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] |
 |  | -or- |
 |  | (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] |