Question 1

Taylor Hospital has well-defined organizational units that provide maintenance,financial services,care for cardiac patients,care for surgical patients,and so on.The organizational chart indicates that surgical units report to a surgical manager and all nursing units report to a vice president of nursing; financial services to an accountant and then to a business executive; and so on.The primary disadvantage of this organizational structure is:

Accepted Answer

In a functional organizational structure,departments and services function according to specialty.This model supports professional expertise but can lead to silos in communication and decision making and discontinuity in patient services.

Question 2

Which of the following would be the most appropriate mission statement for a nursing center?

Accepted Answer

The mission statements of nursing centers are oriented toward achieving optimal health status for a defined group of patients or consumers rather than being treatment or maintenance or social-support oriented.

Question 3

A new CEO has been hired at Valley Hospital who proposes to change the centralized organizational structure that was put in place ten years ago,based on widespread consultation with staff.The proposed structure involves substantial flattening of the organizational structure,with significant decision making being made at the point-of-care and an emphasis on interprofessional collaboration.There is a great deal of discussion about the balance between hospital-wide budget decision making and unit-based decision making.This discussion represents:

Accepted Answer

Reengineering involves a total overhaul of an organizational structure.It is a radical reorganization of the totality of an organization's structure and work processes.In reengineering,fundamentally new organizational expectations and relationships are created. Redesign is a technique to analyze tasks to improve efficiency,and restructuring is a technique to enhance organizational productivity.

Question 4

With revenue reductions and cost-saving measures,the number of managers has been reduced,which has increased the number of team leaders supervised by managers by as many as three.This change may result in:

Accepted Answer

When a span of control becomes too large,supervision can become less effective,which can have a negative effect on staff-manager relationships and on the overall quality of patient care.

Question 5

The chief nursing officer is given the task of reviewing and revising the organization's mission,philosophy,and technology.In reviewing them,the chief nursing officer understands that they should be reflected in:

Accepted Answer

The mission statement is an important foundation for the organizational structure and defines technology and human resources required for the organization.

Question 6

In matrix organizational structures,a nurse manager understands that this type of structure:

Accepted Answer

Matrix structures are complex,integrated organizational structures that involve both functional and service or product-line managers.In this structure,team members or teams from various functional departments may combine to complete a project or program,thereby becoming responsible to both their functional department manager and their product-line manager.

Question 7

Because of rapid turnover and the ongoing hiring of new graduates,the skill levels of staff in a busy CCU are varied.Senior staff are becoming burned out with the need to provide mentorship and guidance to new staff.As the manager,you propose the addition of a nurse in advanced practice to provide consultation and education for staff.This position is termed a(n):

Accepted Answer

Line personnel have authority for decision making,whereas personnel in staff positions provide education,support,advice,and counsel.The nurse in the advanced practice is providing advice and support through education as well as consultation.

Question 8

A primary care clinic is established in Pleasantville to provide comprehensive services to infants,children,and families within the community.The executive director of the clinic oversees physician and nursing services for infants,children,and families; a neurodevelopmental clinic; psychology,family counseling,and social work services; nutritional counseling; speech and hearing services; and physiotherapy.This type of organizational structure is known as:

Accepted Answer

In service-line structures (sometimes called product lines),the functions necessary to produce a specific service or product are brought together into an integrated organizational unit under the control of a single manager or executive.

Question 9

The facilities department is experiencing some challenges and is undergoing reorganization.Because of your familiarity with systems theory,you:

Accepted Answer

By nature,a system such as an organization is an interacting collection of parts that together make up the whole.Changes to one part will affect other parts and the system as a whole.

