Diabetes Mellitus: Management and Leadership Strategies

This document discusses the management and leadership strategies for diabetes mellitus. It covers topics such as accurate diagnosis, treatment options, and lifestyle changes. The goal is to improve the quality of life for diabetes patients and reduce the economic burden of the disease.

Diabetes mellitus

TABLE OF CONTENT
INTRODUCTION...........................................................................................................................1
Aim..............................................................................................................................................2
Objective......................................................................................................................................2
Justification..................................................................................................................................2
Statement of intention..................................................................................................................3
Background..................................................................................................................................3
LITERATURE REVIEW................................................................................................................4
Diabetes mellitus.........................................................................................................................4
Treatment and management strategies.........................................................................................5
Long term complications and their management.........................................................................7
PROJECT PLAN.............................................................................................................................8
Budget..........................................................................................................................................8
Project plan..................................................................................................................................9
Gantt chart...................................................................................................................................9
Project risk.................................................................................................................................10
Opportunities.............................................................................................................................11
DISCUSSION................................................................................................................................11
Leadership approach..................................................................................................................11
Change management and diabetes mellitus...............................................................................13
Force field analysis....................................................................................................................15
PROJECT OUTCOME AND SUCCESS EVALUATION...........................................................15
REFLECTION...............................................................................................................................17
RECOMMENDATION.................................................................................................................18
CONCLUSION..............................................................................................................................18
REFERENCES..............................................................................................................................20
APPENDIX 1.................................................................................................................................22
APPENDIX 2.................................................................................................................................23
APPENDIX 3.................................................................................................................................24

INTRODUCTION
Diabetes mellitus is defined as the chronic disease in which body is not able to produce
glucose normally which is key energy source for the cells (McKnight and Gibb, 2017). The
hormone controlling glucose level in the blood (insulin) is either not produced in sufficient
quantity or body show abnormal response towards insulin. As a result of this glucose level in the
blood is increased along with several other health complications. The uncontrolled and
unmanaged symptoms can even lead to death. The chronic disease does not have any permanent
cure and requires controlling and regular monitoring of sugar level in the blood throughout the
life (Sharma, Nazareth and Petersen, 2016). The disease is also inherited to children through
pregnant women and thus it also become vital to manage the symptoms so that new born
individuals can be prevented from this life threatening chronic disease. It has been analysed that
type 1 diabetes can be caused because of the genes or the weak immune system. Type 2 diabetes
can be caused because of the overweight, obesity or physical inactivity. It usually begins with
insulin resistance.
The primary goal of the diabetes mellitus management is to prevent or eliminate the
symptoms or to even slow their progression. The health care services are characterised by the
essential attributes such as high quality care, effective and safe practices. An effective and clear
leadership is required for driving and encouraging changes at various levels of health care system
to achieve necessary goals and to assure patient safety. Within health care services the leadership
is related to both clinical workforce and management and involves multiple challenges. Diabetes
management does not require only clinical intervention for the patients but also demands for the
suitable leadership strategies to foster the changes in health care settings and communities so that
disease can be prevented and managed.
The leadership changes can assist health professionals to effectively manage their
patients as well as vulnerable groups who needs critical attention and care. At present obesity
induced diabetes among children is major concern for the health communities because improper
life style is giving children a life long chronic diseases at very young age (Mutuota, Hill and
Claydon, 2017). Thus best recommendations about the management of diabetes includes
awareness programs along with the self care and life style changes. For the management of
diabetes there is need of close monitoring of routine activities, eating habits and disease
symptoms. Thus the key purpose of this project is management and early recognition of the
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disease so that cost and severity of the diabetes mellitus can be controlled (Simmons, Wenzel
and Zgibor, 2016).
The major goal of the diabetes treatment and management process is to control the blood
sugar level so that progression or symptoms worsening can be prevented. Type 1 diabetes can be
managed through exercise, dietary changes as well as insulin while type 2 diabetes is
manageable by weight reduction, dietary changes, insulin and non-insulin medications. The
management strategies of diabetes depends upon variety of factors such as health status and
medical history of the patient, impact of medication on patient, accessibility and effectiveness of
health care system and management cost for each patient (Preshaw and Bissett, 2019). The goal
of diabetes management is to maintain the normal value of blood glucose level, triglyceride and
cholesterol. The management practices in correct direction can also assist in restricting the
possible emergence of diabetes related health problems.
Aim
To manage the symptoms and complications related to diabetes mellitus for reducing the
economic cost, mortality and morbidity. The project also aims at improving the quality of life by
providing relieve to symptoms and promoting regular monitoring of diabetes progression so that
health complications can be prevented by delivering timely intervention.
Objective
 To enhance the health outcomes and productivity of life of patients of diabetes.
 To manage the symptoms and development of diabetes mellitus in patients and
vulnerable groups.
 To lower the economic burden, mortality and morbidity of diabetes.
Justification
The number of type 2 diabetes mellitus patients has been rising significantly. At present
nearly 4 million people in UK are living with diabetes (Diabetes Prevalence, 2019). It includes
both diagnosed and undiagnosed individuals. The factors such as symptoms management, life
style, eating habits and access to health care services plays crucial role in managing both chronic
and acute complications related to diabetes. Thus it is essential to manage diabetes mellitus so
that number of deaths and vulnerable people can be controlled. The obesity is one of the key
reason for increasing prevalence of diabetes mellitus.
