Exploring Workarounds in EHR Implementation

This assignment delves into a qualitative exploration of workarounds implemented in mental health hospitals during the initial stages of adopting national electronic health records (EHRs). Drawing on research conducted at early-adopter institutions, the analysis examines the practical challenges and strategies employed to bridge the gap between intended EHR functionality and real-world clinical workflows. The assignment utilizes published qualitative studies and reports, emphasizing the complexities and user perspectives surrounding EHR implementation in healthcare settings.

Contents
Chapter 5. Discussion .....................................................................................................................3
Introduction.................................................................................................................................3
Summary ....................................................................................................................................3
Conclusion ......................................................................................................................................3
References .......................................................................................................................................3
Appendix .........................................................................................................................................3
Personal statement ......................................................................................................................3
Reflecting log..............................................................................................................................3
ABSTRACT.....................................................................................................................................5
Chapter 1. Introduction....................................................................................................................6
BACKGROUND OF THE STUDY ..........................................................................................6
Research problem........................................................................................................................6
Research Aims and Objectives ...................................................................................................7
Limitations of the Study...................................................................................................................7
Structure of the Dissertation........................................................................................................8
Summary ....................................................................................................................................9
Chapter 2. LITERATURE REVIEW ............................................................................................10
Introduction...............................................................................................................................10
1.2 Overview of the topic..........................................................................................................11
1.3 Understand the importance of managing changes in NHS.................................................11
1.4 The effectiveness of managing changes in healthcare to deliver the quality services........13
1.5 The impact of managing changes in NHS ..........................................................................14
1.6 Types of barrier which healthcare organisation face while managing change...................16
1.7 Summary.............................................................................................................................17
Chapter 3. Search Methodology ..................................................................................................17
Research philosophy.................................................................................................................18

Research design.........................................................................................................................19
Research approach....................................................................................................................20
Data Collection method.............................................................................................................21
Sampling...................................................................................................................................22
Data Analyses............................................................................................................................23
Ethical consideration.................................................................................................................24
Reliability and validity..............................................................................................................25
Research limitation....................................................................................................................25
Conclusion.................................................................................................................................26
Chapter 4. Findings / Results / Data Analysis...............................................................................26
Introduction...............................................................................................................................26
Issues in health care organization.............................................................................................26
Importance of managing changes in health care organization..................................................28
Impact of managing changes on service quality in NHS..........................................................29
Barriers faced by NHS while managing changes......................................................................30
Ways for managing changes successfully.................................................................................31
Summary...................................................................................................................................32
Chapter 5. Discussion ...................................................................................................................33
Introduction...............................................................................................................................33
Summary ..................................................................................................................................33
Conclusion ....................................................................................................................................33
References .....................................................................................................................................33
Appendix .......................................................................................................................................33
Personal statement ....................................................................................................................33
Reflecting log............................................................................................................................33
REFERENCES..............................................................................................................................34

Chapter 5. Discussion
3000
Introduction
Summary
Conclusion
1000 words
References
Appendix
Personal statement
Reflecting log

ABSTRACT
In the present dissertation, researcher has major aim to explore the significance of
managing changes in healthcare organisation in order to deliver quality services. Thus, it can be
said that this report provides the detail knowledge and understanding about the significance of
change management in the health and care sector. In addition to this, present investigation also
explains the effectiveness and impact of managing change with respect of NHS.

Chapter 1. Introduction
BACKGROUND OF THE STUDY
In the health and care organisation, it is great responsibility of health care experts and
professionals to deliver effective and high quality of care services of patient so that they can
improve their health issue and problem. However, in this sector there are significant changes
occur at regular interval through which entire process and activities of health and care can be
changed. The major reasons behind these changes are related to the legislation, policies,
technology, business environment, customer demand, types of disease etc. In order to manage
these changes in an effective manner within the health and care sector, it is significant for
scholar to focus on the change management model (Cummings and Worley, 2014). With
assistance of this model, management of health and care can effectively manage all relevant
changes. By use of high quality and advanced technology, health care organisation can easily
cope up with changes and produce high quality of outcome. The current investigation has major
purpose to analyse the ways to manage the significant changes in order to deliver high quality
of care services to patient in NHS.
Research problem
In the present study, scholar have major aim is to explore the significance of managing
changes in healthcare organisation in order to deliver quality services with respect of NHS. One
of the major limitation for this investigation is related to the open as this is very broad subject
so it is quite difficult to include the entire information about subject. Further, limited time
period is another major limitation due to which researcher may face issue regarding conducting
investigation (Grol, Wensing and Davis, 2013). As it is quite difficult to conduct all activities
within small period. Another major issue regarding finance because in order to initiate some
research action like transportation, internet, stationary required sufficient amount of fund.
Research Aims and Objectives
Aim
To explore the significance of managing changes in healthcare organisation in order to deliver
quality services – A study of NHS.

