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An Organizational Chart in Health Care Explained

April 14, 2024

Healthcare professionals considering a career in health administration must understand the various ways an organization may be structured. The design of an organization will determine how well it operates, its patient outcomes, and its ability to respond to change.

To learn more, check out the infographic created by Tulane University’s Master of Health Administration program.

The Need for an Organizational Chart in Health Care

The U.S. healthcare system is a complex network of hospitals, clinics, and health centers serving patients across multiple demographics.

Visits to US Health Centers in 2020               

In 2020, there were 1,375 health centers, up from 1,124 in 2010. Nearly 30 million people received medical care, with 12.4 visits to a health center per 100 people. The top reasons for a visit included preventive care (33.4 percent), new problems (328 percent), chronic problems (32.1 percent), and presurgical or postsurgical care (1.6 percent).

More than half (60 percent) of visits involved screenings, examinations, and health education or counseling. A total of 40.5 percent of visits involved laboratory tests, 11 percent of visits involved imaging services, and 8.1 percent of visits involved procedures.

Types of Healthcare Organizations               

Americans visit various healthcare organizations, including primary care clinics, specialized clinics, mental health clinics, addiction services clinics, community health centers, and retail clinics.

Americans also receive care at acute hospitals, academic medical centers, ambulatory surgery centers, psychiatric hospitals, rehabilitation hospitals, research hospitals, long-term care hospitals, and Veterans Affairs hospitals. Other healthcare organizations include imaging and radiology centers, birth centers, nursing homes, hospice care facilities, orthopedic rehabilitation centers, and health systems with multiple facilities.

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5 Types of Teams at Healthcare Organizations               

A healthcare organization is staffed with a diverse team of medical and administrative professionals who work together on teams.

Interprofessional care teams provide specific clinical services (e.g., pediatrics, oncology, ambulatory care, and long-term care), while clinical support teams provide specific diagnosis and treatment (e.g., clinical laboratories, surgery, and pharmacy).

Logistics support teams provide information, associate support, equipment, facilities, and supplies (e.g., human resources, information services, food services, and security). Healthcare organizations rely on strategic support teams to maintain organizational culture, support improvement, manage stakeholder relations, handle long-term planning and finance, and manage relations with other population health resources, while population health teams integrate services with other community agencies.

What a Standard Healthcare Organizational Chart Looks Like

The goal of organizational planning and design is to align the healthcare organization’s resources and functions with the mission, vision, goals, values, and objectives. A chart typically describes the relations, authority, responsibilities, and interactions of various units and roles.

Typical Hospital Management Hierarchy               

A healthcare organization will typically have a board of directors followed by a CEO and other C-suite executives, which may include chief financial officer (CFO), chief information officer (CIO), chief operating officer (COO), chief medical officer (CMO), and chief nursing officer (CNO).

The next level in the hierarchy may include surgeons, physicians, advanced practice registered nurses (APRNs), physician assistants, and registered nurses (RNs). Other care and operational roles at a healthcare organization typically include licensed practical nurses (LPNs), nursing assistants, medical students, lab technicians, housekeepers, custodians, and medical records and office staff.

Types of Organizational Design               

Organizations may be structured using one of five designs: hierarchical, flat, functional, divisional, or matrix.

Large hospitals and healthcare systems use a hierarchical design, which is characterized by a clear hierarchy with multiple levels of management. A flat design has fewer management levels and greater employee autonomy to support a culture of innovation. However, this organizational design may face scalability issues due to a lack of clear leadership and decision-making authority.

A functional design mentions each department head and their connection to other departments or positions. This design is best for organizations that offer well-defined services or products, face slow environmental changes, and have clearly identified stakeholders.

The segmentation of products, markets, or geographical variations creates a divisional design. A head office with divisional managers overseeing functional units supervises independent divisions. This design is best for large organizations with multiple product or service lines that can be placed into larger divisions.

Organizations with a matrix design have complex connections and hierarchies. This design is used in hospitals that have departments and work cross-functionally. It is best for organizations in highly dynamic or competitive environments. 

How a Healthcare Organizational Chart Is Created

When creating a healthcare organizational chart, identifying the type of organizational design currently in place, gathering data about the roles and responsibilities of each department, and choosing tools that will help visualize the chart are important.

Factors to Consider When Designing a Chart               

Various factors determine the best organizational design for a healthcare facility, including the pace of change, complexity of the external environment, interrelations in an organization, and the decision-making process. Additional factors shaping the organizational design include supporting guidelines, individual autonomy and empowerment, and organizational processes.

Tools and Resources               

When creating an organizational chart, healthcare professionals may rely on organizational manuals, job descriptions, policies, regulations, and legal or administrative documents. Tools such as flowcharts, affinity diagrams, Gantt charts, balanced scorecards, and information systems may also be used.

Challenges of Healthcare Organizational Planning and Design               

Healthcare professionals face numerous challenges when designing an organizational chart. The increasing technical complexity of services, continually changing medical technology, and the diversity and professional autonomy of health professionals can make it difficult to create the right design. In addition, the organizational structure must balance access and equity, efficiency and quality, and robust design with flexibility.

Finding the Right Fit

Though there is no one-size-fits-all approach to organizational chart design, health administrators can draw on their experience to continually adjust and improve the organizational structure.

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American College of Healthcare Executives, “Foundations of Well-Managed Healthcare Organizations”

American College of Healthcare Executives, “Functions, Structure, and Physical Resources of Healthcare Organizations”

Centers for Disease Control and Prevention, Characteristics of Visits to Health Centers: United States, 2020

Definitive Healthcare, Top 10 Largest Health Systems in the U.S.

EdrawMax, Hospital Organizational Chart

Functionly, Understanding Healthcare Organizational Structures

Gallagher Malpractice, What Are the Different Types of Hospitals?

Healthline, “10 Types of Health Clinics and the Services Provided”

Indeed, “10 Types of Health Care Facilities for a Medical Career”

WallStreetMojo, “Divisional Structure”