Create & Refine a Policy for Organizational Structure

Steps to Creating an Organizational Structure Policy

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.
  • 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

Difficulty: Moderate

Outcome: A structured, well-defined work environment in which roles and goals are documented

Time to Complete: Two to six months