The organisational structure, culture and people do contribute towards and also hinder a healthy workplace. The organisational structure is a typical hierarchical arrangement of lines of authority, rights, communication, and duties within any organisation. Different healthcare organisations and facilities follow various organisational structures. Different theories and approaches exist on this hierarchy. However, a common factor in the structure is that it follows the hierarchy of supremacy (Scott 2003). This includes the top management going down to casual workers. The organisational culture involves the observable and powerful force present within an organisation. The shared beliefs of its staff members, symbols, behaviours and culture create it as a whole unit. It guides the decisions and actions of individuals at an unconscious level (Bray 2009). The organisational culture operates mostly outside the awareness of people within the workplace. It standardises the conditions for team members and reduces uncertainties by offering a language used to interpret issues and events (Green & Crowther 2004; Redman 2012). Different theories have been established to explain the culture of various workplaces (Arad, Hanson & Schneider 1997). The people in a healthcare facility or organisation include both staff and non-staff members as well as the patients. These people have an impact on the well-being of a working environment (Awesfo 2013). This paper will concentrate on organisational structures and culture as well as on people to examine their impact on towards and/or against a healthy workplace. In addition, the paper will create an understanding of the healthy workplace and its importance. There are different theories that explain various workplaces. The theories have some advantages and disadvantages that influence the implementation of policies supporting the health of the workplace.
A healthy workplace is a facility that promotes the welfare and health of its staff through the prevention of workplace related injuries, illnesses, personal health risks and fatalities (Walshe & Smith 2011). The healthy workplace benefits the organisation, employees and clients. There are fewer injuries, a less employee turnover and improved morale among others. In order to ensure and promote healthy workplaces, employers offer a wide range of wellness initiatives such as health risks' assessment and screenings, healthy food choices in vending machines and cafeterias, smoking cessation programs, and other health affairs (Pridgeon & Whitehead 2013). Another vital factor in the healthy workplace is the employer's observation of the occupational health law (Hodgins, Battel-Kirk & Asgeirsdottir 2010). This ensures that the employees work in the environment that is free from hazards related to their job description. In general, the healthy workplace keeps the employees as safe, healthy, and happy; and it makes them want to get back to work.
The healthy workplace involves different factors. It focuses on four major categories. These include health-related programs, health-related policies, health benefits and environmental support. Health-related programs involve some opportunities that are available to the employees at the workplace or through an external organisation to start, change, or maintain healthy behaviours (Dannenberg, Frumkin & Jackson 2011). The employer can set-up a wellness centre or become a partner with an external service provider, where employees can approach to ensure that they lead a healthy life. The organisation can subscribe to the centre for all employees. The health-related policies are formal or informal written statements, which are designed to promote or protect the health of employees (Forastieri & ILO 2012). For instance, nowadays, most organisations have a "smoking free zone" policy. This creates a favourable environment for the non-smokers in the workplace through the elimination of passive smoking. Health benefits are a part of the compensation that includes the health insurance coverage and other discounts or services related to the health of employees (Karsonn 2010). The organisation offers these benefits to its employees, hence, ensuring that every worker can access health services whenever necessary. Environmental supports refer to the physical factors within and around the workplace assisting in the protection of the health of employees. An unhealthy workplace does not offer these services to its workers. In addition, it does not have a framework or approach towards the health risk conditions and diseases present in the workplace. In 2013, the Queensland Safe Work Award for the Best work health and safety management system was awarded to Seqwater (Queensland Safe Work Awards).
Importance of a Healthy Workplace
The concept of the healthy workplace is becoming increasingly relevant as organisations recognise that they can only achieve success through a healthy, motivated and qualified workforce (Kreis 2004). The healthy workplace benefits both an employer and an employee. To the employer, the healthy workplace reduces the downtime associated with illnesses and increases the levels of productivity. It increases the employees' morale and retains them as it projects a caring and positive image (Shannon, Robson & Sale 2001). It also reduces the insurance and healthcare costs incurred by the employer (Polanyi & Sullivan 1998). The employees benefit from the healthy and safe working environment, which increases their job satisfaction and enhances their self-esteem. It also improves their ability to handle stress and improves health and their sense of well-being.
Models of Organisational Structures
Social scientists have explored a concept of the organisational structure as one of the perspectives in the organisational theory. The current interests in the organisational culture stem mainly from four sources, which include a national culture, a climate research, conviction approaches, and human resource management. They emphasise on a structural and rational nature of an organisation in order to give a full explanation of organisational behaviour. The approach focuses on understanding the attitudes and beliefs of individuals in different companies.