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The lack of effective diabetes management practices and programs is also one of the key
force which is increasing the prevalence of the disease (Hopkins, Taylor and Lean, 2019). Thus it
is required to develop a project which aims at management practices. The project is vital for
improving the education and awareness among both communities and health professionals. It
will guide service providers so that they can adopt suitable nursing and health care interventions
to assess the care needs of individuals and how they can reduce the severity and complexity of
the disease.
In addition to the prevention of disease there is also need of improving the symptom
management of the patients so that long term risk factors and complications of the disease can be
avoided or delayed. The improved management practices adopted by health care professionals is
also helpful in managing the economic stress associated with the disease (Wisting and Snoek,
2019). The treatment such as insulin therapies, treatment cost for other risks factors or diseases
originated from the diabetes mellitus also needs financial assistance or home care support
services.
Diabetes management requires close monitoring and person centred care approach for the
patient. Thus multidisciplinary teams must work in collaboration with each other so that they can
identify and fulfil the care requirements of the patient (Morris and Bain, 2019). The leadership
plays a crucial role in the quality of services and thus it is vital to understand the different
approaches of leadership and change management for making the project successful and
improving the diabetes management practices.
Statement of intention
The purpose of this project is to increase the awareness among communities about the
management of diabetes mellitus. The health professionals must adopt suitable strategies to
support communities so that diabetes risks can be prevented and symptoms of the patients can be
managed. The project also intend to enhance the quality of life of diabetes patients by improving
the management and leadership attributes of health care professionals.
Background
Diabetes mellitus is metabolic disorder in which blood sugar level is elevates over time.
The project targets the UK population in which diabetes prevalence is increasing rapidly. It is
estimated that by 2025 there will be around 4 million people suffering from type 2 diabetes. In
UK disease is growing rapidly at high rate and is now one of the most common life threatening
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disease. It is also predicted that at present UK have around 549, 000 people who have diabetes
which is yet to be diagnosed. Thus there is strong need to manage the disease so UK population
can be provided a quality life. The disease is also considered as life threatening due to its related
health complications which includes nerve damage, cardiovascular diseases such as stroke or
heart attack, retinopathy, skin diseases, Alzheimer and hearing impairment (Tay, de Bock and
Mayer-Davis, 2019).
For the study different population groups such as children suffering from obesity,
children with family history of diabetes and people diagnosed with diabetes will be taken into
account.. Thus diabetes management project aims at prevention and control of the diabetes
among vulnerable and affected groups by improving health care interventions and management
practices.
LITERATURE REVIEW
Diabetes mellitus
According to Bird and Turner, (2016) accurate and timely diagnosis of the diabetes is one
of the essential aspect for the management of diabetes. The healthcare leaders put a major
emphasis on diagnostic criteria. In addition to this productive management not only prioritise the
controlling of blood glucose level only but also give priority to diabetes associated risk factors
like obesity, smoking and hyperlipidaemia and blood pressure monitoring. Self care is one of the
most effective treatment strategy in diabetes management. Thus the first step of management
involves the diabetes education to communities and individuals. Vulnerable groups and patients
must be encouraged and supported to actively monitor and manage their health outcomes. Self
monitoring strategies enhances the safety, quality and effectiveness of treatment therapy.
In the same context Purewal and Fisher, (2018) stated that diabetes management goals
can be achieved when treatment strategies and priorities are tailored to individual needs. It
begins with the confident and careful diagnosis of diabetes. The measurement of blood glucose
level and the symptoms such as unexplained weight loss, increased urine volume and thirst or
marked glycosuria can be critical symptoms which indicates the diagnosis of the disease. The
individuals who does not have these classical symptoms but which are high risk such as those
with positive family history, obesity and elderly must also be subjected to diagnosis procedure.
The timely and accurate diagnosis is vital for the effective management of disease. As per the
view of Brooks and Chakera, (2019) along with the symptoms clinicians must also pay attention
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to the full history of patients. For this purpose factors such as cardiovascular complications,
hypertension, obesity, smoking, family history, neuropathic complications must also be taken
into account.
Treatment and management strategies
Wilmot, Hammond and Gregory, (2016) suggested treatment strategies of diabetes
consist of three major components like dietary and life style changes, insulin treatment and oral
hypoglycaemic therapy. Education is an integral element of the diabetes management which
ensure that patient, health professionals and carers have adequate knowledge and skills to
promote self care and for achieving desired health outcomes. The health leaders must encourage
or motivate the vulnerable groups or patients to set therapeutic goals for controlling weight,
blood sugar or blood pressure.
Goode and Hoover, (2018) stated that initial management of diabetes must be based upon
combination of dietary therapy with physical activities (if possible). For the patients having
presence of hyperglycaemia the pharmacologic therapies such as insulin or oral hypoglycaemic
drugs must also be taken into account. It is also required that individuals and carers must have
adequate knowledge of therapy targets, nutritional requirements, extent and type of physical
activities, meal planning and life style improvements. The health professionals must also educate
individuals regarding emergency and life threatening situations such as detection and
management of complications like skin care or visionary issues, management of emergency
situations like hypoglycaemia, self monitoring and actions against the results of self analysis.
