CHAPTER I

INTRODUCTION

Organizational analysis is a systematic approach to understanding an institution's

structure, culture, and effectiveness. In healthcare, it plays a critical role in ensuring high-

quality patient care, operational efficiency, and strategic development (Boatman, 2023).

Globally, healthcare organizations face challenges such as workforce shortages, resource

constraints, and the need for innovative care models (World Health Organization, 2020).

Nationally, the Department of Health (DOH) emphasizes maintaining standards like the

recommended nurse-to-bed ratio of one nurse per 12 patients for Level 2 hospitals, a

benchmark that remains challenging for many facilities in the Philippines (DOH, 2022).

This case study focuses on United Davao Specialists Hospital and Medical Center

also known as “UniDav Hospital”, a newly established healthcare facility in Davao City,

which began its operations in January 2023. Despite a licensed capacity of 110 beds, only

50 are currently operational due to resource limitations, particularly a shortage of nursing

staff. As a Level 2 hospital, UniDav Hospital aspires to transition to tertiary-level care

within the next five to ten years, demonstrating its commitment to growth and improved

service delivery. Guided by the motto “Hands that cure, and hearts that care,” the hospital

integrates its core values into patient care practices and community engagement initiatives.

As part of its commitment to community engagement and professional development,

The hospital offers Related Learning Experience (RLE) opportunities for nursing students,

providing essential hands-on training and clinical exposure. During our interviews and

analysis, we, BSN fourth-year Group 2 students, examined the Hospital’s organizational
structure, workforce challenges, and strategic objectives. We also explored how UniDav’s

core values are reflected in its patient care practices and organizational culture, identifying

opportunities for growth to support its transition to a tertiary-level facility. Through this

case study, we aim to deepen our understanding of the hospital’s operational challenges,

particularly in staffing levels, resource management, and its developmental trajectory.

 OBJECTIVES

General Objective:

The group aims to analyze the United Davao Specialists Hospital and Medical

Center organizational structure, challenges, and strategic goals by evaluating staffing,

resource management, and patient care practices to gain a deeper understanding of its

operations. This organizational analysis also seeks to provide a comprehensive view of the

structure at UniDav, emphasizing the importance of a well-defined organizational

framework in the workplace.

Specific Objectives:

Specifically, this case study aim to:

1. Present an overview of the organizational structure at global, national, and local

levels.

2. State the general and specific objectives of the case analysis.

3. Identify the vision, mission, philosophy, and key characteristics of United Davao

Specialists Hospital and Medical Center.

4. Gain a deeper understanding of the hospital's structure, departments, teams, and

individual needs.

5. Examine the decision-making flow and communication types used within the

organization.

6. Recognize the roles of individuals and understand how they contribute to the

organization.
7. Investigate how tasks are delegated and responsibilities are assigned within the

institution.

8. Analyze the organizational structure in terms of management levels, authority,

responsibility, and accountability of personnel.

9. Summarize the findings and provide conclusions based on the analysis.

 CHAPTER II

HISTORY

On January 11. 2023, the UniDav Hospital held its soft opening with its current

management team headed by Dr. Joseph E. Cachuela (Medical Director). Dr. Geoffrey M

Lei (Chief of Clinics) and Dr. Jude Khalyl C Ramas (Hospital Administrator). Thus, the

founders and employees of UniDay Hospital are looking forward in serving Davao City

and its surrounding areas that will surely mark the fulfillment of a dream and the realization

of a profound belief that they have the "Hands that cure, and hearts that care”.

Hence an 1892 square meter lot was chosen and bought to serve as the permanent

home of UniDav Hospital, but in order to raise funds for the construction of the project the

incorporators scouted and invited sixty-five more investors. now totaling 75. With Dr.

Singh at the helm, a 15-member Board of Directors group was formed and tasked with

different functions to oversee the construction of the hospital and eventually the hiring of

its pioneering employees.

Under the tutelage and vision of Dr Ningthoukhongjam I Singh. whose credentials

include successfully managing several Metro Manila hospitals and various health facilities

all over the country the United Davao Specialists Hospital and Medical Center was

originally founded in 2015 by ten youthful but experienced medical doctors headed by Dr

Justin Elfred Lan B. Paber and Dr Joseph E Cachuela who decided to collect their thoughts

and came up with an idea to put up a hospital that is based on the following factors. a

proven business model introduced by Dr Singh, a hospital that can easily be managed and

at the same time one that can fully cater to the needs of its patient’s clientele.
 CHAPTER III

VISION, MISSION, GOALS, PHILOSOPHY

VISION

To be a multidisciplinary center of excellence for health and wellness serving

Mindanao and beyond.

MISSION

To provide accessible and comprehensive health and wellness programs through

unified, aligned and updated delivery of care.

GOAL

Become a model of excellence in healthcare through the following:

1. Implement practices and technologies to minimize errors, infections, and adverse

events.

2. Focus on improving the patient experience through better communication, comfort,

and responsiveness.

3. Develop strategies for preventing unnecessary readmissions by improving

discharge planning and follow-up care.

4. Streamline processes to reduce wait times, optimize resource use, and minimize

delays in care delivery.

 5. Foster a positive work environment to reduce burnout and improve job satisfaction,

leading to better patient care.

6. Enhance the availability of services, such as extending hours, offering telemedicine,

and increasing community outreach.

7. Focus on cost-effective practices, reducing waste, and maximizing reimbursement

opportunities to ensure long-term financial health.

8. Invest in electronic health records, telehealth platforms, and other digital tools to

improve patient care and operational workflow.

9. Obtain recognized certifications such as Magnet for nursing excellence or Joint

Commission accreditation to demonstrate high standards of care.

10. Focus on initiatives that encourage preventative health measures, like vaccinations,

screenings, and health education, to reduce long-term healthcare costs and improve

population health.

WORK PHILOSOPHY

“ Hands that cure, Hearts that care”

Embodies the dual role of healthcare professionals who not only provide medical

treatment but also offer compassion and support to their patients. This phrase highlights

the importance of skilled hands that deliver healing through medical expertise, while also

emphasizing the nurturing and empathetic touch that fosters trust and comfort in the healing

process. Ultimately, it reflects a holistic approach to health that values both physical and

emotional well-being
 CHAPTER IV

CHARACTERISTICS OF ORGANIZATION

1. Organization as a system

A. 1. Work Philosophy and Values of the Organization

An organization’s work philosophy and values are foundational to its culture,

driving both internal and external success. Core values such as integrity, innovation,

teamwork, and customer-centricity guide decision-making, foster employee

engagement, and build trust with stakeholders. A strong work philosophy emphasizes

a commitment to excellence, adaptability in the face of change, and inclusivity in

creating a positive work environment. These principles not only shape how goals are

achieved but also define the organization’s identity and its approach to achieving

sustainable growth (Smith, 2020).

B. Formal Organization

According to Robbins and Judge (2019), formal organizations rely on

structured systems of communication and authority to manage resources effectively

and ensure compliance with organizational objectives. These systems enable

organizations to function systematically, distinguishing them from informal groups that

rely on personal relationships and unstructured interaction. Formal organizations are

prevalent in various sectors, including businesses, governments, and educational

institutions, where their rigidity supports long-term sustainability and growth.

[Link] Structure

Line structure in an organization refers to a traditional hierarchical arrangement

where authority flows in a straight chain from the top management to lower levels. This

structure ensures clear communication, accountability, and decision-making as each

employee reports to a single supervisor, minimizing confusion in roles and responsibilities.

For instance, a CEO delegates authority to department heads, who then oversee their teams,

promoting efficiency and order. However, its rigidity can sometimes stifle innovation and

adaptability in dynamic environments (Jones, 2020).

United Davao Specialists Hospital and Medical Center, is a mid-sized medical

facility that likely follows a functional organizational structure, which is common in

healthcare institutions. This structure groups employees based on their specialized

functions or departments, such as administration, nursing, medical services, laboratory and

support services. It promotes efficiency and expertise within each unit, as roles and

responsibilities are clearly defined. Leadership is often hierarchical, with a hospital director

or administrator overseeing department heads, who, in turn, manage their respective teams.

This structure facilitates clear communication within departments but may require robust

coordination to ensure effective interdepartmental collaboration.

