Improving Efficiency of Healthcare Organizations: A Project Report on Cleveland Clinic Abu Dhabi

This project report focuses on improving the efficiency of healthcare organizations, with a case study on Cleveland Clinic Abu Dhabi. It discusses the challenges faced by the organization, including inadequate staff, weak follow-up system, and poor communication. The report provides an analysis of the issues and suggests solutions for improvement.

Running head: PROJECT REPORT
Project Report
Name of the Student
Name of the University
Author note

2PROJECT REPORT
Table of Content
Introduction................................................................................................................................3
Overview of the company..........................................................................................................4
Operations of the company........................................................................................5
Organizational structure.............................................................................................5
Challenges faced by the organisation.........................................................................................7
Analysis and scope for improvement.........................................................................................9
Project aims and objectives......................................................................................................12
Implementation plan.................................................................................................................12
Stakeholder analysis.................................................................................................13
Communication........................................................................................................14
Activities and Timeline............................................................................................15
Conclusion................................................................................................................................16
Reflection.................................................................................................................................17
Reference:................................................................................................................................19

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Introduction
Being a developed nation, the standard of healthcare in United Arab Emirates is
considered to be generally high. The chief reason behind this is the enhanced spending f the
government of the nation during strong economic years. According to a recent survey
conducted by the UAE government, the total amount of expenditure o the healthcare of the
nation is more than 598 million USD. As per the study of the World Health organization, in
the year 2017, the total expenditure on healthcare was comprised of 3.2 percent of the
Domestic Gross Product (GDP). Not only that, currently, the facility of healthcare is free for
the United Arab Emirates citizens. By UAE, all the seven emirates have been meant.
However, it has been found that in spite of all these investments and measures, several
discrepancy in the services provided by the healthcare organizations in UAE takes place due
to various issues associated with inappropriate management, weak workforce as well as lack
of advanced healthcare technologies. It can be clearly understood that if these issues can be
eradicated, the healthcare service of the nation will definitely become one of the best
healthcare service provider across the world. In this report, a detailed project has been
planned, led and facilitated in order to enhance the efficiency of the healthcare organization.
The organization that has been chosen for the report includes the Cleveland clinic. Being a
medical student, I have been working with the organization for the last one year. There I have
noticed several issues in the workforce and managerial decision making o the organization.
Hence, through this report, I have attempted to draw a plan for an improvement project for
Cleveland clinic (Chiocchio et al. 2015). In this report, firstly, a brief overview of the
mentioned healthcare home will be provided in order to make the audience understand the
operations as well as organizational structure of the company. Secondly, the challenges
associated with various managerial issues as well as workforce which are being faced by the

4PROJECT REPORT
organization will be discussed. Thirdly, the report will contain critical analysis of the
challenges discussed and the scope of improvement. Along with that, this report will also
contain the aims and objectives of the project (Shirley 2016). Next to that, an
implementation plan in order to eradicate the identified challenges and achieve the aims and
objectives of the project will be discussed. Not only that, in order to deal. Finally, evaluation
of the improvement plan suggested and a brief conclusion will be presented through the
report. Along with the report, a brief reflection focusing on how the assignment has helped
me to enhance my theoretical knowledge as well as my practical skill will be performed.
Overview of the company
The Cleveland Clinic Abu Dhabi, popularly known as CCAD is referred to a
multispecialty healthcare home which provides free of cost healthcare services to the citizens
of UAE. The 364 bed luxury hospital which is a part of Cleveland Clinic Foundation, USA,
has been open to the public of the mentioned nation since May 2015. The headquarters of the
mentioned healthcare home is located at Ohio. Being a non-profit organization, the chief aim
of the mentioned organizations is to provide the local patients with best medical care. In
order to achieve the goal, the mentioned organization provides the newly appointed
healthcare service users and healthcare professionals with several medical facilities in order
to enhance and polish their skills and stay up to date with the latest healthcare associated
technologies.

