The US Healthcare Delivery System27In any nursing organizational structure, several types ofrelationships can be identified, including the following:Line relationshipsidentify the positions of superiorsand subordinates and indicate the levels of author-ity and responsibility vested with each position. Forexample, a supervisor in a postoperative surgical unitwould have authority to direct the work of severalnurses.Lateral relationshipsdefine the connections amongvarious positions in which a hierarchy of authority isnot involved. For example, the supervisors of preop-erative and postoperative surgical units would haveparallel positions in the structure and would need tocoordinate the work they perform.Functional relationshipsrefer to duties that are dividedaccording to function. In such arrangements, individu-als exercise authority in one particular area by virtue oftheir special knowledge and expertise.Diagnostic and Therapeutic ServicesThe services provided to patients in hospitals go beyond theclinical services provided directly by the medical and nurs-ing staff. Many diagnostic and therapeutic services involvethe work of allied health professionals. Allied health pro-fessionals receive specialized education and training, andtheir qualifications are registered or certified by a numberof specialty organizations.Diagnostic and therapeutic services are critical to thesuccess of every patient care delivery system. Diagnosticservices include clinical laboratory, radiology, and nuclearmedicine. Therapeutic services include radiation therapy,occupational therapy, and physical therapy.Clinical Laboratory ServicesThe clinical laboratory is divided into two sections: anatomicpathology and clinical pathology. Anatomic pathology dealswith human tissues and provides surgical pathology, autopsy,and cytology services. Clinical pathology deals mainly withthe analysis of body fluids, principally blood, but also urine,gastric contents, and cerebrospinal fluid.Physicians who specialize in performing and interpretingthe results of pathology tests are called pathologists. Labo-ratory technicians are allied health professionals trained tooperate laboratory equipment and perform laboratory testsunder the supervision of a pathologist.RadiologyRadiology involves the use of radioactive isotopes, fluo-roscopic and radiographic equipment, and CT and MRIequipment to diagnose disease. Physicians who specializein radiology are called radiologists. They are experts in themedical use of radiant energy, radioactive isotopes, radium,cesium, and cobalt as well as x-rays and radioactive materi-als. They also are expert in interpreting x-ray, MRI, and CTdiagnostic images.
