An important problem that Greater Home Health Care, Inc. should address is power relations within the organization. Specifically, the bureaucratic structure of the organization leads to a strong system of hierarchy, which makes the process of service delivery much slower. This problem is observed in many health care organizations in the United States. Namely, in US health care companies ‘the delivery of care if often complex and uncoordinated, requiring steps and patient ‘handoffs’ that slow down care and decrease rather than improve safety’ (Institute of Medicine, 2001). Apart from the fact that strong hierarchy makes the process of service delivery more complicated, working at the organization as a home health care nurse, I can attest that there are also strong inequalities among different ranks of employees, which is an obstacle to change. Because of their unprivileged place, the chance initiatives of low-ranking employees are often rejected or not considered at all. Through the lenses of structuration theory, low-ranking employees, however, can play the role of agents who also make a contribution to the introduction of changes to Greater Home Health Care, Inc (Groves, Meisenbach & Scott-Cawiezell, 2001). Therefore, there is a need to create a more egalitarian social environment within the organization. The level of autonomy of each employee should be increased significantly, which will create a situation when diverse perspectives and approaches to decision-making process are taken into account. In addition to this, low-ranking employees should be encouraged to be a part of change team and share their vision of the appropriate process of company’s development. The shift from the classic model of Weber’s bureaucracy to a more egalitarian organizational structure therefore brings hope to positively affect the delivery of services and employees’ comfort levels in Greater Home Health Care, Inc.

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  • Groves, P.S., Meisenbach R.J. & Scott-Cawiezell. (2011). Keeping patients safe in healthcare organizations: A structuration theory of safety culture. Journal of Advanced Nursing 67(8), 1846-1855.
  • Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Institute of Medicine Press.