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Organizational structure: the neglected aspect of the management of modern environmental health organizations.

Environmental health managers who are responding to the pressures of the 90s by attempting to implement changes in "the way we do things around here" must take into account their organization's structure or risk failure in achieving the desired change.

There is no doubt that change is a pressing reality for local, state and federal environmental health organizations. Massive changes in technology, societal expectations, the culture of work, the economic state and the resulting political changes have brought on the need for environmental health organizations to make significant adjustments in how they do things. Among other things, there are increasing calls for better leadership and implementation of new management techniques, such as Total Quality Management, for changes in the way environmental health specialists are trained and educated, for changing the focus from enforcement to environmental risk reduction, and for better planning. All of these are important and are certainly areas that need a great deal of attention, but if they are implemented without a consideration of the best organizational structure to support the change, the likelihood of the change being successful in the long run is poor.

Organizational structure is important to the success of environmental health organizations, as well as to the general delivery of these services. Dr. Bailus Walker points out that:

"Building a strong organizational structure through which environmental health services are provided to an increasingly knowledgeable and environmentally conscious public is central to the task that must be addressed if a true disease prevention strategy is to be developed."(1)

More than anything else, an organization's structure may determine the level of quality of service is delivers. The highest qualified and best people in an organization having the "wrong" organizational design will in the long run only provide mediocre services.

Organizational structure institutionalizes

* how people will interact with each other,

* how communications will flow,

* how rewards are distributed,

* how power relationships are defined, and

* what is important to the organization (2).

In other words, organizational structure provides the basic template for the continuance of an organization's culture; i.e., norms, values, philosophies, and informal activities (3). Organizational culture provides both the organization and its members insight into "how things are done around here" (4).

Environmental health managers who want to successfully bring about change in their organizations need to understand that this can only happen if the changes desired are implemented from a systemic perspective. To do less will lead to mere cosmetic changes having no real effect. Systemic change comes about by both starting and ending with the foundation of the organization -- its structure. It is a conscious process of planning and implementing the desired change, having a clear goal for that change, and knowing how the change will be affected by and effect the current organizational structure. If the current organizational design is "wrong" for the change, then either the desired change should be modified or the organizational structure should be redefined (5). Successful organizational change depends on more than simple cosmetic or surface changes; it requires changes at the core of the organization. Environmental health organizations that are going to make the changes required to effectively meet the demands and challenges of the 90s must begin by addressing organizational structure.

Organizational design theory

There are two general theories of organizational design (6): the universalistic approach (the standard hierarchical design) and the contingency approach, which has no identified form. The universalistic approach is based on the premise that there is one "best" way to structure an organization regardless of the situation (7), and is based on a set of principles that guide the design process. The universalistic approach is based on the classical and the bureaucratic theories of organizational design. The classical and the bureaucratic forms are characterized by having highly specialized jobs, departments based on function and process, narrow spans of control, and centralized authority. These organizations will have several layers of management through which directions and communications must pass; i.e., they have a tall narrow form.

In addition, the organizational structures based on the universalistic principles will have high complexity (e.g., the number of activities or subsystems within the organization); high formalization (e.g., the extent to which rules, procedures and instructions are written); and centralization (e.g., the hierarchical level that has authority to make decisions). Weber argued that the bureaucratic form was "...superior to any other form in precision, in stability, in the stringency of its discipline, and its reliability. It makes possible a high degree of measurement of results for the heads of the organization and for those acting in relation to it."(8)

Supporters of the universalistic approach argue that it best fulfills the organizational need for achieving predictability, human reliability, efficiency and objectivity. In addition, it is argued that the characteristics of high complexity, formalization and centralization lead to high levels of efficiency and productivity as well.

Another universalistic organizational design option is one that historically is a reaction to the classical approach, and therefore has been titled the neoclassical approach. The neoclassical approach is characterized by low levels of complexity, low levels of formalization, and low levels of centralization. It is based on the premise that the uniqueness of individuals who are members of the organization and extensive use of rules discourage innovative behavior (9, 10). Proponents of the neoclassical approach contend that, unlike the classical form, the neoclassical form encourages non-passivity, independent thinking, and creativeness of organizational members (11, 12) and that it maximizes the utilization of the organization's human and technological resources, while the classical form wastes them (13, 14). Finally, it is argued that because the neoclassical form is flatter, less complex and based on maximizing independent thinking by the organizational members, it is more adaptable and flexible when new ways of doing work are necessary.