B.2. Decision Making Process

Decision making in organizations involves selecting the best course of action from

various alternatives to achieve objectives. It can be centralized, where decisions are made

by top management, or decentralized, allowing lower-level managers or employees to

contribute. Effective decision-making is crucial for organizational success, requiring a

systematic approach that consider data, stakeholder input and potential outcomes. (Robbin

& Coulter,2022).

Centralized and decentralized decision-making refer to the extent to which decision

authority is concentrated at the top of an organization or distributed across various levels.

In centralized decision-making, decisions are made by a few top-level managers, ensuring

consistency and control but potentially slowing down response times and innovation.

Conversely, decentralized decision-making empowers lower-level managers and

employees to make decisions, fostering flexibility and responsiveness but requiring

effective communication and coordination to avoid inconsistencies. (Mintzberg et al,

2020).

At United Davao Specialists Hospital and Medical Center, decision-making is

typically carried out by a combination of key stakeholders. Top-level management, such as

the board of directors or the medical director, oversees strategic and organizational

decisions. Department heads and supervisors are responsible for operational decisions

within their specific units, such as nursing, laboratory or administrative departments. For

clinical decisions, medical professional like doctors and specialists collaborate to ensure

patient-centered outcomes. In some cases, committees or teams may be formed to handle

specific issues, ensuring that decisions are well rounded and based on expert input.

B.3. Group Work Segment

Work groups are crucial organizational units in hospitals where medical personnel

cooperate to accomplish shared objectives and provide excellent patient care. These groups

consist of diverse professionals, such as doctors, nurses, technicians, and administrative

staff, who collaborate to ensure effective communication, smooth cooperation, and

coordinated efforts. Each work group often corresponds to a specific department or unit.

In nursing, group work segments are particularly important for sharing knowledge,

providing specialized care, and improving patient outcomes. Nurses from different

specialties work together, sharing best practices and adapting to changes in healthcare. This

teamwork ensures efficient medical care, promotes a positive work environment, and

enhances the overall quality of care the hospital provides.

Under the distinguished leadership of Chairman Ningthoukhongjam I. Singh, M.D.,

at United Davao Specialist Hospital and Medical Center, Inc. is an example of quality

healthcare in the area. As the hospital’s administrator Jude Khalyl C. Ramas, M.D.,

contributes a lot of knowledge and commitment to the goal of offering superior medical

care. Chief Nurse Mary Grace C. Ilagan, RN, MAN an experienced professional dedicated

to providing compassionate and high-quality patient care, leads the nursing team. Under

the capable leadership of Head Nurses (no names) the hospital’s nursing department

continues to thrive. This group of healthcare professionals demonstrates a dedication to

quality and cultivates an environment where patients receive the best possible care and

compassion. With 250 bed capacity, United Davao Specialist Hospital and Medical Center,

Inc. However, they only received an average of 30 patients although their healthcare

industry in the area and demonstrates its dedication to serving the wide range of medical

needs of the community. Committed to delivering high-quality healthcare services to the

Davao City community, UniDav Hospital emphasizes productivity through its commitment

to high-quality patient care and operational efficiency. By leveraging advanced medical

technologies and well-trained healthcare professionals, the hospital delivers specialized

services that cater to a wide range of medical needs. An effective and efficient healthcare

team committed to offering excellent medical services is at the core of its success. The

hospital’s staff, which includes competent doctors, compassion nurses, and support

workers, collaborates well to provide comprehensive, patient-centered treatment. People

obtain timely, high quality care in a responsive and dynamic medical environment as a

result of this collaborative effort.

B.4. Different Departments Compromising the Organization

The organizational structure of United Davao Specialist Hospital and Medical

Center highlights the hospital's services are categorized into support, ancillary, nursing,

and medical divisions, with each division further divided into departments that serve

specific purposes. Unfortunately, the hospital cannot provide a detailed overview of its

organizational structure, as they have not sought approval from the head administrator to

share employee names. However, they were able to share limited information about their

operations, though not in extensive detail, reflecting the confidentiality policies and the

need for administrative authorization before disclosing comprehensive organizational data.

Human Resource

Human Resources (HR) is the organizational department tasked with managing the

workforce and handling employment-related matters. Its responsibilities include attracting,

developing, motivating, and retaining employees to ensure they contribute effectively to

the organization's objectives.

Functions:
 1. Human Resource is involved in the recruitment and selection of employees. This

includes creating job descriptions, posting job vacancies, conducting interviews,

and selecting candidates who best fit the organization's needs.

2. They are responsible for identifying the training needs of employees and

implementing programs to enhance their skills and knowledge. This includes

onboarding for new hires, ongoing professional development, and training

initiatives to address specific organizational goals.

3. They are involved in initiatives aimed at improving the overall effectiveness and

efficiency of the organization. This includes organizational restructuring, change

management, and fostering a culture of continuous improvement.

Finance

The finance department is responsible for managing all financial matters of the

hospital. The main sources of income for the hospital include fees from outpatient and

inpatient services, clinics, and the canteen. Expenses are mainly directed towards operating

costs, administrative costs, and staff-related expenses. In addition to these, the finance

department handles payroll, negotiates contracts with suppliers and contractors, and

manages cash reserves to cover both unexpected and planned costs.

To improve financial operations, most finance departments use databases or

specialized accounting software to keep accurate and efficient records. However, some

departments still use traditional methods, such as ledgers, to track and manage financial

data. This combined approach helps ensure the hospital's finances are carefully and

effectively managed.
Functions:

1. Manages and coordinates all money-related matters for the hospital, including how

it earns and spends money.

2. Watches over financial reporting and gives the necessary money-related support

and information to different parts of the hospital.

3. Plans the flow of cash to make sure there's enough money when needed. Also,

creates and shares monthly, quarterly, and yearly financial statements for

organizations like the Commission on Audit (COA), Department of Health- Central

Office (DOH-CO), and Department of Budget and Management (DBM).

4. Makes sure the hospital follows all the rules and laws about money and reporting.

5. Makes sure that financial reports are on time, accurate, and have the right

information.

6. Keeps track of different hospital tasks, like checking each month:

• Monthly status of Philippine Health Insurance Corporation (PHIC) PHIC

reimbursement

• Monthly quantified free service

• Monthly availability of funds to support hospital operations

• Monthly collection of revenues for enhancement of hospital activities

• Monthly review of utilization of income for direct patient care

• Reviews and signs financial reports and other documents

Housekeeping

Hospital housekeepers are responsible for maintaining sanitation and cleanliness

throughout the hospital. They focus on thoroughly cleaning areas such as rooms,
equipment, and floors. Their duties also include managing laundry services and ensuring

proper waste disposal from patient rooms. To ensure proper disinfection and sanitation of

surfaces and items that come into contact with patients, housekeepers must follow specific

guidelines carefully. This attention to detail is crucial, as diseases can spread through

contact with human fluids or contaminated objects. Therefore, their role is essential in

maintaining high hygiene standards, which play a key part in the safety and well-being of

both patients and staff.

Functions:

1. Maintain cleanliness in patient rooms, bathrooms, and shared areas like waiting

rooms and cafeterias.

2. Remove trash from patient rooms, lobbies, bathrooms, stairwells, and other

common hospital spaces.

3. Clean and disinfect medical tools such as needles, syringes, thermometers,

stethoscopes, and surgical instruments.

4. Perform regular cleaning tasks like dusting furniture, vacuuming floors, cleaning

windows, and wiping walls.

5. Use disinfectants or cleaning agents to sanitize surfaces like walls, floors, ceilings,

doors, and windows.

6. Make beds, change linens, and empty waste bins in patient rooms.

7. Clean floors, toilets, sinks, and other surfaces in both patient rooms and public

areas.

8. Scrub and clean bathrooms and toilets, replace towels, and manage general

sanitation and hygiene tasks.

Maintenance and Security

Maintenance and security in a hospital focus on overseeing and organizing tasks to

ensure that the facility’s infrastructure, equipment, and overall environment are properly

maintained and secure. These functions are essential in creating a safe, efficient, and

dependable space for both patients and healthcare staff.

Functions:

1. Conducting regular inspections, repairs, and maintenance of the hospital’s physical

infrastructure, including buildings, Heating, ventilation, and air conditioning

systems, plumbing, and electrical systems, to ensure a safe and functional

environment.

2. Monitoring and maintaining medical equipment to ensure it operates correctly and

meets regulatory standards, including diagnostic machines, surgical instruments,

and patient monitoring devices.

3. Implementing preventive maintenance schedules to proactively address potential

issues, prevent equipment failures, and minimize disruptions to patient care.