The system theory originated in the natural sciences, and it seeks to understand the relationships between objects. Since then, its application to explain organisational culture is immense. It explains an organisation as a set of different people whose relationship creates the organisational culture (Estrada 2012). The system theory provides an analytical framework for viewing an organisation, in general. It vies the organisation as an organism, that is, a set of elements standing in interrelations. It focuses on its super systems, systems and subsystems.
The contingency theory provides a major framework for the organisation's designs. It holds that the most effective designs of organisational structures fit the contingencies. The approach views organisational structures as adapting to changing environments (Guastello 2002). According to this approach, each organisation has a tailor-made structural design depending on the environmental conditions. Some of the contingencies that the approach focuses on include: suppliers and distributors, technology, a government, customers and competitors, and consumer interest groups. Organisations that operate in the stable environments exhibit a mechanistic organisational structure; while those acting in unstable and dynamic organisations exhibit an organic organisational structure. Since an organisation may have different activities and operate in different areas, most structures tend to take a more contingency approach. This is the case with the Autism Care (UK). The organisation's structure is attached as diagram 1 in the appendix. The structure depends on the organisation's activities.
Human relations theories get the influence from the increased volume of operations in an organisation and the increase in the number of skilled employees. The theory views the organisation as a social system. It focuses on work motivation, communication, working conditions, the morale of employees and informal working groups. The structure of the organisation relies on the relationships between the employees and management. The factors that foster human relationships get applied in order to create an effective organisational structure. At CareUK, humanism is evident in the structure if the organisation. This relates to the organisation's employees. They focus on the skills, hence ensuring that they have the best (CareUK).
The contemporary organisational structures have emerged due to the diverse and complex nature of the present business environment. The new structures fit the new needs of the emerging business environment. The new technology has affected all sectors including a healthcare one. Each of the structures has the qualities that suit the business in a given environment. The matrix structure creates a combination between a product structure and a traditional functional structure (Mason, Leavitt & Chaffee 2012). The boundaryless structure eliminates the traditional barriers between the departments in the company.
It is known as Weber's theory. This approach considers an organisation as a part of a broader society. It assumes that the organisation is based on the principles of a structure, rationality, stability and predictability, specialization, and democracy. It is characterised by hierarchical organisations. The actions of the company depend on a set of written rules. In the organisation that has such a structure, career advancement relies on technical qualifications that are judged by the company and not individuals.
These structures dictate the organisational culture within the organisation. Organisational structures have changed to incorporate new aspects and relate to the dynamic organisational external environment. The health and wellness of a workplace depends on the organisation's structure. This is especially because the structure outlines the hierarchy of power in the company. The structure that focuses on the employee's well-being, for instance, the one that relates to the human relations theory, promotes the employees' health and well-being. Other structures are reliant on top management or the owners of the company, and the workers have limited control over the organisation's operations.
Theories of Culture
Types of Culture
There are four major types of organisational culture, which include clan, adhocracy, market, and hierarchy (Cameron & Quinn 1999). The clan oriented cultures focus on mentoring and working together. They are family-like. Adhocracy cultures are entrepreneurial and dynamic and focus on innovation, risk taking and being the first to do things. Market cultures are oriented towards results. Their main focus is on the achievements, competitions and getting a job done. Hierarchy cultures follow a structure and are controlled. They focus on stability, efficiency and the right manner of doing things (Chandler, Keller & Lyons 2000).
Groups and Teams
A group comprises of two or more individuals who interact in such a way that they influence each other. When the group of people focuses towards a set purpose, they form a team. Teams perform collectively towards a goal while the groups only share the information. The teams have positive synergy while the group's synergy is neutral. Teams perform well in tasks that require experience, judgement and multiple skills. Empowered teams increase job satisfaction and morale. They also promote diversity in the workplace. Teams can be self-managed, problem-solving, cross-functional, virtual, or functional. Groups are regulated by informal rules. The CEO of the London Bridge Hospital gives credit for the organization's success to teamwork (London Bridge Hospital).
Power and Control
Power refers to the possession of influence and authority over other people. Organisational control involves the processes designed to ensure the implementation of plans as designed. Control also refers to the power that one has in regard to influencing and directing the behaviour of others.