According to Barnard and Breton, (2018) for the diabetes management of all target
groups diet is foremost management aspect. The dietary treatment of the disease ensure that
weight of the individual is control and their nutritional requirements are also fulfilled. Thus it is
suggested that cholesterol consumption must be restricted or limited to only less than 300 mg on
daily basis. The nutritive sweeteners and excessive salt intake must be restricted. The dietary
control is not only advised for the diabetic population but is also suggested for the vulnerable
groups who are higher risk of developing disease.
In similar context Hoppe, Cade and Carter, (2017) stated that for the non-diabetic
population alcohol consumptions must also be restricted or limited. In response to the critical
role of diet in diabetes management individual needs and dietary intake assessment must be done
as an essential part of the initial management process. As leader nurses must have abilities to
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lead and work in collaboration with dieticians. In cases when dieticians are not present nurses
can also work with physicians. Contrary to this Kong and Gregory, (2016) suggested that food
intake and choice of people greatly depends upon local circumstances such as food availability,
cultural and social values as well as economic factors. Health professionals must develop
leadership attributes so that they can lead the health care team and dietary counselling can
become a continuing process. The dietary consideration and meal planning becomes more crucial
element of the management plan for diabetes patients. The health professionals must focus on
even distribution of meal throughout the day, energy intake on routine basis and consistency of
food timings.
Berry, Davies and Dempster, (2019) elucidated that physical activities not only
encourages weight loss but also improve the sensitivity of insulin which lowers the level of
blood glucose. As per the capability and requirement of person dietary treatment must also align
with the exercise and physical activity programs. The people must also be informed about
hypoglycaemia risk and strategies to eliminate its complications. In support to dietary and
exercise management strategies Barnes and Harriss, (2018) believed that for quality health
outcomes oral hypoglycaemia drugs must be considered only when combination of diet and
physical exercise fails to achieve the targets of therapy. Patient must be made aware of signs and
symptoms of diabetes at an early stage. In diabetes they might face problem of frequent
urination. This can be because when blood sugar level is high, kidney tries to remove the excess
of sugar by filtering it out through urine. So patients must be given education about this situation.
This can support them in enhancing their health outcome. It has also been analysed that patient
suffering from diabetes also faces problem of increased thrust. The frequent urination that is
necessary to remove excess sugar from the blood can result in the body losing additional water
As per the view of Taylor and Barnes, (2019) a productive and efficient diabetes
management requires high level of awareness. Thus it is necessary to control rise and fall of
blood sugar level, weight and other aspects. Along with the dietary plan it is also required that
individuals must be aware of the impact a particular type of food have on sugar level. In addition
to the food type, the combination of food and quantity of different food is also crucial in
regulation of blood sugar level. When clinicians works in team with dieticians they must give
knowledge to patient regarding portion sizes and carbohydrate counting. The vulnerable groups
who are suggested to manage weight must try to plan meal which has balanced components. It is
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the responsibility of the health professionals to ensure that t here is coordination between insulin
or other diabetes medication and the diet taken so that sugar levels remains within normal range.
Goode and Hoover, (2018) believed that though physical activities are suggested by
health professionals but these3 must be commenced with due care. Along with intensive work
outs the light activities such as gardening, walking or being on feet for extended periods can also
help to improve the sugar level. Thus the health professionals must not only focus on diet plan
and medications but also provide a well formulated exercise plan to their patients. The number of
sets for exercise, type of work out and exercise schedule must also be prepared in consultation
with the health professionals.
In the same context Wisting and Snoek, (2019) stated that insulin and other medications
are designed for reducing the blood sugar level when other management interventions are not
sufficient. However the efficiency of medication plan also depends upon their quantity or dosage
and timing. Diabetic patients must have precaution while taking other medications with insulin
dosage. There must be a balance between meal plan and medication dosage. Along with the self
control and monitoring from the patient, health service providers are also responsible for
ensuring the safety and management of diabetes symptoms.
Diabetes management program bring significant changes to life style. Thus individuals
are also required to make their life stress free. According to Preshaw and Bissett, (2019)
practices such as smoking or drinking alcohols can worsen the symptoms of diabetes and can
also encourage the complications of diabetes likes nephropathy. These changes can make
individuals depressed and anxious. Hence for better care it is recommended that along with the
physical symptoms diabetes management must also include psychological aspects such as
depression so that individuals can cooperate and work together with health communities to
manage the progression and symptoms of their diabetic condition. Effective diabetes
management and prevention programs require support from individual, carers, health
professionals and multidisciplinary team which can provide an integrated care to the diabetes
vulnerable groups or patients.