4. Responding quickly to emergency repairs to resolve unexpected issues and

maintain continuous hospital operations.

5. Installing access control measures to limit unauthorized entry to sensitive areas,

protecting patients, staff, and hospital assets.

6. Using surveillance cameras and monitoring systems to enhance security and

investigate incidents or suspicious activities.

7. Deploying trained security personnel to patrol and monitor the premises, providing

a visible and responsive security presence.

 8. Enforcing safety measures to protect patients, visitors, and staff, including

implementing policies and procedures related to security.

Head of Support Services

No data can be provided due to privacy, as stated by the hospital management.

ANCILLARY SERVICES’ RESPONSIBILITIES AND FUNCTIONS

Ancillary services in a hospital are supportive healthcare services that are vital for

providing complete patient care, though they are not directly involved in diagnosing or

treating medical conditions. These services are important for improving the overall patient

experience, assisting healthcare professionals in their clinical work, and ensuring the

smooth operation of the hospital. Ancillary services encompass a wide range of non-

clinical tasks and specialized functions that support comprehensive healthcare delivery

within the hospital.

Physical and Rehab Medicine

Physical and Rehabilitation Medicine is a medical specialty dedicated to

diagnosing, treating, and managing a wide range of conditions that impair a person’s

physical abilities and overall function. These conditions can result from various factors

such as injury, illness, surgery, or chronic diseases. The specialty emphasizes a holistic

approach to care, considering not just the physical recovery of the patient, but also their

psychological and social well-being. Treatment strategies may include physical therapy,

occupational therapy, pain management, and the use of assistive devices, all aimed at

improving mobility, independence, and quality of life. By focusing on the whole person,
this specialty seeks to help patients regain their functional abilities and integrate more fully

into daily life, fostering long-term recovery and overall wellness.

Functions:

1. Physiatrists conduct thorough evaluations of patients to understand how illness,

injury, or disability affects their overall functioning. They use various diagnostic

tools to pinpoint specific impairments and difficulties individuals may be

experiencing.

2. Physiatrists create tailored treatment plans that often combine medical treatments,

physical therapy, rehabilitation exercises, and adaptive strategies to address

functional limitations.

3. Physiatrists focus on treating pain related to musculoskeletal and neurological

conditions. They use a range of methods, such as medications, therapeutic

exercises, and interventional procedures, to reduce pain and enhance quality of life.

4. Physiatrists provide education to patients and their families about their conditions,

treatment choices, and self-management techniques, including advice on lifestyle

changes and preventive measures.

5. Physiatrists collaborate with other healthcare providers, such as physical therapists,

occupational therapists, speech therapists, orthopedic surgeons, and psychologists,

to offer comprehensive care.

Radiology/Imaging

A radiologist, also known as a diagnostic radiologist, is a medical professional

specializing in radiology. Their main responsibility is to thoroughly examine and analyze

medical images, which is central to their role. Radiologists carefully review different
imaging techniques, such as X-rays, CT scans, and ultrasounds, to produce detailed and

accurate reports for healthcare providers. This process requires ongoing collaboration with

both patients and doctors to ensure a complete understanding of the imaging results.

A radiologist’s role goes beyond just interpreting images; it also involves active

participation in diagnosing and treating patients with illnesses or injuries. Their expertise

is vital in hospitals, private clinics, and other medical settings, where they work alongside

medical teams to improve diagnostic accuracy and support effective treatment strategies.

With ongoing advancements in medical imaging technology, radiologists must work with

complex imaging data to ensure that the most appropriate and cutting-edge diagnostic tools

are used to meet the varied needs of patients. Ultimately, radiologists play an essential role

in ensuring accurate diagnoses and facilitating the treatment of a wide range of medical

conditions in the healthcare system.

Functions:

1. Collaborating with other medical professionals to determine the cause of a disease

or injury.

2. Requesting tests and procedures to gain a better understanding of a patient's

condition.

3. Performing medical imaging, such as X-rays or scans, to examine the internal

condition of the body.

4. Analyzing and interpreting test results to recommend the most effective treatment.

5. Studying the causes and development of diseases in individuals.

6. Reviewing a patient's medical history to better understand their current health

status.
 7. Interacting with patients before or after imaging procedures, explaining the process,

addressing their concerns, and ensuring their comfort and understanding.

8. Participating in research, publishing findings, and presenting at conferences to

further the field of radiology.

Pharmacists

Pharmacists are responsible for the comprehensive management of pharmaceutical

services in healthcare settings. Their duties include the procurement, preparation,

dispensing, and quality testing of medications. Working alongside pharmacy assistants and

technicians, hospital pharmacists ensure these essential tasks are carried out efficiently. In

addition to these duties, they oversee the entire medication supply chain within the hospital,

ensuring that all drugs meet the necessary standards of safety, effectiveness, and quality.

This broad range of responsibilities highlights the crucial role hospital pharmacists play in

ensuring the safe and effective delivery of medications in healthcare environments.

Functions:

1. Dispensing medications for both inpatient and outpatient departments.

2. Producing various pharmaceuticals such as tablets, capsules, and ointments.

3. Preparing and sterilizing injectable medications.

4. Accurately filling and labeling medical containers.

5. Ensuring the correct dispensing of narcotic drugs.

6. Keeping detailed records of narcotic medications.

7. Managing a sufficient supply of antidotes for poisoning and emergency

medications.
 8. Verifying the quality of all purchased drugs, chemicals, antibiotics, biological

products, and other pharmaceutical preparations.

9. Providing detailed information about medications to physicians, interns, and

nurses.

10. Maintaining an organized record-keeping system.

11. Overseeing the requisition and dispensing of all medications.

12. Planning and implementing initiatives from the pharmacy and therapeutic

committee.

13. Carrying out decisions made by the pharmacy and therapeutic committee.

14. Compiling regular reports, annual reports, and budgets.

15. Handling purchasing transactions and managing aspects of the budget, including

inventory control, receipt, supply, and storage management.

Medical Laboratory

In the hospital, the clinical laboratory has the role in conducting tests on patients

that are essential for the identification, prevention, and treatment of diseases. The

laboratory’s duties extend beyond meeting the specific testing needs of the hospital. In

addition to fulfilling the hospital's immediate requirements, the clinical laboratory

participates in a wider range of diagnostic evaluations. Hospitals regularly collect clinical

specimens for analysis, not only from internal patients but also through partnerships with

external sources, such as clinics, private physicians, and other healthcare facilities. This

collaborative approach highlights the laboratory’s importance as a central hub for

comprehensive diagnostic services, promoting teamwork in the pursuit of medical

knowledge and improvements in patient care.

Functions:

1. Receive, label, and analyze samples such as blood, toxins, and tissues.

2. Plan and conduct laboratory tests using established procedures, observe the results,

and interpret them.

3. Perform experiments with precise scientific methods to test hypotheses under

controlled conditions.

4. Safely organize and store chemicals, liquids, and gases following safety guidelines.

5. Accurately document all findings in the appropriate forms, both on paper and

digitally.

6. Maintain laboratory equipment and assist in ordering required supplies.

7. Rigorously adhere to safety protocols, ensuring the lab is kept organized and clean

at all times.

8. Engage in research, stay current with advancements in lab technology, and

contribute to the development of new diagnostic methods.

9. Work with physicians, nurses, and other healthcare staff to discuss test results,

interpret findings, and contribute to patient care plans.

10. Implement and monitor quality control procedures to ensure the accuracy and

reliability of laboratory test results.

Heads of Ancillary Services

No data can be provided due to privacy, as stated by the hospital management.

NURSING SERVICES RESPONSIBILITIES AND FUNCTIONS

Nursing services in a hospital setting involve the professional and compassionate

care delivered by registered nurses (RNs), licensed practical nurses (LPNs), and certified

nursing assistants (CNAs) to hospitalized patients. These services are a core part of

healthcare, covering a broad spectrum of duties designed to promote, sustain, and restore

patients' health and well-being. Nursing roles span across various departments and

specialties within the hospital, playing a crucial part in patient care, education, and

advocacy.

Chief Nurse

The hospital administration assigns the Chief Nurse the crucial task of maintaining

and improving clinical and patient-care standards. This responsibility includes ensuring

patient safety within the hospital and delivering the highest quality medical care. To

achieve these goals, the Chief Nurse works closely with hospital management and engages

with stakeholders to secure the necessary resources and infrastructure to uphold excellent

healthcare standards.