All the objectives of the research are based on the aim which helps in accomplishing the
research in an effective manner. Here are the objectives:
Objectives:
 To understand the importance of managing changes in healthcare organisation.
 To identify the effectiveness of managing changes in healthcare organisation to deliver
the quality services
 To evaluate the impact of managing changes in healthcare organisation on quality
services.
 To identify different types of barriers which healthcare organisation faces while
managing changes
 To recommend different ways for managing changes successfully within NHS for
delivering quality services.
Research questions
 What is the importance of managing changes in healthcare organisation?
 What is the effectiveness of managing changes in healthcare organisation to deliver the
quality services?
 What is the impact of managing changes in healthcare organisation on quality services?
 What are the different ways for managing changes successfully within NHS for delivering
quality services?
Limitations of the Study
The present study has major aim to explore the significance of managing changes in
healthcare organisation in order to deliver quality services with respect of NHS. In this study
have major problem is that health and care sector is largely depends upon the patient's disease
as health experts have to deliver the care services according to the diseases of patient. Due to
changes in the legislation, technology and business environment, it may be quite difficult for
the doctor to adopt such changes in frequent manner.
Structure of the Dissertation
All chapters in the dissertation play a very crucial role for addressing the effective and
accurate outcome of the study. In the dissertation, there are various chapters that help

researcher in attaining the accurate result for the study. The description of these chapters is as
following-
Chapter- 1 Introduction- This is a significant chapter that provides knowledge about the aim,
objectives and research questions. Every dissertation starts with introduction that provides the
understanding about background of the study (Creswell and Poth, 2017). In the present study,
first chapter defines that what is actual aim of the report regarding to manage changes in the
health and care and its significant impact upon the quality of care services in the NHS.
Chapter-2 Literature Review- Once introduction completed then second chapter starts with
literature review which provides the detail knowledge and understanding about the subject of
study. In this chapter, several themes can be made which include all relevant information about
the topic (Carayon, Wetterneck and Gurses, 2014). In the present study, several themes related
to the importance of managing change, effectiveness of managing changes as well as types of
barriers related to managing change in the context of health and care has been included.
Chapter-3 Research Methodology- Research methodology is also very significant chapter in the
dissertation that helps scholar in collecting, analysing ad interpreting information about the
subject and finding out the best solution of the research issue. In this chapter, several
techniques are included such as approach, philosophy, research technique, data collection, data
analysis, sampling etc. All these methods helps scholar in finding out impressive solution of
research problem.
Chapter-4 Data analysis- Data analysis is another one of the significant chapter which helps
scholar in analysing and interpreting information by use of primary and secondary source. With
help of this chapter, researcher can effectively analyse, assess and evaluate the data about the
subject so that right solution can be obtained in an easy manner (Burke, 2017). Thematic
analysis approach has been used through which information can be represented in the form of
chart, graphs, tables etc.
Chapter- 5 Conclusion and recommendation- Once the data analysis chapter completed then
researcher conclude and summarise the collected information. This is very effective chapter
which provide final conclusion of entire study (Bailly and Comino, 2017). In this present
chapter, researcher has also included recommendation about the change management in

health and care organisation so that NHS can make necessary improvement for delivering high
quality of care service to patient.
Summary
From this first chapter of the dissertation, it has been summarised that it is great
responsibility of health experts to manage the changes in the health and care sector so that
right treatment and care service can be delivered to patients. Along with systematic structure
of dissertation, researcher can effectively get knowledge about each activity which will be
conducted in the investigation.

Chapter 2. LITERATURE REVIEW
Introduction
Literature review chapter of the dissertation is one of the important because it is
incorporated of different authors views and opinion. It is one of the critical parts of the thesis.
Under this different scholar, views are presented related to the selected topic. All the
information in this section if collected from the secondary sources which act as a basis with the
help of which further study is carried out. Hence with the help of literature review chapter, the
gap left by the previous researcher is analysed. Apart from this, in this chapter different
researcher views is critically evaluated in brief. This lead to help in building a strong theoretical
base for the subject under the study. The present literature review chapter includes an
overview of the change management in a healthcare organisation. Later it consists of the
effectiveness of managing changes in healthcare to deliver the quality services. Lastly it includes
types of barrier which healthcare organisation face while managing change
1.2 Overview of the topic
The last decade there has been noticed the unpredictable level of change in health and
social care services, with the intention of improving performance and making services more
accessible and sensitive to the needs of people using them. The national health service at the
United Kingdom has gone through plenty amount of changes due to the implementation of new
technologies. It is essential to implement changes so that patients can receive quality services.
Changes not only impact services user but also health care professionals. According to the view
(Curcin and et.al., 2014) of Healthcare Organisation s are complex, in part because of a
confluence of professions, including physicians, nurses, pharmacists, and administrators, each
with seemingly competing for interests, perspectives, and time horizons. To deal with the
changes is one of the biggest challenges for the health care organisation. However, it leads to

bringing growth and success within the firm. With the increase in the new technologies
healthcare form aims to improve their way of delivering services and accomplish success.
1.3 Understand the importance of managing changes in NHS
According to the view of (Cresswell and Sheikh, 2015)evolution of new technologies
bring drastic changes within the NHS as there are many health care professionals who suggest
and provide treatment through video conferencing to patients. Along with this, with the help of
digital technology and managing information system, services user can easily access different
books and journals associated with health care from internet and electronic database of NHS.
Therefore, many new technologies introduced in the market and they play a significant role in
improving services which are delivered to the patient. Healthcare firm is one of the change-
oriented industry and it greatly impacts the techniques used for providing treatment to the
patient. Castle-Clarke and Edwards, (2016) state that at present manager if carrying out its
activities at the challenging positions. It becomes difficult for them to gain competitive
advantage the health care industry and leading firm..
Different types of changes can be implemented within the firm such as the use of new
technology, change in leadership style and way of managing patient et. There is rapid changes
occur within the healthcare firm that lead to encourage to adopt new technology such as
managing information system, electronic health record etc. (Cresswell and Sheikh, 2015) state
that as compare to other sector health care is one of the systematic and organised industries
that’s main aim is to deliver quality services to patient. They are not involved in any kind of
trade activities that can increase sale or profit. With the aim of providing quality services health
care organisation need to ensure that it adopt new technologies on time. Use of new
technology also leads to increase skills and efficiency of health care provider. According to
Sousa, (2015) explained that advancement in healthcare technology move at a rapid pace,
therefore healthcare professional, nurses should stay sharp. This all play a significant role in
healthcare firm as a remote monitoring device and high-tech patient and simulator have
become common in healthcare firm. In different types of facilities, there are different levels of
technology and it is essential for nurses to adoptable at the time when they started learning

