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Organizational Design of Elmhurst General Hospital

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Organizational Design of Elmhurst General Hospital


Every hospital, large or small, has an organizational design and structure that will facilitate the efficient and smooth daily operations for the efficient management of various departments (Burton, DeSanctis & Obe, 2004). Within a hospital setting, organizational design is a formal, guided process that integrates employees, patients, people, information, and technology, and serves as a key structural element that also allows Elmhurst to maximize value by matching its corporate design to overall strategy (Glickman, Baggett, Krubert, Peterson, & Schulm, 2007). This paper examines the organizational design of Elmhurst General Hospital as well as its internal and external factors that defines its size, organizational structure and process.


From a strategic perspective, Elmhurst's organizational design is more of an untapped variable that needs to be addressed in the context of organizational strategy and change. This is critical as attention to clinical quality is top priority to the hospital, and as such is a priority (Burton et al., 2004; Glickman et al., 2007). This is essential for health-care institutions such as Elmhurst to evolve its organizational and management structures that support the design and implementation of quality-improvement initiatives and at the same time, create mechanisms for accountability for quality of care and patient outcomes (Davis & Schoenbaum, 2010).

Furthermore, with the momentum in health care reform and other related debates, health care organizations constantly evolving, therefore organizational designs must have an evolving variable tool for improving their performance (Glickman et al., 2007). As hospital-based care has become the dominant system of health-care delivery in the 20th century, most hospitals such as Elmhurst have adopted a functional model based on discipline-based specialization. In other words, each various clinical departments, nursing, laboratory services and so on within Elmhurst has a manager that reports to higher management levels and then eventually to the hospital's CEO (Burton et al., 2004; Glickman et al., 2007).

Internal and External Factors

At Elmhurst, internal and external factors facilitate the hospital's modifications in order to meet the demands of such factors and the overall accountability at the hospital (Davis & Schoenbaum, 2010). To this end, certain factors that are critical to the changes include but are not limited to: standards committees and regulatory agency to ensure a certain level of patient care is set and maintained. It is also important that patients' privacy is held in the highest regard, and that frauds are made less likely.

The external factors influencing Elmhurst include: patient demands for better care delivery and increased efficiency, government policy changes and health reforms, the economy, demographic factors (e.g., longer wait times), technology, process outcomes and expectations for quality and competition. Internal factors that affect Elmhurst includes but are not limited to turnover rates of staff, lack of communication and flow of coordination, lack of accountability in certain areas such as dispensing of narcotics, complaints and dissatisfaction from employees regarding insufficient perks, and benefits (Chung, Kim, Kim, & Sohn 2010; Davis & Schoenbaum, 2010).

Having said that however, although Elmhurst's centralized design allows for more efficient operations based on scales of economy in particular; it also limits the integration across functions and the ability to develop creative, and innovative quality-improvement processes, structures, and solutions at the level of the service line in relation to patient care and delivery of care ( Burton et al., 2004). For example, the best quality management projects tend to originate and are usually implemented at the level of Elmhurst's management teams through the hospitals high-end administrative and support administrative services (Glickman et al., 2007).

At the same time, however, clinical care at Elmhurst is administered at the service-line level by a team of clinicians. The team also is comprised of a multidiscipline and complementary health-care professionals including but not limited to nurses, nurse practitioners, therapists, and pharmacists. Within Elmhurst, there has been a history of discrepancies and conflicts between the central control and the local autonomy. This is where accountability becomes a key issue to resolve for Elmhurst (Burton et al., 2004; Davis & Schoenbaum, 2010; Glickman et al., 2007).

As it stands, the development of a less centralized, service-line orientation at hospitals would help to support the development of Elmhurst's total quality management processes especially at this clinical level. Like many hospital systems physicians serve primarily as consultants and customers of the hospital and are usually paid on a fee-for-service basis (Glickman et al., 2007). At Elmhurst, physicians also play a more active role and are involved as integral personnel within Elmhurst's organizational management design structure. That said however, there has been little change in Elmhurst's structure to accommodate the hospital's evolving role in its quality management.

Elmhurst's Incentive Structures

So as to



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