Hospital Organizational Structure

Hospitals require precision in the execution of job responsibilities and multiple layers of accountability in order to function. To accomplish this, hospitals use a functional organizational structure with many layers of management.

Understanding the complete hospital organizational structure ensures that hospital employees know their own responsibilities, the responsibilities of those around them, to whom they report, and who to talk to about particular responsibilities or fields of knowledge.

Hospital Organization and Management


All hospitals include some form of governing body responsible for making high-level decisions about the organization. The board of directors is the highest in the hospital chain of command and is made up of experts in their respective fields. Religiously affiliated hospitals often include clergy on their boards of directors. Teaching hospitals often include university faculty from the medical school with which they’re affiliated.


In the hospital leadership structure, executives are responsible for managing the organization, making financial decisions, and overseeing business strategy. Medical and health services managers may oversee entire practices or clinical areas. A hospital typically has a chief financial officer who tends to the financial aspects of the business and a chief operating officer or chief executive officer responsible for high-level business strategy and decision-making.

Department Administrators

Department administrators report to the hospital executives and manage the day-to-day operations of the hospital department structure. The chief of surgery, for example, is responsible for overseeing daily activities within the surgical department as well as performing surgery. A chief of surgery might engage in public relations activities, fundraising and recruitment. Other segments within a hospital, such as transcription or switchboard personnel, also have department administrators.

Patient Care Managers

Nurse managers and supervising physicians are both patient care managers. These individuals manage small groups of professionals who provide direct patient care. They ensure that orders are carried out, that hospital employees are fulfilling their duties appropriately, and that employees are complying with legal requirements.

Service Providers

The vast majority of hospital workers are service providers: doctors, nurses, orderlies, physical therapists, laundry workers, and the many other people required in order for a hospital to function. They provide patient care, maintain records and ensure that the hospital is able to deliver care to patients in an effective manner. Service providers have their own hierarchical structure in healthcare. For example, doctors often give orders to nurses, who might delegate to orderlies.

Move up in the Hospital Hierarchy

Rivier University’s online MBA in Healthcare Administration gives students the skills and knowledge needed to pursue management and executive positions in a hospital. The program takes place in a convenient and flexible online learning environment that accommodates students’ personal and work schedules.