Close Server: KOPWWW05 | Not logged in

Welcome to Health Care POV | sign in | join

Organizational Lines of Authority & Administrative Success

Published January 28, 2009 8:15 AM by Brian Garavaglia

One of the most important features for organizational success is making sure that the lines of authority are well delineated.  Organizational charts within nursing facilities should be quite explicit and larger companies should also make sure that this is clearly understood by those working under the larger organizational umbrella.  Unfortunately, all too often, we see that there fails to be a clear delineation in the levels of authority and who answers to whom.  For any organization, including long-term care organizations, their success depends on a clear understanding of the authority structure within these organizations. 

Understanding the importance of line and staff authority functions is critical for  the success of long-term care facilities.  Line personnel are those that are directly involved in the daily operations of the nursing care facility.  Starting with the administrator, the director of nursing, to the management nurses, down to the certified nurse assistants, these individuals all hold important line functions for the daily operations of the nursing care facility.  Furthermore, this creates a hierarchy of authority that needs to be explicitly understood for proper daily operational functioning within the nursing care facility.  Staff authority provides advice and assistance for the facility or organization.  Staff members do not have authority over line personnel.  However, this is where many organizational problems often start. 

A major problem that I have witnessed in many nursing homes is when many staff workers attempt to get involved in the decisions related to the line staff.  Decision-making and levels of control have to be clear and unambiguous.  Each person plays a particular role and each individual has to understand who they answer to in the organizational landscape.  As companies grow larger, there becomes a tendency for many of these lines to become blurred.  This is especially problematic since many companies have many consultants within their company holding many staff functions on an advisory level.  As the company grows, and the number of staff personnel increases, delineating clearly a line of authority that needs to be followed, with a clear demarcation between those that hold line versus staff functions is imperative.  

One of the critical problems that results from this nebulous distinction between individuals that hold line and staff functions is that role ambiguity results.  Roles have to be clear to not only aid those that hold these two different types of functions, but also to enhance their roles in the respective areas that they are involved in to conduct their jobs effectively and efficiently.  For instance, a nurse or human resources consultant, if they hold a consultant role, would typically be placed under a staff function.  However, if these individuals do hold some level of line function, it needs to be clearly established in the organization chart.

So one can see the need to clearly distinguish between those that hold line and staff functions in nursing care facilities. Although this may seem to be quite trivial, in reality making this distinction is very important for a proper functioning organizational environment. One of the biggest issues that often happens in nursing care settings is worker confusion on what roles certain individuals play and who they should answer to as it relates to their position.  As most individuals, especially those who have been in management within a long-term care  facility can attest to, having workers being confused on the roles of others is very common.  Furthermore, the administrator has to further establish the clarity that needs to exist and reinforce proper line and staff distinctions when ambiguity is found to exist and be a problem. 

The organizational environment works best when authority functions are well known. This helps to foster a clear understanding of the responsibility and expectations for individuals that hold particular positions.  Not only is this important to the non-management personnel, but management personnel also have to understand clearly the responsibilities and expectations that are held for each individual in the organizational environment. Is this a simple problem to rectify? It appears that it would be, but in reality it continues to exist as a major problem in most organizations. 

Moreover, as long-term care organizations grow and get larger, the organizational complexity often leads to this problem being endemic in most long-term care environments.  Therefore, in reality, the organizational complexity that develops from the growth of the organization itself not only makes this problem common, but more difficult to eradicate then it may appear. With that said, the managerial environment within a nursing care facility needs to continue to make sure that clear delineations between levels of authority as well as between line and staff functions exist. The managerial optimization of organizational resources strongly depends on this clarity.         

posted by Brian Garavaglia


its realy like as you stated.

kashfa, nursing - head nurse, government February 26, 2016 7:50 AM
d g khan pakistan PA

leave a comment

To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Enter the security code below:


About this Blog

    Brian Garavaglia, PhD
    Occupation: Long-term care administrator
    Setting: Sterling Heights, Mich.
  • About Blog and Author

Keep Me Updated