new equipment and system. For instance, application that make aware nurse that they are late
in providing treatment allow for simultaneous quality management as well.
According to the Watson and Edwards, (2016), this changes aids in improving the lives of
nurses and also enable team collaboration and providing. Along with this, it provides instant
entree to serious patient information. Nurses and another service provider can give fast
response to the changing physiological constraints with the use of evidence-based protocols
and improve patient outcomes. Tan and Liu, (2013) stated that healthcare firm such as hospital
or general or GP are information intensive industries. Basically, GP provide health care services
to its local people first. Three types of information in the healthcare organisation are such as
management information, patient information and information related to the diagnostic and
therapeutic decisions. Organizational semiotics is the study of organization using concepts and
methods of semiotics. Wager, Lee and Glaser, (2017) claimed that information requirement can
be easily deducted at the time when norms are easily find out within the form. However, each
norm has some general shape and which need to be followed in health care sectors.
1.4 The effectiveness of managing changes in healthcare to deliver the quality services
According to the view of (Marjanovic and et.al., 2017)., change management in
healthcare firm assist in improving skill and knowledge of healthcare workers. Along with this, it
helps in making improvement in way of providing treatment, keeping a record of its existing
patients and their treatments etc. In respect to delivering quality services, it is essential for the
firm to adopt new technologies and trained its staff members so that they can use all the
technologies in an effective manner. Managing change within the firm is to about handling the
complexity of the process. It is related to evaluating, planning and implementing operations and
ensure that changes are worthwhile. Sousa, (2015) argued that effective change is known as
unfreezing old behaviour and introduce a new one. In the organisation, there is some
predictable change take place which can be managed on time. On the other side, some of them
are the unpredictable change that is difficult to manage and respond. However, the healthcare
organisation change is always uncertain and occurs rapidly. In order to gain competitive
advantage, it is essential to possess ability to change, adapt and evolve to do it in better way
from others (Grol, Wensing, and Davis, 2013)

The organisation which gets a failure is because of lack of vision and commitment etc.
The effectiveness of managing change is that it helps in bringing new methods of providing
treatment which enhance the satisfaction level of patients. Along with this it also avoids the
chances of mismanagement, conflict from the from the firm that leads to bringing success.
Similar to this Mintzberg, (2017), state that electronic health record and digital technology help
in maintaining the record of patients effectively and efficiently. This lead to improving
organisational performance and assist in accomplishing success. According to the Cresswell and
et.al., (2013) it is analyzed that systematic implementation of new technology brings changes in
way of providing treatment. Apart from this, the government of UK also encourage healthcare
organisation to adopt new technologies as they help in maintain the quality of services and
keep records of new and existing employees. Along with this healthcare firm can also use new
Lewis change management model in order to implement the changes successfully.
Organisational semiotics
Organisational semiotics is the study of firm using concepts and methods of semiotics. It
is important to understand information architecture in different context and then find out the way
it is best for representing for pervasive healthcare. However, information architecture is related
to taking the information necessity for application universal healthcare. The existing literature
for information can remain. Healthcare firm is mostly seeming as information intensive firm and
a pervasive health care environment. Goal of the pervasive health care is to render services to
anyone and anywhere with the use of wireless network. Further information architecture in it
play significant role in order to provide information related to health care. Hence it can be stated
that organisational semiotic is known as one of the social technical approach that help in sharing
information in order to provide quality health care services.
There are many layers of the firm of information system. Among all the layers three
layers are essential. Semiosis is known as the sigh mediation process or a sense making process
in relation to related to the consisting three universal that is informal formal and technical.
ERP is known as tool to manage healthcare information. Along with this it also supports care
process with order communication and use of decision support techniques. Hence

