INTRODUCTION: For this assignment I’m choosing, Fortis Hospital at Noida, India and Krishna Nursing home at Chitradurga, Karnataka India. Fortis hospital at Noida, India is a part of Fortis healthcare group and mainly focuses on orthopaedics and neurosciences. It’s a medium sized hospital with 300 bedded facilities and about 250 full time staff. Its organisational structure has low vertical and high horizontal distribution. THE HORIZONTAL DISTRIBUTION is as follows, 1) 37 medical departments which covers different specialities.2) Other departments such as HR, marketing, finance, engineering and nursing.3) Social specialisation, example doctors.4) Functional specialisation, example technicians and nurses. VERTICAL STRUCTURE is as follows, 1) Zonal director at the top. 2) 43 departmental heads who work under Zonal director. 3) There is team under each department which report to departmental heads. Organizational structure of fortis hospital ZONAL DIRECTOR United HR medical director Head eng marketing & sales Finance head Nursing matron Team Hr Doctors Eng team Marketing team Finance team Nursing team
Centralisation: Head of department control all departments and they report to the Zonal director. Each individual in the organisation has limited autonomy and financially it is highly centralised and functionally it is moderately decentralised and it has high level of standardisation of administrative task and the recruitment process is very much formalised, whereas doctors have low level of formalisation and everyone follow standard operating procedure. Hence in summary, Fortis hospital is multi-speciality hospital of medium size and its structure has high horizontal complexity but low vertical complexity and it is moderately formalised and there is not much direct impact on centralisation and has moderately flexible structure and decision making is highly formalised and moderately decentralised at operational level.(http://www.hindubusinessline.com; www.fortishealthcare.com; www.hoovers.com)
In contrast to the above mentioned complex structure second mentioned hospital is Krishna Nursing Home which is a small 50 bedded multispecialty
hospital with a simple structure with the director at the top who is in charge of everything and there are heads of recruitment, finance and medical director who report to the director. It is mainly a vertical structure with director who has full decision making power, hence the structure has minimum decentralisation. The other staff has no autonomy.This hospital works basically on loyalty and trust and personal relationship and caters to a small population in the village Chitradurga, India. This structure is compatible with small hospitals like this. But disadvantage is that it is highly dependent on the director and is individual centric (www.healthcaremagic.com)
If we compare the 2 structure in relation to, 1) Central Peripheral relations: Fortis is much bigger hospital and has separate division for each department and there is decentralisation and semi-autonomy for each department and the purchaser and provider divisions are separate. Whereas Krishna Nursing Home has no decentralisation and no autonomy for the departments and all decisions are taken by the director. 2) Links with other organisational groups: Fortis has links and tie-ups with many other smaller hospitals which refer cases to them and also has link ups with various insurance companies.
Whereas Krishna Nursing Home has no tie-ups with any other hospitals and works alone and caters to a small population. 3) Internal structure: Hierarchy, as mentioned above Fortis hospital has minimal vertical but complex horizontal distribution of power so it has a flatter organisational shape which helps in effective communication and decision making and has widened collaborative links between various departments and divisions resulting in internal linking and average spans of control whereas Krishna Nursing Home has vertical structure and is fully hierarchical based and there is no internal linking between departments (Merson et.,al, 2006).
CONCLUSION: Both these hospitals has completely different organisational structure but both are successful because the targeted population for both are different. While, Fortis targets higher and wider range of population and focuses on specialised services, hence has complex organisational structure. Whereas Krishna Nursing Home caters to a small population and provides basic services and hence has a simple vertical hierarchical structure.
‘Fortis Healthcare signs pact with US hospital’ online. Available at: http://www.thehindubusinessline.com/businessline/2000/10/18/stories/021851e 3.htm. (Accessed on 7 January 2013) Krishna Nursing Home (online). Available at: www.healthcaremagic.com (Accessed on 8 January 2013). Merson et.,al (2006) ‘International Public Health’, 2nd Edition, Jones and Bartlett publishers, pp;558-593. (online) Available at: www. Fortishealthcare.com.(Accessed on: 7 January 2013). (online) Available at: www.hoovers.com (Accessed on: 7 January 2013).