Analyzing Strategies and Methods for Improving Patient Safety Culture in Hospital, Saudi Arabia

This dissertation discusses the degradation of patient safety culture in healthcare institutions in Saudi Arabia and the need for an improvement program. It presents the problem statement, aims and objectives, and the current developmental process being undertaken by the organization. The study includes a literature review, organizational development planning process, evaluation of the planning, and discussion and conclusion.

ANALYZING STRATEGIES AND
METHODS FOR IMPROVING PATIENT
SAFETY CULTURE IN HOSPITAL,
SAUDI ARABIA
Einas Al-Ghamdi
A Dissertation submitted in part fulfilment of the degree
of MSc Healthcare Management, Institute of Leadership,
Royal College of Surgeons in Ireland
2018
Student ID:16168526
Submission Date: August 2018
Word Count:
Facilitator:

Acknowledgement
Thank you to all of those who have helped listened and encouraged me throughout this study.
I am indebted to my supervisor ……………………. whose guidance, advice and patience
have been immeasurable. My sincere thanks to all members of the…………… [Mention your
university/college name], both staff and students, whose continuous support have made this
thesis possible.
I would like to thank all of the participants in the study: students, teachers and Local
Education Authorities, for the time and help given throughout. Without their participation,
this research would not have been possible. In this context, I am also thankful to them, whose
research work helped me to execute this paper well.
Finally, I thank my family, without whom this thesis would not have been started or
completed! Your encouragement and support have never faltered; thank you.

Abstract
The following dissertation has focused on the different elements that are related to the
development of King Abdullah Speciality Children’s Hospital located in Riyadh city of Saudi
Arabia. The following study has been divided into five different chapters with each chapter
having its own relevant role in the assembling of the whole study. The study begins with the
introductory chapter where the core matter of the study has been discussed. The introduction
chapter also presents the problem statement and provides the rationale of the study. Apart
from this it also highlights the aims and objectives of the study and the current developmental
process being undertaken by the organization.
The literary review comes in the second part of the following study which has highlighted the
different kind of themes related to the following study. The organizational developmental
process in the third chapter shows the different types of the developmental plans that will be
taken up by the management of the organization. The last two chapters are respectively the
evaluation chapter and the conclusion and recommendation chapter where the theories that
have been used in the developmental process of the mentioned hospital have been provided.
The concluding part of the chapter contains a short summary of the whole study and also
presents the different recommendations which if accepted by the management of King
Abdullah Speciality Children’s Hospital can help the better achievement of the different
Organizational development goals of the organization.

Chapter 1: Introduction

Table of Contents
1.1 Introduction..........................................................................................................................9
1.2 Problem Description.............................................................................................................9
1.3 Background of the organisation...........................................................................................9
1.4 Rationale for carrying out the Project................................................................................10
1.5 Details of Intervention........................................................................................................10
1.5.1 Current Situation.............................................................................................................11
1.5.2 Desired Situation.............................................................................................................11
1.5.3 Process of intervention....................................................................................................11
1.5.4 Desired Impact................................................................................................................12
1.6 Aims and Objective............................................................................................................13
1.6.1 Aim..................................................................................................................................13
1.6.2 SMART Objectives.........................................................................................................13
1.7 Role in the Development Program.....................................................................................14
1.8 Signpost..............................................................................................................................14
1.9 Reflection...........................................................................................................................14
Reference..................................................................................................................................16

1.1 Introduction
The quality of the healthcare being provided in the institutions is failing to maintain
quality and standard in Saudi Arabia. Assumption of this issue is attributed to the degradation
of the patient safety culture in the organisation, which now creates the need for an
improvement program that will help improving the current scenario. This change
management project is attributed for identification of the challenges in the care giving
process and the hospital management and provides solution for improving the situation.
1.2 Problem Description
The possible problem as identified in the chapter is the degradation in the safety
culture of the organisation. This is leading to significant degradation in the quality of the
healthcare being provided, which ultimately leading to the fall in patient flow.
1.3 Background of the organisation
The organisation has been operational more than 50 years and now and has expanded
over time. The number of staffs working in the organisation has exceeded 2000 as well as the
area of service being provided since its initiation days. The hospital follows a mission of
providing quality and efficient healthcare services and healing environment by availing
effective healthcare facilities to the community children and their families with the believe
that they deserve good health conditions. However, some problems have emerged within the
organisation that will be discussed and solved in the following report. The vision of the
organisation is to mitigate the problems faced by the children and the adults being the
members of the society.

1.4 Rationale for carrying out the Project
As identified by Almalki, FitzGerald and Clark (2011) a large number of hospitals are
currently facing trouble in providing quality healthcare to their patients and meeting the
safety requirements. Moreover, the numbers of chronic illness from demographic factors are
considerably increasing over time. Some of these illnesses are occuring due to the eating
disorder, life style, social environment and age. Furthermore, as stated by Ahmed et al (2014)
the shortage of bed had been major issues in the hospitals of Saudi Arabia since 1970s.
The government of Saudi Arabia and the Ministry of National Guard Health Affairs
now aims to improve the quality of the health care services by implementing the safety
system and developing safety culture in the public hospitals in the region. Hence, to improve
the quality of the service, it is important to increase the knowledge of the staffs and other
employees and to aware them about their roles in the organisation. Hence, it falls under the
responsibility of the quality management specialist to increase the knowledge and prepare
them for JCI review of safety management in the hospitals (Wang et al 2011).
1.5 Details of Intervention
The primary aim of all the healthcare organisations is to ensure the patient’s safety
during the treatment procedure. In other words, purpose of the concern about patient safety
standard is to avoid the accidents and non-desired situations that can occur during treatment
procedure being implemented. Negligence in the case can result into critical end results such
as permanent disability or even death. Hence, the role of the quality management authority is
to ensure the safety and well-being of the patients for increasing the value proposition and
customer’s perceived value.

1.5.1 Current Situation
The significant fall in the affectivity and efficiency of the patient care culture in the
organisation has resulted into a considerable declination of the patient flow. The declined
quality can be attributed to a number of factors which includes poor patient management, use
of outdated technology, poor employee management and ineffective safety culture. The
patients in the organisation often undergo medication errors that are results of some unethical
disputed cultures (Bah et al 2011). The patients are often diagnosed by the nurses of the
organisation, or undergo ineffective examination or even surgical complications. This
described unsustainable situation needs modification in order to attain the safety culture in
the organisation.
1.5.2 Desired Situation
It is expected for the project that the implementation of new strategies and
improvement of the existing ones will facilitate in increasing patient safety in the
organisation. Furthermore, the project is also expected to improve the communication process
and structure in the hospital. Additionally the increased knowledge and skills of the
employees providing healthcare in the organisation will facilitate in changing the safety
culture develop the relationship with the patient. Introduction of advanced technology will
also support the cause of patient’s safety along with the other developments and contribute in
increasing the patient flow.
1.5.3 Process of intervention
The project focuses on providing a quality improvement plan for increasing the
efficiency of the organisation and to develop patient safety culture. This will be attained by
forming risk management teams and patient safety unit, performance improvement team,
information management team and JCI accreditation readiness team. JCI is the Joint

Commission International that extends its efforts to the healthcare organisations of the
international market for improving the safety and quality (Day et al 2013. The process
incorporates the offering education, publications, advisory and internal accreditation and
certification. Patient’s safety unit will be accountable for keeping record of daily harm report
and good catch program. Risk management team on the other hand will be forming mortality
review committee. The responsibility of the review team will be to record the unfortunate
events that take place in the organisation and the root cause analysis. This will help the
management to identify the issue behind the quality degradation in the organisation. The
performance improvement team will be focusing on the improvement of the employees by
using lean six-sigma and model for improvement PDSA improvement (Cucoranu, Parwani
and Pantanowitz 2014; Donnelly and Kirk 2015). These models will provide procedures for
improvement required in the organisation to achieve patient’s safety culture. Finally, the JCI
accreditation readiness unit will help will extends its support and facilities for developing
safe, high quality health care by meeting and exceeding international quality standard
(Alkhenizan and Shaw 2011).
1.5.4 Desired Impact
A number of notable positive outcomes are expected through the implementation of
the change. These interventions are likely to improve patient safety culture standard,
efficiency of hospital’s management performance, service quality and organisation’s
competitive advantage. The patient safety culture standards are the first expected impact of
this project that is likely to improve the overall process of operation within the organisation.
Improvement of hospital’s performance management will help in communicating better
practice within the organisation, which will again facilitate in improving the value
proposition. Increase perceived value of the customers will eventually increase the customer

flow in the hospital. The service quality on the other hand is expected to increase as per the
modification is planned. This in turn will develop the proposed value of the organisation and
help it to attract greater number of patients. The above modification on the present and the
impacts identified will further help the organisation to position themselves as the best
healthcare provider in the target market. The organisation is likely to receive advantage
promoting the standard service and culture as the patients will always look for the best
healthcare standards available.
1.6 Aims and Objective
1.6.1 Aim
The purpose of the project is to establish safety culture management in the hospital.
1.6.2 SMART Objectives
SMART objectives are those goals set by the companies that are traceable. In other
words, the company can identify the level of achievement of these objectives in time.
S.M.A.R.T stands for specific, measurable, attainable, relevant and timely. The objectives for
the company are:
 To aware the staffs and develop their knowledge and skills for achieving the
hospital’s safety culture assessment of 96% by the end of 2018
 To attain 95% in hospital’s safety healthcare service practice by 2019
 To increase the management efficiency to 90% by 2019
 To increases the management’s efficiency in handling patient safety culture by 2019

