Project Report: Evaluating and Improving Cleveland Clinic Healthcare

This project report, focusing on the Cleveland Clinic Abu Dhabi, analyzes its healthcare services, organizational structure, and operational challenges. The report begins with an overview of the clinic, including its non-profit status and services, followed by a detailed examination of its operational procedures and organizational chart. The core of the report identifies and analyzes key issues such as inadequate staffing, a weak follow-up system, and poor internal communication, which negatively impact patient care and operational efficiency. The analysis includes potential solutions like recruiting more non-medical staff, improving communication systems, and enhancing follow-up processes. The project outlines specific aims and objectives, proposes an implementation plan with stakeholder analysis, and includes a timeline for activities. The report concludes with a reflection on the assignment's contribution to the student's theoretical knowledge and practical skills. It also provides references for further reading.

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

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

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

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

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

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

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

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

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

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

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

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