The Chief Nurse also provides valuable insights to management, supporting

informed decision-making processes that drive continuous improvement. Additionally, the

they are responsible for developing and implementing innovative nursing strategies. These

varied responsibilities highlight the Chief Nurse Office pivotal role in guiding the hospital

towards excellence, with a strategic focus on infrastructure, resource management, and the

ongoing development of nursing practices to enhance the overall quality of care.

Functions:

1. Ensure nursing staff receives training in the latest best practices, including infection

control and patient safety.

2. Promote collaboration by fostering relationships with departments like

administration, finance, and medical staff.

3. Oversee clinical operations, focusing on staffing, patient satisfaction, infection

control, and the quality of care provided by nurses.

4. Develop nursing policies that align with the organization's goals and values.

5. Equip nurses with the necessary tools and resources to deliver high-quality patient

care.

6. Lead the nursing team by demonstrating excellence in daily interactions.

7. Handle the hiring, firing, training, and discipline of nursing staff.

8. Review and revise nursing standards and care protocols.

9. Collaborate with the hospital’s leadership team to set nursing department goals,

objectives, and policies.

Head Nurse

Head nurses oversee teams of nurses or specific departments in healthcare settings.

They manage nursing care by effectively organizing resources such as nurses, medications,

doctors, and equipment, ensuring they are allocated where needed most. Head nurses also

ensure that all patients receive the necessary care, meeting their needs in a timely and

appropriate manner.

Functions:

1. Review all medical records to ensure accuracy and completeness.

 2. Track and report daily resource consumption regularly.

3. Prepare and distribute weekly duty schedules to the appropriate departments.

4. Verify all consent forms before and after procedures to ensure compliance.

5. Maintain documentation and supervision of all medical instruments.

6. Regularly inspect the Crash Cart for drug availability, expiration dates, and usage.

7. Monitor the cleanliness of the operating theater, conduct culture tests, and manage

waste disposal.

8. Coordinate the scheduling of outpatient (OP) and inpatient (IP) procedures

effectively.

Staff Nurses

Staff nurses provide patient care and professional nursing services in both inpatient

and outpatient settings. Their duties include conducting patient assessments, forming

nursing diagnoses, planning and implementing care, and evaluating outcomes based on

standard nursing procedures. They are also responsible for adhering to established nursing

practices, standards, hospital policies, departmental guidelines, and academic regulations.

Ultimately, staff nurses are essential to maintaining high-quality healthcare by diligently

following established protocols and guidelines.

Functions:

1. Provides direct and professional nursing care to assigned patients in inpatient or

outpatient settings.

2. Prepares necessary equipment and assists physicians during examinations and

procedures.
 3. Evaluates new and existing patients to prioritize treatment needs and determine if

adjustments to care plans are required.

4. Administers medications as prescribed, performs phlebotomy, applies sterile

dressings, and monitors vital signs.

5. Maintains strict confidentiality of patient records and information.

6. Carries out specialized nursing procedures to address the unique needs of specific

patient groups.

7. Oversees and mentors nursing and support staff as needed.

8. Handles additional job-related tasks as assigned.

Emergency Room Staff Nurse

Emergency room (ER) nurses work closely with treating physicians to provide

essential care to patients. They are responsible for attending to individuals who have

suffered from trauma, allergic reactions, or severe injuries, while also offering crucial

support to the medical team during treatment.

Functions:

1. Being prepared and ready to address medical emergencies effectively.

2. Rapidly evaluate patients to determine their needs.

3. Provide care for severe injuries, allergic reactions, and trauma cases.

4. Perform minor medical procedures when necessary.

5. Clean and dress wounds and collect blood samples.

6. Uphold high standards of care in the emergency room.

7. Assist with patient registration and initial insurance documentation.

8. Exhibit strong decision-making abilities during critical situations.

 9. Manage patient triage and oversee check-in processes efficiently.

10. Relay test results and treatment plans to doctors and patients.

11. Collaborate with laboratory staff and report findings to ER physicians.

12. Participate in the care of trauma cases, cardiac arrests, strokes, and conscious

sedation.

13. Make informed decisions based on patient conditions and situations.

14. Provide comprehensive nursing care for ER patients, including performing

intubations, defibrillations, and other critical procedures.

Intensive Care Unit (ICU)

An ICU (Intensive Care Unit) staff nurse is a registered nurse with expertise and

training in caring for critically ill patients in the ICU environment. The ICU, also referred

to as the critical care unit, is specifically designed for individuals needing constant

monitoring, advanced medical treatments, and specialized nursing care due to serious

illnesses, injuries, or complications following surgery. ICU staff nurses are essential in

providing management and support to patients in life-threatening conditions.

Functions:

1. Regularly monitoring and evaluating the vital signs of critically ill patients,

including heart rate, blood pressure, respiratory rate, and oxygen levels.

2. Managing and overseeing the use of specialized ICU equipment, such as

ventilators, cardiac monitors, infusion pumps, and life-support systems.

3. Administering medications, blood transfusions, and critical treatments as

prescribed to stabilize patients with life-threatening conditions.

 4. Working closely with physicians, respiratory therapists, pharmacists, and other

healthcare professionals to create and implement detailed care plans for critically

ill patients.

5. Responding swiftly to emergencies, initiating resuscitation efforts, and providing

immediate care during critical incidents like cardiac arrests or respiratory distress.

6. Performing comprehensive physical assessments and collecting vital data to detect

any changes in a patient's condition that may require immediate attention.

7. Enforcing stringent infection control protocols to minimize the risk of infection

spread in the ICU, particularly for patients with weakened immune systems.

Dialysis Staff Nurse

A Dialysis Staff Nurse is a licensed professional trained specifically to care for

patients undergoing dialysis. This procedure is essential for filtering waste products and

excess fluids from the bloodstream when the kidneys are unable to function properly. These

nurses are integral to maintaining patient safety, comfort, and overall well-being

throughout the dialysis process.

Functions

1. Performing comprehensive evaluations of patients before, during, and after dialysis

to track vital signs, fluid levels, and overall condition.

2. Preparing and setting up dialysis machines and equipment, ensuring all components

operate safely and effectively.

3. Monitoring and maintaining vascular access sites, such as arteriovenous fistulas or

grafts, to ensure proper functionality and prevent complications.

 4. Starting dialysis treatments as prescribed, closely observing patient responses, and

making necessary adjustments to optimize safety and efficacy.

5. Administering medications, such as anticoagulants and other prescribed treatments,

during dialysis sessions per medical orders.

6. Providing education to patients and their families about the dialysis procedure,

dietary and fluid restrictions, and self-care practices for better condition

management.

7. Following stringent infection control protocols to safeguard against infections

within the dialysis facility.

8. Managing fluid balance carefully, ensuring patients do not undergo excessive fluid

removal during dialysis to avoid potential complications.

Heads of the Nursing Services

Chief Nurse: Mary Grace C. Ilagan, RN, MAN

Other data cannot be provided due to privacy, as stated by the hospital management.

MEDICAL SERVICES

United Davao Specialist Hospital and Medical Center, Inc. stands out as a pioneer

in comprehensive healthcare, offering an extensive array of specialized medical services

tailored to the diverse needs of its valued clients. Renowned for its commitment to patient-

centered care, the hospital boasts a team of highly skilled medical professionals from

various specialties. Unfortunately, these are the only details provided and available from
the hospital. The information is limited and not comprehensive, as they have only shared a

few of the medical services offered by the facility.

Based on the data gathered, here are the following medical services offered by the

hospital: The Radiology and Pathology departments utilize state-of-the-art diagnostic

equipment, ensuring accurate and timely medical assessments. Additionally, The UniDav

Hospital has recently opened a rehabilitation center that focuses on physical therapy, pain

and inflammation management, and retraining to address specific functional losses.

Treatment typically includes ongoing, individualized training sessions over several weeks.

PHYSICIANS RESPONSIBILITIES

1. Physicians review medical histories and conduct physical examinations to evaluate

patients for potential diagnoses, addressing both acute and chronic conditions. Their

diagnostic expertise combines thorough assessment skills, medical knowledge, and

sound judgment.

2. In hospital or outpatient settings, physicians provide continuous care for a wide range

of medical issues, including minor injuries, mental health conditions, palliative care,

and surgical interventions. They manage complexities, risks, and uncertainties with

proficiency.