Long term complications and their management
As per Barnard and Breton, (2018) the diabetes mellitus and its life threatening
complications includes a wide range of issues. The key long term complications are related to
eye or visionary issues, cardiovascular diseases as well as kidney issues. The diabetic retinopathy
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which is major cause of visual disability is encountered in less than 10 years of insulin dependent
diabetes mellitus. The effective diabetes control can lower the probability of occurrence of
retinopathy. The use of laser photocoagulation on timely diagnosis of retinopathy can be used to
prevent severe visionary loss. The health professionals must refer regular assessment of diabetic
patients so that retinopathy can be detected in the initial stages only. For this purpose retinal
changes, cataract and glaucoma must be detected and treated at the earliest. The treatment must
also emphasis on controlling blood pressure and glycaemia.
According to Sharma, Nazareth and Petersen, (2016) the prime cause of deaths associated
with diabetes is due to diabetic nephropathy. It is significant reason of morbidity and high health
care costs which can also lead to end stage renal issues demanding renal transplantation or
dialysis. The progression of nephropathy can be slowed or prevented by strict glycaemic control,
timely detection of infections, avoidance of nephrotoxic drugs and effective treatment plan for
hypertension. Thus in addition to the dietary and medication control health professionals must
also be refereed for assessment of protein levels and microalbuminuna in urine annually. The
service providers and family members must not neglect the symptoms such as foot infections or
early lesions.
Bird and Turner, (2016) elucidated that after nephropathy, the cardiovascular diseases
(CVD) such as strokes, coronary heart diseases are also responsible for deaths among diabetic
population. The screening of early signs for the CVD must be performed. The management plan
must include activities which promote physical exercises, weight management interventions,
correction of CVD risk factors and cessation of smoking and alcohol. The hypertension can also
enhance the vulnerability and the severity of the diabetes risk factors.
PROJECT PLAN
Budget
The major expenses of the project will be in data collection and implementation of
management strategies such as promotional events for increasing awareness about diabetes and
to provide necessary support services to the patients. The total cost estimated for the project is
£2000. This total project cost also includes cost for internet, secondary data sources like books,
journals and printing costs.
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Project plan
To evaluate the learnings from the diabetes management project, plan-do-study-act
(PDSA) model is used. Various stages of this model are as follows:
Plan: In this phase of project management strategies, purpose and objectives are planned. The
outcomes will be measured in terms of number of patients, sugar level and other health
parameters of the patients, cost reduction and reduced hospital admissions.
Do: In this stage project activities are implemented and activities are executed to manage the
disease and health outcomes of the patients. An effective interaction is also made with the
patients so that their issues can be resolved and needs can be fulfilled.
Study: In this stage outcomes are monitored and evaluated so that actual outcomes of the project
are compared with planned target. The evaluation is also helpful to evaluate the various
challenges which can affect the future stages or outcomes of the project.
Act: In the last phase of the project conclusions are made if integration of leadership and
management approaches have succeeded in diabetes controlling or not. The stage also guides
health professionals to analyse if patients needs are taken into account or not for the better health
care service delivery.
Gantt chart
The total project duration is of 12 months. The Gantt chart below gives scheduling and
description of various project related tasks.
Project task Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7
Planning
related to
project
Recruitment of
team
Review of
Literature
Session of
training
Implementation
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Evaluation of
performance
Project risk
The success of project may get affected by several risk factors which includes both
organisational risks and project associated risks. The major risk factors identified for the study
are as follows:
Risk Category Management
Communication issues High risk There must be suitable
communication medium and
collaboration among team
members.
Budget over-limit Moderate risk Project cost and activities
must be reviewed and
reevaluated regularly.
Lack of understanding needs
of patients
Low risk Training must be provided to
health professionals and their
monitoring must be done.
Mismanagement and
ineffective leadership control
Moderate risk Feedback from the superior
authorities can help to
eliminate the risk. Proper
monitoring and discussion
can also help to deliver
quality leadership.
The patients may fail to understand the interventions for diabetes management delivered by
project (Hoppe, Cade and Carter, 2017). Thus project outcomes and aim must be communicated
effectively so that unnecessary project delays and confusion can be avoided. Poor management
can lead to project failure so it is required that all resources must be managed properly with
appropriate leadership.
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Opportunities
The project will be helpful for both patients and health care professionals. The suitable
leadership approach chosen by health service providers will lead to deliver quality health
outcomes. The management of diabetes at the early stages is vital to reduce the number of new
incidences of the disease (Simmons, Wenzel and Zgibor, 2016). The existing service users can
also delay the adverse health outcomes by adopting suggested management strategies. The
project is helpful for the health organizations to enhance the quality of services so that diabetes
risk and vulnerabilities can be reduced to a significant extent.
DISCUSSION
Leadership approach
Leadership has been termed as the most prominent factors for developing the
organizational culture which is qualitative and increase the performance of employees working
in health care unit. Leadership is an art that influences individuals to perform certain task, this
when used in organization can support them in achieving their ultimate goals and objectives. It
can also support growth of health care delivery system. In order to manage the change which has
been implemented in health care unit, it requires skilled leaders who have the effective talent and
abilities (Kumar Sharma, Singh and Matai, 2018). Effective leadership approach and right
leadership style will initiate efficient team work that will be useful for managing patients
suffering from diabetes mellitus in health care system. Various types of leadership style can be
used like for example transformational, transactional, autocratic, laissez fair, task-oriented and
relationship oriented leadership styles. Transformational leadership style is that method in which
leaders are engaged in motivating and encouraging staff members to perform better and bring out
innovative and creative ways to solve problems that is been existing in system.
