One interesting topic from our reading was the concept of Centralization vs Decentralization. Centralization is the extent to which management decisions are made at the highest levels of command versus decentralization where the decision making process is extended down through the command structure giving a higher percentage of the work force a say in the decisions (Huber. 2010). Neither an extremely centralized or extremely decentralized system tends to work well in healthcare. This is due to the limited knowledge and specialized expertise a small group at the top is capable of having in centralization or the time consumed and also knowledge deficit that occurs when all have a say in every decision. Essentially the best person to make the decision should make the decision. This requires a more decentralized or middle ground approach.
We can look to the government and recent gridlock that seems to frequently take place in congress. The great majority of people would like to see congress compromise more and get more done related to the issues we can agree upon. Unfortunately the high level of centralization prevents the public input from really reaching any government officials at the highest level. It makes me wonder if we wouldn't be better off with more power in the states individual hands. Is decentralization the answer?
Huber, D. (2010). Leadership and Nursing Care3 Management. (4th ed). Saunders an Imprint of Elselvier Inc. Maryland Heights, MO
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