Change Management Models and Applications

This assignment delves into various change management models, including Lewin's three-stage model (Unfreeze, Transition, Refreeze), McKinsey's 7S framework focusing on Strategy, Structure, Systems, Shared Values, Style, Staff, and Skills, and Kotter's 8-step process emphasizing urgency, team building, vision creation, communication, empowerment, goal setting, persistence, and making change permanent. The assignment examines the core concepts of each model and their practical application in driving organizational change.

DISSERTATION
Introducing a Home Drug
Infusion Therapy program in
my Hospital

ABSTRACT
In the Acacia care home, hospital is facing a significant issue of emergency department
overcrowding. The major issue related to the boarded admitted patient and there is continuous
crisis throughout the week. Cited venture have realized the reduced patient safety level with the
hospital. The present report provides timely, evidence based management of all emergency cases
in the cited venture. In the following dissertation, the change management program has been
systematically addressed with respect of the health and care organization. In order to launch this
change related to the home drug infusion therapy, researcher have used several methods of the
researcher methodology through which it can obtain an appropriate solution. In addition to this
literature review provides the detail knowledge and understanding about the topic so researcher
have bifurcated this section in various themes. The major aim of this dissertation to implement
the change in the health and social care organization so as customer can get huge benefit and
satisfaction. In addition to this, present report based on the implementing lean health care
principles and improve patient flow.

Table of Contents
ABSTRACT.....................................................................................................................................2
1 INTRODUCTION........................................................................................................................1
1.1 Introduction...........................................................................................................................1
1.2 Organizational context..........................................................................................................3
1.3 Rationale of the study............................................................................................................3
1.4 Description of the changes....................................................................................................4
1.5 project Issue..........................................................................................................................4
1.6 Focus and purpose of the project..........................................................................................5
1.7 project Aim............................................................................................................................5
1.9 The expected organization impact.........................................................................................5
1.10 Summary and conclusion....................................................................................................6
2 LITERATURE REVIEW..............................................................................................................7
2.1 Introduction...........................................................................................................................7
2.2 Search Strategy......................................................................................................................7
Database......................................................................................................................................7
Search Engines............................................................................................................................8
Key search Terms........................................................................................................................8
Boolean Operators.......................................................................................................................9
Inclusion and exclusion criteria..................................................................................................9
2.3 Review of the themes..........................................................................................................10
Theme 1 HIDT and its effectiveness........................................................................................11
Theme 2 Inpatient bed utilization and reducing hospital admissions......................................16
Theme 3 Elective surgery cancellation.....................................................................................17
Theme 4 Emergency department boarding...............................................................................18
Theme 5 Reduce hospital infection rate...................................................................................19
2.4 Implication of the project....................................................................................................21
2.5 Summary and conclusion....................................................................................................21
3 ORGANIZATIONAL DEVELOPMENT PROCESS................................................................22
3.1 Introduction.........................................................................................................................22
3.2 Critical review of approaches to organisational development............................................22
3.3 Change models and rationale for Organizational development model...............................25
3.4 HSE change model..............................................................................................................28
PESTLE ANALYSIS:....................................................................................................................30
3.4.1 Initiation...........................................................................................................................33
3.4.2 Planning............................................................................................................................34
3.4.3 Implementation................................................................................................................35
3.4.4 Mainstreaming..................................................................................................................36
3.5 Summary and Conclusion...................................................................................................36
4 EVALUATION...........................................................................................................................37
4.1 Introduction.........................................................................................................................37
4.2 Significance of health care evaluations...............................................................................38
4.3 Evaluation...........................................................................................................................39
4.3.1 Aims.................................................................................................................................39
4.3.2 Methods and measure.......................................................................................................40

4.3.3 Results..............................................................................................................................42
4.3.4 Dissemination plan...........................................................................................................42
4.4 Summary and conclusion....................................................................................................43
5 CONCLUSION AND DISCUSSION.........................................................................................43
5.1 Introduction.........................................................................................................................43
Project Implication....................................................................................................................44
Stakeholders..............................................................................................................................44
Practices....................................................................................................................................44
Theory.......................................................................................................................................44
Strength of the project...............................................................................................................44
5.2 Summary.............................................................................................................................45
5.4 Limitations..........................................................................................................................45
5.5 Conclusion and future development...................................................................................45
Recommendation...........................................................................................................................46
REFERENCES..............................................................................................................................47
Appendix.......................................................................................................................................53

1 INTRODUCTION
1.1 Introduction
In the present era, the need of the health and care organisation is continuously increased
due to the illness and health issues. In order to deliver an impressive service to patient, it is great
responsibility of the health care provider to focus on such measure by which service user can
receive health services and care. In the health and care organisation, health care experts and
doctor plays a very crucial role who gives their best contribution to provide effective treatment
and care to patients so as they can able to improve their health issues.
In the health and care organisation, it is very important for the health care experts and
doctors to understand the issue of the patients related to their health and treat with them in such
manner so as they can improve health illness. As per the project it has been founded that there
are various serious illness and disease occurs in the present time among the people due to the
improper life style, unbalance diet and engaged schedule. By these all reasons, many of the big
health disease founded among the people Ellenbecker and Tsai, (2015). In the medical sector,
there are various effective treatment and acre services developed by which health disease can
easily improve among the people. It has been also founded that in the health and care
organisation various kinds of impressive treatment available by which major kind of health issue
can improve in the fastest manner. In the present time, home drug infusion therapy is mostly
founded in the health and care organisation. In the Today's time, home infusion therapy industry
is the product of technological and medical advancement achieved primary during the past two
decades. Home drug infusion therapy is an example of an effective treatment which includes new
method of drug supplies in the human body, innovation in technology, advance equipment, novel
ways of organising and delivering health care services. In the present era, the service users who
gets the home drug infusion therapy they mostly prefer hospital impatient treatment. In order to
organise the home drug infusion treatment services and supplies vary important on the route of
administration, types of vascular access device, types of therapy and rate of administration. In
addition to this, in order to organise this mentioned therapy program in the health and care
organisation there is huge requirement of high qualified and talented health care experts and
service provider. Sometime, in order to deliver the HDIT service in the hospital, management
organise the training and development program so as they can able to learn the new skill, talent,
ability and knowledge about deliver an impressive services and treatment to them. The cost of
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the home drug therapy program cost depends on the perspective of those paying them. HDIT is
not too much expensive treatment but it needed special expertise on the part of nurse. It needed
substantial amount of pharmaceuticals and clinical pharmacy services. It required an impressive
quality of equipment and technology so as all process of this therapy can conduct in an effective
manner. In addition to this, patient associated cost in the home drug infusion therapy divided into
two categories that are medical cost and non-medical cost.
In the present dissertation, the major objective of the investigator is to introduce a home
drug infusion therapy in the hospital. For this objective, researcher has made several themes
which provides clear understanding and knowledge about the home drug infusion therapy. In this
dissertation, various researcher methodology has also been discussed in order to obtain an
appropriate outcome of the investigation. By having an application of change in the treatment
process with an assistance of home drug infusion theory the issues can be resolved effectively. It
means the consideration of change management is essential because it allows to ensure that long
term goals and objectives can be accomplished properly. Moreover, the issues in regard to
clinical pharmacy services can also be resolved properly by having an application of change
techniques.
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1.2 Organizational context
In the present era, there are continuously increasing the requirements of health and care
service. Due to changing life style, complicated schedule and unbalancing diet every individual
have founded some kind of health disease. By this reason, there are various kinds of health and
care organisation has been developed in the country. An effective health and care organisation
have main aim is to deliver an excellent and high quality of care services to patient and
overcome their health issues. In the Malaysia, there are various effective health and care home
has been developed and in this series Acacia care centre is a famous nursing home which is
located on the London. There are 62 single rooms which all have en suite facilities with 18
bedroom. It is one of the famous care home in the London which delivers various kinds of health
treatment and care services according to the patient requirement Bowen, Privitera and Bowie,
(2011). There are 18 bedrooms on the top floor that are specially designed to cater for resident
who may suffer from the various health disease such as dementia, cancer, physical disability, old
age disease, learning disability etc. The major objective of this hospital is to deliver a high
quality of care services to patient and improve their health issues. Cited venture have high
qualified and skilled staff member and health experts who have complete knowledge and
understanding about to deliver the care service. The main effective feature of this organisation is
that it focuses on the palliative care, respite care, physiotherapy, separate dementia care unit etc.
In addition to this management also organise training and development program for the service's
provider who have lack of knowledge about the care services and who are fresher within the
organisation. This is well designed and structured health and care organisation in the Malaysia
which comes under famous hospital. It is privately owned and registered for a maximum of 62
service users. There are effective arrangement for the operation and treatment of service users.
Moreover, It has various functional department which organise and operate the different
functions and activities of the organisation. Cited venture focuses on the actual issue and disease
of the patient and deliver the care services accordingly. In the present time, within the Hospital
Yan in Malaysia management is going to introduce the Home drug infusion therapy for overcome
the high disease among the patient. Home infusion therapy involves beneficiaries receiving
medication including chemotherapy drugs in their own home by other than oral means.
1.3 Rationale of the study
In this present dissertation, there are several reason by which scholar has chosen this
topic as a project topic. The one of the major reason for choose this topic is that investigator have
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huge interest and curiosity about this topic as they wanted to know that how introduce the home
drug infusion therapy in the hospital. In addition, this, investigator also wanted to know about
this therapy and its benefit for the patient in the hospital. Another reason for selecting this topic
as a project title is that scholar have sufficient data and information about this mentioned subject.
Furthermore, scholar wanted to know that how this home drug infusion therapy conduct within
the hospital and how it is work for improving the health issue and disease among the patient. In
addition to this, it can be said that by having an effective consideration of change activities the
issues need to be resolved so that proper measure can be taken into account. Change is essential
so that issue in health care practice can be overcome effectively. However, there are number of
research studies are being framed in health care practice but very little research are being
presented in context to home drug infusion therapy. It means by having an effective reference of
present study the limitations of previous studies can be resolved.
1.4 Description of the changes
In the following report, team plans to introduce the changes related to implementing the
home drug infusion therapy in the Acacia care home. In this organisation, team will select and
implement evidence based best practices solving the problem within the one year by use of HSE
model. The major reason for implementing the changes is to overcome the crowd in the hospital
and overcome the rate of infection.
1.5 project Issue
In the present dissertation, researcher has been selected the topic of introducing the home
drug infusion therapy in the Hospital Yan in Malaysia. The purpose of the home infusion therapy
program is to provide an effective treatment and care services to the patient so as they can
improve their health issue and disease Tien, Sivinski and Lew, (2017). An eligible service users
receives this services in a qualified setting for improve or sustain in the client health. The
agency's home infusion therapy program includes parenteral nutrition which is also known as
total parenteral nutrition and home infusion supplies and equipment. This topic selected as a
dissertation topic because in the present era, there are various kinds of the big health issues
occurs among the human being due to the improper balancing of diet, ineffective life schedule
etc. In the today's time, many of the people occurs with the heavy disease which cannot easily
overcome by the normal health care and treatment. In order to deliver special services and care to
patient, hospital decided to introduce the home drug infusion therapy. In order to overcome the
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health issues and disease in the present time which does not easily overcome and improve by the
oral medication, this home drug infusion therapy has been applied in the health and care
organization.
1.6 Focus and purpose of the project
In the present dissertation, investigator consider upon the introducing the home drug
infusion therapy in the hospital. For this objective, investigator have design a systematic
literature review along with various themes of the home drug infusion therapy. In the present era,
there are continuously increase the health disease and issue among the people and they want
effective and special care within the health and care organization. In order to deliver special and
fastest treatment of patient, health experts and care provider focus on this home drug infusion
therapy program Ellenbecker and Tsai, (2015). With help of this therapy, patient can instantly
improve their health disease. In this dissertation, home drug infusion therapy and its outcome and
effectiveness has been systematically addressed.
1.7 project Aim
“To introducing home drug infusion therapy in the Hospital:A case study on Hospital Yan in
Malaysia”
1.8 SMART project Objective
 To provide Home drug infusion therapy to at least 50% of patients who are fulfilling the
criteria of new service by end October 2017
 To overcome the elective surgery cancellation rate due to bed shortage by 30% by end
October 2017
 To reduce the financial terms and expense of patient by 30% by end October 2017
 To decrease number of emergency department boarded patient by 30% in the end of
October 2017
 To reduce infection rate in the hospital by 40% in the end of December 2017
1.9 The expected organization impact
While Acacia care home implement the change related to home drug infusion therapy
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then it will directly affect its existing and future situation. In this report includes a description of
how things currently are with respect to the issue like behavioral, structural, personal and cultural
categories. Following are systematic expected organizational impact-
The current situation The expected outcomes
 Current staff are exhausted and feel
insecure as a result of working in a high
patient flow environment. In addition to
this, patient also dissatisfied with
existing delivered services
 Existing staff are always searching for
weaknesses in order to blame the
others.
 Operation and treatment process is too
big due to which patients are
dissatisfied
 In the future, satisfaction of the staff
member and patient will increase
because overall structure of the business
will improve.
 Every staff member have responsibility
to provide high quality treatment and
services to patients and deliver solution
for bad situation
1.10 Summary and conclusion
From this entire discussion in the introduction, the major aim and objective of the project
has been identified. From this introduction it has been concluded that the major objective of the
Hospital Yan in Malaysia is to provide home drug infusion therapy to the patient who are not
able to recover their health issue by oral impatient (Lowes and Hulatt 2013). Hospital Yan in
Malaysia is going to organise the program of home drug infusion therapy under which its health
care experts and doctor will responsible to provide this infusion therapy at home. By this aim,
cited venture wanted to reduce infection rate in the hospital by 40% in the end of December
2017. In addition to this, another objective of the investigator is to decrease number of
emergency department boarded patient by 30% in the end of the October 2017.Thus, from these
analyses it has been founded that there are major three kinds of the home drug infusion providers
who delivers the care and treatment to the patients who are serving from the high disease health
6