This supports in growing and shaping the future success of health care system. In this type
of leadership style, workers are also being given with the authority to make certain decisions, so
that they can also stay motivated. In transactional leadership style leaders are engaged in acting
as managers of change, motivating employees to bring new ideas so that there is being an
improvement in production aspects. In this leadership style leaders promote compliance by
rewarding and punishing workers. In this style staff members are only motivated for quiet
sometime. This type of style is most successful when the problems existing in health care system
are clearly defined and specified. It can be used in situation of crisis. Autocratic leadership style
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can be used when there arises a situation of emergency, in this leader dictates policies and
procedures that needs to be followed by all the staff members (Yahaya and Ebrahim, 2016).
All decisions are made by leader itself without taking into account the thoughts of
employees. Laissez faire leadership style is that in which leaders give free hand to their staff
members to make any decision without involving them. Hands-off approach is used in this type
of style that results in rare changes. Task oriented leadership style includes when leaders are
engaged in giving the job to employees according to their skills and abilities. This can also
enhance motivation among employees. It creates satisfaction among staff members. In this when
roles and characteristics are being clear among workers then this can create employee’s loyalty
and also no chaos can exist in organization. Planning related to activities is also being done by
leaders in this type of style (Nawaz and Khan, 2016). Relationship-oriented leadership approach
is that in which the main focus of leaders is on well-being of employees. In this leaders are
involved in making better terms with their workers so that they can easily analyse problems that
is being faced by staff members. This can enhance the growth of health care system.
Different leadership style produces different health relate outcome, they can broaden or
close the gap that may exist in health care system. Transactional leadership style can be used and
be can be best suited to run this project. It will support health care unit in achieving their goals
and objectives in most effective way. With short-term planning as part of this leadership style,
management ensures that its visions for the company or organization will be realized. This
leadership style consists of structure that is clearly defined, so no confusion can exist in system
while following this leadership style. They make the goals more achievable by ensuring growth
of health care system (Maak, Pless and Voegtlin, 2016). This leadership style is fully based on
motivation and performance of employees. In this approach staff members are being rewarded if
they perform better. Rewards can be in form of monetary and non-monetary. This brings short
term motivation in workers to achieve their goals and objectives. Leaders in this type of style are
more organized and action-oriented. They make sure that goals and objectives of system is being
achieved by them on timely basis. Also they are engaged in motivating employees to provide
high quality services. If staff members are effective in their working then leaders also make use
of punishment, so that their work efficiency can be improves. Leader must make sure when they
are implementing change in health care unit, staff members must be given proper training and
made aware about the changes that is going to be implemented. This can support them in
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enhancing skills and also changes can be implemented easily. Leaders must also motivate
employees to perform better so that their individual goals and objectives are also being achieved.
They must make sure that change is effectively being communicated among them. This can also
support them in making better relationship with workers, it will also create loyalty of workers.
Transactional leadership style motivates employees that directly increases the productivity
of health care system and it also reduces the operational cost. Rewards when being used by
leaders also enhances relationship between leaders and employees that also creates employee
loyalty. In order to improve health care quality team work is also considered as most important
factor. This type of leadership style will ensure that quality health care services are being
delivered across the organization. Transactional leadership style can be best used when the gaols
in organization are being cleared.
Change management and diabetes mellitus
Figure 1Kurt Lewin change management
(Source: Kurt Lewin change management theory, 2019)
As it has been analysed that environment related to health care unit is changing rapidly and
all the health care units are engaged in making use of updated technology and better computer
assisted devices. Implementing change in health care unit is really critical and also the changes
can be really difficult to be adopt. Motivating patients to make use of blood sugar meter to
measure diabetes will be examined by using Kurt Lewin model of change. This model can help
in analysing how changes can be effectively implemented. Lewin’s theory can also be used in
order to understand how alterations can impact the working of health care system. It will also
help in analysing the barriers that are brings resistance to change. This model will also support in
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making employees and patients aware about that change is necessary and it will bring betterment
to them.
Unfreezing: It is the first step towards implementing change. It involves motivating
service users or patients to make use of blood sugar meter so that they can diagnose their
diabetes at home only and they do not have to visits health care unit. The main focus is that all
the change is being communicated to employees, stakeholders, NGO, hospital staff, government
and hospital administration. In this step, the barriers which can be faced by health care unit in
future will be identified and also it will be communicated to all staff members, so that they
become aware about adopting these changes. It has been analysed that the most important factor
by which change can be successfully implemented is that there is an open flow of
communication. If there is no open communication between staff members and employees, then
this can create conflict in firm.
Moving/change: This stage includes the planning and implementation process. Making
patients use the home monitoring meter for measuring blood sugar level will require efforts from
various teams like for example software developer, hospital staff administrators, program
managers, clinical servants, health care professionals, patients, employees and many more.
