Nowadays, with the increase of living quality, more high standard health organizations or facilities are required to meet the population demand of health care. According to the change of the plan of New South Wales Health, the Children’s hospital at Westmead (CHW) determines future developmental direction and formulates its own strategies, vision and mission (The Children’s Hospital at Westmead 2007). In a word, the CHW sticks to respect both children and their families in spite of the change of hospital strategies, mission and vision (The Children’s Hospital at Westmead 2008). Actually, the organizational structure of hospital has relevant relationship that can not be neglected and obliterated with mission and vision. Thus, it is considered that the establishment of hospital structure can help to complete the mission and vision that are designed by organization (University of Western Sydney 2009); meanwhile, mission and vision can impact the hospital structure that is set up (Madden et al. 2006). The purpose of this article is to critically analyse the structure, mission, vision and goals of the CWH, and analyse interaction between organizational structure and mission or vision.
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Initially, according to the Children’s Hospital at Westmead (2008), the CHW adopts line structure to administer the whole operation of hospital. The mission, vision and goals impacts organizational structure of CHW designed; meanwhile, the aim of the structure is to complete the mission, vision and goals (University of Western Sydney 2010). For instance, workforce development which is involved in organizational structure is designed to offer high skill practitioners of “tertiary and quaternary care” (CHW annual report 2008), so that it can meet the demand of mission to complete the promise of hospital. The relationship between clinical operations and department of nursing shows the influence of mission statement which mentions to set up good consociation. In addition, it can be seen from the organizational chart (The Children’s Hospital at Westmead 2008) that there are many departments found for economics, treatment, health care and training and education. All of them established a sustainable foundation for the achievement of hospital vision, which shows that “healthy children for healthy future” (The Children’s Hospital at Westmead 2008). At last, the CHW goals direct the development of finance, emergency, health care and other services; it also requires the high quality of staffs.
Secondly, line structure has both negative and positive impacts on the development of hospital. Admittedly, the line structure of CHW is clear and simple. It shows the clear relationship between each department. Moreover, the organizational chart shows distinct superior-subordinate relationship. For example, according to the organizational chart, clinical operation directly administers allied health, diagnostics, medical, critical care and emergency services; at the same time, clinical operation hands in summary of annual work and feedback from lower levels to the highest level named chief executive(The Children’s Health at Westmead 2008). Another advantage of CHW structure is that not only one authority to judge all things. It is shown by the Children’s Hospital at Westmead (2008) that internal audit has right to supervise the action of chief executive. Even so, there are also some disadvantages of this line structure. Less communication of parallel departments which may decrease the quality of health service is demonstrated obviously. For instance, it is hypothesised that one child is sent immediately into critical care because of emergency situation, but he has renal disease that has not been checked out. If there is no contact with medical and critical care, this child would have life risk. What is worse, sometimes, highest authority can not receive the feedback immediately or receive untruthful information due to the incautiously negligence or deliberately concealing of middle or lower departments (Marquis & Huston 2009). Therefore, the problems of line structure will result in medical issues and descend the health care level of children.
Thirdly, according to the CHW goals (The Children’s Hospital at Westmead 2008), one main line of authority and responsibility is combined by finance and corporate services, community relations and marketing and information services and planning. It is believed that excellent staffs are an important foundation of the high quality health care. It is considered that appropriate incentives can retain the health professionals in different environment, especially in rural and remote areas (Dassault and Franceschini 2006). In addition, high standard of meals and accommodation promote the health care condition. Internet service can help families to solve problems at home; as well as, it can help to book the services, which saves time if it is not emergency problem but some small health issue. Furthermore, fundraising from companies or individuals creates equal chance for every child to accept treatment. It is shown by The Children’s Hospital at Westmead (2008), clinical operation and its subordinate departments combined into another main line push hospital to realize the goals. For example, hospital strengthens the infrastructures (such as advanced equipments) of emergency services, so that patients can accept efficient cure in time. The increase of whole level of clinical services improves the clinical safety and helps to practice good quality health care.
Moreover, some parts of the CHW structure can help to achieve the hospital mission to a certain extent. For example, “Allied health” in the structure provides the service to meet the requirement of “chronic and complex care” which is mentioned in hospital mission (The Children’s Hospital at Westmead 2008). There is a relationship between clinical operation and nursing. Nurses and clinical staffs keep in touch and share working experience with each other to establish good partnership described in mission (The Children’s Hospital at Westmead 2008). Nurses also can express the requirement or complain of patients to clinical practitioners, so that hospital could ensure the profits of children. What’s more, training and education bring up professionals to keep the high quality services. Admittedly, the organizational structure helps to reach the goals. For instance, internet service provides a link to save time of patients or their families to book services. Allied health service offer various health services to detective health issues in the early stage of children.
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Finally, some aspects of the CHW structure could assist the development of hospital and solve some problems. It has been mentioned that there is an internal audit existing with chief executive, so it enhances hospital’s monitoring, which may avoid the appearance of bureaucracy to a certain degree (Withey & Gellatly 2007). The good cohesion and cooperation between different services can make sure the high quality health service and medical safety of patient. One exact situation is that nurses and clinical operations have built a good relationship, which could be useful to operate clinically and solve problems such as conflict between patients and doctors (The Children’s Hospital at Westmead 2008). However, some aspects of this structure also can have negative impacts on the development of hospital and the solution of problems. In spite of the relationship between nursing and clinical operations, it is not enough partnerships for the hospital to promote its health care quality. For example, the lack of linkage between the department of workforce development and clinical operations is one important issue. It is stressed that the method of training workforce is changing with the change of clinical demand (Withey & Gellatly 2007). As a result, the lacking communication between these two departments may lead to the waste of resources including human resources and material resources.
Thus, to sum up, the line structure of the CHW is designed to reach the hospital mission, vision and goals; meanwhile, organizational structure is impacted by mission, vision and goals. Moreover, line structure has both merits and demerits in supply of health care services. In addition, there are two main lines of authority and responsibility which boost the completeness of hospital goals. Furthermore, some functions of hospital structure are useful for hospital to achieve its mission and goals. At last, the aspects of line structure both assist and descend the development of the CHW. Consequently, mission, vision and goals impact the establishment of organizational structure; and organizational structure can help to achieve them. It is recommended that the hospital should change the settled mode of line structure into the informal mode that is more flexible; and hospital might increase the chances of lateral communication as vertical communication (University of Western Sydney 2010).
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