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Operations of the company
The Cleveland clinic, Abu Dhabi currently has 364 numbers of beds. It not only
serves the population of Abu Dhabi but also serves neighboring states. The healthcare home
along with holding the facilities or treatment in the disciplines of surgery and medicine, also
holds facilities for gynecology, cardiology and obstetrics. Along with that it also comprises of
polyclinic in the premises of the hospital (Rotondo et al. 2016). The chief four routes by
which healthcare service users are appointed in the mentioned hospital includes
1. The Emergency Department
2. The Outpatient Specialist Clinics (Dhabi 2014)
3. Transfer from other hospitals and
4. The Polyclinic or referral from other primary care clinics
The total number of employees in the mentioned institution is 5200. While the total
numbers of senior surgeons of the hospital are 120, more than 309 healthcare professionals
are junior. In order to enhance the efficiency of the junior healthcare professionals, the
management of the Cleveland clinic organization provided the junior doctors with on job
trainings (Hammarlund et al. 2018).
Organizational structure
The organizational structure of the Cleveland clinic hospital is vertical. A vertical
organizational structure can be defined as those organizations that are entirely dependent on
the managers and supervisors when it comes to command as well as control the work of the
employees (Weel et al.2018). The organizational chart of the Cleveland Clinic has been
provided bellow for a better understanding of its organizational structure (Al Afari and
Elanain 2014).

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Figure 1: Organizational chart of the Cleveland Clinic Healthcare home
Source (Created by author)
The Cleveland Clinic posses a group of polyclinics along with the hospitals. Both the
sector are looked after by the Board of Directors as well as by the general manager. Two
operational managers for two of the mentioned sectors have also been appointed. The
healthcare service providers of the hospital include general practitioners, nurses, care
providers and specialists. Majority of the general practitioners of the organization are newly
recruited (Kerzner and Kerzner 2017). As a result of this, they are inexperience and require
special training in order to enhance their skills in the healthcare industry. The general
physician of the organization includes ER doctors, surgeons and hospitalists (Al Mansoori et
al. 2018). Other medical staffs of the healthcare home include physical therapists, radiation
therapists, medical assistants, pharmacists, dieticians, Radiology, ultrasound and surgical lab
technologists. When it comes to the administration branch, they mainly include the
employees of the account section, non medical staffs and receptionists. The nonmedical staffs
Board of
Directors
Hospital
Medical
General
practitioners
Nurses
Care providers
Specialists
Adminstration
Accounts
Non-Medical
staffs
Human
Resources
Polyclinics
Medical
Non medical
General
Manager

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of the hospital include receptionists, the housekeeping, maintenance, information technology,
human resource, laundry and logistics personnel.
Challenges faced by the organisation
The major challenges faced by the company includes inadequate staff to complete
enrolment of the patients if they are visiting the first time, inadequate efficient general
practitioners in the emergency sector leading to delays in seeing a doctor, a weak follow-up
system. Outpatient Specialist Clinics with many patients missing appointments, poor
communication system between the clinics and the inpatient wards if a patient were to be
booked for elective surgery or acute medical admission (Hunter et al. 2016).
Issue 1:
Lack of medical staffs in the outpatient department has been identified as one
of the chief challenges faced by the management of the Cleveland clinic (Al Mansoori et
al.2018). As a result of employee shortage the enrolment process of the mentioned
department is getting delayed and even healthcare service users with emergency medical
conditions are made to wait for a prolonged period of time. Delay during the enrolment
process enhances the total amount of processing time and as a result the treatment of the
patients gets delayed to a commendable amount (Elamin, Garemo and Gardner 2018). The
whole process is reducing the operational efficiency of the healthcare home as well as
incising the fatal health issues due to the service dilemma. This fact is hampering the image
of the organization to a great level and is also imposing negative impact on the consumer
satisfaction.

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Issue 2
The weak follow up system of the healthcare home is another major challenge faced
by the management of the mentioned organization. The follow-up system that is being used
by the organization is conventional (Al Hosani et al. 2016). Not only that, Cleveland also
lacks adequate process as well as organized structure for the employees that in turn results in
an enhanced number of missed appointments (Khayal and Farid 2015). The physicians are
not notified about their appointment with the patients on time and as a result several times it
has happened that the patients have to return home without getting treated. Like the pervious
issue, this issue is also decreasing the satisfaction of the healthcare service users.
Issue 3
Another major issue faced by both the employees as well as the management of the
Cleveland organization includes poor communication system within the organization. There
are no internal communication systems like intranet in order to facilitate the communication
between the medical as well as the non medical staffs. This fact has given rise to several
communication related issues. For instance, the nurse who is supervising a patient in the
morning shift lacks the way to inform crucial facts or observation about the patient who will
be supervising the same in the next shift (Paulo, Loneyand Lapão 2017). However, for such
purposes, papers or forms are used. Due to lack of invigilation and time management, in
several cases, nurses are found to have left the form blank and as a result necessary actions
were not taken by the next shift nurse due to lack of communication (Hussain et al. 2016).
Not only that, according to nurse it becomes difficult for them to communicate properly with
the doctors due to lack of internal communication system (Paulo, Loney and Lapão 2017). As
a result of this, there always remains a risk of misdiagnosis of the issue of the patients
resulting in fatal consequences. Therefore like the above two mentioned issues, lack of
internal communication is also imposing negative impact on the reputation and consumer

