|Type of paper:
|Policy Politics United States Business management
The political landscape refers to the overall organization political situation which influence the nature of power within an organization and decision-making processes. The political landscape in any organization play a critical role towards the nature of decisions and execution of the organization objectives (Waring et al., 2018). In the healthcare context, the political landscape is informed by the different structures and positions within the organization which are responsible for the organization, controlling and direction of the individual department or organizational activities. This paper will conduct a political landscape analysis of the formal and informal power structures in the community-based hospital system in the southeastern region of the United States and establish its impact on the healthcare organization strategic objectives.
Lines of Power
The formal and informal lines of power are the most common power dimensions in any healthcare organization (Peiró & Meliá, 2003). The formal power dimension means that power emanates from one’s position within a healthcare organization and the ability of such a position to influence an organization decision making and processes (Waring et al., 2018). On the other hand, the informal power dimension refers to the relationships that are established between employees and the respect accorded to individuals. In the Community-Based hospital system under focus, there is a formal line of power which has been determined by the organizational structure (Peiró & Meliá, 2003).
One of the formal elements of power is the position of the Chief Executive Officer who oversees the day to day affairs of the organization and guides its activities to attain the predetermined strategies. The second element of formal power are the physicians who are the primary influencers in the healthcare policy decision making and protocol within the community-based healthcare organization. The Chief Medical Officer also holds a form of formal line power due to his position as the head of the orthopedic program. Lastly, the Chief Nursing Officer also is a form of formal line of power and has the responsibility of articulating the issues and welfare of the nurses within the healthcare organization (Martin, 2010). On the contrary, there is a case of informal line of power especially in the case of the Chief Medical Officer who is held at high regard and respect by other workers in the community-based hospital setup. The informal source of power for the CMO emanates from his extended experience and good relationship with the local community having worked for more than 25 years in the hospital.
Organizational Power Influences
At the executive level, power influences have a significant impact on any organization decision making. At the executive level, the managers such as the organization CEO and the CMO have immense ability to influence type of policies that will be adopted within the hospital and also have the oversight responsibility in the implementation of the organization policies (Shirey, 2015). For instance, in the community-based hospital the desire to transition Advance Practice Nurses to the Hospitalist group significantly relies on the ability of the CMO and the CEO to convince the Chief Nursing Officer to persuade the APRNs to join the Hospitalist group. The CMO in the hospital is using his influence and organizational position to influence nurses to join the hospitalist group. In this case, the CMO has proposed a policy which seeks to establish privileges for the APRNs and only those who join the Hospitalist group being spearheaded by the CMO will be able to access the privileges. This shows that power influences have an instrumental role in the overall executive decision making which gives the CMO, CNO and the CEO the ability to make decisions on strategy and influence the whole decision-making process.
The Impact of Power on Organizational Policy
The employees with high formal or informal power have a significant impact on the overall organization policies. The physicians in the community-based hospital have both informal power in the hospital and influence both protocol and policies within the healthcare system (Waring et al., 2018). A second example of the power position influencing the organization policy is the ability of the CMO to initiate policies that seek to introduce hospital privileges for the nurses who will join the hospitalist group. Overall, power is an instrumental tool that shapes the healthcare environment policies. The success of the policies depends on the ability of the senior management to involve and cooperate with all the stakeholders who have formal or informal power to make the policy initiatives widely accepted within the care organization (Shirey, 2015). The CMO due to the respect accorded to him for years of experience and having good relationship with the community is given in this case the responsibility to get policies accepted in the community-based hospital under case study. Sources of power in an organization are dependent on the structure of an organization and also the overall influence and respect that an individual has developed overtime (Peiró & Meliá, 2003). In the community-based hospital scenario, the primary source of power is the organization structure in which there are three primarily recognized leaders which include; the CEO, the CMO, and the CNO. Besides, the physicians and the nurse team leaders within the healthcare context will have informal power which is developed from their relationship with other care providers and also other attributes that makes them standout such as level of education.
Overall, the political landscape of any healthcare organization is an instrumental element that should be assessed to understand the scope and influences that different power lines hold on the organization policies. In the community-based hospital both informal and formal power influences are evidence and they play a significant role in the overall success of the organization policy making and also policy implementation. The cooperation of those with formal and informal lines of power is necessary for effective policy creation and implementation in the healthcare context.
Martin, T. A. (2010). Formal and informal power, access to work empowerment structures and intent to stay. Retrieved from
Peiró, J. M., & Meliá, J. L. (2003). Formal and informal interpersonal power in organisations: Testing a bifactorial model of power in rolesets. Applied Psychology, 52(1), 14-35. Retrieved from
Shirey, M. R. (2015). Strategic Agility for nursing leadership. JONA: The Journal of Nursing Administration, 45(6), 305-308. Retrieved from
Waring, J., Bishop, S., Clarke, J., Exworthy, M., Fulop, N. J., Hartley, J., & Ramsay, A. I. (2018). Healthcare leadership with political astuteness (HeLPA): a qualitative study of how service leaders understand and mediate the informal ‘power and politics of major health system change. BMC Health Services Research, 18(1), 918. Retrieved from https://sci-hub.st/https://link.springer.com/article/10.1186/s12913-018-3728-z.
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