Support from all of them is really necessary for successful implementation of this plan. Also
effective planning must be made between different stakeholders. Health care unit also must make
sure that training is being provided to all staff members, so that they can make patient know
clearly about the advantages that is being related to using blood sugar meter (Mak, and Chang,
2019). Also project leader must be engaged in analysing that there is an open flow of
communication and role and responsibility of each staff members is being cleared. In this high
quality training must be provided by health care unit to workers so that the use of blood sugar
meter among patients can be increased.
Refreezing: It is the final stage of model, in this re-enforcing is being done. In this stage
health care unit must make sure that support from all stakeholders is being given to them until
the change is completely being implemented. As it is a really important step for successful
implementation of change. They must also analyse that every staff member is comfortable with
change that is being adopted. In this step a keen support is needed from hospital administration
for the success of this project plan. When changes are being successfully adopted then hospital
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care unit must be involved in analysing future challenges, barriers and problems and finding out
the ultimate solution for them. This can support their future growth and success.
Force field analysis
Force field analysis is that tool which can support health care system in improving the
quality of services that is being provided by them. It will identify driving and restraining forces
that support or work against project. This analysis can also support in understanding the
resistance factors that can occur as barrier to change. To bring new change and more creative
approach brain storming sessions can also be done, so that new ideas can be collected in order to
successfully implement the change. In the project report, the barrier that can be faced while
adopting use of blood sugar meter can be service user’s resistance to use it. There might be
chances that patients are unable to understand the use of blood sugar meter. Situation might
occur when hospital setting is unable to update the technology and make them understand to
their staff members. Increase in workload can also act as restraining forces that must be
emphasize by the health care unit. For overcoming the barriers force field analysis emphasize
that proper training is being provided to staff members so that changes are being implemented
successfully (Cummings, Bridgman and Brown, 2016). This will also enhance skills of
employees and also there will be no barrier towards change. The driving forces in this project
report will be the availability of internet services, making blood sugar meter available to all
patients, finance related requirement. Also to successfully implement the change it is really
necessary that there is support from upper level staff members and resources must be utilize by
them effectively so this can assist growth. It has also been analyzed that managing time can also
act as driving force in project report. Hospital care setting must make sure that goals and
objectives must be made clear so that proper time management can be done. It will help in
overall success and future growth.
PROJECT OUTCOME AND SUCCESS EVALUATION
The project is successful or not, this can be evaluated and measured with the help of
questionnaires that can be filled by patients and staff members. Also the overall data analysis
from time, cost and outcomes.
Stakeholders Measure of success
Patients  In this health care unit will measure
whether there visits to hospital is less or
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not. They have a better health outcome
and facing less stress
Staff members  Roles and responsibilities are achieved
on timely basis.
 Better management of work.
 Less workload.
 More time for making better
relationships with patients.
Hospital administration  Decrease in the appointment of services
users who are facing problems such as
Diabetes
Government/NGO/Health
insurance/authority
 The measurement if success in this will
be wellbeing of staff members, patient
is being provided with safe and secure
environment. Service users has reduced
visiting the health care system.
Patient: Safety of patients, there wellbeing and conveyance are the main aim of this project.
Measurement of success in service users will be calculated by the less number of service users
visiting the hospitals. The success of this project lies in improved outcomes during the type two
diabetes and also the project will be counted as successful when service users are less anxious,
depressed and stressed (Hussain and et.al., 2018). Also success can be measured by evaluating
that patients are less stressed and trying to consult doctor on regular basis without compromising
on their health conditions.
Staff members: This project will be counted as successful when staff members have less
workload in health care unit. It can also be measured when they are being provided with safe and
secure working conditions. Also it would be beneficial when staff members have more time to
make other appointments as well. Also success can be measured when staff members are not
leaving the hospital care setting on frequent basis and they have loyalty towards them.
Hospital administration: From the view point of hospital administration, success can be
evaluated when they have more time to make better appointments with patients and also the
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appointment made by service users facing diabetes is being lowered down. Also the services
users are being handled by them carefully and safely.
Government: From the perception of government success will be measured when service
users have better health outcome and also when high quality service is being provided by health
care unit. Also success can be measured when employee turnover is being reduced and feedback
from staff members by workers is positive.
REFLECTION
From the project outcomes I strongly believed that leaders play significant role in
management of health care practices especially in chronic diseases such as diabetes. The
selection of appropriate leadership strategies helps me to deliver care services in efficient,
sustainable and appropriate manner (Hoppe, Cade and Carter, 2017). For becoming a good
leaders, I must also develop management skills. I have also learned through my experience that
circumstances of patients and health care delivery changes constantly. Thus to cope up with
these situations and to deliver quality health care services I must also develop new skills such as
communication and flexibility. For being a good leader I must also ensure that my team members
are competent enough to understand the needs and objectives of diabetes management. The
continuous learning and education programs can be valuable in accomplishing this goal.
In the role of health care leader, I must identify such barriers which act as key challenge
in the service delivery. For this purpose, I can enhance interaction with the family members of
patient so that their support can be used to improve the condition of patient. There are patients
who does not have access to health care services or the approaches which can improve the
service quality. However, as health professional leader it is my responsibility to identify those
barriers and to motivate other team members so that collaborative working can assist them in
addressing health requirements of the patients. The selection of appropriate leadership strategy is
also vital for me to ensure the active engagement of other multidisciplinary teams and patients.