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satisfaction of the Cleveland clinic. Not only that, the lack of communication system amongst
different departments and wards also decreases the business performance and profitability of
the organisation as well (Latif et al. 2015).
Analysis and scope for improvement
Inadequate staff to complete enrolment of the patients if they are visiting the first time:
A healthcare organisation comprises different staffs, who have different roles,
responsibilities and working procedures. In any healthcare organisation like Cleveland Clinic
Abu Dhabi the non medical staffs are essential components of the service (Paulo, Loney and
Lapão 2017). The duty of the staffs starts from the queuing system management, providing
consumer helpline, providing guidance for checkups for the patients who have come first
time to making internal communication and information interchange. In this current situation
of the Cleveland Clinic the lack of non-medical staff is causing various operational delay that
is leading to the overall service delay and patient attrition (Bhattacharjee and Ray 2014). In
this situation, one of the major solutions can be the recruitment of new non-medical staffs
especially in the reception and helpline department. It can increase the speed of the enrolment
procedure that can lead to optimum operational efficiency from the grassroots level. Along
with the recruitment, the training and development procedure will be also required for the
new and existing non medical staffs as well in order to increase their operational integrity and
value sharing.
Inadequate general practitioners in the polyclinic leading to delays in seeing a doctor:

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A healthcare organisation comprises different medical practitioner who have different
roles, responsibilities and working procedures depending on their zone of expertise. In any
healthcare organisation like Cleveland Clinic Abu Dhabi the medical practitioners are divided
into two sections namely specialist and general practitioners (Devaraj, Ow and Kohli 2013).
Both are essential components of the medical service. The duty of the specialist is to handle
the specific and critical cases depending on the diagnosis results namely cardiac, neurology,
dermatology, psychiatry, ENT and others. However, the duty of the general practitioners is to
check the patient’s condition at primitive level and suggest appropriate medication, treatment
and diagnosis. When required these General Practitioners refer the specific patient to the
specialist for critical and specific treatment. In this current situation of the Cleveland Clinic,
the lack of general practitioner is causing operational delay at the initial treatment and
diagnosis procedure for the patients (Gupta 2013). It is leading to the overall service delay
and patient attrition. In this situation, one of the major solutions can be the recruitment of
new general practitioners from local and national level medical collages. It can increase the
practitioner count and the resulting speed of the primary treatment procedure. Along with the
recruitment, the training and development procedure will be also required for the new and
existing general practitioners as well, in order to increase their operational integrity and value
sharing within the medical practitioners.
A weak follow-up system with the Outpatient Specialist Clinics with many patients
missing appointments:
Follow-up system for patients and their treatment in any medical practice is essential,
which allows the service to successfully coordinate the appointments of the patients with the
doctors. In Cleveland Clinic, the major cause of having a weak follow-up system is lack of
systematic review and implementation plan (Hall 2015). At the same time, conventional

