How to Establish an Effective Chain of Command in Your Practice’s Organizational Structure

How to Establish an Effective Chain of Command in Your Practice's Organizational Structure

A chain of command is critical in any organized unit. From the family unit all the way to huge corporations managing thousands of employees, a sensible chain of command ensures order. It clarifies roles, increases productivity, reduces frustration, improves morale and makes happier customers. According to the 2014 American Employee Survey, having a good relationship with your supervisor is one of the key contributing factors to employee happiness.

However, the chain of command within the organizational structure of a medical practice is often challenging. In fact, describes medical governance structure as “confusing at best, dysfunctional at worst.” Medical offices are complex with a lot of “dotted-line” relationships. How can your office create a chain of command that increases the office’s efficiency? Here are two factors that must be part of your chain of command.

Clearly Defined Roles

Your chain of command should be developed around clearly defined roles. When responsibilities are performed by multiple staff, it wastes time and blurs the line of authority. Conversely, when responsibilities are not clearly assigned to anyone, important tasks may get overlooked. For example, department managers should supervise and evaluate their own employees. Their staff should feel comfortable coming to them with problems, having the confidence they are empowered to make a decision. If clinical or clerical staff overstep the department manager and go directly to the office administrator with problems, they will not build the respect for their department managers that is needed to reap the benefits of the chain of command structure. Following the chain of command also gives the administrator the opportunity to fulfill their role of ensuring that each department has the resources and skills needed to meet the goals of the entire practice.

However, a clear-cut chain of command is not always that easy. Clinical staff often have two bosses, a department supervisor and at least one physician. Even in these cases, though, it’s possible to clearly define the roles. For example, clinical staff should talk to their physicians about issues related to patient care and save operational matters for their department heads. The result will be better relationships within the office. “Clarity removes uncertainty, which is the biggest detriment to the morale and productivity of any office,” noted another article.

Empower Your Supervisors

The many benefits of delegation go beyond just relieving some of the workload of physicians and administrators. A chain of command that allows for effective delegation builds trust, expands the skills and expertise of those delegated to, develops future leaders and contributes to succession planning. However, relinquishing control is challenging. Here are four tips to successfully do it.

  • Let managers take ownership. Instead of viewing delegation as just giving out assignments, help department managers to take ownership. Get them involved in the planning process. Talk about compliance issues. What challenges do they face? What resources do they need? By contributing to the process, they will feel invested in the outcome and more likely to put forth great effort to accomplish mutual goals. The administrator should communicate initiatives, challenges or changes taking place in the office so that managers understand their role. Provide guidance as to how they can help.
  • Encourage collaboration. Don’t silo your department managers. Define common needs that show how each department contributes to the whole. Discuss challenges at department head meetings. It’s helpful for managers to realize they face similar issues as their counterparts. Hold role-playing sessions where managers act out how to respond to staff concerns. Equipping them with the tools and motivation to handle issues will reduce the amount of times they have to look to the administrator for help.
  • Make sure ethical leadership is a priority. Terms like “empower,” “chain of command,” “delegate,” or “line of authority” conjure up thoughts of a dictatorship. Those cold terms do not reduce the importance of ethical leadership, though. Administrators and practice CEOs must set the example. Treating subordinates with respect and trust is key to having them reciprocate that behavior. The survey mentioned at the outset revealed only 46 percent of employees have ever participated in employee experience measurement programs. Of those, only 15 percent felt like action had been taken based on their feedback. Take the time to listen to your department managers, and take action on their suggestions and concerns. In turn, they will treat their subordinates with the same care and respect.
  • Be a resource. Delegation isn’t about just assigning your duties to someone else and walking away. Especially in management, it’s about shaping managers into efficient employees that can make sensible decisions for their departments. The American Employee Survey found that employees crave company leadership that supports long-term growth over short-term gains. Plan for the future by cultivating leaders that contribute to the success of the practice. Be a resource to them by offering guidance and coaching when needed. Even if they have to come to you with questions as first, you are shaping a manager that can more effectively do his or her job in the future.

Your practice’s chain of command speaks volumes about the culture within the office. Establishing an effective organizational structure reduces employee turnover, contributing to the smooth operation of your office. Happy employees with a good relationship with their immediate supervisor feel invested in a company. Cultivate a healthy, productive atmosphere by developing a chain of command that establishes guidelines for staff hierarchy while encouraging collaboration and respect.

Talk to the experts at Advantage Administration Inc. about improving the efficiency of your office. Contact us to learn more.