issues. Hence, from this above discussion about the home drug infusion therapy it has been
founded that in the health and care organisation, this mentioned therapy is a great full treatment
of the patient by which those patient can get an impressive treatment and care services who are
not able to go to the hospital and they have serious health issue which do not improve by the oral
medication within the hospital. In order to deliver this treatment, health care experts use an
impressive technology and equipment through which such kind of therapy can arrange at the
home.
2 LITERATURE REVIEW
2.1 Introduction
In the dissertation, literature review is one of the essential chapter which provide the
detail knowledge and understanding about the project topic. In the literature review there are
various kinds of themes designed by the scholar so as clear understanding about the dissertation
topic can obtain in the dissertation. In the present dissertation, scholar have main intension to
introduce the home drug infusion therapy in the Hospital Yan in Malaysia so as every patient
who are not able to take the oral impatient can get an excellent services and care from the doctor
and health care experts. In order to attain this objective, scholar has bifurcated the entire
literature review in the several themes such as Meaning and concept of the Home drug infusion
therapy, Inpatient bed utilization and reducing hospital admissions, Elective surgery cancellation
etc.
2.2 Search Strategy
Systematic process has followed for searching the literature for the present dissertation
about the topic of introducing the home drug infusion therapy in the Hospital Yan in Malaysia. In
this topic included identification, retrieval and management of independent studies on the project
topic. In this literature search process included the selection of keywords, using electronic data
base, deciding inclusion and exclusion criteria.
Database
In order to search the literature researcher has used the electronic database. The major
reason behind this using electronic data base is that it is very fastest medium to collect the
literature in the minimum time period. In addition to this, electronic database also assist to the
scholar in collect and obtain the information about the large numbers of journals, articles and
acts. Thus, it can be said that scholar can largely beneficial by obtaining relevant studies for the
7

present project on the topic about to introduce the home drug infusion therapy program in the
health and social care organisation.
Scholar has been used the following database
Databases Description
Psych-INFO It is one of the largest resource in the world at
where various kinds of the reviewed literature on
the various kinds of therapy and its impact on
the patients. This web have more than 4 millions
bibliographic records which consider on
behaviour and social sciences and psychology.
MEDLINE This is another bibliographic option of the
database which includes various kinds of article
and journals on the topic of nursing, health care,
medicines and dentistry etc.
CINAHL It is index of journal which includes allied
health, health care, nursing services, treatment of
patients etc.
Search Engines
In order to search literature of the investigation, scholar has sued search engines such as
EBSCO host which assist to investigator in obtaining a relevant content about the topic. It is an
electronic journal host and contains journals from a number of publishers. This also aid to
investigator in search an appropriate article from the varieties of the collection of journals.
Key search Terms
In the process of investigation, scholar has used various kinds of search terms. With help of these
search terms, scholar can obtain relevant information about the topic from internet. It is the main
variable that assist in defining a particular search. Following are some key search terms that will
8

be used for retrieving journal articles for the present project on the topic of home drug infusion
therapy in the health and care organisation-
TERM 1 Health care services, home infusion therapy
TERM 2 Home drug infusion therapy benefits, impacts,
methods
TERM 3 Elective surgery cancellation, its impact, benefits
TERM 4 Emergency department boarding, strategies
TERM 5 Rte of infection within the hospital, Impact
Boolean Operators
Boolean operator refers to the words such as AND, OR and NOT. These words are used
in order to obtain the relationship between the search terms. In the present dissertation on the
topic of home drug infusion therapy Boolean operator OR will use in order to increase the
investigation.
Inclusion and exclusion criteria
While scholar select the search terms then in the next stage he/she decides the inclusion and
exclusion criteria. In the present investigation about the home drug infusion therapy, following
inclusion and exclusion criteria has been used by the investigator-
Inclusion criteria Exclusion criteria
Journal articles published in English In the other language studies investigation can
carried out
Studies are conducted for 2010 to 2017 Investigation done in 2015
Studies on the home drug infusion therapy
assists to the patient who are not able to get
oral impatient.
Investigation carried out on the topic about the
home drug infusion therapy in the health and
care organisation
By having an effective consideration of key measures the issues need to be resolved so that
change can be implemented in desired manner. It has been noticed that there are different
techniques of change management which need to be referred effectively by the management. It
assist in meeting key goals and objectives so that long term sustainability can be accomplished
9

effectively. Moreover, Lewis change model is a factor which assist in ensure that better
awareness is being created in respect to change of home drug infusion.
2.3 Review of the themes
In the present chapter, scholar have main aim is to analyse the impact of the home drug
infusion therapy. With help of the literature review, scholar can introduce the drug infusion
therapy in the hospital and attain the objective of hospital In the following literature review,
researcher has divided the chapter among the various themes. With help of the various themes in
the literature review, scholar can get a deep understanding and knowledge about the topic of
home drug infusion therapy programme in the health ad social care organisation. In this
dissertation, there are major two themes are EDOC and increased EDLOS and lean management.
The other two themes are PF and diagnostic investigation. The mentioned below diagram
represent the literature review and various theme's interrelationship.
10

In the following two graphs represent various themes and their interrelationship. These all are
included in the literature review.
11

Theme 1 HIDT and its effectiveness
As per the view of Liu amnd et.al., (2017) the home infusion care allows patients who are
required regular intravenous treatments to receive their form of treatment in the comfort of their
home. In order to delivers such kind of the treatment and care to the patient, there is requirement
of the well qualified and skilled health experts and doctor who have complete knowledge about
the drug infusion therapy program. In the opinion of John, (2017) the home infusion industry is
evolving rapidly and its characteristic will have an impact on how Medicare policies related to
the home drug infusion therapy. In the 1970 the home infusion provider were provided TPN
solution for patients who have requirement of the hospital pharmacy. In the opinion of Giner-
12

Galvan. and et.al., (2017) home drug infusion therapy is an effective technology, invasive service
that can pose considerable risk to service users. In the home, complication of therapy are more
potential than the hospital. This is because health care experts are not immediately available to
recognise and treat them. In the view of Imran, Incube Labs, (2017) home infusion is a clinically
appropriate treatment under which patient gain effective treatment in order to secure the health
from chronic condition, ranging from bacterial infection to more complex condition such as late
stage heart failure, bleeding inflection, ineffective immune diseases etc. It has been noticed that
by having an effective change in respect to the infusion treatment the issues in respect to health
can be overcome. It is necessary for authorities to have efficient change management with an
understanding a concept regarding home drug infusion treatment.
The major benefit of the home drug infusion therapy is that by help of this treatment
patient can easily get an impressive services and treatment in the fastest manner. In the opinion
of Tien, Sivinski and Lew, (2017) infusion therapy is a treatment under which health experts and
service providers provides the medication with help of the needles and catheter. Basically, this
therapy organised for the service users while their condition is so serious and they are unable to
get the treatment by the oral medications. In the other word it can be said that while patient are
not able or capable to take the treatment in the oral medication then such kind of therapy
program is organised by the health care experts and doctors in the hospital. With help of this
treatment, patient can get the instant relief and care over the health issue and disease. This is the
best therapy to provide the care service to of age patient and those service users who have
serious injury and health issue. In the opinion of infusion therapy refers that a drug is
administered intravenously. This terms also refers to the situations where drug are provided by
the other non-oral routers. By setting out various standards the issues can be resolved in desired
manner. With an assistance of change management practice the work standards can be set out
effectively so that long term sustainability can be measured. Doctors can have change in
monitoring system in respect to diseases so that better application of home drug infusion
technique can be taken into account.
The equipment which is mostly used in the therapy are intramuscular injection, epidural
routes. In order to organize the treatment and therapy of the home drug infusion, various factor
which contributed in the health and care organisation. One of the major factor related to the
technology. In the absence of technology and equipment, service provider can unable to conduct
13