3. Collaborating closely with the healthcare team, physicians coordinate patient care by

making referrals to appropriate services or specialists when necessary. They also share

patient progress and condition updates with services such as physical therapy, home

healthcare, and specialty care providers.

4. Physicians play an essential role in educating patients, their families, and support staff

about conditions, diagnoses, and treatment options. They provide informational

resources and guidance, enabling patients to make well-informed decisions about their

healthcare. Additionally, they contribute to the education of medical students, residents,

physician assistants, and advanced practice nurses.

5. Acting as advocates, physicians support patients and their families in navigating the

complexities of the healthcare system. They ensure care is patient-centered and cost-

effective while addressing individual patient needs, enhancing population health, and

working collaboratively with community partners, public health organizations, and

hospital systems.

6. By offering resources, information, and research, physicians empower patients to make

informed choices about their treatment options.

MEDICAL SERVICES

No data can be provided due to privacy, as stated by the hospital management.

LISTS OF AFFLIATED PHYSICIANS BY DEPARTMENT

No data can be provided due to privacy, as stated by the hospital management.

B.5. INTERRELATIONSHIP OF DIFFERENT DEPARTMENT

The interconnectedness within an organization has a role in fostering strong and

positive relationships among staff across different departments. According to Tarawneh

(2020) An essential aspect of hospital planning is ensuring effective relationships between

sections, departments, and units. Functional units within a hospital often have competing

needs and priorities. Building good relationships among coworkers creates a happy and

comfortable workplace where team members support, motivate, and work well together.

This positive atmosphere improves performance and reduces problems when working as a

team. Also, good coordination between nursing and medical services, like lab tests, billing,

and meal plans for patients, is very important for providing complete care.

This teamwork ensures that patients get complete care, covering both their medical

and nutritional needs. The board of directors at United Davao Specialists Hospital and

Medical Center, Inc., highlights the importance of regular meetings involving staff at all

levels. These meetings provide a platform for sharing ideas, making decisions, building

teamwork, and reducing feelings of isolation in the workplace. This approach strengthens

communication, collaboration, and overall unity within the organization.

B.6 COMMUNICATION FLOW

The medical director plays a key role in sharing information, memos, ideas, and

instructions with staff in lower positions. This communication method ensures that policies

and changes are clearly passed down throughout the hospital. Information is systematically

shared from leadership to staff at all levels, promoting clarity and alignment with the

hospital’s goals. This top-down approach helps maintain consistency in medical procedures
and supports a unified strategy for patient care. It also helps other departments coordinate

resources more effectively and respond to patient needs efficiently. Sharing updates about

decisions, procedures, and new technologies ensures that all departments work together

toward the hospital's goals. Overall, the top-down communication system at United Davao

Specialist Hospital and Medical Center, Inc. helps create a well-coordinated and productive

workplace, improving teamwork and raising the quality of patient care.

 CHAPTER V

ANALYSIS OF DATA

A. Analysis of the Organizational Structure

A.1 Level of Management

An organizational structure serves as a framework that outlines how specific

tasks are performed to achieve an organization's objectives. It encompasses roles,

responsibilities, and guidelines that govern these activities. Additionally, the organizational

structure dictates how information flows across various levels within the organization. By

implementing a clear structure, organizations can maintain focus and operate efficiently

(Akingbola, 2023). A well-designed structure also fosters effective communication and

collaboration, enabling organizations to adapt to changes and align resources with strategic

goals (Sankala, 2024).

A bureaucratic organization is characterized by a structured hierarchy, clearly

defined rules, and formalized procedures aimed at maintaining uniformity and efficiency.

Bureaucracies function by centralizing authority, adhering to standardized rules, and

emphasizing specialization and division of labor. Positions within the organization are

typically assigned based on merit, and decisions are expected to follow objective criteria

rather than personal preferences or relationships (Monteiro, 2022). Sociologist Max Weber

conducted significant research on the notion of bureaucracy, which he saw as the most

rational and effective type of organization for attaining administrative goals. Weber

highlighted impersonal activities, hierarchical authority, and defined norms as key aspects
of bureaucratic institutions. These systems are often used in both the public and corporate

sectors, assuring accountability and consistency but also being criticized for rigidity and

inefficiency in changing contexts. Bureaucratic systems flourish in stable, predictable

environments, but may fail in scenarios needing fast flexibility or creativity.

United Davao Specialists Hospital and Medical Center Inc. employs a bureaucratic

organizational structure, characterized by a hierarchical system and well-defined roles. At

the top level are the Stockholders, Board of Directors, and the President, followed by

directors managing specific departments such as Human Resources, Medical Services,

Nursing Services, Dietary, Housekeeping & Laundry Services, Finance & Accounting,

Records, General Services, Ancillary Services, and Legal Services.

Stockholders occupy the highest position in this hierarchy, serving both as financial

backers and strategic stewards of the hospital. They ensure financial sustainability and

participate in decision-making during shareholder meetings, where they vote on significant

matters influencing hospital policies and direction. This structure enables the organization

to maintain its operational efficiency and continue delivering high-quality healthcare

services to the community. The role of stockholders aligns with the broader principles of

bureaucratic management, which emphasize efficiency, accountability, and structured

decision-making (Weber, 2023; Serpa & Ferreira, 2022).

The Board of Directors plays a pivotal role in shaping the strategic direction and

overall management of a hospital, from decisiion making to budget planning. Comprising

experienced professionals from diverse fields such as finance, administration, and

healthcare, the board is instrumental in defining the hospital's mission, vision, and long-
term goals. It oversees the hospital's executive leadership to ensure operational efficiency,

financial stability, and the delivery of high-quality patient care.

The Board of Directors plays a pivotal role in shaping the strategic direction and

overall management of a hospital. Comprising experienced professionals from diverse

fields such as finance, administration, and healthcare, the board is instrumental in defining

the hospital's mission, vision, and long-term goals. It oversees the hospital's executive

leadership to ensure operational efficiency, financial stability, and the delivery of high-

quality patient care. (Vitolla et. Al, 2020)

Board members contribute a wide range of expertise, offering valuable insights for

approving budgets, formulating policies, and addressing complex challenges in the

healthcare sector. Through regular meetings and collaboration with hospital administrators,

the Board of Directors provides strategic guidance, driving the organization toward success

while upholding its commitment to excellence in healthcare [Link]-level

management gives vital support to the complex framework that ensures the provision of

high-quality treatment. These managers, who are frequently team leads or supervisors,

serve as the essential connections that link the overall organizational strategy to the day-

to-day activities that take place. They are tasked with managing particular teams or

departments and are essential to carrying out the higher-ups' strategic goal.

Lower-level healthcare managers play an important role in ensuring that

organizational operations run smoothly. They serve as the foundation of the healthcare

system, overseeing day-to-day operations, streamlining processes, and bridging the gap

between employees and senior management. These managers increase efficiency and

patient outcomes by organizing resources, monitoring compliance with healthcare rules,

and promoting good departmental communication. They also play an important role in

maintaining financial monitoring, executing quality improvement efforts, and providing

staff training and development opportunities. Their efforts make major contributions to

operational excellence in healthcare institutions (Baird et. Al, 2020).

A.2 Authority, Responsibility and Accountability of the Personnel

Authority refers to the legitimate power to assign roles, make decisions, allocate

resources, and enforce compliance within an organization. It allows individuals to act on

behalf of the organization to achieve its objectives. Those with authority are expected to

utilize resources responsibly and act in the organization's best interests (Burgoin et. Al,

2020).At United Davao Specialists Hospital and Medical Center, top-level managers hold

direct authority, overseeing the institution's strategic direction and overall operations.

Department heads, in turn, exercise authority within their specific domains, managing daily

activities, providing guidance, and planning for staff under their supervision. This

hierarchical structure ensures that responsibilities are clearly delineated and operations run

smoothly across all levels of the organization.

Responsibility involves being accountable for one's actions and accepting

the consequences of decisions and behaviors. It requires fulfilling assigned duties in an

ethical, lawful, and dependable manner, reflecting a commitment to reliability and integrity

(Fatima & Elbanna, 2023).

At United Davao Specialists Hospital and Medical Center, each staff member

assumes responsibility for their specific roles and obligations. The alignment of
responsibilities across all organizational levels ensures efficient hospital operations. This

collaborative effort enables each department and individual to contribute effectively to the

hospital’s mission of promoting health and well-being in the community.