implementation of ERP is one of the biggest part in health care. It is also viewed as a part of
larger socio technical system which comprises various technologies that are clinical pathway etc.
1.5 The impact of managing changes in NHS
According to the view of Imison, Castle-Clarke and Edwards, (2016), there are some
challenges and problems which can directly impact the healthcare sector after implementing
changes. It is because after implementing changes there are many employees who resist
changes and not ready to work out of their comfort zone. For example, while implementing
technological change it is not important that employees have knowledge and skills related to
the use of new technology. Therefore, healthcare firm faces difficulty and it needs to organise
training and development facility for them that consume cost and time. Hence it shows that
implication of advanced technology bring success but it increases complexity and training cost
of the firm. Similar to this Wager, Lee, and Glaser, (2017) state that to manage change is
important but it is difficult to process. However, it is not implemented properly then it leads to
affect the entire operations and activity of the firm. It is essential to formulate some strategies
and planned it so that employees can handle the changes easily and avoid resisting it. Different
authors have stated different views related to the change management in the healthcare firm.
Elton and O'Riordan, (2016) argued that managing changes in national health care
services not only positively impact but also negatively impact the firm and its operations. There
are many reasons due to which employees avoid adopting changes such they do not want to
work out of their comfort zone, or they may not have knowledge regarding the significance of
changes or lack of knowledge. Therefore, at the time of implementing changes, it is essential for
the firm to ensure that it is properly planned and not unpredictable that can affect employees.
Use of Kottler’s model can help in implementing the changes in an effective manner.
According to the view of Wager, Lee and Glaser, (2017), Kottler’s model, is effective and it
provides a proper way of thinking, through the main elements of a change process and it is easy
to use (Mintzberg, 2017). There are eight steps involved in managing change with the help of
which manage of healthcare organisation can easily accomplish success. Here below are
provided eight steps of Kottler’s model

In the first step it is increase in urgency, the role of manager is to identify the changes which is
need to make immediately,
 In second steps involve building and guiding teams and provide them information
related to the changes that are going to implement within the organisation.
 Third step management should set vision of the change and it is essential to have right
vision so that it can help in growth and development of the firm.
 In the fourth stage it is essential to communicate changes with the employees and make
them aware reason behind bringing the changes (Carayon, Wetterneck and Gurses,
2014),.
 At the fifth stage of Kottler’s model management need to take necessary action that is
required for implementing the changes in an effective manner.
 In the sixth step short term goal need to state and accomplish them on time
 Seventh stage is to identify and rectify the error that can become barrier in
implementing the changes successfully.
 At the last stage management need to stick up with the state changes for the growth
and success of the firm.
Apart from this, there is various change management theory that can be used by the
firm in order to implement the changes such as Lewis mode, etc. It is essential for the manager
to ensure that changes are implementing with proper planning in order to avoid the chances of
getting it a failure (Watson and Edwards, 2016). As compare to other sector healthcare sector
need to deliver quality services to its patient in order to provide them a healthy life. For this
purpose, the government of the UK also taken steps for making changes in the health care firm.
As they provide advanced technology to them in less cost and make some policies which help in
implementing changes in an effective manner.
1.6 Types of barrier which healthcare organisation face while managing change
According to the view of Kash, Spaulding and Gamm, (2014)There are different types of
barrier that can be faced by health care organisation while implementing changes in a
successful manner. Resistance to change is the first barrier and it is mostly a political motive.
Mostly people tend to resist change which originates with political adversaries. One of another

reason for resisting the change is the thinking that changes can make their life worse and break
their comfort zone. Therefore, it can be stated that employees resist the changes due to
aggressive behaviour or because of political influence. One of the other barriers is due to
complexity because health and care organisation develop more complex process and due to it
becomes challenging for the employees to adopt changes. For instance, lack of technological
skills can become barrier and management should take a proper step on time so that they can
easily implement the changes. Cummings and Worley, (2014), state that in order to overcome
different types of the barrier it is important for management to involve its employees in change
management process through providing them information related to the change and its
necessity. Further to being transparent in front of customers is also one of the effective
strategies to overcome the barrier and resistance of employees regarding changes. Providing
training facility to employees is also one of the effective technique in enhancing employees
skills and encourage them to accept the changes.
1.7 Summary
From the above literature review chapter, it is concluded that change in healthcare
organisation plays significant role. Changes in the firm help in bring growth and development.
Along with this firm can easily improve its performance and deliver quality services to the
services users. If health care organisation needs to experience a success in their development
efforts then they should have a strong framework for thinking related to change and
determined they key issues which go with change management. In the firm, if changes are
endorsed then employees should understand it they why they are taken place and the way it
can affect them. Further it is concluded that with the use of different change management
model such as Kottler’s and Lewis it can become easy to implement the changes successfully
and deliver quality services to patient.
Chapter 3. Search Methodology
2600 words
Introduction

Research methodology is the systematic approach to conduct a study on particular
subject. It supports in answering the research questions so that valid results can come out.
Methodology aids in resolving the problems by taking assistance of correct research methods.
This chapter will discuss various methods and techniques that are used for conducting this
investigation. Proper justification will be given for selecting particular method (Taylor, Bogdan
and DeVault, 2015).
Research philosophy
Research philosophy is considered as belief of the researcher that guides the
investigation. It is the tool that supports in developing knowledge about the topic and
identifying the significance of the study. Development of knowledge is highly depended upon
the perspective of individual and practical consideration. Philosophy assists the researcher in
finding the way of conducting research in an effective manner (Lewis, 2015). There are various
kinds of philosophies such as: Positivism, interpretivism, realism etc. Positivism is the method
which believes that data about the topic can be gathered from objective point of view. It is
highly structured method and researcher has to involve large sample size in this method so that
accurate results can be generated. It is the type of method which is applied in quantitative type
of researches because in this, scholar has to formulate hypotheses and on the bases of these
hypotheses, further studies are conducted. On other hand, interpretivism is another philosophy
that carries out the research from subjective point of view (Flick, 2015). It is generally applied in
the qualitative type of studies where scholar has to take support of existing models and have to
evaluate these theories in order to get valid results. Realism is another type of method that can
be applied in both qualitative and quantitative type of researches.
As current study is based on significance of managing changes in health care
organisation in order to deliver quality services (Vaioleti, 2016). Organizational semiotics is the
study in which researcher applies various methods of semiotics. It is the social technical
approach that has supported the researcher in sharing information regarding health car
services. For that, scholar has chosen interpretivism philosophy. The main reason of applying
this tool is that theories related to managing changes in healthcare system and effectiveness of