the therapy. In this manner, technological advances that enable safe and effective administration
of infusion therapies in the home. In the absence of effective equipment and technology, service
providers can unable to conduct the home drug infusion therapy. In order to deliver an
impressive treatment and care service to patient, it is very important for the hospital management
to purchase and bring high quality of technology and equipment so as patient can get the fastest
treatment and services. In the opinion of Kondo, South and Branas, (2015) Another factor is
related to the high skilled and qualified health experts. In order to conduct home drug infusion
therapy, organization required high skilled experts. With assistance of the qualified doctor, home
care can easily deliver an impressive services and care to patient so as they can improve their
health issue in fastest and easy manner. In the view of McCarthy and Rose, (2010) growth in the
number of infusible drugs and the medical conditions that can be treated in the home.
As per the opinion of Lowes and Hulatt, (2013) this therapy is the new method of
treatment in medical areas. In home drug infusion therapy doctors or experts prescribe medicines
14

to patient to be consumed at home. This helps the patient to get treated at home by the prescribed
drugs injections. Patient can also enjoy the company of his family members with the treatment
without going to the medical centres. This therapy saves the time of the patients as well as
money. For home based drug infusion treatment, new medical equipment and supplies, new
drugs and drugs in-taking manner, novels and camps are organised to deliver health care
services. This therapy fulfils the desire of patients to live a comfortable life and normal work
activities with continuing the treatment of recovery. This therapy is less costly as compared to
the treatment in hospitals or by experted doctors and nurses. Home drug infusion therapy is
proved as safe and adequate substitute for the patients to be cured at home. Ambulatory Infusion
Suite or AIS is a health care facility provided to the patients without staying or spending short
period at hospitals and nursing homes. It is also necessary for experts to have changes in
treatment process as per needs of patients so that long term sustainability can be attained.
Infusion standards need to be analysed properly as per changes in situation so that better
outcome can be accessed. With an application of treatment of recovery the health issues can be
overcome in desired manner. Along with this, standards in respect to the Physician-based
infusion clinic also need to be referred properly so that long term sustainability can be taken into
account.
The AIS is one of three kinds of Ambulatory Infusion Centres (AICs) i.e. are mentioned
below-
Ambulatory Infusion Suite of the home infusion therapy provider (AIS) are Hospital-based
infusion clinic and Physician-based infusion clinic. In the opinion of McKitterick, (2012) Home
drug infusion therapy can be used for the patients at severe or initial stages of disease like heart
failures, nutrients deficiency, haemoglobin deficiency, cancers etc. The patient are carefully
treated at home under the observation of doctors or experts. Lowering the costs of treatment is
the main objective of home drug infusion therapy so that treatment can be in range of middle
class and lower class patients. Patients has been provided well-skilled doctors and nurses that
observe the disease and provide optimal medication doses at patient's home. The home drug
infusion therapy centres have 24/7 hours call facilities so that they get informed about a needy
patient. The experts visit to the patient's house and checks the medication and improving health
of the patient. The patient receives step-by-step guidance of medication and drug infusion by
experts and nurses. This home drug infusion therapy is receiving high satisfaction rates and every
15

case of infusions is managed through completion. Home drug infusion therapy programs are
beneficial and effectively achieving its objective.
As per the view of Munn-Giddings and Winter, (2013) the major benefit of the home drug
infusion therapy is related to the cost. It is very cost saving program within the heat and acre
organisation. It has been analysed that both health care and pharmaceutical costs are significantly
less for home infusion. While health acre experts and doctors arrange the therapy and treatment
for patient at the home then both health experts and patient needed less cost as compare to the
hospital. According to the view of Reeves, Lewin and Espin, (2011) an infusion therapy provider
is most closed door state licensed pharmacy that specializes in provision of infusion therapies to
service users in their home and other alternative sites. In the health and care organisation, there
are major three home drug infusion providers such as home based versus centre based models,
pharmacy based versus nursing based model and ownership and orientation. Home based versus
centre based models provides all aspects of therapy in the service users home. In this treatment,
the therapy and operation is conducted at the home of patient and it is organised by the health
and care experts. On the other hand centre based providers usually train the service users for
learn to care their self. These experts train patients about their basis care like dressing changes,
using wash room, take food, drink water, take medicine etc. In the context of pharmacy based
versus nursing based model, while the health experts and provider focuses on the pharmacy
related services then it is known as the pharmacy based model. In other word it can be said that
this mentioned model consider on the pharmacy related services with nursing service delivered
or constructed as needed. In the nursing based model, as more service users required multiple
nursing services. In this mode, there are skilled and high qualified patient has appointed for
delivering the care services to the patients in the health and care organisation. In the
contradicting view of Harris, Olsen and Walker, (2012) in the context of ownership and
orientation, the original mission of the infusion provider can dramatically influence that how
being deliver service and what is offer and who is serve.
Thus, from these analyses it has been founded that there are major three kinds of the
home drug infusion providers who delivers the care and treatment to the patients who are serving
from the high disease health issues. Hence, from this above discussion about the home drug
infusion therapy it has been founded that in the health and care organisation, this mentioned
therapy is a great full treatment of the patient by which those patient can get an impressive
16

treatment and care services who are not able to go to the hospital and they have serious health
issue which do not improve by the oral medication within the hospital. In order to deliver this
treatment, health care experts use an impressive technology and equipment through which such
kind of therapy can arrange at the home. The home drug infusion therapy can hep to the patient
in improving their health issue and disease. It is an example of mode of treatment that involves a
various new technologies, innovation in medical equipment and supplies, new drug, novel ways
to organising health care services. With help of this new program about the home drug infusion
therapy in the Yan hospital Malaysia, health care experts and doctor can able to deliver
appropriate care and treatment to the patient who are inpatient in the hospital. With help of this
new program, cited venture can able to improve their standard and bring some innovative idea in
the care services. In the Yan Hospital, the major objective is to provide the Home drug infusion
therapy at least 50% of patients who are fulfilling the criteria of the new services. With help of
this new program, 50% of patients can able to utilise new care services and improve their health
issues.
Theme 2 Inpatient bed utilization and reducing hospital admissions.
In the opinion of Healy, (2011) in the present era, there are various kinds of the major
health issue occurs among the people by which they suffer from heavy illness. In order to
overcome these major health issue, there are various kind of impressive treatment developed by
the health experts and doctors. In the hospital. In the present time, electric surgery is one of the
effective treatment by which all health issue and disease can improve by electronic ways. In this
process, health expert and doctors prepare their operation by help of the electronic resources. In a
simple word it can be said that cancellation of surgery is a dilemma for nearly all health care
service that investigated in order to obtain roots consequences and possible solution. Healy,
(2011) has stated that change management technique allows considering better application of
infusion therapy. It has been witnessed that use of infusion will allow improving the standards of
treatment process. It will assist in advancing the effectiveness of surgery so that long term
sustainability can be advanced. As per the view of Gaieski and et.al., (2017) in the Yan Hospital,
in order to introduce the home drug infusion therapy, another major objective is to reduce the
hospital admission and effective bed utilisation. While Yan hospital enhance the new
technologies, innovation, equipment, resources of services then there may enhance the quality of
care services. Proper infrastructure in the hospital is very important by which patient can not face
17

any difficulties. With help of home drug infusion therapy, hospital can able to improve its proper
utilisation of bed and also there may reduce the numbers of patients because health care experts
delivers high quality of care services to patients. By proper arrangement of the bed, equipment,
care service resources, hospital can able to deliver effective facilities and care to service users.
Through this way the rate of patients can automatically overcome in the Yan Hospital. Thus, it
can be said that with help of the introducing home drug infusion therapy in the hospital, care
experts can bale to reduce the numbers of patients admission and proper utilisation of the bed in
the every departments.
Theme 3 Elective surgery cancellation
As per the view of Tien, Sivinski and Lew, (2017) elective surgery is a process which is
organised in advance because it does not involve a medical emergency. On the other hand semi
elective surgery is a surgery that must be done to preserve the service user's life but does not
need to be performed immediately. In a simple word it can be said that while the patient required
the treatment for their huge health issue and problem then they required non emergency surgical
procedure. An elective surgery is a planned and non emergency surgical process which is
organised according to the systematic planning of the health and care experts and doctors. This
kind of surgery either may required by medical manner or by optional basis. Thus, it can be said
that while people health issue are not being improved by the normal treatment then health care
experts and doctor organised the planned surgery which is known as the elective surgery. It
assists to the patient in extend their life and improve the quality of life physically and
psychologically. In this kind of surgery various treatment are involved such as nose surgery, face
surgery facelift, tummy tuck etc. In the contradicting view Morris and et.al., (2017) stated that an
operation or surgery that can be performed with advanced planning like cholecytectomy, hernia
repair, colonic resection, coronary artery bypass.
As per the project it has been founded that in the US there are 40 million of patients are
engaged with the procedure of elective surgery. There are hundreds of elective surgeries
spanning all the system of the body in modern medical practice. In this elective surgery includes
various kinds of categories such as plastic surgery, refractive surgery, gynaecological surgery,
exploratory and diagnostic surgery, cardiovascular surgery, musculoskeletal system. In the
opinion of AFZAL and ALI, (2017) if any patient consider an elective surgery should review
their coverage requirement with their health insurance before scheduling the procedure. In
18

addition to this, while elective procedure performed at the health and care organisation then
recovery time and postoperative care can vary by this procedure. In this manner, health care
experts provides a complete instruction to the patient in the written manner so as they can take
the proper care themselves. With assistance of the proper care and instruction, patient can get
complete knowledge about the medicine and treatment after surgery. These instructions should
be explained and provided completely by the physician and nursing staff. In the context of risk, It
is depends upon the types of procedure performed in the elective sugary. There are various kinds
of risk included in this process such as risk of infection, haemorrhage and circulatory problem
such as shocks or thrombosis. In the opinion of de Moraes and et.al., (2017) the alternatives
available for a particular surgery will depend on the purpose of the procedure. A cancellation of
the elective surgery is a constant agonizing dilemma for nearly all health care service in terms of
wastage of resource and inconvenience caused to both patients and family members. The major
reason behind cancellation are lack of the resources like lack of elective ore intensive acre unit,
beds or operating room and time. The major reasons of the cancellation of the elective sugary is
divided into three categories such as facilities related factor, patient related factor and
preoperative preparation factor. These three reason are major causes of the cancellation of
elective surgery in the health and care organisation.
In the context of patient related factors included no show patient's refusal to sign consent
form and death prior to the date of the operation. Some time patient does not agree to sign
consent form and death prior. On the other hand facilities related factor including the lack of
time, improper arrangement of the effective operation, no elective or ICU beds, unavailability of
the technology and high quality of equipments., implants or staff administrative errors like
surgery done as an emergency, incorrect booking and conducted elsewhere. In other word it can
be said that while in the health and care organisation, there are lack of the sufficient and effective
resources and facilities such as technology, equipment staff members etc then such kind of
surgery can cancel by the management of the health and care organisation. On the other hand in
the context of preoperative preparation causes includes the need for further optimisation,
abnormal test and change in the treatment plan. In the opinion of Chang and et.al., (2017)
Elective surgery help to the patient in improving their life quality by physically and
psychologically. There are various kinds of the surgery included such as cosmetic, re
constructive procedure, tummy tuck, nose surgery, facelift etc. The major objective of the Yan
19