At United Davao Specialists Hospital and Medical Center, Inc., employees are expected to

take full responsibility for their actions. When malpractice occurs, accountability

procedures are activated to ensure those responsible are held accountable. This process

typically involves a thorough investigation to assess the extent of any negligent behavior

and identify the individuals at fault. This approach ensures that professional standards are

maintained and that corrective actions are taken to prevent future incidents.

Accountability within the organization not only ensures that individuals are held

answerable for their actions but also fosters a culture of responsibility and mutual respect

among staff members. This enhances leadership effectiveness and strengthens

organizational integrity (Indeed, 2023; Sweeney, 2022).

A.3 Level of Decision Making

Within an organization, decision making can be either centralized or decentralized.

It involves selecting options by identifying decisions, gathering relevant information, and

assessing potential solutions. A centralized organization can be defined where the authority

to make decision s starts at the top and filters down (Sun et al., 2021). Centralized

management occurs when planning and decision-making responsibilities are exclusively

handled by executives in an organization (Krosel, 2022). These top management

professionals give instructions to all other levels of management in the organization, who

then help implement the decision. However, at its downside, it becomes difficult to measure
performance while within the centralized governance model (Rubel, 2023). On the other

hand, decentralized organizations utilize flexibility for empowered teams with an

appropriate level of autonomy (Sun et al., 2021). Most of the planning, strategy and

decision implementation are taken by people at the middle and lower levels of managemen

(Admin, 2020). Decentralization is breaking down traditional silos among business units,

shifting roles and creating possibilities for new syntheses. The decision begins with the

strategy of leadership in the organization. Decentralization enables those closest to the

knowledge and deliverables to make decisions flexibly (Chen & Eriksson, 2020). These

are key attributes of a decentralized organization due to the link with the ability for the

employee to be involved in the decision-making process (Sun et al., 2021).

UniDav uses both narrow and wide span of control. Specialized departments like

surgery or intensive care utilize a narrow span of control to maintain a high level of

expertise and precision in medical procedures. While in administrative roles or support

services, a wide span of control is used to streamline communication and decision-making,

allowing for efficient coordination across departments. Ares such as finance, human

resources and general administration also used a wide span of control to manage routine

tasks and ensure smooth nonclinical operations. Balancing both wide and narrow spans of

control within the institution helps optimize administrative efficiency while prioritizing

personalized attention and expertise in critical patient care awareness.

A.4 Span of Control

The span of control in an organization refers to the number of subordinates or

employees that a manager or supervisor directly oversees and manages (Maier-Liu, 2023).
It signifies the breadth or width of management responsibility. Typically, it is either narrow

or wide, resulting in a flatter or more hierarchical organizational structure. Each type has

its inherent advantages and disadvantages. A narrow span of control allows for close

supervision to employees. With fewer subordinates to manage, a manager can provide more

individualized attention and support to each employee (Hossain, 2023). On the other hand,

a wide span of control indicates that a manager oversees a larger number of subordinates.

It has fewer level of reporting in the organization, resulting in a more flexible, flatter

organization (Hassan, 2021). A balanced and effective span of control aims to maintain

efficient communication, coordination, and supervision within the organizational structure.

UniDav uses both narrow and wide span of control. Specialized departments like

surgery or intensive care utilize a narrow span of control to maintain a high level of

expertise and precision in medical procedures. While in administrative roles or support

services, a wide span of control is used to streamline communication and decision-making,

allowing for efficient coordination across departments. Areas such as finance, human

resources and general administration also used a wide span of control to manage routine

tasks and ensure smooth nonclinical operations. Balancing both wide and narrow spans of

control within the institution helps optimize administrative efficiency while prioritizing

personalized attention and expertise in critical patient care areas.

B. Channel of Communication

Effective communication is about more than just exchanging information. It’s about

understanding the emotion and intentions behind the information. As well as being able to
clearly convey a message, you need to also listen in a way that gains the full meaning of

what’s being said and makes the other person feel heard and understood ( Mandell, 2017).

Communication at UniDav - United Davao Specialist Hospital and Medical Center

follows a linear flow through multiple channels, including downward, upward, and

horizontal. The downward flow occurs when the administration communicates with staff.

This involves the dissemination of policies, procedures, and organizational objectives, as

well as updates on changes in protocols or guidelines. To share this information,

administrators use meetings, memos, policy manuals, and handbooks. They use an upward

communication flow from staff to management. Nurses and other staff members participate

by offering feedback, expressing concerns, and reporting problems to higher levels of

leadership. This approach enhances patient care, addresses operational issues, and

promotes a culture of open communication.

Another form of communication they utilized was horizontal communication,

which takes place between individuals or departments at the same level in the hierarchy.

This type of communication facilitates collaboration among nurses, doctors, and other

healthcare professionals, allowing them to exchange patient care information, coordinate

tasks, and ensure efficient workflows within and across departments.

 CHAPTER VI

NURSES ROLE IN THE ORGANIZATION

A. Philosophy of the Nursing Department

Nursing service formulated their philosophy as a subdivision of the entire

organizational philosophy. This is stated as:

The nursing service of United Davao Specialists Hospital and Medical Center

Incorporated believes in their mission which is “to provide accessible and comprehensive

health and wellness programs through unified, aligned, and updated delivery of care.” And

vision “to be a multidisciplinary center of excellence and wellness serving Mindanao”

B.1. Patient Care Management

The United Davao Specialists Hospital and Medical Center Incorporated

exemplifies the nursing service's critical role in patient care management, a cornerstone of

the medical center's operations. This role emphasizes universally accessible health

services, with nurses at the forefront of providing high-quality, compassionate care aligned

with the hospital's commitment to integrated and modernized health facilities. In managing

patient care, nurses address the biological, social, and psychological needs of each patient,

ensuring a holistic and integrated nursing practice.

Nurses, in collaboration with physicians and other healthcare professionals,

develop tailored treatment strategies that are specific and measurable. These strategies

prioritize patient safety, enhance health education, improve satisfaction, and optimize
resource allocation. This multidisciplinary approach, integral to the hospital's reputation as

a center of excellence, aligns with the interdisciplinary care model. Nurses serve as key

coordinators in healthcare team interactions, ensuring comprehensive treatment.

A patient-centered approach underpins effective care management at UNIDAV.

This approach prioritizes patient involvement in decision-making, personalized treatment

plans, and respect for individual values and preferences. Enhancing patient satisfaction

involves regular feedback surveys, personalized care plans, reduced wait times, effective

patient education, dignity, and robust advocacy programs. Nurses act as patient advocates,

ensuring patients’ rights and choices remain central, thereby fostering a positive care

environment.

Effective communication and teamwork are essential components of patient-

centered care. Training in empathy, shared decision-making, and interdisciplinary

coordination—through case conferences, information exchange, and standardized

protocols—enhances collaboration. Nurses continually advance their professional

development, applying evidence-based practices to improve care outcomes. Management

commitment, including adequate staffing and a supportive work environment, further

strengthens nursing teamwork and patient-centered care.

Accountability remains a fundamental responsibility for nurses in their daily duties.

This entails being answerable for the consequences of decisions or actions, closely linking

accountability to the broader concept of responsibility. Nurses at UNIDAV consistently

uphold these principles, fostering a culture of excellence through quality improvement

initiatives, evidence-based practices, and ongoing evaluations to maintain exceptional care

standards.

B.2. Operational Management

Operational management is a critical component of healthcare administration,

ensuring that hospitals operate efficiently while delivering high-quality patient care. At the

United Davao Specialists Hospital and Medical Center Incorporated, nurses play an

essential role in managing patient care, guided by the Chief Nurse, who oversees the

nursing department's operations. The Chief Nurse ensures that all nursing functions align

with the hospital’s mission and objectives while adhering to established standards and

policies.

The nursing staff, under the Chief Nurse's direction, develops and implements

patient care plans that meet patients' needs while utilizing available medical resources and

personnel effectively. Nurses assess patient requirements, design appropriate treatment

plans, and collaborate with other healthcare professionals to streamline care delivery and

resolve any issues encountered. This collaborative approach not only enhances patient

outcomes but also aligns with the hospital's commitment to providing comprehensive and

accessible medical care.

The Chief Nurse's role extends beyond patient care management to include strategic

operational responsibilities. These responsibilities involve workforce planning, resource

allocation, maintaining care standards, and ensuring interdepartmental collaboration.

