There are four frames of organizations – structural, human resource, political and symbolic. Each frame represents different perspective of the same organization just as looking through a different color lens on the same view. In order to understand any organization fully one need to learn how to look through each lens. Structural frame represents architectural design of organization. How departments, units and subunits are structured; assigned roles and responsibilities of the employees, ways of coordination and configurations.
For example, the hospital structure is a structure of a big building with multiple departments such as administrative, clerical, human resources, housekeeping, medical – surgical, pharmacy, dietary, transport, etc. , where is each department also has its own structure. Let me take, for instance, Emergency department where it is very important to follow the policy, rules and procedures to achieve the goal of the department. As our hospital is a designated stroke center, taking care of the stroke patient is the main goal of the entire emergency department staff.
When stroke patient arrives in the emergency department we have very limited time to treat the patient in order to save his life and return him to normal not altered lifestyle. Time is the most important factor when stroke targets the brain. Within minutes it can forever damage brain parts that control our intellectual or physical ability. We cannot control the stroke from happening but we can control patients life if we act as quick as possible.
The Vertical coordination plays very important role in this aspect as the chain of commands and tight supervision of their execution are very important in this aspect of care. The physician in charge receives report on the stroke patient from paramedics. While they are on the way to the hospital, we get the entire team at alert – everyone in the team receives the stroke page. Hospital supervisor and physician ensure that within minutes appropriate procedures take place.
At the door we immediately asses the patient and rush him to computerized tomography scan- CT scan. Radiology team receives patient at the door of the department and take over. As CT pictures taken neurology and neurosurgery teams need to be in radiology and immediately review it and make the decisions based on the stroke target. Immediate endovascular procedure or surgery may be necessary to save the patient. Surgical and endovascular suits and teams are scrubbed and ready for the signal to take action or not.
If surgery needed, surgical team members perform their assigned roles and it is important that the surgeon and the surgical crew are familiar with each other as the performance and outcome of the procedure depends on it. “The surgeon is in charge, but there is substantial lateral coordination. ” (L. Bolman, T. Deal, 2008) After the procedure is done the nursing tem in critical care unit will monitor closely how the patient is responding and will help to full recovery.
“A key ingredient of a top-notch team is an appropriate blueprint of roles and relationships set in motion to attain common goals. ” (L. Bolman, T. Deal, 2008) The vertical ways is important to achieve the time goal, and fewer mistakes noted when control and coordination are in place but collaboration of the teams as one of the aspects in lateral way of coordination, is as important because is often necessary to make decisions based on everyone’s opinion for best possible outcome for the patient.