hospital is to overcome the elective surgery cancellation rate due to the shortage of bed by 30%.
Thus, with help of introducing home drug infusion therapy in the Yan hospital, management can
able to improve the elective surgery and help patients to improve their serious health issue. With
help of home drug infusion therapy, health care experts can able to overcome the elective surgery
cancellation rate in the Yan hospital. By introducing the home drug infusion therapy in the Yan
hospital Malaysia, health care experts can able to enhance the use of elective surgery. Due to
shortage of bed, management cancelled the elective surgery but with help of new program the
use of elective surgery can improve because overall infrastructure and technology will revise
within the hospital.
Theme 4 Emergency department boarding
In the view of Lee and et.al., (2017) within the hospital, there are various kinds of the
departments like emergency department, operation department etc. In this manner, many
emergency department have heavy emergency resource demand which hampers the delivery of
high quality medical care and compromises patient safety. In the health and care organisation
there are the department where the emergency patient are admitted. In this department, only the
energy patient are admitted in order to get the treatment and care services from the doctor. In the
emergency department, the major reason of overcrowding is boarding. Emergency Department
boarding is the process in which patient is kept admitted on stretchers in area of emergency
department hallway of hospitals for hours or days. Strategies should be designed to solve the
problem of emergency department boarding. The constant and practical solutions should be
established so that is may help to overcome this situation. Every hospital or health care unit
should work on how to coup up with emergency department boarding problem. The institute of
medical specifically called on CEO's can take initiatives to make efforts hospital wide patient-
flow improvement. The first line solution to overcome this problem is use of available beds so
that hospital system flow can be improved and reduce crowding and boarding.
The arrangement of beds in the hospital may need to increase or the understandings
among hospitals relating to the availability should be upgraded. Hospitals can maintain data
related to this emergency boarding so that the staff may have idea about the existing beds where
the emergency board patient can be shifted. Instead of increasing beds the another solution to this
problem may be increasing the number of shifting beds in hospital to which patients are
discharged. The campaigns may organized to give the public, knowledge about the health issues
20

in relation to overcrowding in emergency department. This step may prove effective to overcome
the Emergency department boarding. The organizations may decides the limits of time period of
a patient-flow in the emergency department so that other patients may not face the long waits and
crowding.
Government may also take some actions and may also make some rules to record some
boarding regarding issues performed in hospitals. This may only come in action if the
government provides financial incentives to the hospitals. Hospital should expand its area so that
more patient can be admitted in wards to reduce the crowd in emergency department. Hospital
expansion has some demerits as it may take several years to progress, may require large amount
of time, money and staff. While Yan hospital in Malaysia, introduce the new home drug infusion
therapy program then its another major objective is to decrease numbers of emergency
department boarded patient by 30%.With help of this new program about the home drug infusion
therapy, hospital can able to overcome the patient in the emergency department by 30%. In this
new program, management of the Hospital introduce new technology, equipments, machines etc
through which they facilities of the services and treatment can improve.
Theme 5 Reduce hospital infection rate
In the view of Chang and et.al., (2017) in the health and care organisation, there are major
issue related to the infection among the patient. There are several reasons for occurring the
infection among the people like improper cleaning of equipment like noddle, injection,
consumption of expired medicine, improper service delivers etc. According to the view of
Acharya and Aamtya, (2017) a hospital acquired infection also known as a nosocomial infection
that is arisen in the hospital and health care facility. Such kind of infection can be acquired in
hospital, nursing home, rehabilitation facility, outpatient clinic, other clinical setting etc. A well
structured and effective health care treatment is that under which infection rate is minimum. In
the contradicting view Sahadeo and et.al., (2017) stated that an infection rate is the probability or
risk of an infection in a population. This rate is used to analyse and measure te frequency of
occurrence of new instances of infection within a group of people in the specific time period.
While the individual required to obtain the rate of infection that they divide the number of the
infections by the number of those in a population that are at risk of infection. With help of this
formula, health care experts and doctors can obtain the infection rate within the hospital. While
in the health and care organisation, infection occurs among the patients due to the several reason
21

like improper cleaning, ineffective care and services, ineffective equipment used in the operation,
taking expired medicine etc then it is great responsibility of the health experts and doctors to
overcome these infections by use of the several measures like hand hygienes, environmental
hygiene, screening and cohorting patient, care coordination, following evidence etc.
With help of these measures and strategy, doctor can over come the rate of infection in an
effective manner and provide an impressive treatment to them. As per the view of Gaieski and
et.al., (2017) in the health and care organisation, hand hygiene is one of the best strategy to
overcome the rate of infection among the people. It is the simplest approach to protect and
prevent the spread of infections and needs to be incorporated into the culture of the organisation.
While in the health and care organisation, infection rate occurs among the patients then it is great
responsibility of the health care expert and doctors to adopt this strategy of clean their hands and
wash their arms and forearms before a procedure and put on sterile gloves. With assistance of the
gloves, effective equipment and design the hygienic environment in the hospital. On the
contradicting view of Lee and et.al., (2017) environmental hygiene is another important strategy
to overcome the rate of infection in the health and care organisation. One of the most common
reason of the transmission of infection is environmental surface. In the environment, there are
several types of microbial bacteria which are surviving on environmental surfaces for months at
the time.
Thus, it is very important within the health and care organisation is to keep the
environment clean and disinfected. While the environment will clean and safe then it is very easy
to design the infection free health care services in the hospital. In the view of Sahadeo and et.al.,
(2017) care coordination is another way to overcome the rate of infection within the hospital.
With assistance of this strategy, doctor can deliver a hygienic and infection free services to
patients. In this strategy, organisation's management should promote the practices of care
coordination. With assistance of this care coordination practices, service provider and health care
experts can deliver an impressive environment in the hospital. In this strategy, management
should allow to all workers, staff member and care experts for open communication. While every
one freely communicate with each other than they care for each other. By this measure, there
may arise the hygienic environment and atmosphere which influence every one in an impressive
manner. In the Yan Hospital, another major objective of introduce the home drug infusion
therapy is to reduce the infection rate by 40% in the December 2017.With help of home drug
22

infusion therapy in the Yan hospital, management bring some new medical equipment, supplies,
new drug, drug protocol, new technologies, innovation etc. While all resources related to care
services can help to the hospital in improving the care service quality and effectiveness.
2.4 Implication of the project
From this entire discussion in the literature review about the topic of home drug infusion
therapy it has been founded that it is very great full program in the health and care services by
which patient can easily get the care services and treatment at the home. These themes of the
literature review provides an effective understanding and knowledge about the home due
infusion therapy program in the hospital (Lee and et.al., 2017). It has been also founded that with
help of these literatures review themes, researcher can easily able to understand the concept of
major topic and apply in the prices of project. In addition to this, it has been also analysed that
with help of this literature review chapter, scholar can able easily understand the implication of
the home drug infusion therapy within the Hospital Yan in Malaysia. It has been noticed that
such measures allows to have better application of changes in practice so that health regarding
issue can be overcome. By having a consistent learning in respect to care services and treatment
process the overall outcome can be advanced effectively. It is the simplest approach to protect
and prevent the spread of infections and needs to be incorporated into the culture of the
organisation.
2.5 Summary and conclusion
From this literature review its has been concluded that the home drug infusion therapy
program is very impressive treatment for those patient who are not able to improve their disease
by oral impatient. While the patient requires an additional care and treatment from the health
care expert and doctor then such kind of therapy will organise at the home of service users. From
this literature review it has been also concluded that home infusion is a clinically appropriate
treatment under which patient gain effective treatment in order to secure the health from chronic
condition, ranging from bacterial infection to more complex condition such as late stage heart
failure, bleeding inflection, ineffective immune diseases etc. The major advantage of the home
drug infusion therapy is that by help of this treatment patient can easily get an impressive
services and treatment in the fastest manner (Acharya and Aamtya, 2017). It has been also
concluded that the objective of dissertation is to reduce infection rate by 40% among the people
so health care experts and doctor have to made an impressive treatment and care of patient so as
23

they can not occur from the infection.
3 ORGANIZATIONAL DEVELOPMENT PROCESS
3.1 Introduction
In this chapter the major objective of the investigator is to get detail about the
organisation development method and process. It will help to understand the various methods
that are involved in the process of organizational development. It will also discuss the
appropriate model that can be used for the development process of Yan care home Malaysia. In
order to achieve the objective adequately, the researcher have divided the chapter in various sub
parts. It covers approaches of organizational development where viewpoint of different
researcher have been critically reviewed. Further, appropriate organizational development
method will be evaluated which can be effectively implemented in Yan. A plan will be developed
for the model implementation by considering different factors. It will help in getting deeper
understanding of several organizational development approaches that can be used in an entity for
its smooth functioning.
3.2 Critical review of approaches to organisational development
According to Anderson, & Galavan (2016), organizational development is a field of
project directly related to knowledge expansion and improve the effectiveness of people in order
to successfully accomplishing organizational change and performance. According to
Breitsprecher & et.al. (2012), organizational development has influence on behaviour of the
worker and motivation to a great extent. It helps in successfully achieving the goals of an
enterprise. It is beneficial due to changing environment and deeper understanding for the market
avenues so as to generate higher profits. According to Droste & et.al. (2012), it is a helpful
method to implement organizational change based on the dynamic prevailing environment. It
provides opportunities to the workers and every member working in the enterprise to develop
and work in their full potential. However, according to Edwards (2012), the main motive of
organizational development in to develop interpersonal trust among the workers. It helps in
increasing satisfaction level of the employees and their commitment towards work as well.
Strengthening the trust, cooperation and communication helps in successfully achieving
organization goals effectively.
According to Liveng (2010), traditional approach of Organizational development where
the actions were based on analysing data which have been collected to diagnose the problem.
24

