Four-Frame Organizational Analysis Grid – Mental Health Patient Care in the Emergency DepartmentStructural framework to fit purpose, technology, workforce and environment• Goals and Objectives• Specialization and division of labor • Coordination & control • Structures According to Bolman and Deal, structure “is a model for formally sanctioned expectations and exchanges between internal actors and external constituencies”. (Bolman, 2013, p.46) When a structure is inadequate, difficulties arise among both internal actors and external constituencies. However, it is not so much about finding the perfect structure as it is about “putting people in the right roles and relationships” within the chosen structure. (Bolman, 2013, p. 45) When this happens, the structure will enable people to do their jobs well. The goal of my number is to provide safe, quality care to any patient with mental health (MH) issues in our Emergency Department (ED). I have identified the following structural elements in my organization that are driving or restraining forces towards this goal. The first element is "vertical coordination". (Bolman, 2013, p. 49) This vertical coordination in my case occurs between external constituencies. Many area hospitals were diverting HD patients to our Level 1 Trauma Center, Harborview, overwhelming the emergency room. The elements of vertical coordination are “authorities, rules and policies, planning and control systems”. (Bolman, 2013, pp. 51-54) The formal “authority” in this issue is the WA Central Region EMS and Trauma Council, with Harborview Hospital as the leader. The Harborview Authority in King County was established well before this issue arose. A top-down approach to the people of our community by providing quality care in a collaborative environment. “Negative symbols perpetuate evil, just as positive symbols reinforce goodness. Symbols cut both ways. (Bolman, 2013, p. 262) I have worked for large organizations in the past where whining and complaining was part of the culture and represented a very negative force. When I look at my problem through the symbolic frame, I can see where positive symbols have created a positive culture and are driving forces. I have not identified any restrictive forces looking through the symbolic frame. Reference Bolman, LG and Deal , T. E. (2013). Restructuring the Mentally Ill. (2013, October 7). /seattletimes.com/html/editorials/2021988414_mentalhealtheditxml.html