1.7 Role in the Development Program
My responsibility as a Quality Management Specialist is to identify the issues present
in current cultural practices. The responsibility further extends in identifying the necessary
changes required for attaining the safety in the health care institution. The author will utilize
the results identified form the study for supporting the rationale for carrying out the project. It
is my duty in the project to ensure the quality improvement in the hospital. My responsibility
in the research extends to educating, facilitating, and monitoring the preparation of the team
for JCI evaluation. Moreover, the author is liable for ensuring the implementation of the plans
and bring modification where required. As a leader of the quality management team, the
author will have to keep track of every individual’s performance level for ensuring the
implementation of the modification.
1.8 Signpost
The following chapters of the report include literature review, organisational
development planning process, evaluation of the planning and discussion and conclusion. The
literature review chapter of the report will identify the relevant literatures present and discuss
the identified concern. The organisational development planning formulates a proper plan for
eradicating the issues present in the organisation. Evaluation part scientifically identifies the
utility of the plan made. The final part of the report discusses the benefits of the the plan and
the report as well.
1.9 Reflection
The understanding that I now possess about Organizational Development have came
to a point where I can better understand the elements and factors related to the developmental
process. The transition of the hospital to a world class medical facility will help me enrich my
knowledge on organizational Development. The effective use of technology to realise the

goals of the developmental process has been of great help to me. The following chapter has
also provided me a transparent knowledge of the SMART objectives that have will be
implemented by the organization to meet the goals of the change management policies.
Reference
Ahmed, W., Memon, J.I., Rehmani, R. and Al Juhaiman, A., 2014. Outcome of patients with
acute kidney injury in severe sepsis and septic shock treated with early goal-directed therapy
in an intensive care unit. Saudi Journal of Kidney Diseases and Transplantation, 25(3),
p.544.
Alkhenizan, A. and Shaw, C., 2011. Impact of accreditation on the quality of healthcare
services: a systematic review of the literature. Annals of Saudi medicine, 31(4), p.407.
Almalki, M., FitzGerald, G. and Clark, M., 2011. Health care system in Saudi Arabia: an
overview/Aperçu du système de santé enArabiesaoudite. Eastern Mediterranean health
journal, 17(10), p.784.
Bah, S., Alharthi, H., El Mahalli, A.A., Jabali, A., Al-Qahtani, M. and Al-kahtani, N., 2011.
Annual survey on the level and extent of usage of electronic health records in government-
related hospitals in Eastern Province, Saudi Arabia. Perspectives in health information
management/AHIMA, American Health Information Management Association, 8(Fall).
Cucoranu, I.C., Parwani, A.V. and Pantanowitz, L., 2014. Lean Six Sigma. In Practical
Informatics for Cytopathology (pp. 113-119). Springer New York.
Day, S.W., McKeon, L.M., Garcia, J., Wilimas, J.A., Carty, R.M., de Alarcon, P., Antillon, F.
and Howard, S.C., 2013. Use of joint commission international standards to evaluate and

improve pediatric oncology nursing care in Guatemala. Pediatric blood & cancer, 60(5),
pp.810-815.
Donnelly, P. and Kirk, P., 2015. Use the PDSA model for effective change
management. Education for Primary Care, 26(4), pp.279-281.
Wang, H.F., Jin, J.F., Feng, X.Q., Huang, X., Zhu, L.L., Zhao, X.Y. and Zhou, Q., 2015.
Quality improvements in decreasing medication administration errors made by nursing staff
in an academic medical center hospital: a trend analysis during the journey to Joint
Commission International accreditation and in the post-accreditation era. Therapeutics and
clinical risk management, 11, p.393.

Chapter 2: Literature Review

Table of Contents
Literature Review
Introduction
Research strategy
Review of the concepts of quality and cultural Safety in nursing
Implications for the Project
Summary and conclusion
Reference List

Literature Review
Introduction
In this chapter of the report, scholarly articles of various authors are reviewed in order
to get the idea of cultural safety in nursing and healthcare. In literature review section, current
knowledge of cultural safety in healthcare including substantive findings is delineated. Saudi
Arabia has been becoming ethnically diverse and the people are witnessing cultural blending
in Saudi Arabia as employees come from various backgrounds and countries in Saudi Arabia.
In this chapter of the study, concepts of cultural safety in nursing and principles of nursing
practices are discussed from theoretical perspective. Theories related to the cultural safety in
nursing and healthcare are explained. At the end of the argumentative discussion, gap in
literature is given identifying literature gap in the study. Discussion in this section is given
from secondary sources from various original and new experimental works.
Research strategy
In this literature review section, secondary data have been used in order to present the
theoretical understanding of the concept. The researcher has searched over internet and
university library in order to get the related journals, articles and books of the topic. The
search terms of this research topic those the researcher used were ‘cultural safety’, ‘service
quality’, ‘patient safety’ and ‘nursing principles’. The researcher mainly used the database
like Google Scholar in order to search the articles and journals to get the idea. In addition, the
researcher also used the databases like CINAHL Plus, ERIC, MEDLINE and Nursing
References Centre in order to access the premium online journals. The parameters mainly
used in searching the data were credible sources and most of the journals were taken from
reputed publishing houses. Data have been collected from books, journals, websites, online

articles and knowledge forum of Nursing. Specific Arab based data have not been collected
due to inadequate data on nursing. The researcher has used 6 books and 24 journal articles in
order to access them. The exclusion criterion of the data search was that the researcher used
the journals and books which have been published only after 2013. Therefore, the sources
that have been used in this study are not older than 5 years. Therefore, the researcher has used
credible and recent sources of information.
Review of the concepts of quality and cultural Safety in nursing
As opined by Wepa (2015), cultural safety is effective nursing practice of an
individual or family from another culture which is determined by that individual or family.
The concept of cultural safety has come from nursing education and nursing culture ranges
from age or generation to sexual orientation and gender. The concept of nursing education
and principles are associated with religious beliefs, occupation and disabilities. As argued by
McCall and Lauridsen (2014), unsafe cultural practice can be defined through the actions that
demean identification of the culture. In this relation, cultural principles are related to aim to
develop the status, improve the service of health, differences among various people and
understand the unique power of nursing and health services. Cultural safety concept devised
from the leadership of nursing in the year 1989 and this concept first came in New Zealand
by Maori nursing students. In the previous time, nursing schools were mono-cultural in New
Zealand and Australia. Furthermore, in Australia, cultural safety concept in nursing was
developed in social work and in education. In workplace, cultural safety is met when nurses
do the actions related to respect, recognise, nurture and cultural identification of various
people. Safety of the people has to meet with the needs, rights and expectations of the service
users in healthcare. As further added by Richardson et al. (2017), cultures in health are
included spiritual beliefs, ethnic group, migrant experiences and socio-economic condition of

the people. The nurses and midwife deliver the health services and these services can reflect
upon their cultural identity, it can recognise the impact of personal culture on professional
service and practices. Unsafe cultural practice in healthcare is related to actions of
disempowering and diminishing the cultural identity and safety of the individuals.
The following themes emerged as a result of in-depth study on the subject matter and
analysis of various authentic and scholarly resources like peer reviewed research papers,
journals, articles and scientific studies. Important aspects of the subject have been recognised
in the above method and distinctive themes emerged in the process. Some themes have
sections and sub sections which have been clarified lucidly in the following paragraphs.
Theme 1- Principles of cultural safety in nursing for patients
Principle one: to improve well-being and health status of the individuals
Cultural safety in nursing applies in making the relationship through focusing on
health of the individuals to gain positive outcome and well-being. Nurses need to
acknowledge the practices and beliefs that differ from them. The beliefs of the service users
may differ in terms of generation, occupation and ethnic origin, however; healthcare
professionals need to serve them to improve health status of the individuals (Wepa 2015). In
case of Saudi Arabia, culture is conservative and deeply religious and the nurses behave
maintaining the prohibition in the society (Muller et al. 2015).
Principle two: to develop the delivery of nursing and health services
The delivery of health services can be made culturally safe when nurses can make a
healthy relationship with service users. The nurses accept the personal analysis of power
relations and they try to empower the service users. Nurses feel free to express their
measurement of risks of service users and focus on serious and intrusive intervention.

Healthcare providers need to understand the own cultural identity and reality. Nurses apply
the concept of social science to underpin health services (Hall et al. 2014). Nurses provide
service with diverse needs and the services must be safe.
Principle three: make differences among the individuals who are getting treatment and accept
the differences
Culturally safe in healthcare is a broad concept to recognise the dissimilarities within
healthcare centres, employment, education and social interactions that can solidify the
microcosm of differences. The nurses need to understand cause and effect relationship with
the service users and their views on politics, social, housing, employment status,
psychological conditions and personal experiences (McCall and Lauridsen 2014). Nurses’
principle supports the idea of accepting the legitimacy of diversity and differences in social
structure. Healthcare professionals need to concern in improving the quality of service to
service providers.
Principle four: to understand the power of healthcare on persons’ and their families
Cultural safety has its focus on health care providers’ own culture, attitude and life
experiences. Healthcare providers need to focus on their own practices to make a balance of
power relationship so that each of the service users may receive effective service (Alonso et
al. 2015). Nurses need to prepare themselves in order to resolve the tension between health
care centres and culture of the nurses.
Theme 2- Models of patients safety and quality care in nursing and methods of nursing
care
a) Donabedian model

This is a conceptual model to provide a framework to investigate about health
services and examine the quality of healthcare services. This concept of nursing and
healthcare was established by Avedis Donabedian and he developed this model in the year
1966. According to Qu et al. (2014), Donabedian model speaks about the quality of care and
it can be categorised into three categories, process, structure and outcomes.
The structure explains about the context through which care is delivered and it is
related to the staff, hospital building, equipment and finance. These factors in healthcare
control of patients, providers in the healthcare system. These factors also measure the quality
of healthcare.
Process refers to the transaction between providers and transaction throughout the
delivery of healthcare process. The process can be meant the sum of each action in health
care and these factors are related to the preventive care, patient education, diagnoses and
treatment facility. Process in healthcare can be further differentiated to deliver the better care
to the service users in order to increase interpersonal bonding (Qu et al. 2014).
Lastly, outcomes in this model describe about the impact of healthcare in the health
status of the individuals. Outcomes generally are the effects of healthcare on changes of a
health condition, population and behaviour of the staffs. Outcomes indicate the improving
condition of the health status of the service providers.
b) Methods of nursing care
Nursing care concept needs to be carried through a variety of organisational method.
Team nursing concept was originated in the between the 1950s and 1960s. Team
nursing concept involves using a team leader and other team members in order to provide
various approaches to nursing care for a group of patients. Team nursing concept is facilitated

through the division of work where a medication to the patients can be given by one nurse,
while other nurses will provide physical help to the patients (Kelly et al. 2016). In healthcare,
team nursing concept will provide help to mix the skills including qualified nurses and
experienced nurses. The quality of patient care in this nursing system is questionable as the
care is fragmented into the team.
The primary nursing concept is associated with individualised, comprehensive and in
this method; one nurse provides care throughout the period of care for an individual. As
opined by Pauly et al. (2015), primary nursing practice emphasises mainly on continuity of
care and one nurse completes the whole care for a patient. Therefore, the cultural awareness
of the nurse needs to be well-developed as the nurse need to remain with the patient for all
time. The nursing service in this method categorised in a way to meet the patient’s
individualised care. Primary nurse communicates with the family members regarding service
users’ health.
In Progressive Patient Care (PPC) system of the method, service users are placed in
the units based on their needs and medical speciality is given through degree of illness.
According to Cherry and Jacob (2016), PPC is a systematic grouping of patients on the basis
of the degree of illness rather than by classification. Elements of PPC are related to the
intensive care units, self-care units and intermediate care units. In this nursing system, the
nurses need to know about the culture of the patients and hospital facilities need to be strong.
Theme 3- Activities that promote safety in nursing
The user-centred approach can increase the visibility, constraint and affordance of
functions in a healthcare home. Visibility can be increased by following all the factors and
norms in the healthcare. As stated by Wager et al. (2017), affordance is related to the activity
of the nurses. In addition, nurses need to avoid the reliance on memory in workplace