However, as per the views of Lloyd and Marjorie (2010), as per new and emerging approaches of
OD, diagnosis step is excluded enhancing the effectiveness and organizational health. According
to Giner-Galvan and et.al. (2017), T group of traditional organizational development, participants
used to learn from their own actions where they used to evaluate and evolve in group dynamics.
However, in contrast to this, Glasby (2012) thinks that it is a time taking process and need to be
evolved with time and different modern approaches must be utilised by the organizations.
According to Enright & et.al. (2015), another objective of Organizational development is
to provide opportunities to the people which helps them to keep the working process exciting and
challenging. It helps in improving the performance of the individuals working in the
organization. Further, it is an important method that improve the entity's ability in order to
respond to the changes prevailing in the external environment. However, the company have to
improve its internal abilities so that the process of development can be successfully
implemented. It ensures that organizational structure, job design, human resource and
communication system, leadership and managerial process contributes to human motivation and
helps the employees to work in their full potential.
According to Guidi, Bagnara, & Fichera (2012), it is important to measure the
organizational behaviour in quantifiable terms. Surveys and feedback are the integral part of
organizational development process. One approach of organizational development is test – action
– retest approach where, the scholar measures the current happening, develop strategies for it,
implement them and assess the effectiveness of the new implemented strategies. The core steps
of implementation of this approach is Test, Action and retest. Action based feedback is an
important approach adopted by the researcher while implementing this approach.
As per the views of Ismail & et.al. (2012), it is important to identify the strategies that are
directly related to the process of the business. It involves, analytical abilities that are to be used
by the researcher that can help in bringing ideal improvement in the hospital based on the
functioning of external environment. It is important to assess thinking style, behavioural style,
management and leadership approaches in order to identify the improvement being made and
modify the strategies based on the results (Mc Carron, 2016).
The three main approaches of organizational development are: Behavioural approach,
Structural approach and technical approach. According to behavioural approach, it is important
25

to utilize the human resources available in better manner. It can be done by boosting up their
morale, motivation and commitment towards their work. It also helps in achieving the
organizational objective in better manner. Structural approach takes care of organizational
structure of the entity such as, downsizing, centralization and decentralization. The number of
employee should match with the work available in the organization. In case of hospital, it is
important to have perfect ratio of doctors and patients so as to give better and effective treatment
to the patients. Introduction of home drug infusion therapy will require adequate number of
doctors available in Yan. According to technical approach, it is important for an organization to
have better machinery for efficient working environment. The hospital should carry every
instrument and machinery that are required for its successful functioning. Yan has to take care of
all the three approaches of organizational development while introducing a home drug infusion
therapy in the hospital. It will require making strategies considering different organizational
development approaches. The hospital will require adequate number of doctors so that some can
visit to the patient's home and other can handle patients in the hospital itself. However, as per the
views of Karbassi & et.al. (2016), organizational development adds up to the cost of entity as the
strategy adopted may or may not work for the organization. Yan has to be prudent enough while
deciding the strategies that can be implemented while introducing home drug infusion therapy in
the hospital.
There is a difference between NHS model and HSE model:
NHS Model HSE Model
Shared purpose Shared Vision
Continuous innovation Continuous evaluation and learning
Measures in transparent manner Keep changing methods as per learning
Uses improved methodology Keep learning from the change and change the
methodology accordingly
The change management experts recommend strategies that can be adopted by the
26

hospital to bring effective change. It can redesign its approach which includes, decision making,
staffing, work flow and rewards. Lowes and Hulatt (2013) suggested that constant leadership and
information sharing from the past bring out effective change. HSE model is an effective way to
perform this task in Yan. Traditional methods acted as a barrier in the development of the
organization. New methods such as HSE model of organizational development is an effective
method to use.
Project management helps in ascertaining the uncertainties and is established to bring
innovative change in comparison to the existing operations of the business. According to Liveng
(2010), the primary element of project management is to plan, schedule and control. The main
five steps are, initiating, planning, executing, monitoring and controlling and closing.
According to Guidi, Bagnara & Fichera, (2012), change agent plays an important role in
processing change in the organization as it helps in taking new initiatives and assess current
business performance based on which new steps can be taken. However, in contrast to this Haas
and Yorio (2016), diagnosing problem is an effective way before taking any new initiative since
it helps in determines what are the places where change is required to be taken into
consideration.
3.3 Change models and rationale for Organizational development model
The project uses HSE model for various number of reasons. It includes, it emphasises on
people and cultural side of change. Moreover, it is a dynamic model that can be used to create a
strategy to develop the expertise in supporting field. According to Morgan (2013), it helps in
collaborating and working with different geographical boundaries as well. It makes the change
effective and easy to be implemented. Further, it also promoted common understanding of the
new aspects and motivates the employees to accept the change that is going to take place in the
organization. Yan will be able to effectively implement its changes in the hospital with the help
of this model.
While adopting change in the organization, it is important to change strategies in order to
avoid the ineffective or vague method of adopting plan of action. It is an ongoing process which
takes time, efforts, dedication and expertise inn order to implement and run the strategies. Before
adopting any method it is important to understand that why the entity require that change and
how the results can affect the employees working in the enterprise. The changes may affect the
27

society as well which has to be taken care of as well. Following are some strategies of change
management that can be adopted by Yan:
Lewin's Change management model: The change management model by Lewin consist
of three main stages which are, Unfreeze, Transition and refreeze. In Unfreeze stage, involves
preparing for the change to take place in the entity. Researcher finds out the crucial factors that
helps in determinate that the change is necessary. There may be employees that may resist
change and it is important to change their state of them and convince them to adopt that change.
Unfreeze is the stage in which communication is core element. Good communication between
manager and employees should be built so that employees are well recognised about the goals of
the organisation. However, in contrast to this, according to Sahadeo and et.al. (2017), this model
is no longer valid to the organization as once the change is made it gets freeze for a certain
period. The manager no longer change the model and hence the process of change become
tedious for the top management. According to Scott and Spouse (2013), After completion of
initial stage of communication is accomplished, the second stage of lewin's stage i.e. transition
should be undertaken to establish new ways of working and to approve new way of technology
to achieve the objectives of the Yan. Once the transition is successfully adapted by the Yan,it is
constant and the benefits of change is realised. This is the third stage of change management of
lewin's i.e. refreeze. (Mizumoto, Cristaudo, & Hendahewa, 2016). However, in contrast to it,
according to Ndetei and Gatonga (2011)., it is difficult to freeze a planned change into a system.
It is a relevant theory for incremental changes but may not be effective enough for
transformational and radical changes that can take place in Yan. The theory does not consider the
irreplaceable factors that exists in the organization, they are, power and politics between the
employees and the management.
Mckinsey 7 S Model: It is a constant change management model trending till the date.
This model consists 7 steps of change management.
The focus of this theory is on client and customer satisfaction where it focuses on fulfilling the
client expectations. It a guide to organizational change where both emotional and rational
constituents are combined. It is one of the effective ways in order to understand the organization
and its structure which helps in better decision making. It will help Yan to understand the internal
and external environment of the organization and make changes in the structure accordingly.
However, the difference are ignored by this model. Further, it is difficult to be applied in a
28

hospital where every patient and doctor is different. It can lead to failure of Yan to a great extent.
Further, when one part of the organization changes, all the other changes as well as all the factors
of the care homes are interrelated. According to Hadad and et.al. (2013), it helps in assessing the
effects that the company is going to face or may face in near future. It also determines the way in
which a strategy can be implemented in the organization. However, in contract to this, Harris,
Olsen and Walker (2012), thinks that this model is not effective as it does not consider external
variables that may exist in the environment.
Kotter's change management theory: According to Healy, (2011), it helps in
identifying the opportunities and change the vision accordingly.
However according to Morgan (2013), it is a top down model and opportunities can be
missed as everybody in the organization are not contributing to the vision of the company. The
process is followed step by step and it is difficult to miss any step involved in it otherwise the
desired results will not be achieved by Yan. Following all the 8 steps is tedious as well as time
taking. It may not be an effective change management theory that can be followed by Yan for
introducing home drug infusion therapy. According to Giner-Galvan. and et.al. (2017), the model
not focus on change but aolso on its preparedness and acceptance for change in the entity as well.
It helps in making the organizational culture easy. However, as per the views of Glasby (2012), it
is a quite rigid approach and some steps that are included in this model are also not relevant for
modern change management approach.
HSE change model: HSE stands here for health, safety and environment. The main
objective of HSE change model is to make people healthier, providing safety to them and ensure
a pure environment to them. The main purpose of this change model is to fulfil the needs of the
employees in Yan. It helps to develop and improve the outcomes for the patients, service users
staff and communities. It has been used as an effective method to bring changes in Yan. There is
a constant change in the organization based on the learnings and evaluation process followed by
the hospital. However, according to the views of Sahadeo and et.al. (2017), it is important to
assess the leadership strategy, communication and human resource function while making key
changes in the organization otherwise it will not be effective.
3.4 HSE change model
HSE model can be implemented in the health care service providing organization. It is
29

important to adopt the change due to rapid development in healthcare sector. The process of
change in constant and adoptive which requires to be implemented successful. For successful
change in the implementation strategy the enterprise should be dedicated towards the a
compelling and clear vision of change with respect to social and health care services and
delivering the best to the patients (Toderi & et.al. 2013). It ensure that there is a need for this
change in order to provide better services to the patients and the main objective will not be
deviated in the decision making process. Practice in delivering high quality services to the
patients. One needs to measure performance at all level periodically. Moreover, optimum
utilization of the available resources for better functionality of the plan.
The model will help to develop better experience for the service users, help the team and
the staff to provide improvised services, promote consistent approach towards change across all
the system adopted. HSE model will help Yan in increasing staff commitment towards the work
and accept changes in order to attain organizational goals. The core principles followed by the
hospital while adopting HSE change model are:
To prioritize long term sustainable change which improve the effectiveness of the entity.
Allocating responsibilities to the employees so that every function is efficiently completed at
every stage.
Emphasizing of team work of the doctors in the hospital.
Encouraging feedback and surveys so that strategies can be effectively created.
Critically understanding the activities that helps in better implementation of change.
Providing honest and timely information to the patients.
It helps in gaining the knowledge, skills and confidence in order to approach change I the
hospital. According to (Kirton, 2013), HSE change model can be implemented based on
experience and project about it. It emphasizes on importance of involving employees for the
process of change.
SWOT analysis of HSE model of Yan care home UK
Strengths :
 The care home have strong atmosphere of openness, sharing and commitment which
30

increases the confidence the patient.
 Local charities are willing to participate and make care home services success.
 There is a requirement of highly skilled clinical staff which can handle the physically
challenged patients easily and make them comfortable.
 The hospital should provide outstanding and affordable healthcare facilities to the
patients.
Weaknesses:
 The lack of adequate resources can reduce the trust of the patients from the home care
centre.
 Shortage of efficient staff or poor quality of service can lead to patient dissatisfaction.
 The increase in health care costs can reduce the health care quality.
 The major problem faced by the patients is change of staff which them little
uncomfortable.
Opportunities :
 Active and voluntary committees who are willing to plan and organise the events for
boasting the morale of the patients or to help them to join home care.
 Suggestions and opinions can be taken from the active and supportive patients to
encourage other patients and to fulfil their needs.
 Home care services allows to be with the loved ones which provides a peace of mind to
the patients.
 The home care services provides advantage to adjust the timings as per the convenience
of the patients as well as their family members.
Threats :
 The personal details of the patients is at risk and the lack of emergency resources will
cause adverse effect on patients mind.
 The patients might be forced to do the things they do not want to do.
31