The contingency approach to organizational design is based on the idea that different organizational designs are required for different sets of circumstances (15), i.e., there is no one correct way to structure an organization, but the best form depends on several variables. Thus, it may be that a form of the classical model or that of the neoclassical model is the form that is most conducive and supportive to the organization achieving its goals.

Organizational researchers have identified several variables that relate to the structural design of an organization. They include age of the organization; size; form of "ownership;" technology; environmental uncertainty; strategic choice; organization members' needs; and current fashion (16, 17). When using the contingency approach in the design process, the three most important variables used to determine what organizational form will provide the best foundation for the organization are 1) technology, 2) environment, and 3) strategic choice.

Technology is defined as how the task of an organization is accomplished and is classified on a continuum ranging from routine to complex. Routine tasks are repetitive and of a relatively narrow scope, while complex tasks are those that are non-routine and require a high level of knowledge on the part of the person performing the task. It is argued that the more complex the technology, the less appropriate is the classical organizational form.

Organizations operate in the context of an external environment. The external environment can range from being relatively stable (e.g., there is little unpredictable change and low levels of uncertainty) to being turbulent in nature (e.g., high levels of unpredictable change and high levels of uncertainty). The contingency approach argues that the classical organizational design is best suited to a stable external environment while a turbulent external environment is best dealt with by a contingency approach.

Like all organizations (18, 19), public environmental health agencies have a mission, be it stated or not, that identifies what needs the organization strives to satisfy within its customer base (20). To fulfill this mission, management will oversee the organizational process of selecting the organization's strategic goals and the courses of action that are deemed to most effectively and efficiently achieve these strategic goals. Thus, strategic choice involves selecting from an almost infinite list of options of strategic goals and courses of action those that will most likely achieve the mission of the organization as perceived by the organization's customers and stakeholders. Once the strategic choices have been made, strategic planning is initiated which lays out how the organization's resources will be allocated.

In using the contingency approach the choices of organizational design ranges on a continuum from what has been labeled the mechanistic form (e.g., anchored by a classical bureaucratic hierarchical structural form) to the other end of the continuum that is labeled the organic form (e.g., anchored by the neoclassical matrix structural form) (21). Based on the circumstances presented by the external environment, its technology, and its strategic choices, which include its strategic goals, a structural form should be designed that provides the maximum support to the organization in achieving its goals.

Management's responsibility within an organization is to continually carry out three management functions: 1) planning; 2) controlling; and 3) organizing (22). Planning involves defining organizational objectives and developing the methods and resources by which they will be accomplished. Controlling is the process of developing, implementing and using feedback systems that provide continuous information on the success of all system elements that have been put in place in order to achieve the organizational goals. Organizing is the activity of designing and deciding upon the most appropriate organizational structure for achieving the organization's goals.

It is the environmental health manager's task to facilitate the successful completion of these three management functions in such a way that an effective balance is achieved between 1) the task of the organization, 2) the people in the organization, and 3) the structure of the organization (23, 24). When these three organizational elements are in balance the organization has the highest likelihood of maximizing its effectiveness and efficiency, and therefore achieving the desired goals. Conversely, the more imbalance that exists between two or more of these three elements, the lower the likelihood that the organization will be able to achieve the levels of desired efficiency and effectiveness.

Organizational design (the management function of organizing) is the process of consciously deciding what form of position interaction network (structure) is the best match between the task of the organization and the type of people who are and will be organizational members. Personnel, one of the largest and most important resources, must be organized and should be done so on the basis of creating an organizational design that is consistent with and supports the selected strategic choices (25, 26, 27). The wrong form of structure for the type of people and/or the task leads not only to organizational inefficiencies and ineffectiveness, but to the people problems that so many environmental health managers complain about on a regular basis.

Unfortunately, the organizing function all too often receives only cursory attention, presumably because the structure of the organization is assumed to be what it is; and other than some minor tinkering, usually with titles of positions, it remains the standard classical design. From working with a wide variety of organizations that were experiencing problems, experience has shown that the underlying cause can often be attributed to an imbalance in the people-task-structure triangle, and often it is a mismatch between the people and the organizational structure.

If environmental health service agencies are going to change in order to effectively meet the demands being placed on them there has to be some very significant consideration of the best organizational structure for the given conditions of a specific agency. Those who do not achieve an effective balance in the people-task-structure triangle will be unable to effectively meet organizational goals.