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approach of maintaining the activity lists is making increasing amount of failed appointment
notification. In this situation the management has two possible way to improve this condition.
One of these is incorporating advance Database Management System that can store, process,
manage all the information with automated data handling and notification developing facility
(Hulshof et al. 2013). Cleveland Clinic can incorporate the advance DBMS in their data base
system that can also arrange their day to day operation including all the departments and
staffs as well. On the other hand, effective training and development of the non medical staffs
is essential to make this new system adoptable into the regular functions.
Poor communication system between the clinics and the inpatient wards if a patient
were to be booked for elective surgery or acute medical admission:
Any healthcare organisation needs a effective and efficient communication system
within their different departments that helps to maintain the operational integrity and
coordination. Appropriate coordination helps any organisation to deliver their best service
quality to the service receiver. In case of Cleveland Clinic ineffective communication and
conventional information transaction system is causing significant delay and redundancy in
service proving. After the finalising the requirement of diagnosis the patients have to wait for
long time in technical diagnosis department. Apart from that, the availability of the service is
requiring excessive amount of time for the surgical cases or any acute medical admission due
to lack of coordination within different wards (Lakshmi and Iyer 2013). One of the major
reasons behind this situation is poor maintenance of telecommunication equipments.
Currently Cleveland Clinic depends on a third party IT service provider for
telecommunication. In any case of technical difficulty or failure the staffs need to wait long
time for the representative of the service provider (Wang et al. 2014). To avoid this
discrepancy Cleveland Clinic can develop their own internal communication system through
several advance technologies such as, intranet, cloud computing, LAN, Private network and

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others. To operate and maintain the required equipments Cleveland Clinic can recruit new
technical staffs for IT.
Project aims and objectives
The aim of this new project plan is to increase the operational efficiency of the
healthcare service providing process through incorporating new systems as well as altering
the old ineffective procedures. The goal of this project is to implement the new changes with
sustainable platform in exchange with minimum amount of monitory and time investment.
The objectives of this project are presented below:
 To recruit new non medical staffs to increase the efficiency of enrolment process by 30%
within next 6 months
 To recruit new general practitioners to improve the primary care capacity by 20% within
next 3 months
 To develop effective information system through new Database Management System and
increasing information management efficiency by 50% in next 3 moths
 To increase the communication quality by 50% though incorporating internal IT services
 To recruit new IT support employees for maintenance
 To provide adequate induction and training for new employees
 To increase the rate of total patient handling by 35% in next 6 month
 To maintain the cost benefit ratio profitable
Implementation plan
In this following implementation plan the stakeholders of Cleveland Clinic has been
assessed while developing the effective communication plan for them. Apart from that the

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required activities to meet the objectives and achieve the aim of the project are presented with
required timeline
Stakeholder analysis
Stakeholder Type of
stakeholder
Expectation or interest of
stakeholder from the
company
Expectation or interest of
company from the
stakeholder
Board of
directors
Internal and
primary
Increasing the recognition and
reputation through quality of
service to get more funds from
the government, charity and
trusty boards
Taking appropriate decision
for required changes in any
specific or critical situation
Managers Internal and
primary
Improving the performance of
the workforce to gain more
focus from the management
board
Incorporating new changes
appropriately to increase the
efficiency through serving
wider range of patients
successfully
Medical
staffs
Internal and
primary
Providing quality of treatments
to ensure the career growth
Providing appropriate
treatment and diagnosis to the
patients to increase the
success rate
Non
Medical
staffs
Internal and
primary
Providing quality of services
to ensure the career growth
Providing HR, facility,
transport, fiancé and other
services to keep up the
performance of the
organisation with steady
growth
Suppliers External and
secondary
Generating more profit by
providing quality of service in
exchange with better price
Providing quality of supplier
including medical equipments,
communication system, IT
hardware and software
Patients External and
secondary
Getting effective and efficient
medical services in minimum
amount of time
Cooperating with the medical
and non medical staffs as well
as giving their valuable
review or feedback regarding
their experience
Government
and
authority
External and
tertiary
Monitoring to the organisation
to keep track of their
compliance with rules and
regulations
Cooperating with the
organisational scopes and
possibilities considering their
weakness as well as threats

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Stakeholder assessment matrix:
Power
High Government and
authorities
Board of directors
Medium Suppliers Managers
Low Medical staffs
Non medical staffs
Patients
Low Medium High
Interest
Communication
To implement the activities of the project with a sustainable platform the efficient
communication planning is also required for all the internal and external stakeholders
(Lakshmi and Iyer 2013)
WHO WHY WHEN WHERE HOW
Board of
directors
To take appropriate and
decision in any specific critical
situation
At the initial
stage and in
special
situation
Office
premises
Meeting, mail,
phone
Managers Implementing the changes and
forecasting management
operations
From the
secondary
phase to the
end of the
projects
Office
premises
Meeting, mail,
phone
Medical staffs Ensuring the quality and
finding out loopholes
Throughout the
process
Office
premises
Meeting, mail,
phone
Human
Resource
Department
Recruiting new medical and
non medical employees along
with technical staffs
Recruitment
and training
sessions
Office
premises
Meeting, mail,
phone
Non Medical
staffs
Following the orders and code
of conducts
Throughout the
process
Office
premises
mail, phone
Healthcare
related
Informing and negotiating
about regular requirements of
Initial stage of
the
Outdoor
communication
Meeting,
phone

