Discussion: Comparing Frameworks for Analyzing Organizations
Avedis Donabedians work generated a pivotal means of assessing organizational performance relative to structure process and outcomes. However it is clearly not sufficient to view health care quality merely in terms of outcomesthe structures and processes that facilitate these outcomes are equally as important.
In this Discussion you consider multiple frameworks that can be used to analyze an organization. As you proceed consider how these frameworks allow you to examine the interplay of interdependent and related parts and processes that comprise the systems within an organization as well as the arrangements or structures that connect these parts.
To prepare:
Investigate and reflect on the systems and structures of an organization with which you are familiar. Consider the following:
What is the reporting structure?
Who holds formal and informal authority?
How many layers of management are there between the frontline and the highest office-holders of the organization?
How are interdisciplinary teams organized?
How is communication facilitated?
How well integrated is decision making among clinical personnel and administrative professionals?
How are particular service lines organized?
Which departments groups and/or individuals within the organization are responsible for monitoring matters related to performance such as quality and finances?
Select two of the following frameworks:
Learning organizations presented in the Elkin Haina and Cone article
Complex adaptive systems (CAS) presented in the Nesse Kutcher Wood and Rummans article
Clinical microsystems presented in the Sabino Friel Deitrick and Sales-Lopez article
Good to great presented in the Geller article
The 5 Ps presented in the ASHP Foundation article
Review the Learning Resources for each of the frameworks that you selected. Also conduct additional research to strengthen your understanding of how to use each framework to assess an organization.
Compare the two frameworks. How could each framework be used to identify opportunities to improve performance? In particular how would you use each of these frameworks to analyze the organization that you have selected?
Post an analysis of the systems and structures of the organization you selected sharing specific examples. Explain insights that you gained by comparing the two frameworks and how each can be used to assess an organization identify a need for improvement and ultimately enhance the performance of an organization.
Read a selection of your colleagues responses.
Respond to at least two of your colleagues on two different days using one or more of the following approaches:
Compare the organizational structure of your colleagues selected organization to your own.
Ask a clarifying question.
Select an attribute of the identified organizational structure and ask your colleague to elaborate on how this attribute is evidenced in their organization.
Required Readings
Hickey J. V. & Brosnan C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York NY: Springer Publishing Company.
Chapter 1 Evaluation and DNPs: The Mandate for Evaluation (pp. 3-36)
Chapter 3 Conceptual Models for Evaluation in Advanced Nursing Practice (pp. 61-86)
Chapter 6 Evaluating Organizations and Systems (pp. 127-142)
Chapter 1 defines microsystem mesosystem and macrosystem and notes that evaluation can focus on one of these levels or all three. Chapter 5 examines the evaluation of organizations and systems.