An example

San Mateo County Division of Environmental Health Services

San Mateo County is located just south of San Francisco, California and has a fairly stable population of about 641,000. It is the third smallest California county in area, but is eleventh largest in population. The San Mateo County Environmental Health Services Division (hereafter referred to as the Division) administers and delivers comprehensive environmental health programs such as: hazardous waste and material management; underground storage tank monitoring and remediation; hazmat emergency response; hazardous materials management plans; solid/infectious waste; food protection; recreational health; water supply; cross-connection control; housing; insect and vector control; individual liquid waste disposal and general complaints. The general goal of the Division was to achieve a safe environment through compliance with the environmental laws, rules and regulations by focusing on education and partnership with the citizens, businesses, and other entities that impact and are impacted by the environment, rather than through enforcement, which was to be used as a last resort.

In early 1989 the Division was experiencing internal problems, including low morale, numerous grievances and high turnover, and decided that it must take appropriate action to correct the situation. In July of 1989 the Division engaged the organizational consultation firm Byron L. Bissell & Associates of Tucson, Arizona to conduct an organizational diagnosis (28, 29) from which they would develop and make recommendations on what measures the Division should implement to address the problems it faced.

The Division felt that it was important to 1) get an outside perspective, and 2) get to the "root" causal issues, rather than address the presenting symptomatic issues by re-organizing, doing training, tightening people control, and/or implementing different management techniques. These actions may be needed, but one cannot know what is needed until a thorough diagnosis has been completed in which the continued appropriateness of the task of the organization, the people who are to do the tasks, and the organization's structure, all in relation to the goals of the organization, have been assessed.

The organizational diagnosis of the Division found that its task and people were appropriate, but its organizational structure -- a fairly standard and common classical form -- was creating a very high level of frustration for most organizational members, from the environmental health specialists to management personnel. Management of the Division was aware that employees felt there was poor communication, low morale, distrust of management, and lack of faith in management and supervisors. Employees also believed that there was a lack of policies and procedures, that they were not being treated as professionals, that there was a severe lack of feedback, a lack of clear direction/purpose and a continual crisis mode: but management was unable to isolate what was causing these feelings.

The diagnosis identified for management that there was a high level of compatibility between the task and people, but a very low level of compatibility between these two elements and the organizational structure, which was the primary driver of the bad feelings held by the members of the Division. The diagnosis found that the Division's task is complex, uses non-routine technology (30), and requires high levels of independent decision making on the part of its employees. The people aspect of the organization was found to be appropriate to the task, in that employees were found to be highly trained professionals dedicated to the goals of the Division and their profession.

However, the Division's organization structure was found to be bureaucratic and very mechanistic in form, one suited to simple, routine technology and less trained non-professional employees who are not required to make independent decisions. Therefore, the structure was found to be highly incompatible with the Division's task and people aspects.

The results of the organizational diagnosis were shared with all members of the Division, and their input into the meaning of the diagnosis was solicited in a series of staff meetings. Based on the findings of the organizational diagnosis, a process was put into place and facilitated by the consultant, through which representatives from all levels of the organization could work together to develop a recommendation on a more effective organizational structure for the Division (29, 31, 32, 33). The new structure was to bring into balance the task-people-structure elements of the organization.

In order to provide a starting point for the process, it was recommended that the design be formulated using the concept of an organic professional organizational structure. An organization whose members view themselves as being part of a profession will have identification with their profession and with the organization. In this type of organization, standardization is achieved through skills and identification with professional ethics, coordination is achieved through training and indoctrination designed to internalize performance and professional standards, and most of the power is centered with the professionals (34). The reasoning behind this recommendation was based on three premises.

First, environmental health specialists are professionals who are guided by a specific knowledge base, an ethical stance, a commitment, an identification with a profession, and who assume a calling that goes beyond economic incentives. Like all professionals, environmental health specialists do not need or want a structure that is geared to simple repetitive tasks, tight controls and centralized decision making. The tasks of environmental health professionals are complex, filled with ambiguity, and non-repetitive in nature; thus lending themselves to an organic type of organizational structure (35).