functions. Nurses can simplify the process and standardise the workplace process. Nurses
need to decrease the process to use the memory in problem-solving process in the workplace
(Banks and Kelly 2015). Establishing the norm to follow the code of ethics in nursing will
eventually help to simplify the process of working. Moreover, nurses attend the work-safety
training and they have ideas about work-loads, work-hours, distraction and interruption in
safety. Interruption process can lead to medication administration error in order to indicate
the safe zones in healthcare home.
Nurses need to prepare knowledge on patient safety and they should avoid reliance on
vigilance. Doctors keep the vigilance on patients' safety with checklists, well-designed
alarms, adequate breaks and rotating staffs. In the health care homes, management uses
alarms in order to alert the nurses in potential emergency and nurses can get benefits in
scheduling in the overall process. Nurses are given training for the team collaboration and
this training is given on interpersonal communication (Holland 2017). This type of training
increases effective communication among the nurse. It allows the service users to have better
service from various ethnic group nurses. This training also provides knowledge about
cultural safety and it essentially provides information about involving patients in their own
care. Nurses have to take the decisions from the family members of the patients and nurses
offer educational information of the diseases of the patients to their family.
Theme 4- Roles of nurses in promoting cultural safety
According to Ramsden (2013), nurses need to understand about service users' culture
and various cultural identities can lead to effective health care strategies. The management of
healthcare needs to create a non-biased culturally safe place that can demean the healthcare
safety of the service users. In a healthcare setting, poor cultural safety is related to the poor
patient concordance, mistrust and miscommunication (Chartier 2014). Nurses spend more
time with service users and there is a thin line between suboptimal outcome and patient

experience. There is no difference between patient safety and clinical quality. The nurses
provide care to the patients in a safe and effective way that do not differentiate through
culture and religion. Key drivers of loyalty towards work is the team working, listen to the
issues and cleanliness in hospitals. If the healthcare professionals work as a team, the service
users feel safe (Papps and Ramsden 2016). On the other side, cultural safety healthcare
organisations need sustained leadership that can facilitate the nurses' commitment towards the
workplace.
Leaders in healthcare should demonstrate accessibility and visibility of patient safety.
Leaders must be observant and leaders can ask open-minded questions to create transparency
and openness. There is a need to create a purposeful connection between patient safety and
relationship of patient-nurse (Ding 2014). In addition, some of the critics opined that safety in
healthcare is related to the safety of both patients and healthcare professionals. Patients and
nurses need to interact frequently and their behaviours can show a bond. A cultural shift in
nursing is one such crucial thing identifies the importance of mutual respect between nurses
and service users and they must be inclusive, holistic, culturally sensitive and non-
judgemental in order to show their affection towards each other (Holland 2017). Nurses must
have not any preconceived notion regarding service-users’ religion, faith and creed and
orthodox thinking frame eventually leads the situation to worsen. Nurses with this kind of
thinking capability have a number of cultural difficulties and it provides a graphic illustration
to identify discriminatory behaviour.
Theme 5- Safety culture and organisational change management in healthcare
Safety in healthcare is a process related attribute and safety are different from quality
in healthcare. Safety is not perceived as a process of aggregated value. Safety in the
healthcare is manifested as a non-event and the management tries to stop unwanted events.
Safety improvement requires preventive management approach and proactive management

approach to act before the fact occurs. As opined by Polaschek (2015), safety is a shared
value within the healthcare organisation. In addition, culture is another unspoken language in
order to respond to secret complex code within a healthcare. Values are surrounded by
symbols, rituals and practices within healthcare homes. Symbols are associated with visible
that are associated with the external observer. Rituals are related to the cultural meaning and
they are being understood only by those who belong to the culture. Values in a healthcare are
unconscious and not directly perceived from outside and it can only be deduced to the way
people act in certain circumstances.
Organisational culture is associated with shared values and common beliefs; these
interact with the structure of healthcare and control system in order to produce behavioural
norms. Organisational culture is dynamical, continuously, socially constructed by the people
who constitute a healthcare centre. According to Williams (2016), organisational culture is
characteristic that is manifested by the individuals’ behaviours and attitudes. Holistic
management approach in a healthcare home is related to human factors, technical factors and
organisational factors. Human factors are associated with knowledge, skills, motivation,
attitude and behaviour. In addition, technical factors are associated with ITC systems,
equipment, components, quality assurance and maintenance. Organisational factors are
associated with infrastructure, strategy, resources, processes and procedures. Safety culture
enhancement can imply organisational change and safety culture is a mixed method to create
an intangible complex social concept (Memish 2014). Safety culture is a tangible factor to
remove the hazardous issue. External and internal drivers can impact on organisational
performance improvement. Organisational performance is related to the management,
economics, quality, safety, health, environment and social responsibility. The change in a
health care can be brought from present state to the desired state through managing the
change process and through strategic vision (Pauly et al. 2015). There are several other

factors that are associated with leadership, decisions and attitudes, management system, type
of intervention and organisational culture.
Theme 6- Challenges in cultural safety in healthcare
Nurses in health care homes face the challenge in terminology confusion and they do
not have a basic concept how culture relates to a cultural safety issue. Terminology issue is
vital in a healthcare home as nurses need to communicate with the service providers with
accurate terms. In addition, nurses can face lack of support from the management and
educators to improve the knowledge base, pedagogical approach and teaching skills. As
stated by Arieliet al. (2014), the word ‘culture' is unclear to the learners of nurses and they
thought that the culture is limited to the race and ethnicity. Culture safety concept is beyond
the understanding and ethnic-specific knowledge is related to the position of power, cultural
customs and nurses can apply the knowledge in the workplace also. Carayonet al. (2014)
supported this idea by saying sometimes leaders in a healthcare do not support the nurses by
cultural safety education.
Each of the leaders and educators has their own set of interpretation in culture safety
framework. Lack of support and lack of education of nurses for cultural knowledge can lead
to cultural inequalities. Leaders and educators feel unprepared when they teach about
sensitive topics to the nurses like racism, marginalisation. Cultural safety has two distinct
perspectives, paradigm shift and continuum. Continuum is about cultural safety as the
outcome of being culturally competent. On the other side, a paradigm shift is about
transferring the power in the nurse-patient relationship. Transferring the power can foster the
self-determination and it supports the patient participation (Williams 2016).

Theme 7- Measuring service quality in healthcare
People can get satisfied with physiological contentment; however, there is more
demand for satisfaction. In recent time, in the healthcare sector, dramatic changes have come
into technological, economical, liberalisation, privatisation and globalisation policies and
electronic data interchange facilities and they motivate the healthcare sector to improve the
service quality (Graban 2016). Service quality needs increase for changing the lifestyle of the
people. Lifestyle of the people is associated with an increase in affluence, leisure time and
women in working places. In addition, changing world has brought the greater demand for
lawn care, travel agencies, entertainment, daycare centre and home help (Weller et al. 2014).
Changing economies in daily life has brought changes in factors like globalisation and
deregulation. Changing technology in healthcare has brought the demand for service quality
as new technologies increase the demand for service. Highly satisfied service users become
loyal towards the healthcare centre. The satisfaction-loyalty relationship is divided into three
major categories, affection, indifference and defection (Pronovost et al. 2015). Defection is
related to low satisfaction, indifference is associated with intermediate satisfaction level and
affection is related to highly satisfied level.
Dekker (2016) opined that consumers evaluate the quality of service as the result of
gap between perceived quality and expected quality. Therefore service quality is perception
minus expectation. Service Quality Model emphasises on determinants of service quality like
access, communication, courtesy, credibility, reliability, tangibles, understanding of the
customers and security. The authors devised an instrument named SERVQUAL and it is
questionnaire to measure the service quality of the healthcare. Knowledge gap is about
difference between nurses’ belief about customer expectation and actual needs of the service
users. In addition, standards gap is the gap between quality standards and perception of
customer expectation. Delivery gap is about difference between actual performance and

specified delivery standard (Kansra and Jha 2016). Service gap is about difference between
customer expectation and the perception of the customers. SERVQUAL is specified overall
gap between what is delivered and what is expected. Service quality concept is relative and it
is not absolute. Moreover, quality can be determined through customers; perception, not by
the healthcare professionals. Service quality can be gained through exceeding expectations of
the service users.
Theme 8- Increasing healthcare management efficiency
Healthcare management are concerned about losses and profit; however, they have to
be concerned about management efficiency. Culture Care Theory provides a framework for
giving services to the diverse population and it gives an approach to promote culturally
congruent nursing to different people who have similarities and differences in well-being,
health and illness (Zineldinet al. 2014). Healthcare management efficiency can be increased
if the nurses get training about safety of the service users and cultural factors of the service
users. Enterprise Resource Planning can be used in healthcare in order to increase the
healthcare system. Implementation of ERP system can smooths the work process in
healthcare stopping the impediments. ERP can heal the project if it costs more than budget
and if it takes longer to implement the project.
Efficiency of process in healthcare incorporates about operational practices and
planning that can reduce the negative impact on clinical services. Efficient people is needed
to enhance the quality of service as the challenge to deliver better service lies in efficient
nurses who can adopt innovative way to communicate, providing services and technologies
(McFadden et al. 2015). In addition, collaboration is needed in workplace with better
infrastructure that can improve the potential problems and it can engage stakeholders in
healthcare process. Technologies in healthcare will eventually improve the success factors.
The challenge lies to balance the complexity of implementation and cost. Application of

technologies will eventually help the transform the information and it will also increase the
service quality. Moreover, it is needed to implement the solution effectively with right
outcome. Implementation of system needs to support the key consideration of the business
with objectives, people-centric process and ROI (Winters et al. 2016).
Implications for the Project
The cultural safety concept and framework have many positive implications for
nurses in Arab country and many nurses are there in Arab communities to provide health
services. Nurses have to treat the patients have different views, religions and differently
aware culturally. Making culturally safe healthcare may promote the retention of the nurses
more and safety and quality of the service users can be ensured through this. Nurses face the
issue to adjust institutional climate, emotionally and socially alienation when promote the
cultural safety. Cultural safety helps to improve the patient safety culture and service quality
of the hospitals eventually increases. Improvement of hospital performances is needed in
order to ensure better performances of the nurses. Nurses will understand the cultural safety
at workplace and it can promote the standard of services to the patients. Cultural safety is a
guide to the nurses to work in multicultural environment, however, the encounter of the
patient and nurse is bicultural encounter (Margaret et al. 2015). The cultural safety
framework has its potentiality in order to create attention to legitimacy of differences to raise
aware of patient safety.
Summary and conclusion
In this section of the study, cultural safety and quality in healthcare has been specified
with identification of issues. The discussion has been done using secondary sources and
culture of nurses has not been overemphasised, service users’ quality care has also been
discussed. In Arab, culture safety is important aspect as there most of the nurses are believers

of Islamic faith. Simplified application of cultural safety can promote reductionist viewpoint
to find the issues in ethnic groups. In Arab, cultural safety needs to make an impact to take
grass root initiative in order to understand the complex pedagogy. Theoretical perspective has
to be used in practical spheres and cultural safety framework can be included in government
planning and public policy.
Reflection
The Organizational Development must be able to identify the different components to
produce a positive outcome. It is important to understand that the developmental process of
the company and also must be able to identify the needs of the change of the company and
communicate the problem in a clear and precise manner. The following chapter has also
provided the research strategy where stress has been given on the use of the secondary data
sources to conduct the thematic analysis of the following study. The key importance was
provided to the cultural safety and respect of the organization, patient safety and different
nursing principles followed by the management of the Hospital Authority.