Question 10

At Hospital XYZ,staff members on Y3 have dealt with the third head nurse in three years.Donna,the current head nurse,lacks confidence in patient-nurse relationships,and scheduling and other processes are routinely left to the last minute.Staff members approached Donna first and then administration with their concerns about Donna's effectiveness as a leader.The staff was told that the problem is likely staff related,that it is simply an unhappy group,and that there is nothing that will be done further about their concerns.The philosophy of the organization indicates that "open,transparent communication between staff and management is desired and supported," and that "innovation and creative thinking are the foundation of the organization's progress." In assessing this situation as a newly hired senior executive,you anticipate that:

Accepted Answer

Lack of congruence between the stated philosophy of the hospital and the experienced organizational culture does not support either the staff or the head nurse and likely will result in ongoing frustration,confusion,and morale,which could result in increased attrition.

Question 11

"At Thoroughcare,we provide health care for women and children in transition" is an example of a:

Accepted Answer

Mission statements provide a reason or rationale for the existence of the organization and are indicative of the structure of the organization and of who consumes the services provided.

Question 12

In opening a new dialysis unit,the nurse manager has to develop a philosophy for the unit.This philosophy needs to:

Accepted Answer

A philosophy expresses the values and beliefs that members of the organization hold about the nature of their work,about the people to whom they provide service,and about themselves and others providing the services.

Question 13

The chief nursing officer and the dean of the School of Nursing believe that by establishing rules and regulations and controlling the environment,this partnership will:

Accepted Answer

Bureaucratic structures have a centralized command structure (chain of command).with a clear division of labor and well-articulated and commonly accepted expectations for performance.Rules,standards,and protocols ensure uniform actions and limit individualization of services and variance in workers' performance.Although bureaucracy enhances consistency,by nature,it limits employees' autonomy and thus the potential for innovations.

Question 14

At Orangetown Hospital,the nursing department is developing a mission statement for nursing.Which would be a suitable mission statement?

Accepted Answer

A nursing mission statement within an organization needs to establish the reason for nursing within the organization and lays out relationships with clients,the community,and other disciplines.

Question 15

A new director of nursing in a small rural hospital wants to make changes from the traditional model of governance to a shared-governance model.Select the characteristic below that best describes the traditional organizational structure in which a staff nurse is assigned to carry out nursing tasks for clients but is not given the chance to provide input into forming the policies and procedures by which care is delivered or the standards by which care is evaluated:

Accepted Answer

In traditional structures,decision-making authority (right to act)is held by a centralized decision-making body,so that staff members have responsibility for certain functions but do not participate in decisions related to those functions.

Question 16

In which of the following situations would you expect low morale and frustration?

Accepted Answer

Although frustration may occur with external factors that affect ability to act on values and aspirations,lack of congruence between what is espoused as a value within the organization (such as promising advancement as an incentive to join the organization)and what is actually done (such as restricting advancement to internal candidates with much organizational history)can cause low morale and confusion.

Question 17

Collaborative partnerships between hospitals and schools of nursing are examples of hybrid organizational structures.A hybrid organizational structure:

Accepted Answer

Hybrid structures include characteristics of various organizational types and reflect the needs of the situation and the environment.

Question 18

A hospital is working toward becoming a Magnet™ hospital.The chief nursing officer is aware that professional nursing departments of the future will:

Accepted Answer

Hospitals that are successful in recruiting and retaining nurses have found that the major contributing characteristic to success is a nursing department that is structured to provide nurses the opportunity to be accountable for their own practice.Accountability is guided by nursing standards of practice and thus,successful nursing departments emphasize maintenance of these standards.

Question 19

The hospital administration gives approval to the chief nursing officer to hire clinical nurse specialists in staff positions rather than in administrative positions.A clinical specialist who has staff authority but no line authority typically is able to:

Accepted Answer

Staff positions provide support to line positions but have no direct accountability for staff or patient outcomes and therefore function through influence.

Question 20

"Georgia Hospital will provide care that is a national example of consumer service" is a:

Accepted Answer

A vision statement is an articulated goal that provides an inspirational target to which the organization aspires at some future time.A statement of philosophy expresses values and beliefs,and a mission statement provides the reason for the existence of the organization.

Quiz 8: Understanding and Designing Organizational Structures