees
ii) classified; defined; differentiated
iii) informal organization
iv) Change; negative; fulfillment; organization; objectives; rumour,

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1) i) Can be a big waste of money;
ii) Can be misused;
iii) In situations of deadlock, a compromise is reached at the cost of quality of
result being obtained.
iv) The platform may be used towards a negative influence by some members.
2) i) To make certain about its necessity.
ii) To develop agenda for the committee meeting and to send the same in
advance to all concerned.
iii) To give careful consideration to the invitees.
iv) To give undivided attention to the meeting.
v) To be prepared adequately.
vi) To be prepared to stimulate discussion from participants as and when
_ such participation is required.
vii) To keep to the agenda as far as possible.
viii) To conclude with a summary and highlights including actions.
ix) To have the proceedings correctly recorded.

3.10 FURTHER READINGS

Arora S. P, Office Organization and Management, Vikas Publishing House Pvt.
Ltd., New Delhi.
Awasthi & Maheshwari, Public Administration; Agra: Educational Publishers,
1999.
IGNOU SIM ECO-03-1-4
Kallaus, Norman F. and Kealing, B. Lewis, Abridged Administrative Office
Management: Cincinnati, Ohio: South Western Publishing Co. 1988: 9th Ed.
Lockst Martin & Spean Roger, Organizations as Systems, Milten Keynes.
Mescon, Michael H, Albert Micheal and Khedouri, Franklin, Management,
New York: Harper and Row Publishers, 1985, 2nd Edition.

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