Second, the Division's external environment is very political, made up of entities with widely different expectations of the Division; very volatile in that there is a high probability of crisis situations materializing on any given day; and demanding, in that the technological aspects of the field are constantly changing, creating a need for a high level of flexibility--yet requiring that decisions and actions remain within the bounds set by law and regulation. Thus, due to this turbulent external environment, the Division needed to be oriented to proaction rather than reaction. Organic organizational structures are defined as being able to respond effectively and efficiently to new conditions in the external environment (36).

Third, the Division had made the strategic choice to achieve its overall goal of maintaining a safe environment for the people of San Mateo County, through a focus on education of and partnership with those entities that could pose threats to the environment, rather than through enforcement. In order to accomplish this, there needed to be a high level of employee skill and independence, de-centralized decision making and central organizational support, as opposed to direction. This strategic initiative requires a staff of professionals and an organizational climate that supports high levels of autonomy for those professionals. A committee composed of representatives from all levels in the organization was created and charged with the task of developing a recommendation for a viable organizational structure for the Division. After much deliberation and input from all organizational members, the committee designed what they termed the "bubble" organizational structure.

The foundation of the new organizational structure is six teams, one for each of the six geographic areas in the County. Each team is composed of environmental health professionals with specific program assignments from the five program areas: food, water, housing/vector control, land use and hazardous waste. Each team selects its own team leader, and the position of team leader can be rotated every six months.

The next major change for the Division was to take the first line supervisors, in the traditional sense of the word, and convert them to program managers. The individuals in these positions are responsible for the management of the programs, but not the direct supervision of the employees carrying out the tasks that will accomplish the goals of the programs. Management of a program includes developing the mission; setting the goals and objectives; tactical planning; identifying needed resource requirements; developing appropriate policies and procedures; creating effective and relevant management control systems; developing program evaluation procedures; conducting training; investigating and understanding the organization's relationship with the external environment, and; facilitating organizational behavior that will increase the probability that the goals of the program are achieved.

The key ingredient of the program management function is the gathering and dissemination of pertinent information, rather than the direct supervision of people. In other words, the old role of supervisor has been replaced with the role of an operational manager responsible for the planning and controlling of a specific program area. This change is predicated on the premise that professionals will "supervise" themselves, given that they have been provided with clear goals and objectives; and that there is an effective management control system in place that provides appropriate feedback.

The directorate of the organization is composed of the Director, Assistant Director, Administrative Services Manager, Administrative Secretary, the Fiscal Unit, and the Clerical Supervisor/Office Manager. The primary purpose of the directorate is to provide policy/strategic level planning, controlling and organizing for the organization. The directorate manages the whole, rather than managing the separate parts. It is focused on developing and maintaining the most effective environment for the professionals to do the job, developing the resources needed by the organization to achieve its goals, and preparation for the future.

The Division's new organizational structure was designed to bring a balance to the three organizational aspects of task-people-structure. The new structure is organic in nature, designed to be most compatible with the people within the Division and to support the completion of tasks of the Division. In addition--and very importantly--it provides the infrastructure for allowing the changes to be institutionalized and maintained over time. Finally, it does all of this without compromising accountability of the organization or of the individual organizational members.

The purpose of the intervention was to make significant improvements in the existing conditions within the Division that included: high levels of interpersonal conflict; high levels of conflict between management and staff; and low morale, all of which was fostering an escalating turnover rate, a high rate of grievances being filed, interpersonal and employee-supervisor-management conflict, poor communication, and a high level of mistrust. In the two years since implementation, the Division has seen its turnover rate drop from 15 percent or more to about five percent, which in and of itself has more than paid for the cost of the intervention. After the implementation of the new structure, one employee who had already accepted a higher paying position with another county ultimately decided to decline that position and remain with the Division. The employee explained that he decided to stay because of the new approach being taken by the Division.

At the subjective level there appears to be continued excitement among the organizational members about the new organizational form, as demonstrated by the fact that there has been very little impetus to go back to the old structure, and by unsolicited comments from customers and others outside of the Division. Though not quantified, feelings of esprit de corps appear to be much higher than before the implementation of the new structure. A strong sense of ownership in the Division, something that was decidedly lacking before the implementation of the new structure, appears to have developed. The staff have learned and are continuing to learn how to effectively resolve conflict, rather than expecting the conflicts to be resolved by supervisors and management.

