The organisational structure is mainly determined by the size of the hospital.
The chief executive or head is responsible to the board of management and his functions are to coordinate the work of the various departments, to act as a channel of information between the hospital staff and board of management, to advice the board on the hospital’s general affairs, and to ensure that the board’s directions are properly implemented.
The role of the top management is to direct and coordinate the activities of heterogeneous group of other subordinate managers engaged in managing the hospital’s various services.
Each of them exercises control over a unit. These “departmental managers” include at the upper end of the management scale the “line” managers of medical and nursing units (individual chiefs of medical or surgical teams, ward matron, matron-in-charge of operation theatres, etc. none of whom may consider themselves as managers at all).
The organisational process stems from the underlying premise that there should be a common goal toward which collective effort is directed, that the goal is spelt out in detailed plans, that there is need for clear authority- responsibility relationships, that power and authority factors need to be reconciled so individual interactions within the organisation are productive and goal directed, that conflict may be reduced through clarity of organisational relationship, that unity of command must prevail, and that authority must be delegated.