Using the case scenario provided, write a 3-4 page analysis of the organization’s political landscape, including formal and informal power structures at play and their impact on culture, policy, and communications. Provide a short conclusion to your analysis in the form of a summary or editorial. Your analysis should be 3–4 pages in length, excluding the title and references pages. Assessment 1 Instructions: Political Landscape Analysis
• PRINT
Using the case scenario provided, write a 3-4 page analysis of the organization’s political landscape, including formal and informal power structures at play and their impact on culture, policy, and communications.
Introduction
Understanding the political landscape of an organization is key when developing strategic priorities. Knowing the key players and how to leverage relationships will help you develop a strategic plan that is meaningful to all stakeholders. Gaining stakeholder buy-in is the key to success when attempting to meet the strategic goals outlined on a balanced scorecard.
This assessment provides an opportunity for you to gain insight into organizational power structures and their effects on organizational culture, policies, and communications.
Preparation
For this assessment, use the following case scenario:
You are a new nurse executive at a community-based hospital system in the southeastern region of the United States. The system is not-for-profit and serves five rural counties. The system comprises one flagship hospital, three smaller critical access hospitals, and a number of clinics and urgent care centers. The health care system serves a diverse population of insured, Medicare, Medicaid, and uninsured patients. The hospital is Joint Commission accredited and for three years in a row has been rated as a Top 100 Hospital.
Historically, the hospital system has been physician-centric, meaning that the physician staff have had the power to influence change, policy, and protocol. The current chief executive officer (CEO) was recently hired from a large university-affiliated hospital system. The chief medical officer (CMO) started the organization’s orthopedic program (one of the most lucrative service lines) and has been with the organization for more than 25 years. He is well respected in the local community and serves on a number of community boards. In light of this strong influence from the department of medicine, nursing has struggled over the past five years. You are the second chief nursing officer (CNO) in four years. The hospital board is applying pressure to seek Magnet designation, which was recently lost due to poor leadership by your predecessor.
The hospital has recently adopted the hospitalist model to cover all in-patients. The hospitalist group was developed by physician leaders in the organization and operates as a separate department within the organization. The hospitalist group desires to become a limited liability corporation (LLC) to maximize benefit offerings but needs a larger staff to make this happen. They have presented a proposal to executive leadership to transfer all advance practice registered nurses (APRNs) working in the organization (there are more than 50) to the hospitalist group, which is housed under the department of medicine. The CMO is spearheading this initiative. Traditionally, ARPNs were hired and managed by the department of nursing.
As the new CNO, you have been approached by a group of 15 APRNs who are against the transition as it will severely impact their scope of practice, in addition to affecting their paid time off, salary, and work hours. The CMO has offered to make APRNs eligible for the annual physician hospitalist bonus structure, as an incentive. At the same time, the CMO has informally proposed that a new policy be created for APRN hospital privileges. If the APRNs choose not to join the hospitalist group, they will not be eligible for hospital privileges. In the state in which the organization is located, a supervising physician is required for APRN practice.
Instructions
Analyze the organization’s political landscape. Examine formal and informal power structures at play and how they affect organizational culture, policies, and communications at all levels.
Lessons learned from your analysis of the organization’s political landscape will provide useful insight into important contextual factors for consideration as you work through Assessments 2, 3, and 4.
Analysis Format and Length
Format your document using APA style.
• Use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis. Be sure to include:
• A title page and references page. An abstract is not required.
• A running head on all pages.
Use the following section headings to ensure thorough content coverage and flow.
• Formal and Informal Lines of Power.
• Organizational Power Influences on Executive-Level Decision-Making.
• The Impact of Power on Organizational Policy.
• Sources of Power.
Provide a short conclusion to your analysis in the form of a summary or editorial.
Your analysis should be 3–4 pages in length, excluding the title and references pages.
Assessment
The following tasks correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
• Analyze the formal and informal lines of power within the organization in the case study.
• Describe the informal and formal lines of power within this organization.
• What source of power is being used by the different stakeholders? For example: authority, rewards, coercion, expertise, reputation, personal power.
• Describe the effects of power structures on organizational culture, policies, and communications at all levels.
Incorporate organizational power dynamics as a factor in executive-level decision making.
• Based on your analysis of internal power structures and your perspective as CNO, what would be the best way to respond to the concerns of the ARPNs in this scenario, and why?
• What support for your response can be found in the evidence-based literature?
• What underlying assumptions might influence your decision making?