these changes can be identified by using theories and models (Three Dimensional Norm-Based
Knowledge Management for Knowledge Intensive Business Service Organizations: An
Organizational Semiotics Perspective. 2016). This subjective viewpoint has supported the
researcher in developing understanding about the topic. By this individual become able to
know about information architecture from technical aspects. That has supported the scholar in
identifying impact of managing changes on quality of services in health care organisation. This
method focuses more on qualitative nature of the research problems that has supported
researcher in critically analysing the topic and gathering quantifiable detail about managing
changes in NHS (Gast and Ledford, 2014).
Research design
Research design is the scientific procedure of carrying out the investigation that helps in
conducting research in systematic manner. It can also be defined as detailed outline that
supports the scholar in identifying the way of conducting entire study. It is the tool that assists
in gathering factual details about the subject matter. Types of research designs are as following:
descriptive, exploratory, experimental etc (Ross, Rogers and Duff, 2016). Descriptive research
design is the method that pays more attention on theoretical analyses and uses the models and
theories so that information about the topic can be gathered. On other hand, exploratory
research design is another type of method that focuses on uncovered issues. Experimental
design concentrates on gathering detail about the topic by doing experiments.
Organizational semiotics is based on fundamental observations. Semiosis is sign
mediation that consists of three universals. As it is based on observations thus, in the current
research, scholar has taken support of descriptive research design. This has supported
gathering in-depth detail about managing changes in NHS in order to improve quality of
services in the organisation (Sunderland and et.al, 2015). This method has supported in
developing understanding about significance of managing changes in health and social care
organisation and impact of these changes on quality services. As in the current project,
researcher has to give detail about social technical parts such as implementation of ERP and
other technical software. These details can be gathered by using descriptive research design.
Thus, it is suitable for the study and has helped the researcher in identifying various changes

that are needed in NHS so that it can improve its service quality. Descriptive research design is
the appropriate method for the present research topic because it helps in providing clear
picture of the current situation of NHS and how these changes can impact on the services
quality of health care organisation. It assists in justifying current practices and importance of
managing changes in the organisation (Haydon, Browne and van der Riet, 2018). That describes
clear picture of medical professional those who are working in the NHS and how they are
providing care to the patients. By this way, researcher can explain importance of managing
changes in the NHS in order to improve quality of care services in the health care sector.
Research approach
Research approach is the technique that helps the researcher in identifying the way of
conducting the research in appropriate manner. Inductive and deductive are two main types of
research approaches that are applied in different types of investigations. Inductive method is
the tool in which scholar observes the situation by using theories and models in order to find
out real situation. It observes the things and develops explanation (Leiblein and et.al, 2016).
There is no need to develop hypotheses in order to reach to the final results. This is the type of
method that gives benefit to the scholar to make changes in the current practices as per the
suitability of the investigation. It collects data about the topic and tries to develop relationship
so that theory can be developed. On other hand, deductive approach is another type of method
which is applied in quantitative types of researches. It is the method in which scholar
formulated hypotheses and test these hypotheses by using statistical tools (Dudovskiy, 2016).
That supports the researcher in finding accurate answers about the topic.
As current study is based on significance of managing changes in health care
organisation in order to deliver quality services to patients. For that, researcher had to involve
significance of managing changes, its effectiveness and how these changes impact on the health
care services. Scholar has involved information system and technical changes in the health care
organisation in order to find out its impact on service quality (Cope, 2015). For that, scholar has
applied inductive research approach. It is beneficial for the current research project because in
order to identify impact of changes, researcher has to understand current practices of NHS and
for that, it has to talk to great number of individuals so that information about current practices

of health care organisation can be gathered. For that, use of inductive approach is suitable that
supports in analysing the outcome in an effective manner. This approach is suitable in
developing relationship between managing changes and service quality of NHS (Turner and
Shaw, 2016).
Data Collection method
Data collection is the essential part of the research project, it assists the scholar in
gathering information and measuring these details so that real facts about the situation can be
measured. It is the method that make the person able to answer research questions and finding
results. Primary and secondary are two main types of data collection methods that are applied
in different types of research project (Chakraborty and Ledwani, 2017). Primary data collection
is the tool in which scholar has to gather details by own. The main reason of selecting primary
details is to gather real facts and understand the current situation of the place. On other hand
secondary data collection is the technique in which researcher take support of already available
details in order to develop understanding about the topic.
As present study discuss about impact of managing changes in NHS. Technological
changes affect overall health care system. Use of secondary information assist in developing
knowledge about changes that affect NHS. In the present study researcher has applied
secondary data collection method (Bach and Dohy, 2015). Scholar has used five to six NHS
associated trusts data in order to identify current service practices of these firms. Use of these
details have supported the scholar in knowing the improvement areas and things that require
changes so that NHS can be able to deliver quality care services to consumers. In order to
enhance reliability and validity of the study investigator has used previous studies of the other
scholars (Turner and Shaw, 2016). This has helped the researcher in finding the issues in the
health care organization and making effective changes so that its practices can be improved.
Secondary data collection methods are such as books, journals, internet articles, CERNER etc.
All these material are able to provide in-depth detail about the subject matter and researcher
can be able to get detail about subject matter within less time (Sunderland and et.al, 2015).
In order to complete this research in effective manner scholar has to understand
perspective of patients for services of the health care organization. These details can be