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Chapter 3: Organizational development process

Table of Contents
Introduction
Overview of Organizational Development
Brief Critical Review of the Approaches to Organizational Development
Rationale for the Model Selected
Choice of Model
Core principals of the chosen Model
Initiation of the Model
Planning of the Model
Planning will involve some steps. They are as follows;
Implementation of the Model
Mainstreaming of the Model
Ethical Considerations
Findings and Conclusion
Appendix
Appendix 1
Appendix 2
Appendix 3

Chapter 3
Introduction
The term Organizational Development can be termed as the study of the specific
perspective and the area of expertise, which speaks for the particular challenge (Aarons et al.,
2015). A particular way to define organizational development is that it can be termed as the
systematic approach that helps to improve the organizational effectiveness. It helps to align
the strategy, people and processes. The organizational development is one of the most
integrated models of the business development and it helps in the proper and efficient growth
of the organization (Aldosari, 2014). The theory and practice of planned system can be
considered as a planned and systematic change towards the attitudes, beliefs and values
possessed by the employees working in the organization (Anderson, 2016). Organizational
Development is much more action oriented in nature and helps in the proper growth of the
business.
Various factors affect the success of the large-scale medical industry, which include the
knowledge, and the abilities of the employees, the technologies and the customers of the
business. Organizational development helps the employers to determine which kind of
processes can help improve the business and take care of the business related activities
(Aldosari, 2014). The organizational Developmental so helps in the development of the
personal and professional skills of the employees and helps in the development of the
business in a constructive way. The management of the organizations selects the different
kinds of the organizational development models and process according to the needs of the
organization. Some of the most common methods selected by the management of the
organizations are as follows:
a) Revamp the organizational structure

b) Develop the customer service training
c) Creating a revamped Project Management System
d) Improving the Customer Relationship Management
e) Review Product line
The points mentioned above can help in undertaking positive change in organizations. A
proper organizational structure can help King Abdullah Children’s General Hospital to
understand the priorities in the business. Customer service training can help in providing
perfect services to the customers and ensure that the children and the parents remain satisfied
with the type of service that is provided by the hospital. A revamped project management
system can help in ensuring that excess financial loss is not sustained by the hospital owing to
the implementation and application of new equipments for undergoing changes. The product
line can help in improving the relationship system with the customers as products related to
the satisfaction of the children as well as communication with the parents can be undertaken
properly.
Overview of Organizational Development
The capability of the organization to formulate and apply practical; strategies in order
to retain and attract more and more nationals into the health profession is a clear priority for
the effective reform of the health care system of Saudi Arabia (Anderson , 2016). The main
concept of the organizational development of the healthcare industry will be to make the
Saudi Arabian people more skilful and developed to have a proper understanding of the
different types of the changes in the industry. However, the efforts of the industry may not be
enough to solve the problems or the different challenges faced by the industry (Anderson,
2016).

It is necessary that the hospital formulate realistic goals and adopt a long-term strategy so that
consolidation with the management of different industries such as Government and private
sectors can be undertaken. This provides an opportunity for the hospital to remain aligned
with the strategies undertaken and work towards the satisfaction of the customers. To meet
the increasing pressure of the Healthcare system of Saudi Arabia, more autonomy has been
provided to the regional directorates of the country in terms of planning, recruitment and
proper and effective training of the different kinds of staff of the organization. The
developmental changes have also considered the implementation of the financial discretion of
the organization. The financial discretion of the organization has been mainly due to the
expenditure on the majority of the modern equipments and installation of new and advanced
systems to bring a positive change within the organization.
The health ministry of King Abdullah Children’s General Hospital has implemented a
number of different strategies for the improvement of the management of the public sector
hospitals during the past decades, including the direct operation and cooperation by the
Ministry of Health. The different types of such improvement will help to deliver the best
services within the organization. The relation to this with King Abdullah Children’s General
Hospital is that the relationship with the customers can improve. The hospital can develop a
stable mode of communication with the customers and provide assurance that it could proper
care of the children. Proper training and recruitment of experienced and talented employees
can help King Abdullah Children’s General Hospital to proper in the hospital industry.
Brief Critical Review of the Approaches to Organizational Development
According to Anderson (2016), the Organizational Development process is dependent
on a number of different types of approaches. These kinds of approaches are generally based
on the implementation of two different kinds of theories. Theories such as Change Process
Theory and Implementation theory can be considered to understand the organizational

development process. The reason behind the selection of these two changes is that the
Change Process Theory helps in identifying the dynamics related to changes. On the other
hand, the Implementation theory helps in generating the changes and different actions are
taken as guide for managing the change process in organizations. On the other hand,
Aaronsetal (2015) states that each of the different theories encompasses the different
categories of the development and are further comprised of many other kinds different
individual models. One of the most key differences between the development process and the
implementation approaches is the fact that the former concerns the dynamics of the change
management whereas the latter addresses how the different actions generate change and what
actions can be initiated to guide the developmental process.
According to, AlBuhairan et al., (2015) the theories of the organizational development
include the utilization of the HSE model. For example, the model states the assumptions for
the individual models are guided by the combination of one or more theories related to the
model. Instead, Aldosari (2014) states that most of the organizational change models have the
tendency to change in the presence of different change processes or different kinds of
implementation theories.
In the following review, the phases through which the organizational change unfolds as
described by the different types of Organizational Development Models. The HSE Model
will be reviewed in this following chapter on the following elements. The reason of the use of
the HSE Model is that it provides an analysis of the organizational development and the
mitigation theories that can be applied for preventing drastic change in the organizations.
Some of the factors that will be used to review the application of the model include:
1. Characteristics of the planned change model comprising of the background
2. Key individuals and assumptions

3. Comparison of the models
4. Strengths, weakness and effectiveness of the HSE Models
5. Implications of the creation for the learning organizations
Rationale for the Model Selected
Organizational change is also dependent upon the change in the minds of the people. This
means that with the changes in the type of business that exists in the competing market,
employees and employers sometimes demand changes to maintain competitive advantage. In
order for the change to be successful, it is necessary that a certain set of factors be
considered. These include:
 A compelling and clearly articulated shared vision of the integrated health and social
care delivery
 Effective utilization of the different resources that supports the developmental process
 Measuring the amount of performance that helps to ensure accountability at all levels
 A commitment to ensure that the needs of the different kinds of the service users and
the communities are at the centre of planning and decision-making
The HSE Change Model has been developed in order to
 Improving the efficiency of the employees of the organization
 Improving the experience of the patients and the relatives of the patients
 Promoting a consistent approach that will help to change the system and develop
changes in the organization
Choice of Model
The HSE Change model has been accepted and put into use by the management of the
following organization to usher in the development process in the chosen medical institution.
Change is a constant feature in health and social care. The Saudi Arabian hospital though late

in implementing the changes has finally started the process of the developmental change in
the organization. The management of the organization was able to make sure that the change
implemented by them was able to address the different kinds of the cultural aspects of the
organization.
Core principals of the chosen Model
The foundations of the HSE Change Model are based on the formulation of a proper and
healthier lifestyle (AlBuhairan et al., 2015). The mission and vision of the HSE Change
Model is to make sure that the organizations can provide an enriched user experience and a
fulfilled if the core purpose of the HSE model (Baldwin, 2016).The vision of King Abdullah
Children’s General Hospital is to provide access to each and every person with high quality
care and services. As stated by Aldosari (2014) some of the core principals of the HSE Model
are as follows:
 Ensuring that the needs of the service users and the local communities together with
the interests of the staff are at the core of the different parts of the system
 Placing a particular emphasis and focus on the partnership and team working.
 Prioritizing the long term sustainable changes and improved form of organizational
effectiveness
 Providing for the transfer of knowledge and skill son that the system equips
themselves with the tools to manage the different changes
 Promotion of different processes of organizational learning through the maintenance
of a regular feedback program.
 The regular feedback and maintenance program will help the organization to keep a
tab on the developmental process and get a clear idea of the improvement process of
the organization

 The management must give ample importance to the long term sustainable change and
must take care to improve the organizational effectiveness
 Building a proper communication, integration, connection and focusing on
establishing long term relationships within the organization and also within the other
people who are related to the organization
The HSE Model can be divided into four different phases which leads it to the different types
of the organizational development process. This includes the four stages starting from
Initiation, Planning and Implementation and last but not the least mainstreaming. Figure 1
provides a detailed framework of the model
Figure 1: HSE Change Model
(Source: Anderson, 2016)
Initiation of the Model

Figure 2: Initiation of the HSE Model
(Source: Aldosari, 2014)
This is the earliest stage or the first stage is to create readiness and a considered case for
change, to establish a sense of shared responsibility and to scope out a solid foundation for
successful change. The phase will determine what one will pay attention to and plan for the
future (Aldosari, 2014).
The key point or the groups will be directly impacted upon the by the change or the person
who is responsible for carrying it out. The initiation process of the model is divided into a
number of different steps. This includes:
1. Identification what is driving the need for change and the degree of urgency- The
HSE Vision for Change is identified by the vision of easy access, public confidence
and staff pride. It is believed to be the guiding context for the change in the
organizational service, team and the individual levels. It provides a unifying and
consistent direction for the change across the total system. It is also important for the
hospital to access the different drives and measure the degree of urgency for the
change to happen in the organization. The relationship of this with the project is that

without proper drive, it can be difficult for organizations to instigate change and at the
same time ensure that urgency is maintained in the organization.
2. Clarification of the leadership Roles and Identification of the important influencers
and the stakeholders of the organization- The management must clarify the roles of
the different leaders. It is the task of the senior managers to carry on the delivery and
the responsibility of the improved services of the population so that the company
serves and act as the key change leaders in the system. The leadership roles must be
communicated within the organization to maintain a proper and effective productivity.
A part from this the management of the hospital must take care to identify the
influencers and the stakeholders of the organization as because it is a multi-cultural
and multi structural environment. This could be an effective in the structural changing
process of the medical organization, as good leaders will surely give a major boost to
the organizational performance.
3. Assessing the readiness and the capacity and capability for the impending change-
The identification of the key influencers and leaders in the change process is
important for the development of an organization. Apart from this, the next step of the
management is to make sure that the on how ready people are to undertake the things,
which are required, and to identify the most proper ways of supporting the people
through the change. The readiness for change must pre-empt resistance and increase
the potential for effective change within the organization. Apart from this, the
capacity of change relates to levels of organizational commitment to resource the
change and ensures that all the staffs have the knowledge, information and skills to
take important responsibilities for the actions of the departments. In the case of the
organization, the readiness and capacity of the change can help in motivating
employees to accept the changes.

