The strategic apex is weak with no consistent, committed leadership or administration

Chester Bernard's book, The Functions of Executives, from the human relations school of thought, emphasized the need for clarity and cooperation among managers and workers to further the interests of everyone. Bernard said that organizations by their very nature are cooperative systems and cannot survive otherwise. He listed three forces to achieve this cooperation; executive leadership, subordinate acceptance of organizational goals, and the power of informal work groups. Clearly in a hospital there is room for strict rules and processes outlined by the leaders, but because there are also large areas of independent decision making, you must have a cooperation and a balance of both.

Employees also need, and are more likely driven by intrinsic motivators. These can come from reaching personal career goals, making enough money to buy a new house, or simply feeling good when a patient gets well as a direct result of their care. Putting a Human Resources management in place could provide rewards programs in the form of money, recognition, and promotion. These are all triggers for employees to set themselves goals to reach these rewards.

The lines of authority for the division of labor between the apex and the middle line are not clear. This makes leadership difficult.

Unit grouping would be the design parameter most required to help facilitate the mutual needs of each unit. Grouping these under the same supervision would encourage cooperation and help to promote a more efficient and cooperative working environment. Once the needs of each area are clear, you need to establish liaison positions, or roles that can coordinate the work of two units. These liaison positions are missing in the hospital and LCHC structure. Task forces are also missing. Task forces can plan meetings, bring the members of each unit together, and integrate mangers to coordinate what is important to the units. These initiatives would eliminate competition for the best nurses and doctors, and provide a fair an accurate financial accounting for both facilities. It is difficult to tell how much impact the support staff for either the Limora hospital, or the LCHC have on the operating core and the quality of care. I'm sure the support staff could also be optimized by unit groupings.

The Bishop is not motivated to take on this leadership, or he does not have the leadership expertise to lead. It is the Bishop that should set forth the proper leadership characteristics, and develop the triggers that will motivate his organization. There seems to be no communication from him about the mission, strategy, or goals of either facility. If this is missing at the top, it cascades down throughout the organization very quickly. It is evident that the professionals in the operating core are confused, and don't have clear goals to follow. These goals would help pull all of them in the same direction.

Although there doesn't appear to be a middle line, Dr. Macdonald has been left to promote coordination and proper design on his own. His leadership attempt is valiant but he needs the help of qualified middle line managers. The missing parameters of design are Behaviour formalization, Training, and Unit grouping.

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Approximate Word count = 3988
Approximate Pages = 16 (250 words per page double spaced)