gathered from Internet articles. If research applies primary sources then it would be difficult to
examine the gap between existing practices and required practices. Thus, use of secondary is
appropriate for the investigation (Gast and Ledford, 2014). This has helped the researcher in
finding all information related to current practices of NHS and related organization, what kind
of services get by patients and what are the essential areas that needed to be worked.
Sampling
Sampling can be defined as principles of selecting samples in the research project.
Probability and non probability are two main types of sampling techniques. Probability
sampling can be defined as the method that describes probability of the samples to be selected
in the study. On other hand non probability is another sampling technique in which every
members does not get fair chance to be selected in the research (Lewis, 2015). Both these
sampling techniques give appropriate results but in the current research scholar has applied
probability sampling method. For the topic significant of managing change in the health care
organization to deliver quality services to patients, researcher has applied random sampling
method. It is considered as moist suitable and simple way of selecting the sample in the
investigation. In this technique each members have equal chance to be selected and share their
views on the subject matter (Taylor, Bogdan and DeVault, 2015). The main reason of choosing
simple random sampling method in the research project is that, it enables to extract data of
health care organization and get specific detail about changes required in these firms such as
changes related to ERP or other technical changes. By this way individual has become able to
identify impact of managing changes on NHS.
Data Analyses
All the above described method support the researcher in gathering information about
the topic. After collecting necessary information it is essential to convert these data into
meaningful information (Sunderland and et.al, 2015). This is done through data analyses
method. This method supports the scholar in evaluating the data and answering to the research
questions. It is beneficial in filtering the data and getting insight detail about the area of
research. Different methods of data analyses is being used in different types of researches. In
the qualitative type of studies scholar takes support of thematic analyses methods. This

thematic analyses tool is helpful in presenting details about the topic in effective manner. By
using graphs and charts individual can define the research problem and its answers. On other
hand in quantitative type of research projects scholar generally applies statistical tools (Turner
and Shaw, 2016). These statistical tools assist in involving numbers into the study and
calculating these data. By this way research become able to get accurate information about
subject matter and become able to answer the research questions. In such type of studies
scholar take support of SPSS, chi square test etc. This aids the researcher in performing
calculations and finding results on the bases of calculation (Three Dimensional Norm-Based
Knowledge Management for Knowledge Intensive Business Service Organizations: An
Organizational Semiotics Perspective. 2016).
Present study is qualitative in nature. Researcher has tried to describe current practices
of NHS and associated organization, how these firms are providing services to patients and
significance of managing changes in this health care firm in order to deliver quality services to
patients (Bach and Dohy, 2015). For that researcher has applied thematic analyses tool. Use of
this method has supported scholar in presenting detail about significance of managing changes
in the health care organization. This has given answers of these research problems through
graphs and charts about how changes like ERP implementation and formal structure can
support health care sector in providing high quality services to care users (Dudovskiy, 2016).
Ethical consideration
Ethical consideration is the standards that describes researcher things that needed to be
followed while carrying out the research on specific topics. While conducting the present study
on significance of managing changes in health care organization in order to deliver quality
services to patients, scholar has followed ethical aspects that has supported investigator in
completing thesis in effective manner without any major complications (Bach and Dohy, 2015).
As study was based on keeping electronic records of patients in NHS but in the present research
scholar has not used data of any patients and has not liked personal information of any
individual. Investigator has maintained confidentiality (Vaioleti, 2016). All the data that have
been used in the present research have been kept secure in computer which is password
protected and researcher has not shared its password with any third party. As researcher has

collected information from secondary sources so there are no involvement of medical
professionals or patients in the investigation. This has supported the scholar in completing the
research within less period (Leiblein and et.al, 2016).
Researcher has not copied any detail from any site. All these data that have been used
are written in own language of scholar. Investigator has read previous articles of other authors
on the same topic and have developed understanding level but researcher has translated their
details in own word. Thus, there is no issue of plagiarism (Flick, 2015). Researcher has framed
aim and objectives by looking at the topic, deception regarding aim and objective have been
avoided by the scholar. This has supported the scholar in conducting the investigation to the
point and avoiding unnecessary details. Researcher has maintained transparency and has
carried out the research with honesty. That has given positive result to the investigator and
individual become able to reach to the financial conclusion (Cope, 2015).
Reliability and validity
Reliability and validity both are essential part in the dissertation. Reliability can be
defined as extent to which other researchers get same answers if they use same data. If
research is having high level of reliability that means other studies will also generate the same
results on other hand if there is poor reliable data then other studies will give different results.
Validity is another essential aspect in the research project (Dudovskiy, 2016). It can be defined
as the extent to which researcher has followed scientific research methods in order to complete
this research in effective manner. Validity is the complex aspect because it directly impacts on
the result of the investigation.
In the present research on significance of managing changes in health care organization
in order to deliver quality services to the patients researcher has taken care of validity and
reliability (Flick, 2015). This reflects accuracy, credibility of the entire research paper. In order
to maintain reliability and validity researcher has collected information from different sources.
Apart from this scholar has taken expert views after involving these details into the research.
This has supported the scholar in finding validity and creditability of particular details and using
these data in the research in effective manner. Scholar has taken support of expert views

