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Table 1 Characteristics of functional organisation and process-oriented organisations

From: Towards an organisation-wide process-oriented organisation of care: A literature review


Functional organisation

Process-oriented organisation

Organisation design

Similar capacities are grouped in a department (according to their specialisation, education and training) [1, 3], product layout [53]

(a) Similar capacities are grouped in a department (according to their specialisation, education and training) [1, 3], product layout [53] with additional coordinating structures (e.g., care programmes) [4]


- or -


(b) Multidisciplinary organisational departments which are organised around and based on care processes [1, 21], process layout [9, 13, 53], layout follows process [21]

Organisational Orientation

Vertical orientation [15], objectives for an organisational department can only be linked indirectly to value for the patient [21]

Patient-oriented [21]; horizontal orientation that cuts across the organisational departments [4, 21], activities can directly be linked to value for the patients [13, 15]

Management focus

Managing departments (pieces of the process) [15], optimising department performance (capacity use) [9]

Managing processes (holistic view) [11, 15], optimising patient flow

Decision making

Centralised [11]

Devolved to multidisciplinary teams [21]

Responsibility for care processes

No one is in charge of the processes, because work is organised around tasks [21]

Process owners have the full responsibility for the effective and efficient running of a care process [21]

Coordination between departments

Ad hoc, frequent handovers of patients between departments which remain largely uncoordinated [15, 54]

(a) Systematic coordination of handovers and co working as rule [54] through additional structural coordination dimensions at the top of the functional structure [21]




(b) Departments have relatively few interdependencies because everyone relevant to the process belongs to the same department, coordination across departments is kept at a minimum [1, 21]

Patient flow

Unstructured, unforeseeable and ill-defined [9, 15], and therefore a lot of variation in care activities for the same patient groups

Defined [15] and therefore predictable [9], except for clinical exceptions to standardised care processes

Inefficiency costs in care processes

Lots of waste and transfer points resulting in inefficiency costs in the care processes [9]

Lower inefficiency costs in care processes then in functional organisation, because waste and transfer points are reduced [9]