4. Participate in the organizational Politics- The people must understand the
organizational politics and the political dynamics of the organization and the power
environment. The different types of cultural and political factors can have a positive
or negative impact on the success of the change in the behavior. The culture of the
organization and the relationships between the people at all the levels are key to the
success and should be used in a constructive manner. Organizational policies can help
in gaining power in the organizations
5. Identification for the points that provides opportunity and also the different types of
leverage- Leverage points is places in the organization where small focused action
can produce different kinds of efforts in the system. The leaders need to continuously
scan the environment to identify the different kinds of change in one part that will be
producing a key change in the system of the organization. This could be an effective
in the structural changing process of the medical organization.
6. The management must perform a primary assessment about the impact that the
change will produce- At an early stage of the change process it is important to assess
the impact of the change on the current services. The initial impact of the analysis is a
powerful process to gain insight into the different kinds of the impacts that are a part
of the process. The personal and team development work concentrates on the
relationship building and the leadership capabilities helps the organization to make
the most of the cultural environment. The build up to the alignment with all the
stakeholders for the overall change processes will help to assist the potential tension
or the conflict in the system.
7. The management must also outline the initial objectives and the outcomes for the
change- The management must also make sure to communicate the objectives of the
organization including the vision and purpose of each and every of the objectives. The

information will be useful for the proper functioning of the business. Outlining the
changes can help in maintaining the focus of the employees towards the organization.
The information that will be gathered will be used to assist in bringing the clarity to
the processes of outlining early objectives and outcomes (Aldosari, 2014).
8. The management must consult with all the stakeholders and parties involved in the
process and decide on the amount of the initial resources that are required-The
management of the team must consult with the different employees and the
stakeholders of the organization to get a clear idea on the initial amount of resources
that are needed for the organization. The main types of the resources include hospital
equipments, technological resources and other kinds of different resources that are
needed for the advancement of the business. This could be an effective in the
structural changing process of the medical organization.
9. Last but not the least in anyway, the management must also outline or mark the
initial business case for different kinds of change- The last stage of the HSE Change
Mode l is based on the outlining of the business case. In line with the project
management methodology it is always appropriate conduct an end stage review so
that the changes that need to be made can be agreed and approved at the appropriate
level before progressing to the next stage. This could be an effective in the structural
changing process of the medical organization
Planning of the Model

Figure 3: Planning the HSE Model
(Source: Aldosari, 2014)
The main purpose of the planning is to ensure the specific purpose of the change to be
implemented and organize detailed procedure to ensure that the process of the change is
much smoother. The support provided helps to aid the communication process and make the
process of the development easier. Some of the main tasks that are carried out in this stage
include:
1. The organization creates a shared vision for change and is much concerned to take
the following forward.
2. The management of the mentioned Saudi Arabian Hospital will design the future
state of the hospital and the impact that the development will have will also be
discussed
3. The management of King Abdullah Hospital will negotiate and agree with all the
different stakeholders and the management will also create a project plan
4. The management will also have to assess the company’s capability to meet the
changes as it may be not possible for the organization to meet the demand of the

organizational development
5. A steady communication plan for case change will be implemented by the
organization.
Planning will involve some steps. They are as follows;
 Building a shared Vision- The HSE vision for change is easily accessible and
formulated with proper form of public confidence and pride of the staff. The
employees must need to understand the meaning of the development and also gain an
idea on the change that is being undertaken. It is important to get an idea of the
different type of the vision to perform better and achieve the desired results for the
organization.
 Communication of the business vision- The employees will be aware of the change
that has been undertaken after they gain a proper idea on the different characteristics
of the organizational development process. It is important for the employees to gain a
clear understanding of the change and their new roles in the organization.
 Increase the readiness and capacity for the change- It is important for the
organization to prepare the capacity and readiness to make sure that the management
is easily compatible enough to easily accept the change.
 Showing that the change is ongoing- The people must be shown the change process
to make sure that they are convinced about the change and that they will be positive
towards the change.
 Determination of the change details- The key tasks of the change details includes the
gathering of information and also designing the different actions to bring about the
change in the hospital
These steps can help King Abdullah Children’s General Hospital to implement the
changes and ensure that the hospital maintain a reputation in the business. The capacity of the

hospital and the manner in which changes can be implemented in the hospital can help it to
determine the changes with an increase readiness and capacity for change.
Implementation of the Model
Figure 4: Implementation of the HSE Model
(Source: Anderson, 2016)
The implementation is perhaps one of the most crucial tasks of the organization and it
involves extreme accuracy and professionalism to make the most of the organization. The
implementation will lead to a detailed design of the organizational services and changes that
will enable the organization to achieve the vision for the development (Aldosari, 2014). The
preparation work that will be completed by the management of the organization will help the
management to implement the developmental plan much smoothly and in an organized
manner. The following step will involve the communication of the different designs in the
future and the detailed study of the design formulated by the organization on its feasible and
continue with the implementation of the model in the hospital. It can be related with the
organization as the implementation of the data along with the acknowledgement of changes

in the communication strategy can help in the continuous improvement of the hospital. The
main factors that are considered for the implementation includes:
 Clarity of the commencement of the implementing dates
 Acknowledging the change management tasks and proper communication with the
different stakeholders and the employees of the mentioned hospital
 Supporting of the new behaviors that are required to adopt in the changing
environment
 Continuous scanning to ensure that the old ways of working has been phased out
suddenly
 It is important for the managers to be available to the staff all the time to solve the
difficulties of the employees
Mainstreaming of the Model
Figure 5: Mainstreaming the HSE Model
(Source: Anderson, 2016)

The mainstreaming is the last step of the HSE Model. The purpose of mainstreaming is to
focus on the attention to the success of the change effort and on integrating and the sustaining
the new ways of the working and behaving (Aldosari, 2014). The mainstreaming will be
delivered by the organization by a number of different ways. This includes;
 The individuals and the teams will be supported in understanding how best to work.
 The temporary structures that were being followed will be discontinued by the
hospital. This includes, old software and other types of traditional practices
 The people involved in the change will get the idea that the change is completed
 There will be no issues or minor issues in the workplace and greater efficiency will be
noticed. This again will prove the success of the change plan
The organization can benefit from the implementation of the HSE Model by engaging various
team members. The old software that is included in the organization includes implementing
the ideas of change and gain efficiency in the workplace.
Ethical Considerations
Ethics is said to be one of the most important considerations of the organizational
development project. The project plan must be based on a proper ethics, honesty and
integrity. The project participants who will be used for collecting the primary information
related to the organizational development of the hospital must not be harmed physically and
should not be forced in any way to manipulate their choices. Apart from this, the people must
not be forced to participate in the survey. There should also be a consent form that entails the
permission of the management of the hospital so that it can carry on with the organizational
development project. The consent form must have the signatures of both the management of
the organization as well as the participant. The participant must also have the scope to quit
the project whenever he feels to do so. The ethical considerations can help in the legal

management of the project and provide free access to the employees to either continue or
discontinue with the project.
Findings and Conclusion
The analyses of the report on the organizational development that need to be
implemented in King Abdullah Children’s General Hospital have produced positive results
for the hospital. This includes the proper and transparent understanding of the HSE Model.
The HSE Model has shown the proper ways by which change occurs in the Saudi Arabian
hospital that starts from the plans to implement it, its planning, integration and adaption of
the employees.
The following chapter has provided the beginning of the change in the organization and the
developmental process that has been implemented in the organization. The report has been
able to point out and highlight the important elements related to the developmental process of
the organization in focus. The next two chapters will further provide a more detailed
discussion regarding the same topic.
Reflections
The literary review of the study has also provided the depth of the given study.
According to me the literary review of the given study has included all the components of the
related subject which will help to deduce the actual results of the developmental process in
the organization. The following chapter has helped me to learn the plans on how the
management will implement the change in the developmental process of the organization.
This will include the likes of the revamp in the structure, Development of the customer
service training of the organization and also focus on building a strong between the customers

and the management. The rational for the HSE Model will help me to conduct future research
on the same subject. It has also helped me to develop the understanding and conscience on
how to choose a particular model and get the idea of its effectiveness in the organization.