 Geographical limits can cause lack of residential home benefits which can discourage and
cause discomfort to the patients.
 The patient might feel isolated if the response of the family members is not positive
towards them.
PESTLE ANALYSIS:
Political:
 A wide range of change in the facilities that are provided by government to the hospital
can affect the strategy.
 Change in the rules and regulations issued by the government for health care industry can
also affect Yan. Reduction in the cost of health care will also affect the strategy.
Economic:
 Change in the economic conditions of the country affect the investment made in the
hospital and bring change in buying behaviour of the patients as well. Lack of investment in the health care industry can lead to failure of the strategy.
Social:
 Acceptance level of the society is another important concern. People may not accept the
change and lead the strategy of home drug infusion therapy to failure. People may not be able to afford this assistance provided by Yan.
Technological:
 The project will require wide range of technological instrument for better
implementation. As the doctors will visit at patient's home which will require extra
instrument that have to be made available for the doctors staying in the hospital (Marcatto
& et.al. 2014).
 Constant up gradation in the technology can be a hassle as well as costly for Yan.
Legal:
32

 Legal obligations are attached in adding a new activity in the present business activity.
Yan have to make sure that the strategy implemented is legal and can be adopted.
 Changes in health care laws of the country can affect its functioning. Unavailability of suitable drug due to ban can act as a barrier for doctors in Yan in order
to treat patient.
Environmental:
 Natural disasters, flood and other calamities can act as a barrier in providing medical
services at home.
 Change in the weather results in demand of more doctors to serve the patients.
Porter’s five forces model
Bargaining power of the customers:
 Customer may not be satisfied by the price on which these services are being offered to
them
 People with less buying power cannot negotiate on pricing and do not opt for this facility.
Bargaining power of the suppliers:
 An increase in the prices of instruments and machinery which are provided by the
suppliers can affect the cash budget of the entity.
 Inadequate availability of drugs forces them to buy from the suppliers who are providing
at prices as well.
Threat of new entrants:
 Currently only Yan is providing these services in Malaysia. New entrants in this field can
affect the profits and customer base as well.
 Quality regulations issued by the government may pot hindrance in its establishment as
well.
Threats of substitutes
 People who cannot afford these services tend to take care of the patients by their own
33

rather than investing in care homes.
 Natural treatments adopted by the patients restricts them from visiting to the hospital
Industry rivalry:
 Presence of numerous hospitals can affect the revenues of the company and it would be
difficult to make customer base in the beginning of the care home.
 Low fixed cost but high working capital.
There is a specific process that is followed by the hospital in order to implement HSE
change management. The below mentioned steps are included in sequential order :
 Initiation
 Planning
 Implementation
 Mainstreaming
34
Illustration 1: HSE Change model process
Source: (Marcatto, F. & et.al. 2014)

3.4.1 Initiation
According to Liveng (2010), this is a first step of HSE change model where, the
organization have to identify the changes that are required to be implemented in the organization
for better functioning. The main purpose of initiation is to establish a scope and foundation for
successful change. It is the phase where the researcher decides that what it needs to pay attention
on. It is important to understand the scope of change in the initial stage otherwise it will difficult
to progress with the plan. It also identifies the directly impacted area before carrying out the
change in the organization so that corrective actions in the early stage only (Droste & et.al.
2012).
Initiation helps in assessing the need and purpose of the change. It will help to identify is
there is any need to introduce home drug therapy in the Yan home care in Malaysia. The hospital
has to follow certain code of conduct to identify the need in better manner. The key stakeholders
of the plan will be identified. The impact of the plan on people who can be directly affected due
to the change can also be taken care of while preparing strategies. Yan also have to identify
change drivers, degree of urgency and key points. Greater attention will be paid to the staff as it
is important for entity that the employees should accept the change, otherwise its implementation
will become an issue for the entity. A document regarding desirous outcome will be prepared in
order to compare it with the actual outcome and make changes in the strategy accordingly. The
document containing all the relevant notes is also known as Project Initiation Document (PID).
According to Lloyd and Marjorie (2010), clarifying leadership roles is an important
process while initiating change in the organization. Yan will require making a group doctors
responsible for visiting to patient's home in order to treat them. It is important that set of doctors
accept the change otherwise its implementation will be very difficult for Yan. Defined role in the
hospital will ensure that better implementation of strategy. The researcher at Yan also have to
find out the opportunities of change and how it can add value to the core competency of the
hospital. It will help to attract the patients who are sitting at home, who cannot come to hospital
for their treatment. However, according to Lowes and Hulatt (2013) there may be some barriers
in the change which are required to be identified and corrective actions can be taken beforehand.
An initial assessment is an important aspect of change in Yan which includes evaluating the
internal and external factors of the entity. It will bring clarity in the strategy and develop the
objective based on it.
35

Yan also have to make sure that it has all the resources in order to meet the objective of
new strategy. According to Liveng (2010), resources such as, human resource, technology,
finance and infrastructure are important and hospital should have all of them to implement home
drug therapy objective. It is important to assess the objective, purpose and outcomes of the
change and communicate the strategy to the other doctors. It will help in planning the system in
better manner. It also helps in assessing the risk involved in the project.
3.4.2 Planning
Planning is another step of HSE change management. It is an important step as it assess
the specific detail of change and support the changing process. It acts as a support in strategy
implementation as the commencement goes according to the plan that have already been created
beforehand. Further, it increases the participation of the employees in the change process and
build increased understanding of the strategy among the stakeholders.
It increases the commitment for the change and build engagement which increases
readiness and capacity which can be required in near future. According to (Marcatto & et.al.
2014), it is important for the project to assess the complete plan of the strategy as the
stakeholders shares same vision as decided to increase the effectiveness of change in the near
future. Planning will include, staff, finance and infrastructure requirement in order to process the
first step that is initiation. The comprehensive vision is then shared with the consultants and
experts to get a refined view from them. It further involves preparing a communication process
where every employee is aware of to whom he has to report to. Target group will also be decided
while planning for the introduction of home drug infusion therapy. It will help Yan to develop an
estimated outcome which can be compared with the actual ones in the end (Anderson, &
Galavan, 2016).
According to Liveng (2010), Mapping the needs of the patients and making the
instruments available according to it is the another factor to be considered by Yan. It allows us to
understand the needs of the patients and make the treatment available according to it. It has an
important impact on the functioning of the organization.
In order to do correct mapping, it is important to ascertain the problems and find the
solution according to it. Involving staff in order to conduct surveys and highlighting the needs is
36

another important factor to be considered by Yan. It also helps in understanding the patient's
perspective and focus on providing improved services.
In this project, understanding the needs of the patient is an important aspect. It also
important to evaluate the problems faced by the patients so as to reduce it ineffective manner. It
can be performed by preparing flowcharts, recognizing patients and doctor ratio, understanding
demand and capacity. Preparing a blueprint of the process so that it will be easy for the
subordinates and stakeholders to perform and implement it in the implementation process.
Keeping the records of the patients is another factor to be considered while providing
services at home. A proper track record of all the data will improve the services. It can be
performed by maintaining a database of the patient's prescription who have been treated at home.
It helps to assess that due to which disease patients are most often called at home. With the help
of it, technicians and doctors can be made available in the hospital.
In the end of the HSE model, detailed change is made readily available to the
stakeholders containing all the details for better execution of the plan.
3.4.3 Implementation
It is an important phase where the planned activities are finally executed in real practice.
The agreed plan is assembled and implemented after monitoring all the required facors. The
process ensures that the execution should be done according the plan and all he estimated
objectives are effectively fulfilled. It is important that leader should ensure proper
implementation within the specific time frame as decided during the planning phase of change
strategy. The actual schedule may slightly vary however, it is important to get adapted in
different situations.
The first step of implementation is to implement the change. Since, the staff and the
stakeholders have accepted the change, it should enhance the performance of the hospital. The
change was supposed to begin in October 2017. It is required to have physical infrastructure, the
machines that are portable and can be carried ton patient's home, more doctors so that there are
enough doctors in the hospital and to visit patient's home as well. Basic instrument of
investigation for proper examination of the patient by the doctor.
It is important to raise the awareness of home drug infusion therapy among people for
which a conference will be organized inviting the experts who can counsel potential customers
37

through an informal discussion in September 2017. Effective communication has to be there
between the departments in order to provide the assistance at specific time period. The main
advantage of involving the staff in the project is to ensure that they feel associated to the project
and helps in improvement if strategies as well (Breitsprecher & et.al. 2012,).
3.4.4 Mainstreaming
Mainstreaming is the last step of HSE change model which involves assessing the
implementation of the project. It compares the estimated data with the actual one and make
changes in the strategy accordingly. It is important to keep in constant touch with the stakeholder
for better assessment. Feedbacks and surveys are the important methods that can be used in order
to assess the quality of the change and its direct impact on the hospital practices. It is important
to interact with the patients in order to monitor and observe the quality of services provided to
them at home by the doctors.
It is a huge responsibility on the management to make the project a successful one or else
change the implementation strategy for better results.
3.5 Summary and Conclusion
It is important for Yan to prepare the strategies and implement them in order to get
desirous results. The chapter presented and evaluated the HSE change model for introducing
home drug infusion therapy in Yan care home, Malaysia. The process of change had four major
steps in sequential order which are, initiation, planning, implementation and mainstreaming.
Overall result have appeared to be good and advised to be implemented.
4 EVALUATION
4.1 Introduction
In this present dissertation, evaluation and analysis is one of the important chapter by
which scholar can analyse the actual current aspect of the project. In the dissertation, in the
absence of the evaluation, scholar can not achieve the outcome of the investigation. In order to
attain an effective and appropriate solution of the investigation, researcher required to analyse
and evaluate the outcome of the project. In a simple word it can be said that evaluation is a
systematic determination which assist to the company, program, project and any other
intervention to assess any objective. Basically evaluation used and apply at the time when
someone wanted to take the decision about some aspect. It is a structured interpretation which
assist to predicted or actual impact of proposals and outcomes. With assistance of the evaluation,
38

researcher can easily analyse the appropriate outcome of the investigation and take the effective
decision. In addition to this, evaluation helps to the scholar in identifying an appropriate outcome
of the investigation Rasheed, (2013).
Objectives of the Evaluation
 To overcome waiting time by 30 minutes
 To improve patient satisfaction by 20%
Overview of Organisational development structure and expected outcomes
In the present dissertation, the major objective is to implement the new changes related to
the home drug infusion therapy within the Acacia care home. The structure of the project contain
various kinds of the minimal physical space redesign to allow efficient triaging and to
accommodate the huge numbers of non-emergency cases. In addition to this, the physical space
redesign included the medical equipments and IT requirements. In the Yan hospital in Malaysia,
with help of the change management model, scholar can redesign the organisational structure and
expected outcome. In this detailed implementation plan, the structure of the project contain
minimal physical stage. This is to be achieved through dividing the current two triage room to
four, establishing a 6 to 8 bed fast track area and creating closed loop ED system by installing
access control door and back door room. In the new implementation, hospital will acquire the
new HIS and electronic bed management program. All arrangement for the patient will redesign
in systematic manner so as every patient can get excellent care and services. In the new policies
and procedure includes admission, discharge policies, facilities related to the health care etc. In
this document needed a train staff so as they can easily deliver an impressive service to patients.
In addition to this in the context of organisational development expected outcome includes some
objective of the project which is related to the short and long term impact. The major objective of
redesign the project is to reduce of the patient overcrowding and the shortening of patients.
4.2 Significance of health care evaluations
Health care evaluation is very essential for awareness regarding to the health of patients.
It is significant for the advancement of the quality of health care performance. Evaluation of
health care can be considered complex and challenging because it needs time to analyze about
39