Strong leadership, strategic thinking, effective communication, and a focus on quality and

resource management are vital attributes of the Chief Nurse. By efficiently managing staff,

equipment, and facilities, the Chief Nurse supports the hospital in achieving its

organizational goals while maintaining exceptional service standards.

In essence, operational management at United Davao Specialists Hospital relies on

a well-coordinated nursing team led by the Chief Nurse. This leadership ensures that the

hospital continues to provide patient-centered care while upholding the highest standards

of service and operational efficiency.

Chief Nurse

A. Chief Nurse is the executive head of the Nursing Service

B. JOB SUMMARY: Under Direction

Chief nursing officers, also referred to as chief nursing executives, work within

healthcare organizations as leadership team members. These highly qualified leaders

perform many important job duties, such as regularly interacting with department leaders

ensuring consistent operations and assessing department needs for more staff or resources.

(Payscale, 2023)

The Chief Nurse of United Davao Specialists Hospital and Medical Center

Incorporated plays a leading role to supervise the administration of the nursing department

while ensuring the delivery of quality patient care in all of its units. The Chief Nurse is the
part of the management for operations, through which she is expected to supervise the

nursing workforce, design and implement nursing policies and programs, and ensure all

care practices are aligned with the mission of the hospital in providing affordable and

inclusive health and wellness services.

This position also includes responsibility for managing the budget for nursing services,

ensuring cost-effective operations, and supporting the hospital’s broader goals of

excellence and sustainability. The Chief Nurse acts as a liaison between nursing staff and

hospital administration, advocating for the needs of both patients and healthcare providers

while promoting a culture of teamwork and continuous improvement.

C. Qualification Requirements

1. Education Master’s Degree in Nursing

2. Training and Expertise

a. Chief Nurse I-II: A minimum of three years of nursing experience, one year of

which has been spent in a supervisory position as a Senior Nurse, Supervisory

Nurse, and/or Assistant Chief Nurse. Demonstrated professional competence in

clinical practice and administration. Completed Chief Nurse Training Course or its

equivalent at least 15 units in public administration or course in nursing

administration and supervision of at least 15 units leading to Master’s Degree in

Nursing is required.

b. Chief Nurse III-IV: A minimum of five years of nursing experience, three years of

which have been in a supervisory and/or Assistant Chief Nurse Level.

 Demonstrated professional competence in clinical nursing and administration.

Completed Chief Nurse Training Course Master’s Degree in Nursing is required.

3. Job Knowledge

Broad knowledge and comprehension of nursing practice concepts derived from the

biological, social, and physical sciences and how they apply to nursing care in order to

address nursing issues. sufficient familiarity with and comprehension of research,

administration, and supervision principles. by being aware of the nursing service's

organizational structure as well as the hospital's organizational functions, policies, rules,

and procedures. knowledge and proficiency in balancing the objectives of nursing services

for the hospital as a whole with the needs and ambitions of nursing practitioners.

D. Job Relationships

I. Source of Workers - Professional Nurses

E. Specific and actual functions and activities

1. Plan, organize and supervise the nursing service in order to provide

adequate nursing care to patients;

2. Coordinate all activities of the nursing service department with other

departments in the hospital;

3. Preparing and handling of the nursing service budget in order to provide

adequate personnel equipment and physical facilities needed to be

submitted to the administrative office;

4. Interview and screen all applicants for the nursing service and evaluate their

qualification and experiences;

5. Observe and evaluate the performance of personnel, as well as analyze and

evaluate their nursing activities to determine whether they are meeting the

desired standards;

6. Formulate and recommend policies for improvement of patient care,

participates in planning of personnel policies, and interprets to the Chief of

Hospital the needs and interests of the nursing personnel;

7. Encourage personal development by keeping up a staff education program

and holding monthly sessions for nurses and nursing assistants;

8. Promote and maintain cordial relationships with patients, their families and

the community to provide opportunities for nursing staff to work with other

groups so that the aims of the hospital can be interpreted to convey a good

interpersonal and interdepartmental relationships;

9. Takes part in outreach initiatives run by the hospital;

10. Represents the nursing service and staff at professional meetings and

ensures that nursing staff members have a healthy living environment;

11. Subject “to call” as the need arises; (Attends seminars, workshops, locally

and nationally, etc.)

12. Ward rounds every day. to learn more about the issues and requirements that

the patient, family, nurses, and other medical professionals present;

13. Approves schedule of duties and off duties prepared by the assistant chief

nurse;

14. Signs daily time records;

15. Performs other duties such as required by the chief of hospital;

B.3. Human Resource Management

Human Resource (HR) groups in healthcare organizations are responsible for

standard HR functions, such as recruiting, hiring, and advising senior management on

competitive pay and benefits packages to attract and retain the best talent. In addition to

these general responsibilities, healthcare HR managers handle industry-specific tasks,

including managing high employee turnover rates, supporting employees’ mental and

physical health, monitoring certification compliance, and evaluating success based on

patient outcomes and satisfaction levels (Lindquist, 2023).

At the United Davao Specialists Hospital and Medical Center Incorporated, Human

Resource Management (HRM) plays a pivotal role in supporting the hospital’s operations.

The HRM department is dedicated to recruiting and retaining skilled healthcare workers,

providing ongoing training, and fostering a positive work environment. HRM also oversees

staffing, conducts performance evaluations, and ensures compliance with healthcare

regulations. These efforts are instrumental in upholding high standards of patient care and

achieving the hospital’s mission of delivering comprehensive health services.

C. Environmental Influences Affecting Nurse’s Work

Nurses’ work environment is described as organizational characteristics that

promote or restrain nursing practice. A healthy work environment is satisfying, mentally

and physically safe, and encourages nurses to work to their full potential and provide

quality care. Important factors that influence nurses’ work environment are workload and

staffing levels, decision-making latitude, job demands and complexity, good leadership,

and the ability to participate in unit-based decisions. (Boudreau and Rhéaume, 2024)
C.1. Internal Influences

The relationship that exists between nurses and physicians must be deemed to

represent an essential building block of effective healthcare delivery systems in the context

of a hospital setting. This building block of the relationship is uniquely defined through

variables like mutual respect, active cooperation, and clear, open lines of communication.

Nurses play an important role in conducting detailed patient assessments, administering

appropriate medications, and continuously evaluating the patient's reaction to therapy.

These physicians rely on important information obtained by the nurses to make informed

and successful decisions about patient care. Nurses collaborate closely with physicians and

one another to develop integrated care plans for patients, which are highly beneficial for

overall results and well-being. This allows them to combine their special knowledge and

work together to ensure that patient care is not just comprehensive and timely, but also

aimed at improving the patient's overall health

Nurse to Nurse Relationship

Effective communication among nurses is crucial to preventing missed care. The

work environment greatly influences how well nurses collaborate with one another. In

outpatient oncology settings, teamwork between nurse practitioners and registered nurses

plays a key role in promoting collaboration. This is especially important for addressing

skill gaps, managing transitions, and improving communication. In a supportive

workplace, nurses can find personal satisfaction while helping to achieve organizational

goals. Positive and open communication among nurses fosters collaboration and is vital for

creating a healthy work environment.

 Chief Nurse Ilagan (2024) mentioned that when a nurse wants to swap duties within

their department, they must inform the chief nurse ahead of time. The nurse should submit

a request at least three days prior to the intended swap. The written request should include

details such as the names of the nurses involved, the date and time of the swap, and the

reasons for the change. Research has shown that shifting duties can have a negative impact

on nurses' physical health, as it may contribute to fatigue and energy depletion.

Furthermore, while absenteeism among nurses is often discussed, it is equally important to

recognize the effect of absenteeism on those remaining on duty, as it can increase their

workload and affect their overall well-being.

Nurse and Physician Relationship

The relationship between nurses and physicians serves as a fundamental pillar of

effective healthcare delivery systems in a hospital setting. This collaboration is

characterized by mutual respect, active cooperation, and clear, open communication.

Nurses play a vital role by conducting detailed patient assessments, administering

appropriate medications, and continuously evaluating patients' responses to therapies.

Physicians rely on critical information provided by nurses to make well-informed and

effective decisions regarding patient care.

Collaboration between nurses and physicians extends to the development of

integrated care plans, which significantly contribute to patient outcomes and overall well-

being. By combining their specialized knowledge, both groups ensure that patient care is

comprehensive, timely, and focused on improving overall health. This partnership

exemplifies the importance of interdisciplinary teamwork in achieving high-quality

healthcare standards.