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Appendix
Appendix 1
Figure 1- Organizational Chart of King Abdullah Hospital
Source: (Weaver et al. 2016)

Appendix 2
Figure 2- Efforts to Improve Patient Safety Records
Source: (Frich et al. 2015)
Appendix 3

Figure 3- Routine Checkup of the management on organizational development
Source: (Burgess et al. 2015)

Chapter 4: Evaluation

Table of Contents
Chapter 4: Evaluation
4.1 Introduction
4.2 The significance of Healthcare Evaluation in Saudi Arabia
4.3 Evaluation
4.3.1 Aims
4.3.2 Methods and measures
Qualitative Methodology
Quantitative Methodology
Methods for the use of the Study Models
The Approach to the Organizational Development Process
Design of the Study
4.3.4 Results
4.3.5 Dissemination plan
Data Collection Technique
Data Analysis Technique
Ethical Considerations
4.4 Summary
References

4.1 Introduction
The literature review part of the following chapter showed the organizational development
model. The literature review most importantly helped the project to construct the
organizational development model that was needed to properly guide the study. The
following helped in the identification of the different elements of the study The aim of this
project was to get the idea of how the management of King Abdullah Children's Specialty
hospital undertook the organizational development change. The changes involve a number of
techniques and processes by which the organization carried out the changes and the ways by
which these changes were implemented and adopted by the employees, workers, doctors, and
nurses of the mentioned hospital. The report also provides a detailed analysis of how the data
was collected and how it was analyzed.
4.2 The significance of Healthcare Evaluation in Saudi Arabia
The economic development of the oil-rich state of Saudi Arabia has contributed a great lot for
the development of the health picture of the country. The last two decades has been a game
changer for the Saudi Arabian Health Services as it has expanded and developed itself to
global standards. The Ministry of Health Services, under the monarchial government of Saudi
Arabia, provides almost 60% of the health services to the people of the country, whereas the
rest 40% is shared between other agencies of the government and the private sector
(Zamanian et al., 2015). The rapid development of the health education facilities, quality
infrastructure, good quality hospitals, and trained manpower has been the main reasons
behind the success of the Saudi Health services (Zamanian et al., 2015).
The health services of the mentioned West Asian nation existed from the year 1949 when a
small number of doctors, medical staffs and a limited number of hospitals were present in the
country. However, the oil economy of the country provided to be the catalyst for the

development of the health industry (Frich et al. 2015). The increase in population, rise in the
demands for affordable healthcare and healthy investments in the sector helped in the growth
of the country. The country provides around 60% of the health services totally free of cost
through thirteen health directorates. The health sector will, however, face several challenges
in the coming future which if not tackled properly can be destructive for the health sector of
the country (Zamanian et al., 2015). Some of the main challenges include;
a. The management and financing of the health services
b. Development in administration of the hospital
c. Development in the organizational structure of the hospital
d. Development in the way the hospital provide treatment
4.3 Evaluation
4.3.1 Aims
The aim of this Chapter is to evaluate how to successfully implement a change management
in the chosen medical institution for the betterment of the organizational performance.
4.3.2 Methods and measures
The methodology is concerned about the general theoretical perspective of the study and
states the overall nature of the activities undertaken in the study. It is concerned with the
perspective of the study that the investigator wishes to examine (AlBuhairanet al., 2015).
This particular study has involved the use of both the qualitative and quantitative methods to
find out the results and analyze them accordingly (Aarons et al. 2015). The use of both the
study methods has helped the study to become flawless and has also helped to include all the
different information to make a compact study. While constructing the fundamental planning
of the project it was seen that to ascertain the information needs of the following study and

the different ways and patterns of seeking the information a guide to the study design was
needed to determine the different approaches of the following report. The main theme used in
the following study is both primary as well as secondary.
The purpose of the project is to establish safety culture management in the hospital and the
objectives have been well identified in this chapter. The objectives are;
➢ To aware the staffs and develop their knowledge and skills for achieving the
hospital’s safety culture assessment of 96% by the end of 2018
➢ To attain 95% in hospital’s safety healthcare service practice by2019
➢ To increase the management efficiency to 90% by2019
➢ To increases the management’s efficiency in handling patient safety culture by 2019
Qualitative Methodology
The use of both the qualitative as well as the quantitative methodology can be seen in this
chapter which has been helpful to determine the results of the organization. The qualitative
study methodology concentrates on the theoretical aspects of the study that is quite important
for the evaluation of the study. According to, Ciottone et al., (2015) a qualitative study is thus
rarely simple because it clearly recognizes the different dimensions and layers of the issue
being studied. The following methodology of this particular study describes, interprets,
verifies and evaluates the literary part of the study and thus presents the readers with a clear
picture of the topic.
The above-mentioned discussion thus paves the way for the use of qualitative study
methodology in the proper analysis of the study as because it helps to determine the ways by

which the management of the mentioned hospital has applied the Organizational development
into their system. The study is highly interpretive as it provides aims to gain insights into the
different process and technological changes that help the organization to fight any kind of
challenges in the future and provide high quality, safe and secure services to the patients of
the hospital. The information has been received on a secondary level analysis collected from
different sources, like that of earlier studies on the same topic, books, journals and another
similar kind of sources. The qualitative study of the collected data shows the different
dimensions of the organizational development in King Abdullah Hospital and thus becomes a
crucial part of the study.
Quantitative Methodology
The following methodology clearly requires the proper amount of information that can be
measured by means of a statistical analysis of the organization. Such a study will involve the
collection of several different observable events and facts that can be measured easily. The
study introduces a theoretical framework that is established from the literature review
(Aarons et al. 2015). The framework, on the other hand, helps in the formation of a
hypothesis which emerges and creates a few different variables. This then transforms itself
into the different kinds of aims and objectives of the project. However, in this study it does
not uses any hypothesis or rationale and is based on simple data like that of patient review,
employee review to calculate different types of observations.
Methods for the use of the Study Models
The investigator has used a number of different models in this business which includes the
likes of Three Step Model, HSE Change Model and has also used the PSDA Cycle to show
the organizational development process in King Abdullah Children's Specialty hospital.
Beginning with the first model or the three steep models the employees and the management

have provided quality inputs to the use of the freezing, defreezing and refreezing ways to
attain the development in the organization. Similarly, the HSE Models have also been
discussed accordingly (Buffoli et al., 2014). The study showed a qualitative method to show
the plan implemented by the organization and the different resources used by the organization
to support the different changes made by the mentioned organization. The HSE model was
developed by utilizing the different types of information that was received from the
management on how the process of development in service quality and other changes were
accepted by the organization and the use of the processes to ensure sustainability in the
mentioned healthcare enterprise. The PSDA cycle of the organization has also been provided
in the assignment which shows the staffing policies, security policies and the reaction of the
management to emergency situations. The use of all these methods has been helpful for the
following study as because all the different observations regarding organizational
development process was followed in determining the topic of the study. The objectives were
evaluated by analyzing the developments and keeping a strict observation over a certain
period of time.
The Approach to the Organizational Development Process
The approach used by the investigators is basically the particular approach where the
hypothesis is formulated based on the previous studies and concepts. The deductive approach
thus provides the investigators to build on the already existing set of studies and other
previous observations (Gilman et al. 2015). Thus, the time limit of the study gets reduced as
the investigator does not have to waste time in gathering other types of information. The
investigator can also be able to understand all the objectives of the study and can easily
construct the different kinds of study questions. Moreover, the following approach of the
study helps the investigator to make observations based on the previously existing literatures,

concepts, and theories. Therefore, the investigator is easily capable to understand whether the
objectives of the study, questions arising from the study is fulfilled or not. Moreover,
deductive approach is also concerned with the transformation of generalized information to a
precise and specific form of information. The deductive approach has another advantage as
because it is best suited for going well with the positivism philosophy. On the other hand,
inductive approach in the project deals with the findings of new approaches and patterns.
Therefore, in the case of the inductive approach, the investigator must again search for new
information and develop new kinds of concepts and different new theories. Therefore, it
automatically increases the time to conduct the study and shifts the attention of the
investigator from questions to observation or description of the findings to the analysis of the
observations.
Design of the Study
Study Design provided by the investigators helps the study to attain a proper shape and
increase the scope and effectiveness of the study. There are generally three kinds of different
study designs (Frich et al. 2015). This includes exploratory, explanatory and descriptive
forms of study designs. An exploratory study design when used in a study is seen to be
testing the hypothesis of the study and the study questions and objectives. The following type
of study design also helps the investigator to clarify the various themes and topics that are
used in the review part of the study. The explanatory study design is the study design that can
provide different kinds of opportunity for the investigators to explain the reasons behind a
kind of phenomenon. The implementation of the explanatory study design helps the
investigator to predict the future occurrences of a phenomenon that has been discussed or is
related to the study. Last but not the least in anyways, the descriptive type of study design is
the combination of both the explanatory as well as the exploratory types of study design. The

descriptive type of study design clearly describes the characteristics of a population or the
selected participants of the study by means of data collection. The dual benefits of the
descriptive design make it an automatic choice for the investigators for implementing this
kind of study design.
As mentioned earlier the investigator has used the descriptive study design to complete the
Organizational Development analysis of the study. The descriptive designing of the study has
been useful and has provided a proper opportunity to clarify the formulated hypothesis and
the study topic. The use of the study design has allowed the investigator to develop a strong
understanding of the cause and effect phenomenon of the study rationale and has also allowed
the investigator to predict the future occurrences of the specific rationale of the study (Frich
et al. 2015). The clarification and the prediction of the future occurrences were not possible at
the same time by using any of the other types of study designs. The descriptive design was
also used for the formulation of the study as because it detailed out the different changes that
took place in the management system of the organization. The investigator has also been able
to get a detailed picture of the hospital’s organizational change policies and the way they
implement them. The study design has thus been chosen based on the suitability of the study
topic. The designing will help the project to get a certain path which will help in its proper
evaluation.
4.3.4 Results
While collecting data from 50 different employees in the mentioned hospital, there are few
distinctive factors that have been observed. Some of the respondents have mentioned that
they would prefer an enhanced technology usage that will improve the overall security and
safety issue of the hospital. A better technology will help the management to protect its
patients’ data from any unethical usage. Few employees mentioned that the organization has

experienced litigation issues due to leaked data of patients in the past, therefore the
management should immediately work on this issue so that they can gain the trust of their
patients which will eventually also help to improve the overall productivity of the
organization. Some healthcare managers have expressed their views on providing adequate
professional service in the mentioned hospital. One of the participants has indicated that to
gain better productivity in the organization, it is necessary for the organization to perform
better at the same time. Therefore, having more expertise in the organization would be
helpful for performing better. Some respondents have also mentioned that not only the
doctors, nurses and the other individuals associated with the health care should improve their
expertise but also the administration should enhance their performance by improving their
effectiveness. One has mentioned that improving the safety and security system may be a
significant aspect in this case, however at the same time the administration should also focus
on the other aspects such as managing the teams in a better way so that the organizational
duties can be performed appropriately, bringing an enhanced human resource in the
organization etc. Other than that, some respondents have also mentioned that the organization
does not really have on job training and development programs that can help their employees
toshape their credibility and performance and take in to a higher level. Some of the
respondents have also mentioned that the mentioned hospital lacks a proper communication
process between the management and the employees therefore there have been several
instances of severe misunderstandings. Some employees have also mentioned that the
organization lacks a separate department for managing the organizational communication.
Numbers of respondents repeatedly mentioned that they consider that the administration of
the mentioned hospital lacks proper training and development programs for each of the posts
they hire. Some mentioned that theyreceived a brief training however it was difficult for them
initially to cope with the entire system of the mentioned hospital. Along with that, some of

the respondents also indicated that the organization needs a proper training program for
handling the children’s department as well.
4.3.4 Dissemination plan
As mentioned earlier a scientific based study consists of four most advanced types of study
strategies. These include case study, action study, survey conduction and different kinds of
interviews. Case study concept of study strategy includes the highlights of the real-life factors
that are evaluated by analyzing individual behaviors related to a particular topic (Gilman et
al. 2014). This helps the investigator to analyze and conduct the behaviours of different
people related to the study. The strategies selected by the investigators thus helps to analyze
and individual behaviours of the people or analyze the different organizational change
policies to determine the results of the study. Action study, on the other hand, is generally
implemented to find the different issues that are related to the studies. Solutions of the study
issues are provided at the
time of the conduction of action study. Interview and survey are two totally different forms of
study strategies where the raw information or basic data is collected and then analyzed
accordingly both in qualitative and quantitative ways (Jabri, 2017). The survey is thus the
strategy of data collection where the when, where, how and what are determined that
provides a rich statistical perspective of the mentioned organization. All the different kinds of
strategies have their own set of interests. The investigator in this study on the organizational
change process of King Abdullah Children’s Hospital has selected the survey strategy to
determine the results of the study. The survey has been basically conducted by 50 different
employees of the mentioned hospital of Saudi Arabia.