method in order to check reliability and validity of the research (Taylor, Bogdan and DeVault,
2015).
Research limitation
The current research has been subjected to some limitation. These are explained as
below:
 As researcher has used secondary data collection method and all secondary details have
been used that is the major limitation of the present research. Because scholar is unable
to find out the real facts and current detail about NHS practices. As all these data are of
past years thus, researcher was unable to get current details (Ross, Rogers and Duff,
2016).
 Scholar was having limited time and in such short duration collecting information on
such vast topic was very difficult. Because current practices of health care organization,
identify areas of changes were time taking aspects. Though researcher has scheduled
each activity properly and manage their work that has supported scholar in completing
the research in effective manner (Gast and Ledford, 2014).
Conclusion
From the above study it can be concluded that research methodology assist the
researcher in carrying out the investigation in effective mane. Use of interpretivism philosophy,
descriptive research design and secondary data collection sources has supported the scholar in
gathering reliable data and reaching to the final results.

Chapter 4. Findings / Results / Data Analysis
Introduction
Present study is based on significance of managing changes in health care organization
in order to deliver the quality services. This report will analyse the data in order to find out
results on how managing changes impact on delivering quality services to patients.
Issues in health care organization
From the secondary data, it is identified that health care organization is facing many
issues that is affecting its service quality to a great extent. One of the major issues in these care
homes is poor communication in between patients and medical professionals. Communication
is the major part that supports practitioner in understanding needs of patients and providing
them services accordingly (Ginter, Duncan and Swayne, 2018). Sometimes, due to coordination
issue, medical professionals fail to deal with them effectively. It has been identified that NHS is
trying to implement advanced technologies in the hospitals so that doctors can become able to
provide quality care services to patients. Due to absence of advanced technologies, record
keeping has become the major problem in hospitals. This is the reason; if same patient comes in
the future again to get treatment then medical professionals have to again suggest them to do
all the tests in order to examine their medical conditon. It is because; they have to again
diagnose them and understand their situation (Finkelman, 2015). Record keeping is considered
as one of the most important factors that assist health care organization in managing actives
well and providing quality care services to patients. If proper maintenance of records is there,
then it assists other medical professionals in identifying situations and in the absence of one
medical professional, others can treat the patients well.
From the secondary analysis, it is identified that poor technical equipment create issues
for the general practitioner in delivering quality services to care users. In the absence of
technical support, practitioners fail to diagnose patients properly and operate them well. This is
the major issue that is affecting overall working of NHS to a great extent (Drummond and et.al,
2015). This is the major issue due to which death rate is increasing in the health care
organization. It is identified that personal information of patients is required to be stored
electronically. This helps in maintaining the confidentiality that can enhance trust of users on

doctors. In the absence of this, doctors fail to gain trust of people and they do not discuss their
serious medical problems with practitioner.
Health care organization is completely responsible for any pervasive health service
delivery that occurs due to technical issue. It is an ethical and moral responsibility of doctors
and other administrative staff members to take care of ethical requirements and ensure that
technical issues do not impact on service quality (Aarons and et.al, 2015). But, it is occurring in
the health care organization. From the secondary analysis, it is identified that behaviour of
individuals is getting affected by communication problems. Use of appropriate signs can
support other cultural people to understand the words of others. Doctors use such sign
language to treat the patients with other culture in the hospitals. However, due to ineffective
data management and poor technical aspects, these care providers fail to provide care
environment to the patients (Woods, 2017). It creates confusion among all practitioners and
they feel confusion regarding the way to deal with other patients.
Importance of managing changes in health care organization
From secondary analysis, it is identified that information technology is considered as
one of the essential aspects that supports in improving service delivery in health care
organization. NHS and associated organizations are required to manage changes well.
Communication is the main issue in health care firms (Khan and Hashemi, 2017). This is
considered as one of the major faults due to which entities are required to make some changes
in its practices. Use of ERP is very important in the organization. This can support in minimizing
the cost of hospitals and keeping records of patients well. This is the way that assist medical
professionals in understanding medical needs of care users so that they can examine their
conditions accordingly and provide them quality care services in care home (World Health
Organization, 2015).
From the secondary data, it is analysed that patients' safety and security are the
essential parts of health care organization. In order to provide them a safe environment, these
firms are required to make changes in current practices so that they can fulfil their objectives
effectively. Ineffective communication among professionals now has become the major cause
of medical errors and that is why patients are unable to get adequate services in the health care