Assess the potential impact or influence of power on this change in organizational policy.
• What is the basis for your conclusions?
Identify the appropriate source of power for achieving the CNO’s primary strategic objective.
• For example: authority, rewards, coercion, expertise, reputation, personal power.
• What evidence do you have to support your conclusion?
Articulate meaning relevant to the main topic, scope, and purpose of the prompt.
• Write with a specific purpose and audience in mind.
• Adhere to scholarly and disciplinary writing standards.
• Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.
Apply APA formatting to in-text citations and references.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
• Competency 2: Analyze formal and informal power structures in an organization.
Analyze the formal and informal lines of power within an organization.
• Incorporate organizational power dynamics as a factor in executive-level decision-making.
• Identify the appropriate source of power for achieving a primary strategic objective.
•
Competency 4: Recommend policy changes that support a strategic plan.
• Assess the potential impact or influence of power on organizational policy.
Competency 5: Address assessment purpose in effective written or multimedia presentations,
• incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards.
• Articulate meaning relevant to the main topic, scope, and purpose of the prompt.
• Apply APA formatting to in-text citations and references.
SCORING GUIDE
Use the scoring guide to understand how your assessment will be evaluated.
VIEW SCORING GUIDE
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Analysis of the Organization’s Political Landscape
Introduction:
Understanding the political landscape of an organization is crucial for developing strategic priorities and achieving stakeholder buy-in. This analysis focuses on the political landscape of a community-based hospital system in the southeastern region of the United States. The analysis explores the formal and informal power structures at play within the organization and examines their impact on culture, policy, and communications.
Formal and Informal Lines of Power:
In the case scenario, the organization has historically been physician-centric, with physicians wielding significant power and influence over change, policy, and protocol. The chief medical officer (CMO), who has been with the organization for more than 25 years, is highly respected and holds strong influence within the local community. Additionally, the hospitalist group, created by physician leaders, operates as a separate department and is now seeking to become a limited liability corporation (LLC). This move would involve transferring advanced practice registered nurses (APRNs) from the nursing department to the hospitalist group. The CMO is leading this initiative, indicating his power and influence within the organization.
The Impact of Power Structures:
The power structures within the organization have had a significant impact on organizational culture, policies, and communications. The physician-centric approach has marginalized nursing, resulting in a high turnover rate among chief nursing officers (CNOs) and the loss of Magnet designation. The dominance of physicians has hindered effective collaboration between nursing and medical staff. Moreover, the proposed transfer of APRNs to the hospitalist group raises concerns about the scope of practice, work hours, and benefits for the affected APRNs. The CMO’s informal proposal to limit hospital privileges for APRNs who do not join the hospitalist group further exacerbates the power imbalance.
Organizational Power Influences on Executive-Level Decision-Making:
The formal and informal power structures influence executive-level decision-making within the organization. The CMO, with his extensive experience and community standing, holds significant sway in shaping decisions related to organizational policies and initiatives. The physician-centric culture has resulted in a lack of support and resources for nursing, as evidenced by the turnover in CNOs. The pressure from the hospital board to regain Magnet designation reflects the recognition of the need for change and the desire to shift the power dynamics within the organization.
Sources of Power:
The different stakeholders within the organization utilize various sources of power. The physicians, including the CMO, primarily rely on their expertise and reputation within the medical community to exert influence. The CMO’s position as a respected leader and involvement in community boards enhances his power base. The hospital board, on the other hand, derives power from its authority to set strategic goals and expectations for the organization. The APRNs, who oppose the proposed transfer, are seeking to leverage their collective power as a group to protect their interests and preserve their scope of practice.
Best Response to the APRNs’ Concerns:
Considering the power dynamics and the potential impact on organizational culture and policies, the best response as the new CNO would be to address the APRNs’ concerns and advocate for a collaborative approach. This would involve engaging in open dialogue with the APRNs, the CMO, and other key stakeholders to find a mutually beneficial solution. It is essential to balance the needs of the organization and the APRNs while fostering a culture of collaboration and shared decision-making.
Conclusion:
The analysis of the organization’s political landscape reveals a physician-centric power structure that has negatively impacted nursing and resulted in the loss of Magnet designation. The formal and informal lines of power, along with the sources of power utilized by different stakeholders, significantly influence decision-making, culture, policies, and communications within the organization. To address the concerns of the APRNs, a collaborative approach that promotes shared decision-making and considers the interests of all stakeholders is necessary
