Organisation Development Process in Healthcare: Addressing No-Show Rates and Implementing Change

Running head: ORGANISATION DEVELOPMENT PROCESS
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Organisation development process
Name:
Institution:

ORGANISATION DEVELOPMENT PROCESS 2
3.0 Organisational Development Process........................................................................................3
3.1 Introduction............................................................................................................................3
3.2 Critical Review of Approaches to Organisational Development...........................................5
3.3 Rationale for OD Model Selected..........................................................................................6
3.4Organisation Development Model..........................................................................................8
3.4 The Change Process...............................................................................................................9
3.4. 1 Initiation.........................................................................................................................9
3.4.2 Planning.........................................................................................................................10
3.4.3 Implementation..............................................................................................................14
3.4.4 Mainstreaming...............................................................................................................15
3.5 Ethical consideration............................................................................................................15
3.6 Summary and Conclusion....................................................................................................16
References......................................................................................................................................17

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3.0 Organizational Development Process
3.1 Introduction
The healthcare sector is one of the world’s most multifaceted, prevalent and fast developing
businesses. The health care structure in United Arab Emirates (UAE) is a mixed private-public
system. There is a public system for Emiratis with centralised control and financing frameworks
and there is a huge and developing private sector in the key metropolitan parts. Private health
care services are growing at swift rate each day in the UAE through the medical cities, clinical
and private hospitals. The number of private hospitals exceeds the number of the public health
care centres. This growth has been reinforced by a huge number of expatriates and foreign
personnel who normally incur a high cost compared to local individuals in the Ministry of health
amenities. Therefore, it causes a lot of attendance of private hospitals. No-shows are schedules
missed by patients, either non-attendance or failure to terminate in a suitable period for another
patient to be reserved as a replacement. Rates for missed appointments (no-shows) are especially
high in Internal Medicine Department of ABC clinic. No shows adversely affect the efficacy of
healthcare structures and also influence patient care. Patients who do not show up to their
planned clinic appointments can considerably interrupt productivity further upsetting cost-
effective healthcare, patient quality and well-being. The present no-show rates for the ABC
clinic are greater than anticipated. Therefore, appointment reminder systems are an effective
method for increasing appointment attendance and cancellations.
In the health and social care service, change has been argued as a constant feature, which has a
significant impact on the culture as a whole i.e. the way people work within the organisation, the
way they communicate with each other, the way in which services are scheduled to safeguard

ORGANISATION DEVELOPMENT PROCESS 4
optimum level of paybacks to service consumers, local populations, and patients (Waibel, Henao,
Aller, Vargas & Vázquez, 2011). Considering this, transformation has been argued as an
adaptive and incessant process, where all the elements are interrelated and have influence on
each other. More importantly, it has been indicated that organizational change focuses
extensively upon the change in people, as they are the most important resource of the
organisation that helps in the achievement of desired goals and objectives. Therefore, it has been
revealed that change cannot be easily predicted and it emerges over time (McCance, McCormack
& Dewing, 2011).
The business dictionary describes Organisational Development (OD) as a routine and framework
of intended, systematic transformation in the philosophies, attitudes and values of the workers
through the reinforcement and generation of long-term training packages (Bartle & Leuenberger,
2014). OD is action oriented. It begins with a suitable organisation wide evaluation of the present
conditions and of the forthcoming needs, and uses approaches of behavioral knowledge such as
modeling behaviour, transition assessment and sensitivity training (Burgess & Radnor, 2013).
The OD aim is to help the organisation to appropriately adapt to the quick-transforming external
surrounding of novel markets, technologies and regulations. Change is unending feature for the
organisation both at the strategic and functional level (Lanzarone, Matta & Sahin, 2012). This
chapter will plan a proposal for an Organisation Development process within the ABC clinic in
the Health Service Executive to enable a more efficient and effective means of decreasing ‘No-
Show’ Rates by Implementation of the Appointment Reminder System in an Internal Medicine
Department.
3.2 Critical Review of Approaches to Organisational Development

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Kurt Lewin change model
Kurt Lewin is a German psychologist and the author of the model of planned change (TPC) in
the 1950s (Stivers & Wheelan, 2012; Patnoe, 2013), presently well-known as a change
management theory. Lewin coined the phrase “there is nothing as practical as a good theory”
(Hamel & Zanini, 2014, pp.21) and also invented the word “group dynamics” (Stivers &
Wheelan, 2012, pp.44). He proposed that the group dynamic had robust effects on the single
person, and the essential change at the group level needs a change at the team level and not on
the personal level (Stivers & Wheelan, 2012).
Change management model begun as early as 1945 when Grabbe and Kurt published Conduct,
Knowledge, and Acceptable of New value (1945) on the culture modification and divergence.
The change management theory stated is vital before transformation can happen (Stivers &
Wheelan, 2012).
The Lewin change model comprises three steps namely; the initial stage in the change
management model is the unfreezing point where undesired behaviours are ceased (Stivers &
Wheelan, 2012; Patnoe, 2013). The second stage is transition which joins the wanted traits. The
third stage is the refreezing, which denotes to the change stabilization. Workers in this phase will
continue to model novel and wanted behaviour (Stivers & Wheelan, 2012; Patnoe, 2013).
The Kurt Lewin’s work controlled the model and routine of change management for over five
decades. But, in the last two decades, Kurt’s strategy to change, specifically, the three-phase
theory has attracted key criticisms because is it regarded as management-driven and favours top-
down leadership style. Additionally, the health system is in another time of major transformation

ORGANISATION DEVELOPMENT PROCESS 6
and re-organisation. Therefore, find that this framework could be deemed inappropriate for this
transformation initiative (Rowbottom, Jones & Cobb, 2015).
Nevertheless, Lewin’s model has attracted major criticism as it postulates that the firm work with
stable surrounding and fails to offer deliberations to the concerns around the organisation’s
politics and power. It is also alleged that the model is simply relevant to isolated and
incremental change projects which thus makes it unable to tackle transformation change
(Rowbottom, Jones & Cobb, 2015)..
Figure 1: (Stivers & Wheelan, 2012).
Kotter Change Model
The Kotter model is subdivided into eight sequential phases; building a sense of urgency,
creation of coalition rules, generating a transformation vision, vision communication to the
workers, empowering personnel to take actions on the vision, forming a short term objectives,
consolidating paybacks and generating more transformation, and employing novel cultural
techniques to sustain change (McAllister, Dunn, Payne, Davies & Todd, 2012). Kotter pinpoint