organization (Baum, 2016). If these issues have been minimized then doctors can be able to
provide quality services to the users.
Above graph reflects that implementation of ERP can support in improving the
functionality of health care organization to a great extent. It is analysed that this ERP is
beneficial in improving schedule activities so that timely care can be provided to the patients
(McWilliams and et.al, 2014). Though it increases cost of the health care firms, it assists in
improving quality of services in health care organization.
From secondary data, it is analysed that communication is the main issue in health care
organization and in order to resolve this issue, these care homes are required to improve their
technical aspects. IT equipment assist in diagnosing the patients properly and examining their
situations well (Gatchel and et.al, 2014). Apart from this, these IT equipment support the
healthcare firms in enhancing communication between medical professionals so that they can
understand their duties and no confusion will take place in this respect. Electronically, data
management assists doctors in providing correct treatment to each care user without failure.
Impact of managing changes on service quality in NHS
From secondary data, it is analysed that change management is complex process that
impact on service quality of health care organization (Zerwekh and Garneau, 2017). One of the
major concerns of management after managing changes is to improve satisfaction level of
patients. After making changes in communication and technologies, medical professionals have
become able to provide high quality services to the patients. These techniques have supported
in enhancing communication between practitioners and care users as well. Management pays
attention on implementing strategies and ensuring that changes are worthwhile for the care
unit (Baum, 2016). It assists in changing the behaviour of care providers. By this way, they will
deal with patients well and will coordinate effectively with the care users. It is the way that
assists in understanding medical requirements of individuals and providing care accordingly.
Categories help in proving guidelines regarding level in organizational semiotics. This
guidelines can be applied and modified as per the requirement and circumstances. Informal,

formal and technical are three contexts. This constructs practices ad dimensions so that person
can perform relevant task effectively with having full of knowledge.
From the above graph, it can be interpreted that in the year 2017, 1.9 m diagnostic tests
were undertaken. It is 1.8% more as compared to the previous year. Implementation of changes
gives positive results to the health care organization because by this way, medical professionals
have become able to diagnose the condition of patients immediately (The Impact of eHealth on
the Quality & Safety of Healthcare, 2008).
From the secondary data, it is analysed that change management is an effective process
that assists business unit in improving their lacking points and condition of workplace. Kotler's
change management model defines 8 steps of making alteration at the workplace. It helps in
understanding the requirement of changes and making necessary modification by utilizing
resources properly. It helps in making people understand the requirement of changes so that
they will cooperate with management and will support in implementing alterations significantly
(McWilliams and et.al, 2014). Creating sense of urgency is very important that assists in
implementing EHR technology in the health care organization. By this way, medical profession
can become able to identify and diagnose the real condition of patients and their reactions
while treatment. It is analysed that if information of patients is being kept electronically then it
supports in understanding the necessity of changes effectively. By this way, doctor will fulfil
their roles and responsibilities significantly that will support in minimizing the death rate in
hospitals (Khan and Hashemi, 2017).
Barriers faced by NHS while managing changes
Secondary data reflects that making changes in the health care organization is a
complicated task. Health care units have to maintain the relationship between patients,
professionals and carers. Making changes as per the clinical guidelines is a time consuming
process. For that, management has to look at the scale of changes and have to measure results
against their expected outcomes. From the secondary data, it is found that medical
professionals are unaware with the latest technologies and their operating procedures (Gatchel
and et.al, 2014). In such condition, any kind of technical change creates the situation of
conflicts and confusion at workplace. Staff members resist accepting modification because they

have to make modification in their working practices. This is the biggest barrier in health care
organization.
Limited resources are the major barriers while managing changes in health care
organization. Health care entities feel requirement of changes as most of the hospitals are
managing records of patients manually (Khan and Hashemi, 2017). There is no facility of
electronic data storage. In such condition, when new technologies are being implemented then
due to limited monitory resources, these units fail to implement these devices in the
organization successfully. In such condition, cost of the entity gets increased.
From secondary data, it is analysed that poor monitoring is the main barrier in managing
changes in health care organization. It is issue that causes difficulty for entity in gaining
expected results (Woods, 2017). Entities assume to improve their service quality after
implementation of technical equipment, but due to poor monitoring, still these technologies
are not being used effectively at the workplace. This is major barrier that fails firm in improving
its service quality.
Ways for managing changes successfully
From secondary data, it is analysed that observation and continuous monitoring are the
best ways through which entity can manage changes effectively. Observation supports the
management in observing current behaviour of individuals after implementing modification in
health care organization. By this way, they can make strategy to change their behaviour.
Observation is beneficial in monitoring the progress of changes. It helps in analysing the details
whether changes are worthwhile or not. If behaviour of medical professionals is not good then
management can adopt strategy to motivate them. By giving them rewards and recognition,
management can encourage professionals to implement these changes in their working
practices and deliver quality services to the patients.
From secondary data, it is analysed that whenever changes are being implemented at
the workplace then people resist these alterations. This is the major issue that creates difficulty
for managers because this resistance impact on current working practices of hospitals. Most of
the people refuse to accept new technologies because they have no knowledge about it. Thus,
providing training to the medical professionals is a great way through which NHS can improve

their knowledge and make them understand benefits of using these techniques in order to
deliver quality services to patients. Such type of training programs enhance knowledge and
skills of practitioners and they become able to handle these equipment well. It improves their
efficiency and they can deal with the care users effectively. This assists them in examining
condition of the users well and thus, doctors can be able to provide them correct treatment
immediately.
Summary
Above study can be summarized as changes are helpful in delivering quality services to
care users. Implementation of ERP and changes in communication techniques can give better
results to NHS. ERP supports in maintaining records electronically so that doctors can examine
their details by looking at their medical reports effectively and can provide them quality
treatment immediately. It helps in minimizing confusion and improving the condition of health
care organization.
Chapter 5. Discussion
3000
Introduction
Summary
Conclusion
1000 words
References
Appendix
Personal statement
Reflecting log

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