Sampling Technique and Sampling Size
The investigator in order to conduct the survey and collect the genuine information regarding
the topic selected in the particular study has to select the appropriate and most applicable
sampling technique. The choice of the best sampling technique is essential for the success of
the study. In this particular study, the investigator has used both the probability and the non-
probability sampling technique to determine the results. The samples of the survey are
selected from a wide array of population based on some specific criterions that include age,
sex, gender as well as the experience of the employees. The probability sampling technique
can be defined as the particular way in which the participants are provided equal chances for
the process of the collection of data. All 50 participants of a selected group are provided with
the equal opportunity to participate in the survey and provide their responses. On the other
hand, the non-probability sampling technique can be defined as a set of different
unequal or uneven chances of the participants of the survey for a group or population that are
to be selected for the process of the collection of data. In this particular case of non-
probability sampling technique, the investigator has the ultimate say in the selection of the
different participants. The investigator selects the participants according to their suitability
with respect to the study topic. The investigator in this particular study has selected the most
experienced and the most talented employees who have a clear idea of the change process in
the organization. Thus, the employees who were earlier considered as a part of the
participants were neglected from the survey process.
The current study has used the systematic probability technique to complete the sampling
process as because the investigator wanted to gain clear and genuine information regarding
the Organizational Development process. Only the best employees of the organization who

have a clear understanding of the organizational policies, the experience of the change
process and the persons who had earlier felt the impact of the change process in the hospital
were selected for being the study participant and conducting the study. The systematic
probabcfility sampling technique was also conducted to avoid any forms of biases within the
employees. The data was collected from a selected group of 50 individual employees of King
Abdullah Children's Hospital and analyzed accordingly. The response of the employees was
collected both by formal and online survey processes.
Data Collection Technique
For the particular study, the investigator has used both the primary as well as the secondary
data collection techniques. The completion of the literary part of the study was completed by
the use of the secondary study. The use of relevant books, earlier studies, articles, scholarly
sources were used to develop a clear understanding of the following study which is based on
the analysis of the Organizational Development process of King Abdullah Children’s
Specialty hospital (Zamanian et al. 2015). The use of the secondary data collection methods
also helped the investigator with the opportunity to use the theories and models on the
organizational change process. The investigator has also used the primary data collection
methods to conduct the study. This included the formulation of both open-ended as well as
close-ended questions to make the most use of the following survey. The data was collected
from a total of 50 employees of the mentioned child care hospital of Saudi Arabia. The study
questionnaire was provided by the organization according to the study topic and the
responses received were analyzed properly to reach the conclusion of the following study.

Data Analysis Technique
The wide range of information that was collected from the use of primary as well as
secondary study techniques was needed to analyze to prove the null hypothesis and the
alternative hypothesis of the study. The data collected consisted of tables, graphical
representations, bar graphs and different charts. The providence of such figures helped to
consolidate the quality of the study and helped to increase the scope of the study. Statistical
analysis of the study always makes the study more approximate and accurate. The use of only
a data analysis design could have limited the scope of the study as because data analysis
technique in most of the cases fails to analyze the exact results, which leads to the
miscalculations and leads to false findings. Therefore, statistical analysis is always preferred
over the other forms of analysis.
Ethical Considerations
Ethics in a study is the most important and primary things that need to be considered in the
study. The absence of ethics will lead to the failure of the study and will not provide the
desired results of the study. The failure to reach the desired results of the study is never
acceptable. Ethics can be defined as a set of fixed guidelines that leads to the success of the
study. An investigator is bound to follow the ethical considerations of the study whether he is
willing or unwilling. The following of the different kinds of ethical considerations helps the
investigator to maintain a positive philosophy and gather the original as well as the genuine
data. The investigator needs to complete several different tasks to make the study a grand
success. First and foremost, the investigator needs to ensure the safety and security of the
study participants while the data or information is being collected. The investigator also
needs to take the permission of the Hospital Authority before starting the study and collecting
data from all the targeted participants of the study. The consent of the study participants is,

however, one of the most necessary tasks to be done by the investigator. Apart from this the
work must be genuine and honest in nature and the investigator must not copy anything from
other sources.
4.4 Summary
The following chapter has provided the detailed methodology and measures taken up by the
investigator to complete the following study. The investigator has also detailed the study
methodological tools with a suitable justification. The investigator has detailed out the study
approaches, study designs, study sampling and has explained in detail the use of these study
tools and other selected methodologies. The sampling technique has also been identified and
explained in detail to complete the following study. The methodology section thus has been
prepared in the correct way to attain the different types of the objectives as stated at the
beginning of the followingstudy.
References
The HSE Change Model selected for the study is quite appropriate to me as because it
is best suited for the developmental plans of organizations of such a stature. Apart from this
overall the following study has been of great help to me because it provides me with a
practical and precise example of the ways and processes to develop a business into a world
class height.

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Chapter 5 Discussion and Conclusion

Table of Contents
5.1 Introduction
Analytical Analysis
5.2 Summary
5.3 Interpretation
5.4 Limitations
5.5 Sustainability
5.6 Potential of Spread
5.7 Recommendation and Conclusion
Reflection
References

5.1 Introduction
Analytical Analysis
The following study had the aim to determine the security measures and the processes
by which the change management will be taking place in King Abdullah hospital for children.
As described in the previous chapters where the evaluation of the results have taken place, the
information and the data regarding the change management of the organization have to be
taken from the health care professionals and other people who are engaged with the particular
hospital. The survey that has been carried out in the project has provided a detailed and
compact analysis of all the kinds of the organizational charts that has been evident from the
calculation. The result from the first domain has showed that 81% of the respondents were
positive in nature and the result was quite equivalent to that of the outcome of the different
types of the measures and the respected benchmarks provided by the organization. A positive
response was found in other kind of studies that were done in the past in other parts of the
world (Zamanian et al. 2015). Communication and Team Work are very much important in
the build up to the organizational development as because effective, smart and technological
communication makes the employees of the hospital more and more effective and dedicated
in serving the company. Such an activity helps the organization to achieve high quality health
care and gain success in the market. The teamwork and such kind of activities are important
for the organizational development. Patient safety culture, good relationships with the
employees and implementation of the new policies in a proper way are important for the
organizational development. The results of the following study clearly show that no such
specific interventions are needed in terms of any kind of works concerned with the
development of the hospital. The positive team work may be equal in terms with that of the

positive ratings. Further steps can always be taken to improve and maintain the skills that are
required for providing the best services that will help to deliver the required tools for the
development of the organization. Team training for the implementation of the organizational
development is very much important for the delivery of proper health services by the
organization. The team training clarifies the roles of the individuals and also helps the
organization with advanced roles. The following approach helps the organization to improve
the awareness of the HSE Model in a proper adapted environment of mutual respect wherein
the health care team members are free to express the rules concerning patient safety
irrespective of the perceived roles and positions. The team concerned with the
implementation of the rules and policies of organizational development is unable to achieve it
in case; there are no such agreements or goals that are to be achieved. Effective team work
and leadership will help the management of the organization to ensure a trust and deep
relationship among the people. The more is the trust, cultural similarities, deep understanding
among each other, the more the chance to success. Previous failures in implementing the
organizational development process also acts as an extra trust for the organization. The
Stabilizing an environment of trust is key to the success of the organization.
The goals set by the management to implement the set of organizational goals will be
important for the success of the business organization. Organizational culture is one of the
most key forms and plays an important part in the development of the organization. The
absence of culture implies the absence of values, vision and integration of an organization.
There are different kinds of cultural development styles that are related to the different types
of the good or bad culture. However the management of King Abdullah Hospital believes
culture to be neither good nor bad or better or worse. All of the groups that work in the
following hospital has their own sets of advantages and disadvantages. This includes the likes
of the homogenous corporate culture that is implemented within the organization. However

the manager must also pay close and compact attention to the balance between sociability and
solidarity factors. The information gathered from the 4th chapter of the following study clearly
highlights the organizational learning, continuous improvement and the frequency of the
reporting of the different kinds of events that are directly related to the development of the
organizational set up and the organizational structures. The following can be done by means
of interpreting the domains which in turn will lead to less attention in comparison with other
kind of domains. However continuous monitoring of the domains requires the maintenance of
quality health care by the staffs and the management of the following Saudi Hospital.
Organizational development is one of the most vital elements in the development of the
hospital by all means. The establishment of an organizational learning capability and
providence of an emphasis on teamwork among the healthcare professionals have a great
form of importance and influence on the patient safety culture. Psychological safety is closely
associated to the organizational development process of King Abdullah Children’s Hospital.
The safety affects the organizational climate of the organization and thus the employees are
comfortable and express themselves without any hesitation. The psychological safety
contains taken for granted beliefs about how the employees response to the questions asked
by individuals and seeks feedback. Improvement in the healthcare and the training and
education has long been a tradition in the medical profession. The management of King
Abdullah Children Hospital has selected to instill development process to improve the
performance of the following organization.
5.2 Summary
The better the benchmark still it needs continued attention for maintaining and
improvement of the event that reports the ability of the health care professionals.
Organizational Development is a growing field as it helps organizations succeed in the

global, competitive and an interconnected world. There are many HR professionals, managers
and other kind of strategists in the competitive world that are interested in acquiring
Organizational Development mindsets. As mentioned earlier Organizational Development is
a data driven process for change and as a result the successful application of Organizational
Development interventions and tools has become increasingly dependent on the use of
information technology. The following chapter also focuses on the role of information in
contemporary change efforts and the impact that technology has on the practice of
organizational development over the last decade. The management of the mentioned hospital
has decided to enhance the skills of the employees and also transform the performance of
health care in Saudi Arabia. The use of data enhances the performance capability of the
organization. Each and every organization of the world is dependent on the data driven
process. Technology comes to the rescue of the different organizations by collecting different
kinds of information, processes and interfaces and helps to make data meaningful for the
people. Although many people take its impact for granted, information technology is what
connects different people in the hospital, organizations and the social systems of Saudi
Arabia. Technology generally drives;
 Organizational Communication (This includes E-Mail, Web sites, virtual contacts
and many more as such)
 Development of the organization efforts which includes the like of targeted
developmental feedback aimed at driving leadership and manager quality, self
directed learning and different kinds of knowledge that is important for the
management
 Standard Human Resource processes that includes the likes of online benefits, online
enrollments and many more as such