My ineffective leadership skills can also result in failure to manage necessary resources for
health care services. Thus diabetes management depends greatly to the health care leadership and
management approaches (Simmons, Wenzel and Zgibor, 2016). In addition to this project has
also helped me to analyse various challenges, responsibilities and strategies for becoming a good
health care service leader.
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RECOMMENDATION
It has been analysed from the report that health care unit must be engaged in evaluating the
cost effectiveness of home monitoring blood sugar meter in patients suffering from type 2
diabetes needs to be performed. Service users must be realised that making use of this meter can
support them in knowing about the early signs and symptoms so that disease could be managed
and diagnosed at an early stage (Simmons, Wenzel and Zgibor, 2016). It will also reduce
mortality rates among patients. Also more number of patients can be made aware at an early
stage of disease. This can support them in improving their health related outcome. I will like to
recommend to other individual who is going to make same project to prioritise the task according
to its importance. It is being recommended by me that the project maker must get involved in
doing intrinsic research so that better results can be obtained by them. They must involve more
staff members and hospital administration as someone or the other will always have an idea to
improve. I would recommend the project should not be started by individual while not having
proper knowledge about the blood sugar meter. They must also make other learn about the use of
blood sugar meter. In order for successful completion of project, I would recommend that
individual must also take support from technical as well as hospital staff.
CONCLUSION
From the above report it has been summarised that controlling blood sugar level is one of
the major goal of diabetes treatment. It has been analysed that type 1 diabetes can be managed
while changing diet of patients. It can also be treated while exercising regularly and having a
control over the insulin. Type 2 diabetes may be managed with non-insulin medications, insulin,
weight reduction, or dietary changes. It has also been interpreted from report that in order to
improve the health care service, various leadership approaches can be used. In this project
transactional leadership approach has been utilised so that staff member’s stays motivated and
changes are being implemented firmly. In the report Kurt Lewin change management model has
also been used so that no barriers occur while adopting changes. In order for successful
implementation of change, health care unit must make sure that alterations are communicated
properly to all staff members, hospital administration staff, government and NGO’s. Support
must also be taken from the patients. It has been analysed for motivating patients to use the blood
sugar meter, they must be given proper education. They must be realised that this meter will help
18

them in monitoring and analysing disease at an early stage. Also training must be given to staff
members as the technology will be updated in health care system. It has also been analysed in
report that there are various signs and symptoms which occur at initial stage like increase in
thirst, frequent urination. So these signs must be made known to patients. This step can help
them in improving their health outcome. It has also been analysed that by exercising regularly,
patients can have a control over their diabetes. It is also recommended to them to stop consuming
alcohol and smoking cigars, as it will help them in improving their health conditions.
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REFERENCES
Books and Journals
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Losers?. Journal of diabetes science and technology. 12(6). pp.1227-1230.
Barnes, S. and Harriss, A., 2018. Role of OH following type 2 diabetes diagnosis. Occupational
Health & Wellbeing. 70(9). pp.24-27.
Berry, E., Davies, M. and Dempster, M., 2019. Exploring the perceptions of emotional distress
among couples living with Type 2 diabetes and among diabetes healthcare providers, and
consideration of support needs. Diabetic Medicine.
Bird, H. and Turner, B., 2016. Integrated Diabetes Care for Adults with Diabetes: A Patient.
Integrated Diabetes Care: A Multidisciplinary Approach. 4. p.215.
Brooks, A. and Chakera, A.J., 2019. The challenge of managing Type 1 diabetes in frail older
people. Diabetic Medicine. 36(4). pp.453-456.
Goode, P. and Hoover, E., 2018. Early recognition of chronic kidney disease in patients with
diabetes. Journal of Kidney Care. 3(2). pp.92-95.
Hopkins, M.D., Taylor, R. and Lean, M.E.J., 2019. The DiRECT principles: giving Type 2
diabetes remission programmes the best chance of success. Diabetic Medicine.
Hoppe, C.D., Cade, J.E. and Carter, M., 2017. An evaluation of diabetes targeted apps for
Android smartphone in relation to behaviour change techniques. Journal of human
nutrition and dietetics. 30(3). pp.326-338.
Kong, M.F. and Gregory, R., 2016. Preventing foot complications in diabetes: the St Vincent
Declaration 26 years on. Practical Diabetes. 33(5). pp.154-156a.
McKnight, J.A. and Gibb, F.W., 2017. Flash glucose monitoring is associated with improved
glycaemic control but use is largely limited to more affluent people in a UK diabetes
centre. Diabet Med. 34(5). p.732.
Morris, F.M. and Bain, S.C., 2019. Clumsy hands in a woman with long‐standing diabetes.
Diabetic Medicine.
Mutuota, C., Hill, M. and Claydon, A., 2017. Enhancing diabetes education and self-
management in South Asian populations in the UK. Nursing Standard (2014+). 31(35).
p.47.
Preshaw, P.M. and Bissett, S.M., 2019. Periodontitis and diabetes. British dental journal. 227(7).