There are five bases of power. They include reward, coercive, legitimate, referent and expert types of power. Reward power emanates from an individual's capability to reward others. Coercive power comes from the ability of an individual to punish others. Legitimate power is received from a position in a hierarchy; and referent power is derived from a role model, where followers desire to be a leader. Expert power results from the person's knowledge, information and skills. In a healthcare facility, the nurse managers have coercive and reward power over their subordinates. After a manager and the subordinates have worked together for a while, an expert and referent power develops. At Bromley Healthcare, the Chairman has the overall power but is supported by the board of directors. In most cases, they pass the rules and regulations of the organisation, with or without the consent of the subordinate staff (Bromley Healthcare).
Control can be classified as a preliminary, concurrent, and post action. Preliminary control is also known as feedforward. It is accomplished prior to the commencement of work. It is used to anticipate possible problems before they occur. Concurrent control gives an immediate feedback on the efficiency of the conversion of inputs into outputs. Post action control is also referred to as the feedback control and focuses on the output of an activity.
Motivation is a psychological process that arouses persistence and direction of voluntary actions ruled by goals. Some of the motivation theories include a hierarchy of needs, Nash theory, a self-efficacy theory, job design, an equity theory, goal-setting, and an expectancy theory. Autonomy, finances, flexibility, and recognition are some of the factors that affect motivation. Employees are motivated when they have the freedom to make their own decisions and choices. Bonuses and incentives also enhance motivation and recognition after undertaking a task that motivates employees.
Conflict refers to arguments or disagreements. In an organisation, conflict is inevitable. Conflict can be interpersonal, intergroup, intragroup, or inter-organisational (Falconer 2004). Conflict can result from some differences in goals and time horizons, overlapping authority, task interdependence, different evaluation or reward systems, inconsistency in status, and inadequacy of resources. Conflict management strategies include a functional conflict resolution, a compromise, collaboration, accommodation, competition, and avoidance.
Leadership is the ability to influence, enable and impact others to contribute to the efficiency and achievements of an organisation. It is the capability to encourage a group of people towards the achievement of a set goal or vision. There are different theories that relate to the leadership of the company. All the theories consider the theories of management, but they are different (Bolden, Gosling, Marturano & Dennison 2003).
Contingency Leadership Theory
The theory states that leadership focuses on different variables before determining situations for organisations. It insists that each situation is different, and no single style is suited for all cases. The theory has been proposed by Fred Edward Fiedler. In order to influence the effectiveness of leadership, there is an interaction between the leader's behaviour and traits, and the situational factors. Both the relationship and task-oriented leaders can be effective if their orientation fits the exact situation (Northouse 2004). Favourability in this model is determined by a relationship between the leaders and the members, a structure of a task and the leader's position of power.
Participative Leadership Theories
The theory increases the employee morale and promotes it. The employees have an active role in a decision-making process. A participative leader expects and encourages stakeholders to contribute to a final decision (Beach & Connoly 2005). The leader functions as a facilitator. Participation enhances capacity building; hence, the employees nurture their skills as future leaders. It encourages corroboration rather than competition (Clark 2009). The three participatory leadership styles include autocratic, democratic and laissez-faire styles. Although it is difficult to have a single leadership style in a leader or organisation, the Chief Executive Officer of London Bridge Hospital, Mr John Reay, is a participative leader. He likes working through the inclusion of all the staff members. He once stated that the outcomes of the organisation demonstrate multidisciplinary teamwork that is second to none (London Bridge Hospital).
Situational Leadership Theories
The theory states that there is no single best way to influence individuals. It suggests that the leadership styles to be used should use groups or individuals depending on their performance readiness level. It focuses on the behaviours that a leader should adopt depending on the situation.
Transformational Leadership Theory
Leaders who apply this theory recognise and exploit the needs of the employees, and search for potential motives as well as needs of workers (Bass, 1997). The leaders using this style engage employees until they achieve the highest potential. In an organisation, the leader makes a worker feel appreciated and needed. It assumes that people are motivated by rewards and punishments.
Transactional Leadership Theory
The styles that follow this model involve the use of a clear structure. The work requirements are outlined clearly; a structure of reward and punishment is clear. Through a contract, subordinates get salaries and other benefits, and the management or leadership gets authority over the subordinates.