The beginning of the digital and revolutionary age is one of the main reasons for the
change in the organizational development. The role of information as key signs in driving and
evaluating initiatives related to the organizational development process and human resource
development is rather much more significant and important in nature. The organizational
change and Human Resource Development of the following organization is much more
important than all other aspects. The guiding principles and standard content underlying the
organizational change efforts has to be undertaken by the management by means of the
performance of the data driven process. High level technology is one of the most important
additions of the organization as because it helps in the determination of the organizational
goals and makes the most of the organization. Technology has presented significant
opportunities for the different kinds of organizations to advance in the different kinds of
unknown fields and develop new kinds of health care technologies. The implementation of
latest technologies in King Abdullah Children’s Hospital is also one of the largest
organizational development process undertaken by the organization. The technology
implemented has helped in the improvement of the safety of the organization. The safety
approach has been helpful for the organization to attract more and more people to the
organization.
As mentioned earlier in the introductory part the Health Ministr5y of Saudi Arabia
has implemented a number of different strategies for the improvement of the management of
both the public and private sector hospitals of the organization during the past decade. This
includes the likes of the direct operations or granting funds through third party. Different
surveys have shown that the organization will attract more and more number of people after
the inclusion of the development program. The management of the King Abdullah Children’s
Hospital has selected HSE change model for the proper implementation of the change

procedures. The selection of the HSE change model is significant as because it suits to the
demand of the organizational demands and the main demands of the
5.3 Interpretation
There are a number of different factors that have an impact on the current state of healthcare
in the mentioned hospital. Globalization has led to a number of different demands within the
industry, among which the main types of demands are;
a. The rise in the demand for high technology
b. The rise in the need for professional care in the hospital
c. The rise in the need for a high-quality care
d. Demand for a change in the health sector policies of the hospital
e. The rise in the demand for the organizational duties
The rise in the demand for the above-mentioned factors has been a revolution in the lives
of the patients visiting the mentioned hospital. The organizational development process in the
mentioned country depends on not only the local residents but also on the doctors and other
healthcare professionals from other countries of the world (Zamanian et al. 2015). The
absence of a proper infrastructure in Saudi Arabia, lack of adequate medical colleges has
been the building blocks to the smooth organizational development. The language is also a
barrier to the organizational development process. The people of Saudi Arabia mostly prefer
Arabic whereas the other people coming from overseas mostly prefers English and thus the
communication gap makes the developmental process vulnerable.
5.4 Limitations
Though the organizational development model has been implemented in the
appropriate way, there have been some serious limitations that have limited the development

process of the mentioned Children Hospital of Saudi Arabia. A number of serious limitations
have been observed during the course of this study. The management of the hospital has still
not been able to implement the high-quality services to the patients in spite of the
developmental planning in place (Weaver et al. 2016). The presence of a weak measurement
system on the performance of the employees of the organization has been a real failure on the
part of the management. Apart from this, there is also a lack of proper coordination and
communication between the different departments of the hospital which the investigator
believes the most vital among the paths to success.
5.5 Sustainability
As hospital business falls under the category of the hospitality industry, providing
service is the only factor that can effectively increase the profitability of the organization and
can enhance the reputation of the organization. Not only that, if the organization is able to
provide services to the customers or the patients and satisfy their needs effectively, the word
of mouth publicity by them can effectively increase the reputation of the organization
(Weaver et al. 2016). This team of the Hospital should utilize all the training and
development programs introduced by the management of the hospital in order to improve
their organizational performance so that the management can experience better productivity
along with profitability (Waddell et al. 2016). Securing the best interest of the company
introducing at dedicated for ensuring the safety and security of the patients is necessary. Thus
it can be said that introducing such a team in the organization is vital to ensuring the success
of the healthcare provider. Sustaining the organizational communication is also vital for the
best interest of the company. Thus to be precise the management of the hospital should stress
on increasing the organizational communication and ensuring the safety and security of the

children in order to overcome all the challenges that the company is facing nowadays
(Weaver et al. 2016).
5.6 Potential of Spread
The Organizational Development Process has high potentiality to spread to other
aspects of the market. This may include the likes of other business, educational Institutions,
other forms of business and many more as such.
5.7 Recommendation and Conclusion
The management of King Abdullah Specialty Children hospital should emphasize on
how they can improve the safety and security related issues within the organization. It has
been seen that for various reasons, the patients of the organization is getting exposed to
various types of threats. It should be the primary concern of the management of the hospital
that they should ensure the safety and security of the patients in order to sustain the reputation
of the organization. The managerial Board of the Company should deploy a dedicated team
who will observe and identify the issues that can potentially harm the safety and securities of
the patients and take in social actions in order to eradicate the issues (Vogus&Iacobucci,
2016).
It can be said that the disaster management team of the organization will continuously
try to develop their professional skills and get updated with time so that the organization can
expect better performance from them. The immense significance of better organizational
performance is one of the main necessities in today's situation. It can be said that the proper
maintenance of the safety and security of the patients is the key aspect of the administration.
This will help to project how effective the administration of the hospital really is. It is a
matter of fact that in today's world the management of the business enterprises should stress

on the safety and security in order to sustain the productivity reputation as well as the
profitability also. For this particular change, it can be saved that the hospital's management
can effectively implement various policies for the betterment of the situation and can space
on training and development programs for the employees of the business firm in order to
enhance the safety and security of the patients (Stroud et al. 2015). As the hospital is
dedicated to treating the patients for children the management should put in extra effort in
order to secure their safety issues in order to experience increasing flow of patients and better
profitability too. The management of King Abdullah Specialty Children Hospital can think of
introducing various programs in the organization for increasing the skills of the employees.
Such kind of training programs can help enhance the skills of the employees and help ensure
a better security in the hospital. The management of the organization should stress on
improving the organizational communication as that can effectively eradicate the
misunderstandings among the employees and the sharing of experiences and knowledge can
help the management to deal with all sorts of issues in the workplace (Weaver et al. 2016).
It should be the primary concern of the management of the hospital that they should
ensure the safety and security of the patients in order to sustain the reputation of the
mentioned hospital. The managerial Board of the hospital should deploy a dedicated team
who will observe and identify the issues that can potentially harm the safety and securities of
the patients and take in social actions in order to eradicate the issues. The disaster
management team of the healthcare enterprise so continuously tries to develop their
professional skills and get updated with time so that the organization can expect better
performance from them as it has become immensely significant in today's situation (Weaver
et al. 2016). It can be said that maintaining the safety and security of the patients is one of the
most vital aspects of the administration and it would project how effective the administration
of the hospital is. It is a matter of fact that in today's world the management for the business

organizations should stress on the safety and security in order to sustain the productivity
reputation as well as the profitability also. For this particular change, it is seen that the
hospital's management can effectively implement various policies for the betterment of the
situation and can space on training and development programs for the employees of King
Abdullah Hospital in order to enhance the safety and security of the patients of the
organization. As the hospital is dedicated to treating the patients for children the management
should put in extra effort in order to secure their safety issues in order to experience
increasing flow of patients in the hospital and better profitability too.
Reflection
The following assignment is one of the very best in the following subject and has
been of great help to me. The assignment has helped me to get a clear understanding of
Organizational development in a large scale organization and the different types of the
elements and processes that are involved in the build up to such a powerful process of change
management in the organization. I personally believe that an organization dedicated to the
commitment of providing quality health care facilities and services to the people must have
proper policies and continuous improvement in their structure. The change process will also
help the organization to ensure sustainability for the business.

References
Frich, J. C., Brewster, A. L., Cherlin, E. J., & Bradley, E. H. (2015). Leadership development
programs for physicians: a systematic review. Journal of general internal medicine, 30(5),
656-674.
Gilman, M., Adams, E. K., Hockenberry, J. M., Milstein, A. S., Wilson, I. B., & Becker, E.
R. (2015). Safety-net hospitals more likely than other hospitals to fare poorly under
Medicare’s value-based purchasing. Health Affairs, 34(3), 398-405.
Gilman, M., Adams, E. K., Hockenberry, J. M., Wilson, I. B., Milstein, A. S., & Becker, E.
R. (2014). California safety-net hospitals likely to be penalized by ACA value, readmission,
and meaningful-use programs. Health Affairs, 33(8), 1314-1322.
Gilman, M., Hockenberry, J. M., Adams, E. K., Milstein, A. S., Wilson, I. B., & Becker, E.
R. (2015). The financial effect of value-based purchasing and the hospital readmissions
reduction program on safety-net hospitals in 2014: a cohort study. Annals of internal
medicine, 163(6), 427-436.
Jabri, M. (2017). Managing organizational change: Process, social construction and dialogue.
Palgrave.
Johnson, M. E. (2015). Changing course in the anti-domestic violence legal movement: From
safety to security. Vill. L. Rev., 60, 145.
Stroud, C., Walker, L. R., Davis, M., & Irwin, C. E. (2015). Investing in the health and well-
being of young adults. Journal of Adolescent Health, 56(2), 127-129.
Vogus, T. J., &Iacobucci, D. (2016). Creating highly reliable health care: How reliability-
enhancing work practices affect patient safety in hospitals. ILR Review, 69(4), 911-938.

Waddell, D., Creed, A., Cummings, T., & Worley, C. (2016). Organisational change:
Development and transformation. Cengage AU.
Weaver, C. A., Ball, M. J., Kim, G. R., & Kiel, J. M. (2016). Healthcare information
management systems. Cham: Springer International Publishing.
Williams, J. M. (2016). The safety/security nexus and the humanitarianisation of border
enforcement. The Geographical Journal, 182(1), 27-37