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Purewal, R. and Fisher, P.L., 2018. The contribution of illness perceptions and metacognitive
beliefs to anxiety and depression in adults with diabetes. Diabetes research and clinical
practice. 136. pp.16-22.
Sharma, M., Nazareth, I. and Petersen, I., 2016. Trends in incidence, prevalence and prescribing
in type 2 diabetes mellitus between 2000 and 2013 in primary care: a retrospective cohort
study. BMJ open. 6(1). p.e010210.
Simmons, D., Wenzel, H. and Zgibor, J.C. eds., 2016. Integrated Diabetes Care: A
Multidisciplinary Approach. Springer.
Tay, J., de Bock, M.I. and Mayer-Davis, E.J., 2019. Low-carbohydrate diets in type 2 diabetes.
The Lancet Diabetes & Endocrinology. 7(5). pp.331-333.
Taylor, R. and Barnes, A.C., 2019. Can type 2 diabetes be reversed and how can this best be
achieved? James Lind Alliance research priority number one. Diabetic Medicine, 36(3),
pp.308-315.
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Wilmot, E.G., Hammond, P. and Gregory, R.R., 2016. Launch of the ABCD Insulin Pump
Network UK. British Journal of Diabetes. 16(1). pp.33-34.
Wisting, L. and Snoek, F., 2019. Terminology matters:‘diabulimia'is insufficient to describe
eating disorders in individuals with Type 1 diabetes. Diabetic Medicine.
Hussain, S.T. and et.al., 2018. Kurt Lewin's change model: A critical review of the role of
leadership and employee involvement in organizational change. Journal of Innovation &
Knowledge.3(3).pp.123-127.
Cummings, S., Bridgman, T. and Brown, K.G., 2016. Unfreezing change as three steps:
Rethinking Kurt Lewin’s legacy for change management. Human relations.69(1).pp.33-
60.
Mak, A.H. and Chang, R.C., 2019. The driving and restraining forces for environmental strategy
adoption in the hotel Industry: A force field analysis approach. Tourism Management. 73.
pp.48-60.
Kumar Sharma, S., Singh, R. and Matai, R., 2018. Force field analysis of Indian automotive
strategic sourcing risk management enablers and barriers. Measuring Business
Excellence.22(3). pp.258-275.
Mak, A.H. and Chang, R.C., 2019. The driving and restraining forces for environmental strategy
adoption in the hotel Industry: A force field analysis approach. Tourism
Management.73.pp.48-60.
Yahaya, R. and Ebrahim, F., 2016. Leadership styles and organizational commitment: literature
review. Journal of Management Development.35(2). pp.190-216.
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new ‘full‐range’theory. International Journal of Management Reviews.19(1).pp.76-96.
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review. Leadership.16. pp.1-7.
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Online
Diabetes Prevalence. 2019. [Online]. Accessed through <https://www.diabetes.co.uk/diabetes-
prevalence.html>
Kurt Lewin change management theory. 2019. [Online]. Accessed through <
https://study.com/academy/lesson/lewins-3-stage-model-of-change-unfreezing-changing-
refreezing.html>
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APPENDIX 1
As a leader I am going to implement change in hospital care setting, so I am must make sure
that it has been effectively communicated so that no conflict arises and change has been
successfully implemented. I must make sure that every employee working with me stays
motivated so that they can adopt the change easily. I must also make sure that patients know
about the benefits of using the blood sugar meter. This device will help them in knowing about
the signs and symptoms at an early stage so that better diagnosis can be given to them. This will
help me in improving the health outcome of patients. As a team leader I will try to learn from my
experience so that it can also help my other team members to understand requirements of
patients. Being a part of the health care services it diabetic management require good team work
and cooperation with other professionals, patient and their family members. Thus for effective
management services it is my duty to manage conflicts among team members. During the project
I also learned that lack of understanding of patient's needs is critical challenge in delivery of
quality health care services. For instance, most of the vulnerable groups are unaware of the
diabetes risks and their further complications. As a result they does not support prevention
initiatives.
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APPENDIX 2
Information related to participation
What is the purpose of the study?
The purpose of the study is to manage diabetes. It is been conducted to make people
aware about the signs and symptoms of diabetes. The health professionals providing services for
diabetic care and management within health organizations are also considered for the study. In
most of the cases lack of awareness and ineffective weight management is primary reason for the
uncontrolled sugar level and other symptoms of diabetes.
Why I have been chosen?
I have been chosen as I am suffering from diabetes and I need an immediate acute care in
order to overcome this disease.
Do I have to take part?
Decision of taking part is totally up to the patient, if I wish to take part in the change
management process of hospital care setting then I can.
What will happen If I take part?
If you take part, then you will be given with blood sugar meter machine that can support
you in measuring your blood sugar level. You can use the machine even at home.
What is the potential benefit of taking part?
The potential benefit of taking part is that I will be made aware about the signs and
symptoms of diabetes.
Will my taking part in the study will be confidential?
Yes, all the details related to you, whether it is your medical history, your personal
information will remain confidential.
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APPENDIX 3
REF NO-
Title of the Project- Diabetes Mellitus
Do you understand the project report?
I understand that information related to me will remain confidential
I understand that participation of me is voluntary.
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