Motivation in the organisations is a process of arousing and sustaining behaviour that is focused on a set goal, through the expectation of satisfying the needs of employees. There are two classifications of motivation theories, which are process based-theories and need-based theories. The need-based theories include Marlow's need hierarchy, Herzberg's two-factor theory, McGregor's X and Y theory, McClelland's need theory, and Alderfer's ERG theory. The process based theories include an equity theory, an attribution theory, an expectancy theory, a reinforcement theory, and a goal-setting theory (Sagie 2000).
A team is a group of people who possess complementary skills and work together to achieve a set goal. Some of the team-working theories include Beldin's team role theory, which explains an individual behaviour and how it influences the team success (Webb 2007). John Adair's Action Centred Leadership Theory has three circles that overlap. There are tasks that require a team as one person cannot complete them. If either the needs of the team or individual needs are not met, the team will suffer.
An organisational structure and culture rely on the theories that an organisation adopts. In addition, the theories relating to the people also have an impact on the well-being of the workplace. The different theories have their advantages and disadvantages in relation to the health of the workplace. The best theories are those that ease or advocate for a healthy environment. The theories that focus on the human relations offer a better platform for the organisation to set up a healthy environment (Bember, 2011). This is especially due to the inclusion of the needs of an employee in the structure and business culture. Participative leadership theories also assist in the creation of a healthy working environment. However, the human relations and participative theories may result in a non-conducive workplace if the majority of people support a negative aspect. Since they rely on democracy, it may result in the incorporation of poor standards if it is the majority choice. In organisations, there are a few influential people who are able to sway and influence the choices and decisions of others. If such people do not support a set policy, they may influence others against it even if it would have promoted the wellness of business.
Contingency and situational leadership theories could assist an organisation where there is a need to make an instantaneous alteration in the working conditions, or when there is a need to develop a new culture. Since the two theories depend on current situations, it is easy for the leadership to make alterations in the policies or procedure and incorporate new policies that support the wellness of the workplace (Schyns & Meindl 2005). Motivation is an essential concept in the success of any organisation. It increases the output of employees. Setting up a healthy workplace acts as a motivation to its workers. Therefore, the motivational theories are essential in the organisation towards creating a healthy workplace. In a bureaucratic structure, the top management has control over the decisions. Therefore, decision making is quick no matter the size of the organisation. However, a bureaucratic structure can also discourage innovation and creativity in the company. Since the top management has the overall control in decision making, the innovativeness and creativity of the subordinate staff is not given an opportunity. Consequently, if an employee has a great idea, which would contribute to the development of a healthy and working environment, it is difficult to harness that idea.
Transformational leadership theories seek to transform and incorporate the employees' views to the highest possible level (Deluga 1990). Therefore, when a business structure has such leadership at the helm, it is easy to develop and incorporate policies and procedure that promote the health of a workplace. All the theories that relate to the organisational structure, organisational culture or the people in the organisation have their advantages and disadvantages in relation to the development of a healthy workplace. However, what matters is who has power and control in the organisation. When the power and control are held by few individuals, it is difficult to promote a healthy workplace. However, when the approach in the company supports the views of all employees, developing such cultures becomes easy.
The people, organisational culture and organisational structure have an impact on the health of a workplace. The healthy workplace promotes the welfare and health of its staff through the prevention of workplace related injuries, illnesses, personal health risks and fatalities (Walshe & Smith 2011). The healthy environment at work is essential to an employer, an employee and the clients. The theories or approaches that an organisation adopts should enable it to implement the four major categories of the healthy environment. They include health-related programs, health-related policies, health benefits and environmental support (Biron, Burke & Cooper 2014). The organisations should also support and encourage innovation and creativity of employees. They should also consider their views when implementing organisational policies. Globalisation in the world has resulted in the competition and borrowing of the ideas that incorporate health in the workplaces. An organisation should strive to keep up with other organisation in satisfying the employees as it results in improved productivity (Holmqvist & Maravelias 2011). It also ensures the employee retention; hence, lowering the costs associated with high employee turnover. In addition, it also reduces the costs related to health insurance and health care.
The model, approach or theory that the organisation incorporates in relation to its culture or structure has an impact the well-being of the workplace. It is evident that control and power are vital in the policy development and implementation. The organisations that support the inclusion of employees in the decision making and development of policies often have healthy workplaces. However, the implementation is slow since multiple consultations are made prior to the implementation of such policies. Organisations, where power and control lie with the top management, are quick in development and implementation of policies, but they do not support creativity and innovativeness (EASHW 2006). Therefore, people, culture and a structure of the organisation have different impacts on the development of the healthy workplace.