Based on informal comments from both people within the Division and external to the Division, there has been significant improvement in the communication process within the organization, both laterally and vertically. Management reports that there is significantly less "holding in" of bad feelings, and more positive expression of true feelings, resulting in improved two-way communications between management and staff and between peers. Problems are being solved and resolved at the staff level rather than being pushed up to be solved by management. Finally, and maybe most importantly, with the implementation of the organic professional organizational structure, being a professional has become a cultural norm within the Division.

Though the Division reports that there have been many positive outcomes from the new organizational design, that does not mean that there have not been problems. One of the problems the Division has had to deal with is the fact that the Division is a sub-unit of the San Mateo County government, a large bureaucracy. Therefore, management of the Division has had to spend a considerable amount of time in explaining the new structure and alleviating bureaucratic concern. Another problem is centered around the issue of role confusion (37). The old classical structure had been in place for a long time and roles were clearly defined, including who was "in charge." As was expected, the new bubble structure significantly altered role definitions within the Division. One of the causes of the change in roles is based on the principle that staff have a professional commitment to do a quality job, not on the principle that employees need to be told what to do. The role confusion came from employees being used to being told what to do, and were hesitant to take initiative without permission after the change in the structure.

Another aspect of role confusion was with the first-line supervisors whose role was changed to program supervisors. There was tendency for the program supervisors to slip back into the role of being people supervisors. These issues had to be dealt with by management by simply working them through with the employees involved and by having a strong commitment to the new structure.

Conclusion

It was not the intention of this article to present a scientific test of any hypotheses concerning organizational structure. Rather, the intent was to discuss and observe that organizational design is an important aspect of organizational behavior for environmental health agencies across the country, especially at this time of great pressure to significantly change our nation's environmental behavior.

Implementing change in an organization, i.e., adopting new methods to achieve old and new goals is always a difficult process, but one that is almost impossible if the organization's structure is ignored. Making changes in the organization without considering its design is like stretching a rubber band to its limit and letting go, expecting it to remain stretched. Lewin (31) calls this phenomenon "refreezing." Provision must be made to hold the rubber band stretched out for a prolonged time in order for it to assume its new shape permanently. In organizations, a major component of the process of holding the rubber band in its stretched form is provided by the organizational structure. The organizational design provides the infrastructure for the culture of the organization, and unless the culture of the organization is altered to match the change, it will not be long before the rubber band is back to its original shape.

San Mateo County Environmental Health Services, when faced with internal problems and the realization that the future of the organization was at risk, undertook the enormous task of taking a critical look at itself. What was discovered was that the organizational structure, something that had simply been taken for granted up to this time, was having an extremely negative impact on the climate within the organization. Thus, the Division's structure was acting as a barrier to achieving its goals, rather than providing the appropriate support for achieving those goals. Like most organizations that experience people problems, the attempts to alleviate the symptoms were directed at "fixing the people," which lead to tighter supervision, reprimands, more formalization, and high levels of mistrust. This lead, of course, to increased levels of frustration and apathy on the part of staff, and the cycle started over again with a stepped-up level of intensity. But, once the "real" problem of the lack of compatibility between the organizational structure and the task-people aspects was identified and an organizational design was created and implemented to bring the system back into balance, the symptoms appeared to be eliminated--or at least significantly reduced.

At the application level, we hope to have shown that managers of environmental health organizations need to consider the design of their organizations when attempting to bring about change. At the theoretical level, there is need for a greater understanding of the interaction of the various aspects of an organization, including organizational structure (38). We would hope that environmental health managers would get involved in this theory development through discussions with organizational theorists and supporting research in their organizations that investigates the inter-relationships between the elements of an organization and its organizational design.

References

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Table 1

Principles of the universalistic approach to organizational design

Bureaucratic form (2)

A. A clear division of labor, with each job well defined, understood and routine

B. A formal hierarchy that clearly defines the management/supervisory relationship between managers and subordinates

C. Specific rules, policies and procedures which are used to guide behavior for all employees

D. Impersonal application of all rules, policies, discipline and rewards

E. Hiring of employees based on rigid and equitable selection criteria

Classical form

A. Work should be divided and subdivided to the greatest degree possible

B. Jobs/tasks should be grouped together on the basis of function or process--specialization

C. Centralization of authority with top management

D. Authority should be distributed according to the job responsibility

E. Each employee should have one and only one supervisor

Byron L. Bissell, Ph.D., Byron L. Bissell & Associates, 7451 E. Victoria Dr., Tucson, AZ 85730.
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Date:Jun 1, 1993
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