the procedures used in health cares. Evaluation in health care is important to identify the
improvement in the health programs. Evaluation is important to know that the initiatives taken in
relation to health programs are sufficiently effective or not. The evaluation is essential to analyze
about the steps designed for the betterment of health care are going in the suitable direction. It is
important to have a systematic data about available resources in health care. For the information
about the health improvement of patients, evaluation in health care is very important. Evaluation
is important so that the staff or the doctors can be aware about the treatment and medications that
should be given to the patients. Evaluation is also required economically. It helps in calculating a
correct amount that is contributed in different areas of health care. Economical analysis is
important to decide the correct use of available resources for increasing the health prosperity.
Economical evaluation in health care involves minimization of cost, utilization of cost,
effectiveness of cost and benefits of cost. Health economical evaluation specially operate with
the appropriate use of resources in improving health. Hospital managers can be aware by quality
service to patients so that they can rapidly overcome to their diseases. The patients may get
satisfied by the treatment given to them by the staff, only by the evaluation of the methods used
in the health care. Practices can be taken forward by the evaluation in order to develop the
knowledge that is instantly needed in improving health care quality. This evaluation helps to
fulfil the expectations of patients for health care. People are getting latest treatments, affordable
care, and options. The evaluation of health care helps to demonstrate the achievement in health
care programs.
4.3 Evaluation
Evaluation is one of the most important chapter in the business development plan by
which scholar can analyses the information and interpret it for obtain an appropriate solution.
Evaluation is a process to analyze, measure and interpret collected information for achieve the
objectives. Evaluation is always conducted at the end of the project so as scholar can able to
collect and analyses the outcome. In the present dissertation, evaluation is a quality evaluation
tool which provide the high quality of solution of the research issue. With help of the evaluation ,
researcher can achieve the perfect solution of problem. In the present dissertation, researcher
have main aim is to introduce the home drug infusion therapy program in the Hospital Yan in
Malaysia that is why they make various efforts to finding an effective outcome of the project. In
this manner, researcher used various methods of the project methodology. This chapter plays a
40

very significant role in the entire dissertation. With help of this chapter, researcher can achieve
an appropriate outcome of the investigation. In the project methodology chapter, there are
various kinds of project methods included such as project approach, project philosophy, project
design, project analysis, data collection, sampling etc. In the present dissertation, the main topic
is introducing the home drug infusion therapy program in the Hospital Yan in Malaysia. Thus,
evaluation in the health care organisation is very important aspect so as researcher can collect an
appropriate information and obtain the perfect solution in the health and care organisation. In this
chapter, project has used the survey method for evaluate the program of infusion therapy in the
health and care organisation. In addition to this they also prepared a systematic questionnaire
about the questions of home drug infusion therapy and collect the information from the health
acre experts and doctors in the Hospital Yan in Malaysia.
4.3.1 Aims
The major aim of the evaluation in the health and care organisation is to provide an
effective treatment and care services to patient so as they can improve their health issue and
problem related to the health. Evaluation and assessment is the responsibility of the top
management in the organisation who are responsible to evaluate the services and treatment of the
patient. With assistance of the effective evaluation and assessment of the care services and
treatment, service provider can deliver an excellent service to the patient. In the present
dissertation, the major aim and objective of the dissertation is to collect and analyse the
information about the home drug infusion therapy program in the Hospital Yan in Malaysia and
its outcomes.
4.3.2 Methods and measure
Project methodology chapter in the dissertation plays a very crucial role by which scholar
can analyse and interpret an appropriate outcome of the investigation. There are various methods
of the project methodology which assist to the scholar in analysing and evaluating an appropriate
solution of the investigation such as project approach, project philosophy, project design, data
collection, data analysis, sampling, project techniques etc Morgan, (2013). This evaluation is
goal oriented where the focus is one the intervention's effectiveness, efficiency and economy In
the following manner, there re systematic description of evaluation cycle which is primarily for
internal use. In order to obtain balanced insight, scholar can employed blended evaluation
methods buy utilising qualitative and quantitative approaches and formative and summative
41

prospective. With hep of these techniques, scholar can able to concluded the result which aid in
deliver effective satisfaction to patients. In addition to this, this new project included bed
management, admission and discharge policies , treatment protocol training etc which will be
evaluated by the Model mentioned below:
Kirkpatrick Model-This model have major four levels that is reaction, learning, behaviour and
results. In the context of reaction, while any changes occurs in the business enterprise then it is
important to measure the reaction because it helps you to understand how well the training was
received by the members. Reaction is important for analysing the impact of changes among the
people. In the second level included learning in which it is analyses that how individual learn
their self for obtain the solution of the investigation. When individual plan the training session
then they learn their self. In the next stage behaviour, individual evaluate how far trainees have
changed their behaviour based on the learning they received. While any individual learn
something then learning and their knowledge reflect from their behaviour. Sat the last stage
included result under which individual can analyse the final result of the training. This includes
outcome that organization have to determined to be good for business and good for employees
and good for the bottom line. While in the Yan hospital, training program is planned then
experts used various evaluation tool for attain the training objective. With help of the mentioned
model, type 6a design evaluate a structural element in the project.
In the entire dissertation, scholar used the quantitative standards or unit of capacities,
process and outcome which are used for the evaluation. On the basis of this measure, the
evaluation plan will include a numbers of measure for obtain a perfect solution of the project
objectives. From the collected information it has been analysed that monthly percentage of the
Yan hospital patient who breach the 6 hour target or have more than 30% of their visit as waiting
time are two outcome measures. Three other time based process measures to be monitored are
the monthly percentage of the service users who breach the 30 to 45 minute target of the
consultation. All of these five time based measures will be develop in the new HIS. In the
context of descriptive evaluation method, the first project objective will be assess. With help of
the Closed loop and nurse led PF system management can ensure that no services users may skip
the triage step in their access to the Yan services of the health. In order to measure the
satisfaction level of patient, qualitative and quantitative method can used which reflect the
project influence on the patient and staff member in the Yan hospital.
42

As per the above discussion it has been analysed that there are various kinds of the
methods and tool in the project methodology by which scholar can find out the appropriate
solution of the investigation. In the present dissertation, scholar has prepared a systematic
questionnaire for collecting the information from the health care experts and doctor of the health
and care organisation about the topic of home drug infusion therapy program. Following are
systematic questionnaire which prepare for the health experts of Hospital Yan in Malaysia in
order to collect information about home drug infusion therapy program. It is very important for
the hospital to listen the voice of patient. In this cited hospital, two process measure to be
monitored. For analyse the patient who received immediate report after CT scan and the daily
rate of discharge from in patient.
The balancing measures includes-
 The rate of canceled elective patient admissions
 From the in patient ward, the average LOS of discharges
 The rate of unscheduled Yan revisits
4.3.3 Results
In the present dissertation, researcher has organised survey program in the Hospital Yan
in Malaysia under which they selected 10 health care experts in order to collect the information
about home drug infusion therapy program. Following are collected data which obtained by the
scholar from doctor of cited organisation. This data assist to scholar in obtaining the appropriate
solution of the project issue-
The measure The expected result
Hospital Yan delivers a high quality of care
services to patients
70%
Drug infusion therapy will effectively work
for patient
65%
Patient satisfaction rate 90%
43

Yan staff member satisfaction 90%
Yan patients who received report after CT
scan
90%
Infection rate among the patient has been
reduced 30%
80%
4.3.4 Dissemination plan
As per the entire discussion about the home drug infusion therapy in theYan hospital
Malaysia it has been concluded that this therapy will assist to the patient in improving their
health issue and disease. In order to implement this change program in the hospital, health care
experts and doctor required to understand the change model and theories by which they can
effective implement the change within organisation (AFZAL and ALI, 2017). In addition to this,
in order to collect the information about the drug infusion therapy, researcher selected the 10
doctors from the cited organisation. Researcher has prepared a systematic questionnaire along
with question of the drug infusion therapy program and send it to doctors who are working in the
cited venture. In order to send this questionnaire, investigator taken personal mail id of the
doctor and sent the questionnaire at email address. In addition to this, it can be said that by
having an effective consideration of diverse measures the issues in respect to home drug infusion
can be employed properly. It has been witnessed that change management model need to be
referred properly so that long term sustainability can be attained effectively. It has been noticed
that health care authorities need to ensure that needs are being analysed properly so that better
assistance can be offered to overall treatment process. Home drug infusion therapy assist in
decrease the numbers of patients in emergency department. It means the application of change
management practice will allow to have continuous development in the process. With an
assistance of change aspects the issues need to be referred properly so that infusion can be
employed effectively to meet the outcome.
4.4 Summary and conclusion
From this collected data it has been concluded that in the survey many of the doctor are
strongly agreed by the statement that drug infusion therapy program helps in improving the
44

health issue and disease in the hospital. In addition to this, it has been also concluded that From
the survey of 10 doctor of the Yan hospital in Malaysia it has been founded that 8 doctors are
agreed by the statement that home drug infusion therapy helps in reducing the elective surgery
cancellation rate. In the survey of 10 doctors of the Yan hospital in the Malaysia it has been
founded that 7 doctors are strongly agreed by the statement that drug infusion therapy assist in
decrease the numbers of patients in emergency department.
5 CONCLUSION AND DISCUSSION
5.1 Introduction
From this entire dissertation it has been concluded that Yan hospital can effectively
implement the change model for introduce the drug infusion therapy program. The HSC change
model was used to structured the project and outline various stages. In this entire dissertation,
various evaluation method used to attain the major objective of the investigation (Morris and
et.al., 2017). It has been also concluded that various doctors in the survey are strongly agreed
that mentioned home drug infusion therapy program can aid in reduce the infection rate among
the patient and also assist in overcome the patient in the emergency department. This attainment
was confirmed by comparing the result to those in the reviewed articles which has discussed in
the previous.
Project Implication
The major impact of this dissertation is to understand the changes occurred within the
health and social care organization. Impact is the long term effective which arise by the
development intervention. This project will long term impact on the researcher who deal with the
health care projects. In the next three subheading the author illustrate the expected impact that
will affect the stakeholder who are connected with the Yan hospital.
Stakeholders
In the health care organization, stakeholder plays a very crucial role which directly and
indirectly affected by the business practices, policies, activities and functioning. There are
various stakeholders such as staff members, services experts, patient, suppliers, government etc.
These stakeholders are directly and indirectly affected by the organization's decisions. In the
context of patient, they want effective care services and treatments.
45

