A Municipal Hospital Administration Positions, Organizational Diagnosis And Analysis

ObjectiveThrough the comprehensive investigation on the management position in a tertiary hospital in shanghai, this research are to evaluate the organizational management structure, the responsibilities of the positions, and their related characteristics of the hospital, to establish a useful method and work flow for an organizational diagnosis and position analysis in hospitals, and to establish a framework of position description that is adapted to modern hospital management. In addition, this research is to promote the improvement in the ways of hospital management, especially in human resource management, to provide an experience of using the methods of organizational diagnosis and position analysis to standardize the position responsibilities, to optimize human resource management and to advance the comprehensive development for tertiary hospitals in our country.MethodsA third-level and first-class comprehensive hospital in Shanghai was selected as an investigated hospital ("A hospital" is used for short name in the following). 112 persons working in the management departments of this hospital were investigated. For collecting and analyzing the data about the organizational structure, the behavior, work satisfaction, work expectation, work responsibilities, work characteristics and others, the Likert scale questionnaires, the supervisors' analysis, interview, and the existing data were used. All data were input to the software of Excel 2003, and were statistically analyzed by SAS6.12. The qualitative data were analyzed by the method of analytical induction.ResultsThe management structure of A hospital was mainly linear with a centralized characteristic, but it also simultaneously had some functional patterns with decentralized elements. Currently, the management structure of A hospital had some significant problems that need to be fixed. The willingness of the management staff to make efforts to do work better was relatively strong and their working behaviors were quite positive. On the whole, comparatively few persons working in the management departments had the regressive behaviors in the management, but 11.68% of the persons working in the management departments had certain psychological regressive behaviors and thoughts. The management staff of A hospital lacked high progressive expectations as a whole and 58.1% of the persons working in the management departments had low expectation to the position promotion. The majority of the persons working in the management departments were not satisfied with the present working condition and only some parts of the working condition were quite satisfied by the management staff. The deviation degree of the index was roughly consistent. What the management staff was not satisfied with were "promotion opportunity", "working environment", "symmetry between responsibilities and authorities" and "existing management pattern". What the management staff was quite satisfied with were "colleagues", "immediate directors" and "the attention to staff's opinions by higher authorities". In the survey of 112 persons working in the management departments in A hospital, 16 of them (14.3%) did not fill in any information on position analysis, 37 of them (33.0%) did not completely analyze their own positions in details, and other 59 analyzed their own positions with some defects, mainly in work goals, work description and work responsibilities.Discussion and Suggestions:(1) The management structure of A hospital was adjusted quite passively. The linear management pattern was already not suitable. The present linear management pattern with some functional elements in organizational structure is quite suitable to a big hospital such as A hospital. The organizational structure, management flow, work responsibilities and authorities of A hospital should be modified in order to implement management effectively.(2) The measurement results of the work satisfaction, work expectations, work behaviors of the management staff in A hospitals showed that the management staff were positive. The management pattern of A hospital were suitable for the management staff to finish their daily work. But, there were quite a few persons working in the management departments were not satisfied and had some negative behaviors, mainly in position promotion, working condition, rationality of responsibilities and authorities, certain management methods, working time arrangement and others. The main reasons for these problems were insufficient in organizational support and hospital policy's support and had defects in hospital management. A hospital should promptly take the comprehensive clear position description as the guidance to present the positions' relative value, to play the proper role in staff's development, to close the gap among staffs work expectations, organization promises and real work perception, to improve staff's working behaviors, and to improve work satisfaction.(3) A hospital has not yet carried out the position analysis as a whole. This research confirms that the position analysis can be used in the other departments of the hospital, but needs work orientation, supervisor orientation and staff orientation so that the position analysis can be objective and reasonable. The position description based on the position analysis can make the explanation of position requirements clear, standardized and specific. This will support any staff to do the work more effectively, will reduce the internal and external factors that may have bad influence on the staff's working behaviors, will simultaneously guide the staff to develop their working career and make the work expectations reasonable, and will improve the staff's work satisfaction.(4) A big hospital, such as A hospital, should regularly take the evaluation on staff's working behaviors, work satisfaction, work characteristics, work roles, the organization fairness, as well as promptly make hospital diagnosis to keep on improving and enhancing management. A big hospital, such as A hospital, should carry on position analysis in all positions in the hospital, formulate the explicit position description to maximize the staff's working efficiency to reduce the cost of manpower. (5) The governmental organization that responsible for hospital management should strengthen the introduction and research of the management methods, such as organizational diagnosis and position analysis, should promote the active use of organizational diagnosis and position analysis to enhance the hospital management.