Deck 8: Understanding and Designing Organizational Structures

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:

A)Breakdown in function and communication across specialties.
B)Lack of congruence in culture and organizational values.
C)Highly centralized decision making and authority.
D)Wide span of control.

Answer 1

Breakdown in function and communication across specialties.

Question 2

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

A)"At Plentyville, we provide rehabilitative services for addicted adolescents."
B)"Georgiatown provides treatment and prevention services for county residents."
C)"At Heart, our aim is to provide services that lead the nation in health education and research."
D)"At Coeur, we strive to achieve optimal pain management with patients who are experiencing chronic pain."

Answer 2

"At Coeur, we strive to achieve optimal pain management with patients who are experiencing chronic pain."

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:

A)Chaos theory.
B)Organizational redesign.
C)Organizational reengineering.
D)Restructuring.

Answer 3

Organizational reengineering.

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:

A)Decreased patient satisfaction.
B)Increased efficiency in costs.
C)A more positive perception of managers.
D)Little change to manager-staff relationships.

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:

A)The organizational structure.
B)Line and staff responsibilities.
C)The policies and procedures.
D)Government regulations.

Question 6

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

A)Is a simplified organizational structure.
B)Has both a functional manager and a service or product-line manager.
C)Arranges departments strictly according to function.
D)Promotes harmony in organizational decision making.

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):

A)Hierarchical position.
B)Ancillary.
C)Line position.
D)Staff position.

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:

A)Hierarchical.
B)Bureaucratic.
C)Service-line.
D)Matrix

Question 9

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

A)Know that this challenge is their issue and that it has nothing to do with your unit.
B)Understand that such events are localized and do not have an impact on the organizational culture.
C)Know that the nature of challenges and reorganization in facilities will have an impact on other areas.
D)Anticipate that your prior experiences with facilities have no effect on the current situation.

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:

A)Staff members will resolve the conflict on their own.
B)The situation will lead to ongoing disgruntlement and attrition.
C)No further discussion or concerns will come out of the situation.
D)The head nurse will be able to resolve the conflict on her own.

Question 11

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

A)Vision statement.
B)Mission statement.
C)Goal statement.
D)Statement of philosophy.

Question 12

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

A)Reflect the culture of the unit and its values.
B)Be developed by the nursing manager on the unit.
C)Identify the clients that will be served on the unit.
D)Replicate the organization's philosophy.

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:

A)Promote professional medical authority, autonomy, and responsibility.
B)Need a degree of flexibility to engender success.
C)Be essential for self-governance.
D)Provide for the establishment of medical committees.

Question 14

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

A)"Nursing provides services for patients admitted to Orangetown Hospital."
B)"To participate fully in the professional services offered by Orangetown Hospital."
C)"To lead by the lamp; services for seniors."
D)"At Orangetown, the nursing department provides caring services that recognize the diversity of clients and promote optimal health with clients through partnership, education, and interprofessional collaboration."

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:

A)Bureaucratic
B)Decentralized
C)Delegated authority and responsibility
D)Delegated responsibility but no authority

Question 16

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

A)Statement of philosophy indicates "We value our staff." When staff members leave, careful evaluation is done to determine whether staff should be replaced by full- or part-time employees.
B)Practices include annual staff recognition celebrations. During times of change, staff members are actively included in issue identification and solution finding.
C)Recruitment ads promise opportunities for advancement for everyone. Promotions are given only to individuals with long-standing service and entrenched relationships.
D)The vision indicates that there is strong commitment to lead in research. The organization has tried to implement a strong campaign to attract leading nurse researchers but has experienced difficulty in doing so.

Question 17

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

A)Has many divisions of labor.
B)Best fits long-term care units.
C)Has a mixture of the characteristics of various organizational types.
D)Places the authority for decision making closest to the places where workers perform.

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:

A)Not be directed by nurses.
B)Be virtual organizations.
C)Be designed to maintain nursing standards of practice.
D)Be entitled to have client care departments.

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:

A)Function through influence.
B)Take complete responsibility for the care of clients.
C)Interview and hire staff nurses for designated nursing units.
D)Be granted functional authority to determine standards of nursing care and enforce them.

Question 20

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

A)Vision statement.
B)Statement of philosophy.
C)Mission statement.
D)Rationale for care.

Question 21

In the Unity Healthcare organization,decisions,including those at the unit level,are made by a group of senior executives.Rules for employees are clear,and nursing care is delineated by procedures and protocols.This exemplifies:

A)Transformational leadership.
B)Transactional leadership.
C)Bureaucratic organization.
D)Chaos theory.

Question 22

Organizational culture includes (select all that apply):

A)Norms.
B)Traditions.
C)Behaviors.
D)Values.
E)None of the above

Question 23

Sarah is a clinical nurse educator in the dialysis unit at Pines Health Center and provides education,consultation,and training support.Sarah has:

A)Direct responsibility for patient care.
B)Direct accountability for patient outcomes.
C)An authority relationship to staff.
D)An influence over patient outcomes.

Question 24

In the Unity Healthcare organization,communication flows:

A)Laterally.
B)Bottom to top.
C)Top to bottom.
D)Intermittently.

Question 25

A statement such as "We believe in the right of patients to make choices and to have care that is sensitive to their preferences and needs" is a _____ statement.

A)Mission
B)Goal
C)Vision
D)Philosophy