As you plan for your agenda for change, you begin to wonder about the current organizational structure in your department. Several key roles within the department have been created specifically to meet the skill mix of the incumbents and to basically find a place for them. If your agenda for change is to be successful, how do you decide how to best organize your department?

Organizational structure defines roles, responsibilities, and reporting lines. The prime consideration in developing an organizational structure is that it should meet the needs of the group and/or organization. In general, organisational structure should not be solely dictated by the skills and personalities of the leaders; therefore, you should seldom be designing a structure to meet the needs of individuals. That doesn’t mean people shouldn’t be provided the opportunity and helped to change, but if the skills and personalities cannot be remediated to meet the organizational needs, then perhaps the wrong leaders are in place? The organizational structure, with roles and responsibilities, should be articulated and transparent to the entire group or organization.

Organizational charts are an explicit articulation of the structure. The first level of an organizational chart should specify titles with lines to indicate reporting structure. While leaders have over-arching responsibility, major subsets of activity such as education, clinical and research can be assigned to individuals with titles such as Associate or Vice Chairs/Chiefs. As you begin to implement your agenda for change, along with the ongoing needs and activities of the group, make sure your organizational structure can achieve those goals.

Another important component of your group or organization is committees. Committees are usually permanent. Committees, like leaders, also need specific roles and articulated terms of reference. These must specify responsibilities, objectives, membership terms for committee members and to whom the committee reports. Periodically committees need to review and revise their terms of reference. While many bemoan participating in committees, with explicit responsibilities, and if well run, committees can accomplish much (see also my post on Running a Meeting).

Committee structure is also important for success. In general, committees should have a single chair. A single chair clarifies accountability for committee activities. However, multidisciplinary membership on committees sends the message that objectives will be obtained through the involvement of multiple disciplines, that hierarchy is discouraged, and that change can only come from engagement of all relevant disciplines. When orientating committee members to the committee it is critical to emphasize that their prime role as a member is achieving the activities and goals of the committee, and secondarily representing their constituencies. Ideally committee meetings should be held more, rather than less, frequently with shorter, rather than longer, agendas. Committees that meet monthly may not achieve much change; weekly or biweekly meetings with a shorter timeline for implementation are more likely to be successful in implementing change (I will be writing more on the subject of running a meeting in an upcoming post).

In summary, the organizational structure serves to indicate specific roles and responsibilities and to whom individuals and committees are accountable to and for what.