Nurse and Patient Relationship

The relationship between the nurse and the patient is fundamental and cannot be

absent when there are effective healthcare services involved. Such a vital relationship

derives its essential foundations from essentially and fundamentally based elements of

trust, empathy, and open communication. Nurses actively connect with their patients and

extensively assess each patient's emotional and psychological needs, as well as their

physical ones. This strategy promotes patient involvement in their own care and treatment,

creating a safe and pleasant setting that stimulates active participation. To improve

outcomes and reach the highest levels of patient satisfaction and well-being, rapport is

largely established via sympathetic interaction and active listening.

Manpower

The man power at hospitals play an important role in ensuring quality care for

patients. These people are a variety of nurses, physicians, allied health workers, and

administration staff working together to fulfill the requirements for the patients. Effective

staffing coupled with constant training and development is what helps maintain an all-

rounded and competent workforce. Facilitating interaction and openness among the staff

ensures that resources are utilized on all fronts to fulfill the primary mission of accessible

as well as holistically wholesome health services.

Flexibility

Anyone seeking authority should establish a reputation as someone who is willing

to compromise. Being new in a particular field needs further information and knowledge

in order to be competent enough. Through this, every nurse and health care practitioner

will be able to give quality and holistic treatment to the patient, making the organization's

actions more effective and efficient.

Resilience

To adapt to the shortage of nurses, UNIDAV has made changes to continue meeting

its goals. Due to the limited number of nursing staff available, the hospital has decreased

its bed capacity from 100 to 50. This adjustment was necessary as the hospital cannot

efficiently care for a large number of patients with the current nurse shortage. Although

currently operating at a reduced capacity of 50 beds, UNIDAV has not yet reached full

capacity. However, the nursing team is ensuring the delivery of safe and quality care within

this smaller capacity.

C.2. External Influences

External influences pertain to include technology, social-cultural, economic, and

legal elements that will affect an organization. The following external resources explore

the effect of the technological, family involvement, environmental conditions, and

economic variables, all contributing to the overall enhancement of the nursing profession.

Technology
 During interviews, it was mentioned that in situations where conflicts arise within

a particular unit, there is a committee or group in place to discuss these issues. However,

if the problem extends beyond the unit, such as errors, it is not within the unit's authority

to make decisions. Instead, such issues must be escalated to the Chief Nurse and potentially

to Human Resources for resolution. HR has a grievance committee specifically tasked with

reviewing errors, incident reports, and other conflicts that may need to be addressed at a

higher level. The appropriate course of action depends on the nature of the case and the

conflict involving staff members.

Family

As stated, that important matters related to a family member would affect the

nurses’ performance in the hospital. For example, upon admission in Emergency Room

(ER), a designated hospital staff make sure to entertain with both the family and patient, as

much as possible. They separate the family and the patient because the health care team

cannot move if there is patient’s family and the healthcare team can do their work without

distractions. This way, nurses and doctors can focus on helping the patient right away.

There are also staff members available to look after the family, asking what's going on to

make sure everyone's needs are met quickly and prevent any delay in providing care to the

patients.

Environment

The nursing environment at UniDav hospital is relatively low-stress, as it currently

accommodates a small number of patients due to its 50-bed capacity, which began
operations last year. Consequently, nurses experience less exhaustion and stress, enabling

them to provide patient-centered and individualized care that yields excellent feedback

from patients. However, the current staffing shortage largely attributed to the growing

number of Filipino nurses working abroad, creates a staffing dilemma.

Economic Variable

It is a well-known truth that the majority of freshly graduated Registered Nurses

(RN) in the Philippines want to work overseas. Some, or the majority, picked nursing as

their profession because they believe they will be able to earn more money abroad than

working in the Philippines. Though for some Nurses, they are trying to make a good

foundation of themselves by working at United Davao Specialists Hospital and Medical

Center Incorporated to develop and hone their nursing skills to become a more competent

nurse.
 CHAPTER VII

SUMMARY, CONCLUSION, AND RECOMMENDATION

 CHAPTER VIII

BIBLIOGRAPHY

Akingbola, K., Kerekou, S., & Tohon, A. (2023). Employee engagement in nonprofit
organizations: the role of perception of HR and organizational culture. Journal of
Management Development, 42(3), 215-233.
Baird, K., Tung, A., & Su, S. (2020). Employee empowerment, performance appraisal
quality and performance. Journal of Management Control, 31(4), 451-474.
Boudreau, C., & Rhéaume, A. (2024). Impact of the Work Environment on Nurse
Outcomes: A Mediation Analysis. Western journal of nursing research, 46(3), 210
218.
Centers for Disease Control and Prevention. (2023, May 15). Preventing chronic disease:
Tips for healthy living. U.S. Department of Health and Human Services.
Chen, Q. and Eriksson, T. (2020). The mediating role of decentralization between strategy
and performance: Evidence from Danish firms, Journal of Organizational Change
Management, vol. 32 no. 4, pp. 409-425,
[Link]
Christiansen, S. (2023, March 27). What is a chief nursing officer (CNO)?
[Link].
Cleveland Clinic. (2023, November 22). Endocrine system. Cleveland Clinic. Retrieved
November 22, 2024, from [Link]
endocrine-system
Cleveland Clinic. (2024, May 2). Respiratory system. Cleveland Clinic. Retrieved
November 22, 2024, from [Link]
respiratory-system - Medical News Today. (2021, July 30). Cardiovascular system.
Retrieved November 22, 2024, from
[Link] -
Jacobsen, C. B., Hansen, A. K. L., & Pedersen, L. D. (2023). Not too narrow, not too broad:
Linking span of control, leadership behavior, and employee job satisfaction in
public organizations. Public Administration Review, 83(4), 775-792.
Joseph, J., Klingebiel, R., & Wilson, A. J. (2022). Organizational structure and
performance feedback: Centralization, aspirations, and termination decisions.
Organization Science, 27(5), 1065-1083.
Kabene, S. M., Orchard, C., Howard, J. M., Soriano, M. A., & Leduc, R. (2024). The
importance of human resources management in health care: a global context.
Human resources for health, 4, 20. [Link]
Monteiro, P., & Adler, P. S. (2022). Bureaucracy for the 21st century: Clarifying and
expanding our view of bureaucratic organization. Academy of Management
Annals, 16(2), 427-475.
Morrison, V., Hauch, R. R., Perez, E., Bates, M., Sepe, P., & Dans, M. (2021). Diversity,
equity, and inclusion in nursing: the pathway to excellence framework alignment.
Nursing Administration Quarterly, 45(4), 311-323.
Robbins, S. P., & Judge, T. A. (2019). Organizational Behavior. Pearson.
Rubel, A. (2023). Centralized and Decentralized Organizational Structure: The Impact on
Employee Satisfaction and Performance. In Proceedings of the International
Conference on Industrial Engineering and Operations Management.
Sankala, A. (2024). Strategic Alignment: Evaluating Organizational Processes through the
Lens of Global Standardization.
Serpa, Sandro, and Ferreira, Carlos. "Bureaucracy: Characteristics, Advantages, and
Disadvantages." Simply Psychology, 2022.
Smith, J. (2020). Core values and organizational success: A guide to sustainable business
practices. New York, NY: Business Insights Press.
Sun, J., Wang, C. C., Yang, Z., Yu, T., Li, J., & Xiong, X. (2022). Impact of organizational
decentralization degree on job satisfaction and job performance: A hierarchical
linear model analysis for construction projects, Engineering, Construction and
Architectural Management, vol. 29, no. 4, pp. 1642–1660,
[Link] 2020-0503.
Vitolla, F., Raimo, N., Marrone, A., & Rubino, M. (2020). The role of board of directors in
intellectual capital disclosure after the advent of integrated reporting. Corporate
Social Responsibility and Environmental Management, 27(5), 2188-2200.
Tarawneh, D. W. (2020). Hospital Departments and Relationship - PART

II. [Link]
departments-and-relationship-part-ii
Weber, M. (2023). Bureaucracy. In Social theory re-wired (pp. 271-276). Routledge
APPENDICES
 Figure 1. ACSU Figure 2. Medical Ward

Figure 3. ICU Figure 4. Operating Theater

Figure 6. Documentation

Figure 5. UniDav Hospital