She takes pride in saying that the hospital has a decentralized structure. Which of the following is not compatible with this type of model?
A. Flat organization
B. Participatory approach
C. Shared governance
D. Tall organization
Correct Answer: D. Tall organization
Tall organizations are highly centralized organizations where decision-making is centered on one authority level. A tall organizational structure means that management is broken down into several layers, with executives on top and normal employees on the bottom. In a tall organization, there will be a large number of managers, and each manager will usually be responsible for a small group of employees.
Option A: Flat organizations have a structure with few levels of middle management between leadership and employees—or, in some cases, no middle management at all. Small organizations and startups often have flat structures because they have fewer employees and less of a need for hierarchical management.
Option B: A participatory approach means that the person in charge of solving a problem or designing an innovation involves people who are directly concerned by the result of his or their work. Problem solving and innovation are thus conducted directly with regards to the situation to be transformed.
Option C: In its simplest form, shared governance is shared decision-making based on the principles of partnership, equity, accountability, and ownership at the point of service. Shared governance increases nurse engagement, improves patient outcomes, and allows hospital administrators to optimize efficiency, increase nurse retention and promote quality care, a study in The Journal of Nursing Administration found.