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Avedis Donabedian’s work generated a pivotal means of assessing organizational performance relative to structure, process, and outcomes. However, it is clearly not sufficient to view health care quality merely in terms of outcomes—the structures and processes that facilitate these outcomes are equally as important.

In this Discussion, you consider multiple frameworks that can be used to analyze an organization. As you proceed, consider how these frameworks allow you to examine the interplay of interdependent and related parts and processes that comprise the systems within an organization, as well as the arrangements or structures that connect these parts.

To prepare:

Investigate and reflect on the systems and structures of an organization with which you are familiar. Consider the following:

What is the reporting structure?

Who holds formal and informal authority?

How many layers of management are there between the frontline and the highest office-holders of the organization?

How are interdisciplinary teams organized?

How is communication facilitated?

How well integrated is decision making among clinical personnel and administrative professionals?

How are particular service lines organized?

Which departments, groups, and/or individuals within the organization are responsible for monitoring matters related to performance, such as quality and finances?

Select two of the following frameworks:

Learning organizations, presented in the Elkin, Haina, and Cone article

Complex adaptive systems (CAS), presented in the Nesse, Kutcher, Wood, and Rummans article

Clinical microsystems, presented in the Sabino, Friel, Deitrick, and Sales-Lopez article

Good to great, presented in the Geller article

The 5 Ps, presented in the ASHP Foundation article

Review the Learning Resources for each of the frameworks that you selected. Also conduct additional research to strengthen your understanding of how to use each framework to assess an organization.

Compare the two frameworks. How could each framework be used to identify opportunities to improve performance? In particular, how would you use each of these frameworks to analyze the organization that you have selected?

Post an analysis of the systems and structures of the organization you selected, sharing specific examples. Explain insights that you gained by comparing the two frameworks, and how each can be used to assess an organization, identify a need for improvement, and, ultimately, enhance the performance of an organization.

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