Project - Organizational Chart & Stakeholder Relations ✓ Solved

Project - Organizational Chart & Stakeholder Relation Di

Project - Organizational Chart & Stakeholder Relationship Diagram. The organizational chart depicts reporting relationships. The relationship diagram assesses interactions and relationships in an organization or process. Use these tools to describe and identify the stakeholder relationships for a health care organization of your choice.

Narrative: Based on the organizational chart and relationship diagram, submit a 5-page narrative, excluding references, that describes the organization and what you have learned in this exercise. The paper should be in APA format with appropriate references. An abstract is not required, and the title page does not count in the 5-page limit. Use the following structure:

  • Brief background or description of the organization, including the mission or purpose, number and types of employees, and a description of the stakeholders/customers.
  • Review of the organizational structure and the effectiveness for meeting the mission and vision of the organization.
  • Review of the stakeholder relationship diagram/map explaining the relationships, interconnections, and impacts of the relationships on the organization.
  • Analysis of what you learned using the tools in this assignment.
  • Citations and references.

Organizational chart: Submit the organizational chart for the organization you have selected. Note any characteristics that make the organizational structure unique. The organizational chart does not need names, just position titles.

Relationship diagram: Identify how your organization relates to at least seven of its external stakeholders or customers, including at least two other entities in the broad health care community.

Paper For Above Instructions

Introduction and Selected Organization

This analysis uses Duke University Health System (Duke Health) as the selected health care organization to develop an organizational chart and stakeholder relationship diagram. Duke Health is an integrated academic health system that combines clinical care, research, and education. Its mission emphasizes patient care excellence, discovery, and training health professionals. The system employs a large multidisciplinary workforce including physicians, nurses, allied health professionals, researchers, administrators, and support staff; employee counts vary by campus but exceed 20,000 system-wide (Duke Health, n.d.). Primary stakeholders include patients and families, clinical staff, researchers, students, payers, federal/state regulators, suppliers, community partners, and academic partners.

Brief Background: Mission, Workforce, and Stakeholders

Duke Health’s mission centers on advancing health through integrated care, research and education. The workforce spans clinical (physicians, nurses), operational (facility management, IT), administrative (finance, HR), and academic roles (faculty, researchers). Stakeholders/customers comprise: (1) patients and families, (2) clinical and non-clinical employees, (3) payers including Medicare/Medicaid and private insurers, (4) research sponsors and academic partners (Duke University), (5) suppliers/medical device companies, (6) government/regulatory bodies, and (7) community health organizations and referral hospitals. These stakeholders shape strategy, operations, funding, and reputation (Freeman, 1984; Mitchell, Agle, & Wood, 1997).

Organizational Structure Review and Effectiveness

Duke Health uses a hybrid structure combining hierarchical clinical service lines with matrixed academic and research reporting. Clinical service lines (e.g., cardiology, oncology) report into system-level clinical leadership, while academic departments report into university academic leadership—creating dual reporting lines for many physician faculty (Mintzberg, 1979). This matrix supports integration of care and research but can create coordination challenges and ambiguity in authority. Strengths include clear clinical command for patient safety, centralized corporate services for finance and compliance, and academic integration that fosters research translation. Weaknesses include potential conflict between clinical productivity goals and academic/research missions and the complexity of coordinating cross-functional initiatives (Bolman & Deal, 2017).

Organizational Chart Description

The organizational chart (submitted separately in graphical form) represents the following top-level positions and reporting lines (titles only):

  • Board of Trustees
  • President/CEO, Duke Health
  • Chief Medical Officer
  • Chief Nursing Officer
  • Executive Vice Presidents: Clinical Services, Academic Affairs, Finance, Research
  • Hospital Presidents (Duke University Hospital, Duke Regional, Duke Raleigh)
  • Service Line Chairs (Cardiology, Oncology, Neurosciences, etc.)
  • Department Chairs and Center Directors
  • Support Functions: HR, IT, Compliance, Legal, Facilities

Unique characteristics: matrixed reporting between clinical service lines and academic departments; joint centers that report to both clinical and academic leadership; a corporate structure that centralizes finance and compliance while allowing decentralized clinical governance—features that facilitate academic-clinical synergy but require robust coordination mechanisms (Mintzberg, 1979).

