Create and Refine a Policy for Organizational Structure
Time to Complete: 2-6 months
Difficulty: Moderate
Outcome: A structured, well-defined work environment in which roles and goals are documented
Steps
Conduct a baseline survey of all staff
Ask the following questions:
- What is the practice's organizational structure?
- How would you describe the practice's culture?
- What is the practice's chain of command (i.e., who reports to whom)?
- What are your responsibilities within the practice?
Describe the culture of your practice
The culture is your practice's "personality," reflecting assumptions, values and norms that are shared by everyone in the practice. It influences the way people in the practice interact with one another and with patients and others outside the practice.
- Create a written culture policy, including information on respect and conflict resolution.
- Develop a mission/vision statement for your practice.
- The mission statement briefly explains your practice's core purpose.
- The vision statement describes what your practice would like to achieve.
- The vision statement may be included within the mission statement or may be separate.
- Everything in a business or practice should be aligned with the mission/vision.
- Check staff placement in your mission/vision.
- Does each staff position align with and support the mission/vision statement? If not, you need to revise the position.
Describe the organizational structure of your practice
This step involves developing a detailed organizational chart that spells out the hierarchy in your practice.
- For each staff position, list key responsibilities.
- Refer to the job descriptions for each position.
- For each staff position, state accountability.
- Answer the question "To whom does the position report?"
- A staff position may be accountable to (i.e., report to) only one person for all responsibilities.
- A staff position may be accountable to more than one person, depending on the responsibility.
Hold an all-staff meeting to share the organizational chart, culture policy, and responsibility and accountability lists
This is especially important if your baseline survey revealed that many staff members don't have a clear picture of your practice's culture and hierarchy or how their position should function effectively within your practice.
Evaluate your practice's overall performance
Don't let your organizational chart, culture policy, and responsibility and accountability lists gather dust. Take a closer look at whether your day-to-day practice actually aligns with these policies.
- Evaluate current staff roles.
- Monitor staff time utilization.
- Map workflow within your practice.
- Analyze annual performance reviews.
- Conduct surveys of staff and patients to evaluate your policies, and then compare/analyze the results.
- Ask staff members:
- Do you have more clarity about the organizational structure of the practice?
- Do our practice's policies help you effectively fulfill your roles and responsibilities?
- Ask patients to share their impressions of your practice.
- Ask staff members:
- Determine financial impact.
- You can determine the effectiveness of structural changes by comparing financial reports from before the changes with those from after. If the changes have been effective, the post-change financial reports will show increased productivity.
What You Will Need
- Word processing software, such as Microsoft Word
- Time for an all-staff meeting
- Time to observe staff and evaluate staff time utilization and workflow
- Access to staff performance reviews and time to analyze them
- A survey instrument for staff and patients
- Staff time to fill out surveys
- Time to review data from surveys
- Access to practice's financial data and time to analyze it
Examples
- Culture Policy: View the AAFP's organizational culture policy.
- Organizational Chart: View an organization chart template from Microsoft Office Online that can be downloaded in PowerPoint and modified to fit your practice.
- Mission and Vision Statements: View the AAFP's mission and vision statements, as well as strategic objectives for achieving the organization's mission and fulfilling its vision.
Where to Go for Help
AAFP Buyer's Guide
The AAFP Buyer's Guide is an online database that provides profiles of consulting firms according to your specifications. Select your state and the service you seek to find consultants in your area.
AAFP Practice Management Resources
If you need help developing policies, goals or a mission/vision statement, helpful materials are available through the Practice Management section of the AAFP Web site. The Academy also offers Operational Procedures for the Physician Office, a customizable CD-ROM you can purchase to get help creating policies tailored to your individual practice’s needs.
TransforMED
Read Mission Possible from TransforMED for more information on the process of creating a mission statement for your practice.
AAFP Videos
If you've thought of moving your practice to a more collaborative, team-based model, watch these AAFP videos for inspiration: Improve Care with Patient Self-Management Support and Improve Care with a Team-Based Model.
Join a free collaborative online network committed to practice transformation. Learn more about Delta-Exchange.
This Patient-Centered Medical Home section of the AAFP web site was supported in part by a grant from Merck & Co.
This Patient-Centered Medical Home section of the AAFP web site was supported in part by a grant from Merck & Co.
