Organizational_Paper

The Organizational Structure of M.D. Anderson Cancer Center Reenamol Mathai Dr. Johnie Tarver December 3, 2010 Leadership and Management Practicum Fall 2010 The Organizational Structure of M.D. Anderson Cancer Center Description of Organization The University of Texas M.D. Anderson is an academic institution; a hospital specialized in cancer treatment, and a research center located in the Texas Medical Center in Houston. The institution consists of over 30 buildings that are clinics, and outpatient radiation centers. This non-profit institution provides service for over 60,000 patients in one year. The M.D. Anderson Radiation Treatment Center in Istanbul at American Hospital is the first international location. The cancer center is named after Monroe Dunaway Anderson who was a cotton trader from Jackson, Tennessee. Wikipedia.org has cited that Mr. Anderson started the MD Anderson Foundation in order to avoid paying estate taxes upon the death of his business partner. According to mdanderson.org, “the mission of The University of Texas M.D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.” Organizational Structure The Purple 10 floor at the M.D. Anderson main building is a specialty unit that focuses on Melanoma and Sarcoma patients and their treatment. This unit is a bureaucratic functional structure, because it is arranged by its specialty. A functional structure has departments that provide similar functions with a common manager or executive. The advantage is that functional structures tend to support professional expertise and encourages advancement. The disadvantage is that there may be a discontinuity of care and delays in decision making. Issues that require communication across functional groups typically must be raised to a senior management level before a decision can be made (Yoder-Wise, 2007, p. 139). Barbara Summers is the Vice President and Chief Nursing Officer for the division of Nursing at the hospital. She makes all of the decisions regarding the nursing profession, and the nursing manager and directors all report to the Vice President. A bureaucratic structure has a clear division of labor and well-articulated and commonly accepted expectations for performance. In bureaucratic organizations, communication and decisions flow from top to bottom (Yoder-Wise, 2007, p. 137). The advantages of a bureaucratic structure is enhanced consistency and bureaucracy, but the disadvantage is that it limits employees’ autonomy. The mission of the hospital clearly states the hospital’s goals and how important it is to be the best cancer center. The nurses play a vital role in the hospital’s structure, because they implement the prescribed treatment. The client’s satisfaction depends on how the nurse carries out the interventions that the doctor orders. Communication Style The assistant nurse manager on P10 and the staff nurses use assertive communication style. According to cedanet.com assertive communication is the style in which you stand up for your rights while maintaining respect for the rights of others. An example of this communication style occurred when a staff nurse hung calcium gluconate along with other medications, and the assistant nurse manager explained to her that calcium gluconate is not compatible with many medications. The nurse calmly explained to the assistant manager that she checked the compatibility of the medications using the available computer program, and the medications were compatible. The manager and the nurse avoided a conflict by speaking in a calm voice and collected voice, and by providing rationale for their reasoning. Leadership Style The assistant nurse manager explained that she believes that she uses a democratic leadership style. However, when Joint Commission decided to visit M.D. Anderson the assistant manager changed her style to autocratic. Every day she would quiz the nurses on her unit about different procedures, and she would get frustrated when they did not know the answers to her questions. The assistant manager was ordering her staff to clean up the nurse’s workstation and make sure that all of the expired medications were disposed before the Joint Commission came to visit. The advantage of using autocratic leadership during a time of crisis is that it helps for people to stay organized and work toward one common goal. The disadvantage is that the nurses on the unit are individuals that may not appreciate being told how to do their job. Conflict Resolution The only conflict that P10 had to deal with during the past few months was when an international patient came for treatment, and they did not feel as though the nurses were providing the best care. The patient’s family called a conference with the healthcare team, and the managers negotiated with the client. They explained to the family that each nurse is given multiple patients, and sometimes there is not enough time during the shift to take care of every need. Scheduling Scheduling is based on a classifying system that the nurses use during their shift to rate how much care each patient needs. The classification is not accurate and fails to provide enough options. The charge nurse uses the system to assign the patients for the next shift, and he/she will base it on the level of care that will need to be performed during the shift. The nurses with high dose chemotherapy (IL-2) patients are only allowed one other patient. A nurse with one IL-2 patient will have another patient that is not receiving chemotherapy. Delegation The discharge nurse handles the discharge planning, education, and ordering the take home supplies for the patient. The charge nurse makes sure the nurses classify their patients during the shift, and assigns the patients for the next shift. The charge nurse also makes sure that the unit is adequately supplied and helps with the patient load when the unit is extremely busy. When the high dose patients are assigned, the charge nurse will make sure to only assign a senior nurse with the task. The senior nurses have been working on the unit for more than 2 years and have also taken the Oncology certification exam. References Cancer Treatment and Cancer Research - MD Anderson Cancer Center. (n.d.). Cancer Treatment and Cancer Research - MD Anderson Cancer Center. Retrieved December 2, 2010, from http://www.mdanderson.org The University of Texas MD Anderson Cancer Center - Wikipedia, the free encyclopedia. (n.d.). Wikipedia, the free encyclopedia. Retrieved December 2, 2010, from http://en.wikipedia.org/wiki/The_University_of_Texas Yoder-Wise, P. S. (2007). Leading and managing in nursing (4th ed.). St. Louis, Mo.: Mosby.