Organisational structuring of merged laboratory departments

Is there any other solution to managing also another similar department at a different hospital site, other than assigning deputies at both sides ?

There are 8 teaching hospitals located in the Netherlands, from which 2 of them situated in the city of Amsterdam. One is associated with the Free University (Free University Medical Center, VUmc) and the other one with the University of Amsterdam (The Academic Medical Center, AMC). The VUmc and AMC are located 4 miles from each other. Both hospitals employe about 7000 fte and are organised according to a more or less decentralized, divisional structure.

Since 2013, these two hospitals are engaged in an administrative merging proces, the main aim being circumscribed, complementary patient profiles for both hospitals, leading to -to everybody’s conviction- improvement of ‘academic output’. It is expected to take only some months from now, that the National Trade Commission will come to a verdict on the request of both hospitals to merge administratively. It was decided though, that a negative outcome will not effect the intended merging of some non-clinical departments, more specifically the diagnostic and research laboratories. Therefore, the preparation of this merge by both boards of the laboratory divisions, has already made substantial progress.

During this preparation, it has become clear that it is feasible to locate two laboratory disciplines at just one of the hospital sites, thus resulting in an actual concentration. For the other two departments, it is obvious that a location at two sites will have to be remained.

Both laboratory divisions are comparable with regard to the number of employees (about 800 fte) and also the size of each corresponding department does not differ much; the departments of Clinical Chemistry, Medical Microbiology, Pathology and Clinical Genetics all employe between 100 and 150 fte personnel. Thanks to a proactive HR-policy and some luck with the circumstances, all departments have already -or soon will have- one head of department. This means that within a short time notice, 8 laboratory departments of 2 hospitals will be led by 4 heads of department.

The issue where both laboratory boards are struggling with, is the way that these heads of department want to deal with their expanded span of control, since in all cases that will be doubled. From two of them, an offical request has been received to assign a deputy head for each site.

Both boards of the laboratory divisions are hesitating. Although the problem of the span of control is obvious, there is anxiousness that a well-intended and highly valued participative style of management will be lost eventually, due to more remote managementcontrol. Also, both boards are reserved to see responsibilities of a head of department being delegated to a deputy, who’s selection has not been subject to discussion with the division board. Besides that, there is conviction that formally installing deputies, is not adding a lot to the possibility that certain tasks of a head of department can be delegated to other members of staff anyway.

So the key question is; is there any other answer thinkable to challenge the problem of a doubled span of control, other than creating a new managementlayer.


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Participant comments on Organisational structuring of merged laboratory departments

  1. You may want to consider look at the positions that currently report into the Heads of department to expand their responsibilities and provide more leadership and expand their span of control and then do the same with the next layer down. This helps support the head of department with the larger scope of their position, but also prevents adding another layer, while providing career opportunities for those employees below them. Its hard to know for sure if this is possible without understanding the positions, but we have done this successfully and it really improved morale, productivity and our supported our succession planning initiatives.

    1. Thank you for your comment !
      It sounds quite plausible and the fact that you did something similar with succes in your organisation, makes it worth exploring.


  2. I believe expanding the span of control is not a long term issue in a laboratory setting as processes are repetitive and once there is a system in place I think it should be ok. Alternatively, it might be a good idea to have an interm high-performance task force to handle the merger and stabilise the processes and the system. Later on the HOD may delegate some functions to supervisor and seniors in the department if necessary and he remains overwhelmed.

  3. Hi there Kais.
    Thank you for your comment. I can imagine that you consider the repetitiveness of the processes a relevant factor, but I can assure you that some of these laboratories are highly robotized. Still, you have a point.
    But also, the span of control is dubbled, not some some percentage higher. So, it will really have an impact on the HOD.
    And it surely is a good idea to have a supporting projectteam for an extended period, so that we have the time to tune the coordination of workprocess in an action oriented, incremental way.
    Having said that, you come up with about the same suggestion as Julia; spread responsibilities across more memebers of the staff. We will explicitly discuss that with the teams involved.

  4. Hi Theo,

    I face the same kind of problems in my organization. We actually have design rules for these situations, as soon as the number of employees exceeds a certain quantity a management position is created. I find this quite frustrating. It takes away initiative and ownership and makes it hard to reach any synergy goals that come with two merging organizations like yours. I was thinking: isn’t this the time for you to totally redesign your laboratory organization? Can’t you rearrange processes and put in a totally different type of steering? At this time I am experimenting with a matrix structure inspired on the Spotify model. See: Because you are in a totally different environment I have no idea if this might work for you. It is actually a hell of a job to make this work in my environment and on a much smaller scale. What might be interesting to look at is if you can make a division between people responsible for the outcome of the laboritories and those responsible for managing teams of professionals.

    Our organizational models are so old fashioned and not fueling inspiration. I find great inspiration in the Buurtzorg model of Jos de Blok. A 350 million euro company with about 9.000 employees and no management. Best employer for many years in a row. And we keep on designing our organizations like the Romans did 2000 years ago. I would recommend taking a lot of time to look around in the laboratory world and other industries all over the globe for inspirational examples. Get people with lots of other background involved, you need some out of the box thinking.

    See you on sunday or at the flight to Boston, Erik

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