How to Build an Organizational Chart

organizational chart

Establish and review your practice’s hierarchy to streamline

By Lisa M. Mackell, MPT

I have often been asked by my staff and managers about the importance of organizational charts. Some wonder why they are necessary since everyone already knows who their bosses are. Others depend on seeing the visual layout to know their place in the company and understand the ladder of command. I have also consulted with companies that have a very detailed organizational chart yet never shared it with anyone and it remained in the computer for no one to see. Where do you fall on the importance of creating and maintaining an organizational chart for your practice?

The organizational chart provides a visual of the organizational structure. It includes job titles, employee names, and can even include contact information for each person (Figure 1). An organizational structure typically only becomes outdated with significant growth, yet the organizational chart can become outdated very quickly and often. As people shift in and out of certain roles, the organizational chart may need to be updated, and it is critical to name who is responsible for keeping this chart up to date. Organizational charts provide a visual of the management structure for the business and add accountability to the employees. Well-designed organizational charts provide transparency to the staff regarding the chain of command.

org chart figure 001

Additionally, an organizational chart can motivate employees for career advancement when they can see the tiered positions in their department.


First, you must clarify the difference between organizational structure and organizational charts. A company’s organizational structure is the written plan that outlines the roles, functions, and the movement within a department. A company’s organizational structure may even include key performance indicators (KPIs) for each department. However, this structure is broad and does not include job titles or names of employees. The organizational structure only changes when the company changes its strategy or initiatives.

As you tackle this project for your practice, I suggest that you first write out the organizational structure on paper for your company and review it with key members of your team. Once you agree that you have truly captured the vision of your practice, you can then work to visualize it with an organizational chart. Templates for organization charts can be found in PowerPoint and Excel, as well as tutorial videos on YouTube, showing details on creating and personalizing a chart for your practice.


When was the last time you reviewed your organizational chart? A lack of clarity in terms of hierarchy may cause logjams in your business, namely through problem-solving and communication. Reflect on any possible bottlenecks to your processes to find if your organizational chart needs review. If so, get with your team to untangle those knots. Remember, as your practice shifts and grows, both the organizational structure and chart may need updates. They will only hold value if they are current, shared, and utilized by all. 

Lisa M. Mackell, MPT

Lisa M. Mackell, MPT, is a member of the Impact Editorial Board. Lisa owned a pediatric physical therapy company that grew to 32 centers in four states before selling her practice. Lisa now provides consulting services to therapy practices. Lisa has presented at APTA Private Practice annual conference and CSM. Lisa can be reached at

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