Discussion: Organizational Structures and Leadership


In most health care settings, it is unlikely that you would hear the terms “ad hoc” or “matrix” as you walk down the hallway. Although it is helpful

for any organization to delineate pathways of responsibility and authority in an organizational chart, the lived experience of these structures is most

apparent through the inquiries and behaviors people share everyday.

In your own workplace, you may find yourself wondering, who should I turn to when I have a practice dilemma? or Where can I go to learn more about this

issue? These questions speak to the intricacies of formal and informal organizational structure and leadership.
To prepare:
• Review the information presented in Chapter 12 of the course text. Focus on the information about formal versus informal structure as well as the

types of organizational structures.
• Consider the overall structure or hierarchy of your organization or one with which you are familiar. Which organizational structure best describes

your organization—line (or bureaucratic), ad hoc, matrix, service line, or flat?

• Note: It is possible to have a combination of structures in one organization. Is decision making centralized or decentralized in this organization?
• What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and

informal leadership.
• Reflect on how decisions are made within a specific department or unit. Which stakeholders provide input or influence the decision-making process?

Assess this in terms of formal and informal leadership.
• To support your analysis, consider your own experiences and investigate these matters by speaking with others at the organization and reviewing

available documents. Be sure to consider how the concepts of formal and informal structure and leadership relate to one another and are demonstrated in

the organization and in the particular department or unit.

Post a depiction of your organization’s formal structure, indicating whether it is best described as line, ad hoc, matrix, service line, flat, or a

combination. Describe how decisions are made within the organization and within one department or unit in particular, noting relevant attributes of

centralized/decentralized decision making. Explain the influence of formal and informal leadership on decision making within this department or unit.