The Hidden Power within the Hierarchy

By Greg Hunter, RT (R) (T)

      Beth Boynton, RN, MS

When there is talk about hierarchy in the healthcare setting, more than the structure of an organization, hierarchy is often highly associated with ego, power, status and even money.  A lot of health care workers complain about one-sided flow of communication, with a focus on following orders and protocols, and less on finding solutions as a team.

With the term hierarchy, we often refer to the ‘gap’ between levels in the organizations. Well in fact, when taken in a different and logical point of view, it should mean sound clinical decision-making, expertise and leadership.

Should hierarchy be abolished?

Leveling the hierarchy by placing each member of an organization in one level is just not possible. After all, who can imagine a hospital without a leader? What extreme chaos that would be!

But leveling in terms of teamwork process and not structure is something to consider. In this way, we successfully bridge the ‘gap’ while letting sound decision making, expertise and leadership work their wonders in the achievement of organizational goals.

What helps to level the hierarchy?

There is not a single solution to leveling the hierarchy. But definitely, a lot of respect and emotional intelligence would go a long way for it to be realized. Among others, collaborative leadership plays a crucial role. Leaders are forefront in ensuring that they are effective in reaching out to other members of their organizations.

Collaborative leadership recognizes the power of the concerted effort of appropriate people in creating visions and in working on strategies to bring forth great accomplishments. In fact, some organizations, like ManageUP, offer services to enhance this important part of management. They propose to work on the following:

1.   Transparency

Members feel they could trust the management when everything is in black and white. They feel that they are involved in the process of positive change when they are aware of what is happening to the common purpose to which they are contributing to. What is commendable of ManageUP is that they do it that way. They provide real-time visibility into what staff has accomplished, and into what are still needed to be done while making available to the staff relevant information.

2.   Promoting closed and strategic loop communication

Closed loop communication ensures that flow of information goes smoothly through the right channels and back. This means that there is an effective method of disseminating information to the right people and still have room for feedback.

Automating this process whereby a tailored view of all important procedures, guidelines, processes, and training materials are constantly updated makes this strategy a very powerful tool in promoting enhanced collaborative leadership.