Stakeholder Relationship Diagram and Analysis

The stakeholder relationship diagram maps internal and external actors and the flows of information, resources, and influence. Key external stakeholders (at least seven) include: (1) Patients/families; (2) Payers (Medicare, Medicaid, private insurers); (3) Government/regulators (CMS, state health departments); (4) Academic partner (Duke University); (5) Other healthcare entities (community hospitals, public health departments); (6) Research funders (NIH, foundations); (7) Suppliers and device manufacturers; (8) Community organizations and advocacy groups.

Relationships and impacts: Patients are the primary recipients of care and influence quality metrics and revenue through demand and satisfaction. Payers influence reimbursement, care pathways, and financial sustainability. Regulators set compliance and safety standards that shape operations. Academic partners provide talent and research integration, while community hospitals and public health departments form referral and population health networks (Bryson, 2004; AHRQ, 2019). Research funders and sponsors drive strategic research priorities; suppliers affect cost and technology adoption. Community organizations support population health initiatives and trust-building. The diagram highlights bidirectional flows: e.g., research output flows from Duke Health to academic partners and funders, while guidelines and regulations flow from regulators into clinical operations.

Effect of Relationships on Organizational Performance

These stakeholder interconnections directly affect mission fulfillment. For example, payer mix and reimbursement policy determine resource availability for academic programs. Regulatory requirements influence staffing and reporting systems; strong academic partnerships enhance innovation and recruitment. Community partnerships enhance population health performance and social accountability. The matrix structure supports these interactions but requires effective governance to manage competing stakeholder demands (Mitchell et al., 1997; Freeman, 1984).

What I Learned Using These Tools

Creating an organizational chart clarified formal authority, decision nodes, and reporting redundancies—essential for allocating accountability for quality, safety, and financial performance (Mintzberg, 1979). The stakeholder relationship diagram revealed the multiplicity of external influences and the necessity of deliberate engagement strategies. Stakeholder salience (power, legitimacy, urgency) varies by issue—for instance, regulators and payers become highly salient during compliance or reimbursement changes, while patients are most salient for quality initiatives (Mitchell et al., 1997). Using these tools emphasizes the need for explicit governance policies, cross-functional teams, and communication channels to reconcile clinical, academic, and operational priorities (Bolman & Deal, 2017).

Practical Recommendations

  • Strengthen cross-reporting governance: formalize decision rights for matrixed roles to reduce ambiguity.
  • Develop a stakeholder engagement plan that maps salience and prescribes tailored communication for payers, regulators, and community partners (Bryson, 2004).
  • Implement integrated performance dashboards linking clinical outcomes, research metrics, and financial KPIs to align incentives (Kaplan & Norton, 1996).
  • Invest in liaison roles (e.g., payer relations, community health officers) to maintain active, structured relationships with external stakeholders.

Conclusion

Organizational charts and stakeholder relationship diagrams are complementary tools that illuminate formal structure and the external ecosystem affecting a health system like Duke Health. The chart clarifies authority and accountability; the diagram exposes interdependencies that shape strategy and daily operations. Together they inform practical governance and engagement strategies that enhance mission alignment and operational resilience (Freeman, 1984; Mintzberg, 1979).

References

  • Agency for Healthcare Research and Quality (AHRQ). (2019). TeamSTEPPS and organizational culture resources. U.S. Department of Health and Human Services. https://www.ahrq.gov
  • Bolman, L. G., & Deal, T. E. (2017). Reframing organizations: Artistry, choice, and leadership (6th ed.). Jossey-Bass.
  • Bryson, J. M. (2004). What to do when stakeholders matter: A guide to stakeholder identification and analysis techniques. Public Management Review, 6(1), 21–53.
  • Duke Health. (n.d.). About Duke Health. https://www.dukehealth.org/about
  • Freeman, R. E. (1984). Strategic management: A stakeholder approach. Pitman Publishing.
  • Kaplan, R. S., & Norton, D. P. (1996). The balanced scorecard: Translating strategy into action. Harvard Business School Press.
  • Mintzberg, H. (1979). The structuring of organizations: A synthesis of the research. Prentice-Hall.
  • Mitchell, R. K., Agle, B. R., & Wood, D. J. (1997). Toward a theory of stakeholder identification and salience. Academy of Management Review, 22(4), 853–886.
  • Porter, M. E. (1985). Competitive advantage: Creating and sustaining superior performance. Free Press.
  • World Health Organization (WHO). (2007). Everybody's business: Strengthening health systems to improve health outcomes. WHO Framework.

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