Practices
In the admission process, Yan hospital used various kinds of the policies and practices
for the patients. With help of these policies and practices, comp[any will deliver an impressive
care services to patient. These practices and policies will help to the management in developing
an impressive working environment in the Yan hospital. Timeliness in providing services,
especially consultation.
Theory
A well systematic and planned project is the first study of the kind of Kuwait. A
systematic project provides the detail understanding about the projects. This planned project
initiation and planning stage revealed a lack of quantifiable assessment of the national problem
of the Yan health and care organization.
In this entire dissertation, data analysis chapter shows the various result of the introducing home
drug infusion therapy. With help of this planning, Yan hospital has effectively able to introduce
the home drug infusion therapy which help to the patient in overcome the heath issue. This plan
also affected ion overcome the rate of infection and crowd of patient in the emergency board.
Strength of the project
In the present dissertation, the major objective is to implement the change with respect of
introducing the home drug infusion therapy in the Acacia care home so as patient can get
effective improvement and services related to the health. This project help to the scholar in
understanding the changes made within the company.
5.2 Summary
From the entire collected data it has been concluded that many doctors are agreed that
home drug infusion therapy assist in overcome the elective surgery cancellation rate, decrease
number of emergency department boarded patient and reduce infection rate in the hospital by
40%.Many of the doctors believed that this program will assist to patient in improving their
health disease and issue in effective manner. From the survey of 10 doctor of the Yan hospital in
Malaysia it has been founded that 8 doctors are agreed by the statement that home drug infusion
therapy helps in reducing the elective surgery cancellation rate. It has been also concluded from
this entire dissertation that many of the doctors strongly agreed that cited venture can able to
overcome infection rate by 40% with help of the home drug infusion therapy program. Thus, it
46

can be said that from the collected data in the survey it has been summarised that cited venture
can able to introduce the home drug infusion therapy program for attaining its mentioned
objective. This therapy will beneficial for patients and assist in overcome health issues.
5.4 Limitations
In the entire dissertation, the major limitation is to figure out the required change and
implement it since the project focused on the infusion program. In order to attain the objective of
the investigation, researcher have very limited time period and source of fund. Time is one of the
factor which create the barrier in attaining the aim of the dissertation. In addition to this, the
study sample was not too large in compare to sample in the literature reviews but this dissertation
was accomplished within a short period. Moreover, limited source of fund is another major
limitation for the scholar. Some of the doctors are not ready to provide the accurate information
about the hospital due to the confidently principle.
5.5 Conclusion and future development
In the entire dissertation, the implementation of changes may beneficial for organisation
and patient. It will directly impact on the patient, stakeholders, managers and whole hospital. In
the context of patient, they will able to get the high quality of treatment and care services by
which their health issue can overcome within a short time period. In addition to this, doctors and
health care experts can able to get the effective arrangement and operation of the work. It assists
in improving the working condition of the hospital. Cited venture can also able to overcome the
patient treatment cost, rate of infection and patient in the emergency board department with help
of this change such as home drug infusion program. Thus, it can be said that the project result
has been achieved in an effective manner and this change facilitate the corporation to meet and
promote its value ad vision. This entire dissertation and investigation can also use in the other
like voluntary organisation.
Recommendation
From the entire dissertation, it has been analyse that Yan hospital in the Malaysia can
effectively introduce the drug home infusion therapy and change the entire environment of the
hospital. From this discussion it has been analysed that action research is the backbone of the
organisation development project and if delivers practical sound evidence on the workplace. It
47

should require to imp[rove its existing performance. Following are some recommendatory which
should follow by the company like it should organise training and development program for its
health experts so they can more deliver excellent care and services to patients.
48

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Appendix
Name
Designation
1 From who long you are working in the Hospital Yan in Malaysia?
 From one year
 From two year
 From five year
 From seven years
2 Does Hospital Yan in Malaysia effectively deliver quality care and services to patients?
 Yes
 No
3 Do you understand the meaning of the home drug infusion therapy programme?
 Yes
 No
4 Do you agree that drug infusion therapy will effectively work for the patients?
 Strongly agree
 Agree
 Strongly disagree
 Disagree
5 Do you agree that home drug infusion therapy can overcome the health issue of patients?
 Strongly agreements
 Agree
 Disagree
 Strongly disagree
6 Does this home drug infusion therapy helps in reducing the elective surgery cancellation rate?
 Yes
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 No
7 Does home drug infusion therapy assist in decrease the numbers of patients in emergency
department?
 Yes
 No
8 Does Hospital Yan in Malaysia able to overcome the hospital infection rate by 40%
 Yes
 No
9 Do you agree that home drug infusion therapy help to Hospital Yan in Malaysia in attaining its
objectives
 Strongly agreements
 Agree
 Disagree
 Strongly disagree
10 Recommend the strategies to introducing the home drug infusion therapy in an effective manner
Change Models
Appendix 1: Lewin's Change management model:
Appendix 2: Mckinsey 7 S Model
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Appendix 3: Korter's change management theory
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Appendix 4: Stakeholders analysis
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PESTLE ANALYSIS
Political  A wide range of change in the facilities that are provided
by government to the hospital can affect the strategy.
 Change in the rules and regulations issued by the
government for health care industry can also affect Yan.
 Reduction in the cost of health care will also affect the
strategy.
Economic  Change in the economic conditions of the country affect
the investment made in the hospital and bring change in
buying behaviour of the patients as well.
 Lack of investment in the health care industry can lead to
failure of the strategy.
 Lack of investment can result in less patient doctor ratio
in the hospital.
Social  Acceptance level of the society is another important
concern. People may not accept the change and lead the
strategy of home drug infusion therapy to failure.
 People may not be able to afford this assistance provided
by Yan.
Technological  The project will require wide range of technological
instrument for better implementation. As the doctors will
visit at patient's home which will require extra instrument
that have to be made available for the doctors staying in
the hospital (Marcatto & et.al. 2014).
 Constant up gradation in the technology can be a hassle as
well as costly for Yan.
Legal  Legal obligations are attached in adding a new activity in
the present business activity. Yan have to make sure that
the strategy implemented is legal and can be easily
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adopted.
 Changes in health care laws of the country can affect its
functioning.
 Unavailability of suitable drug due to ban can act as a
barrier for doctors in Yan in order to treat patient.
Environmental  Natural disasters, flood and other calamities can act as a
barrier in providing medical services at home.
 Change in the weather results in demand of more doctors
to serve the patients.
SWOT ANALYSIS
SWOT analysis of HSE model of Yan care home UK
Strengths:
 The care home have strong atmosphere of openness, sharing and commitment, which
increases the confidence the patient.
 Local charities are willing to participate and make care home services success.
 There is a requirement of highly skilled clinical staff, which can handle the physically
challenged patients easily and make them comfortable.
 The hospital should provide outstanding and affordable healthcare facilities to the patients.
Weaknesses:
 The lack of adequate resources can reduce the trust of the patients from the home care
centre.
 Shortage of efficient staff or poor quality of service can lead to patient dissatisfaction.
 The increase in health care costs can reduce the health care quality.
 The major problem faced by the patients is change of staff which them little uncomfortable.
Opportunities:
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 Active and voluntary committees who are willing to plan and organise the events for
boasting the morale of the patients or to help them to join home care.
 Suggestions and opinions can be taken from the active and supportive patients to encourage
other patients and to fulfill their needs.
 Home care services allows to be with the loved ones which provides a peace of mind to the
patients.
 The home care services provides advantage to adjust the timings as per the convenience of
the patients as well as their family members.
Threats:
 The personal details of the patients is at risk and the lack of emergency resources will cause
adverse effect on patients mind.
 The patients might be forced to do the things they do not want to do.
 Geographical limits can cause lack of residential home benefits which can discourage and
cause discomfort to the patients.
 The patient might feel isolated if the response of the family members is not positive
towards them.
Porter's Five Forces Model
Bargaining power of the customers:  Customer may not be satisfied by the
price on which these services are being
offered to them
 People with less buying power cannot
negotiate on pricing and do not opt for
this facility.
Bargaining power of the suppliers:  An increase in the prices of instruments
and machinery which are provided by the
suppliers can affect the cash budget of
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the entity.
 Inadequate availability of drugs forces
them to buy from the suppliers who are
providing at prices as well.
Threat of new entrants:  Currently only Yan is providing these
services in Malaysia. New entrants in this
field can affect the profits and customer
base as well.
 Quality regulations issued by the
government may pot hindrance in its
establishment as well.
Threats of substitutes  People who cannot afford these services
tend to take care of the patients by their
own rather than investing in care homes.
 Natural treatments adopted by the
patients restricts them from visiting to
the hospital.
Industry rivalry:  Presence of numerous hospitals can
affect the revenues of the company and it
would be difficult to make customer base
in the beginning of the care home.
 Low fixed cost but high working capital.
Change Management Models
 Lewin's Change management model: The change management model by Lewin consist of
three main stages which are, Unfreeze, Transition and refreeze. In Unfreeze stage, involves
preparing for the change to take place in the entity. Researcher finds out the crucial factors
that helps in determinate that the change is necessary. There may be employees that may
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resist change and it is important to change their state of them and convince them to adopt
that change. Unfreeze is the stage in which communication is core element. Good
communication between manager and employees should be built so that employees are well
recognised about the goals of the organisation. After completion of initial stage of
communication is accomplished, the second stage of lewin's stage i.e. transition should be
undertaken to establish new ways of working and to approve new way of technology to
achieve the objectives of the Yan.
 Mckinsey 7 S Model: It is a constant change management model trending till the date. This
model consists 7 steps of change management.◦ Strategy - Strategy is the process made to achieve the goals. This stage will help Yan to
have a step-by-step process of development.◦ Structure - This stage of change management includes the formation or the structure that
Yan pursue.◦ Systems - This stage is related to the process which involves the performance of daily
activities by Yan in order to achieve the goals.◦ Shared values - This includes the main values on which the organisation functions.◦ Style - Style stands for the process in which the changes are followed by mentioned
organisation.◦ Staff - This involves the employees of Yan and their abilities of working.
◦ Skills – The talent and skills gained by the employees of Yan is included in this stage.
 Kotter's change management theory: Kotter's change theory is categorized by 8 steps:◦ Increase the urgency for the change – This step includes developing a perception
within the employees to encourage them for adapting the changes and achieve the
objective of Yan.◦ Build a team dedicated to change – This involves the selection of correct employees in
order to achieve change in the favour of Yan.◦ Create a vision for a change – vision related to the connection, creativity and goals to
get appropriate results of change is included in this stage (Savelyev, 2016).◦ Communicate the need for change – To communicate with employees of the
organisation is also an important part of this change. Yan should also adopt this change
in order to achieve its objectives.
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