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Material
Suppliers
garments, bedding, grocery
and other products
implementatio
n
Mechanical
and IT
equipments
suppliers
Informing and negotiating
about Communication
hardware and software
requirement
In the process
of network
setting and
developing
information
integrity
Outdoor
communication
Meeting,
phone
Patients Making aware of the new
operation and enrolment
system
Final stage of
the process
Outdoor
communication
mail, face to
face
Government
and authority
Showing the compliances and
ethical consideration with
transparency
Throughout the
process
Outdoor
communication
Meeting, mail
Activities and Timeline
Activities 1st wk 2nd wk 3rd wk 4th wk 5th wk 6th wk 6th wk 7th wk 8th wk
Communication with
stakeholder
Budget and forecast
Resource allocation
Installing new
equipments
Recruitment and
training
Executing testing
session
Collecting feedback
and evaluation

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Conclusion
From the above discussion, it can be concluded that an effective improvement plan
posses the potential to enhance the potential to eradicate the issues associated with the
Cleveland Clinic organization. As per the discussion, it can be said that being a non-profit
organization, the chief aim of the mentioned organizations is to provide the local patients
with best medical care. In order to achieve the goal, the mentioned organization provides the
newly appointed healthcare service users and healthcare professionals with several medical
facilities in order to enhance and polish their skills and stay up to date with the latest
healthcare associated technologies.
The major challenges faced by the company includes inadequate staff to complete
enrolment of the patients if they are visiting the first time, inadequate efficient general
practitioners in the emergency sector leading to delays in seeing a doctor, a weak follow-up
system with the Outpatient Specialist Clinics with many patients missing appointments, poor
communication system between the clinics and the inpatient wards if a patient were to be
booked for elective surgery or acute medical admission. In order to deal with that several
strategies has been designed. As per the above report it can be said that, to implement the
activities of the project with a sustainable platform the efficient communication planning is
also required for all the internal and external stakeholders. Moreover, the mission of this
project has to be implementing the new changes with sustainable platform in exchange with
minimum amount of monitory and time investment.

17PROJECT REPORT
Reflection
The chief aim of this project is to provide all the students an effective idea of project
planning and management. As a student of business Administration, I have found the entire
project highly interesting and helpful for my future professional life. This project has helped
me to understand the potential difficulties that can be faced by the management of a
healthcare home and the effective ways to get rid of the same. Firstly, I understood the
importance of consumer satisfaction in the business and how it can impose adverse effect on
the revenue as well as reputation of the organization. Not only this, this project has also
taught me the importance of the internal communication between the employees, supervisors
and management.
I understood that, lack of communication in healthcare homes bear the potential to
impose adverse impact on the health of the employees. During analyzing the challenges and
identifying the scope of improvement, I understood the importance of the stakeholders. The
development of stakeholder communication plan helped me to identify the purpose of each of
the stakeholders of the mentioned healthcare home and how proper communication with them
posses the potential to enhance the revenue of the organization. After identifying the major
challenges, I developed an improvement plan that includes implementation of possible
strategies that posses the potential to eradicate the issues. Not only that, I had to set
appropriate time line for each activity in order to ensure that that the task will get completed
within the stipulated period of time. During implementing the time frame, I understood the
importance of timeline in any kinds of business plan. In order to eradicate the issue associated
with the communication within the Cleveland Clinic healthcare home, I had implemented a
communication plan. During designing the communication plan, I understood the importance
of using the basic 5 “wh” model in order to implement the activities of the project within a

18PROJECT REPORT
sustainable platform. Finally, during the evaluation of the mentioned improvement plan, I had
implemented Lawrance force field Analysis as well as situational leadership model. Both the
model have helped me to develop effective strategy so that the management of the Cleveland
Clinic can monitor the changes made and helps the employees to get comfortable and
habituated with the changing processes of the organization.

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