Al-Immam Abdulrahmen Bin Faisal Hospital: Patient Safety Project

This organizational development project focuses on improving patient safety culture within Al-Immam Abdulrahmen Bin Faisal Hospital in Saudi Arabia. The project addresses declining healthcare service quality and aims to identify and analyze strategies to mitigate risks associated with patient safet...Read More

Running head: HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Healthcare Organizational Development Project: Analyzing Strategies and Methods for
Improving Patient Safety Culture in Hospital, Saudi Arabia
Name of Student
Name of University
Author Note

1
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Abstract (250 words)
Chapter 1: Introduction (1500 words)
1.1. Introduction
The patient safety culture is a concept that has originated outside healthcare. Patient
safety culture is important as it helps in maintaining the quality of the healthcare services
provided. Patient Safety Culture acknowledges the high risk nature of an organization’s activities
with a determination to achieve consistently safe operations. The organizational development
report aims in accessing the issue related to patient safety culture in hospitals of Saudi Arabia
(Ulrich & Kear, 2014). There have been a constant decrease in the quality of healthcare services
provided in Saudi Arabia. The organizational development report focuses on Al-Immam
Abdulrahmen Bin Faisal Hospital. Safety culture however, can be described as a local problem
with variations in perception of the safety culture. The Introduction chapter introduces the
organizational context, intervention details and the rationale for carrying out this organizational
development project.
1.2. Problem Statement
Issues in patient safety culture has given rise to the need of reviewing the patient safety
culture in hospitals of Saudi Arabia. The decrease in the quality of the healthcare services
provided to the patients have given rise to the need of accessing the issues related to patient
safety culture (Almutairi, Gardner & McCarthy, 2014). It is quite necessary to access the patient
safety culture in a hospital as degradation of patient safety culture can result in decrease pf the

2
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
patient flow within the organization. Therefore, working on this particular organizational
development project is justified.
1.3. Organization and context of the change
This particular organizational is one of the leading hospitals in Dammam. It is one of the
ministry of National Guard Health Affairs Medical cities. The hospital was officially opened in
the year 2002. The hospital has the capability of 112 beds, an intensive care unit consisting of 6
beds, a Neonatal Intensive care and 4 operation rooms. Although the hospital aims in provide ng
quality services to the community children and their families, recently, there have been issues
related to patient safety culture in hospitals of Saudi Arabia.
The issues and the problems will be discussed in this organizational development report.
The issues in patient safety culture will be discussed in this report with an aim of identifying the
strategies that can help in addressing the risks related to patient safety culture in the chosen
hospital (DiCuccio, 2015). The chosen organization aims in providing an excellent medical
services to their clients. The organization development report aims in identifying and analyzing
the strategies that can help in improving the patient safety culture in the chosen hospital.
1.4. Rationale for Carrying out the Project
It is identified that a number of hospitals in Saudi Arabia is facing problems related to
patient safety culture. It has been identified that leading hospitals in Saudi Arabia are currently
facing troubles in providing a quality healthcare services to the patients. There are a number of
factors that can affect the patient safety culture of a hospital (El-Jardali et al., 2014). On analysis
of the patient’s safety from nursing perspective, it is found out that the safety of patient culture is
associated with better scores on the supervisor of the hospital or managers of the hospital.

3
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The government of Saudi Arabia along with the ministry of National Guard health
Affairs are trying to improve the quality of healthcare services by implementing appropriate
patient safety culture in the hospitals of Saudi Arabia. The project undertaken aims in analyzing
the strategies of implementing patient safety culture and therefore the choice of this project is
justified.
1.5. Details of the Intervention
The aim of the chosen hospital and other healthcare organizations of Saudi is to ensure
patient’s safety and to provide the patient with appropriate healthcare facilities. Decrease in the
maintaining the quality of patient care services increases the need of this intervention.
Negligence of the staffs and the healthcare providers can affect the organizational effectiveness.
The negligence can often risk the life of the patients (Ammouri et al., 2015). Negligence in
patient care is considered to be a critical issue and therefore the issue is needed to be mitigated.
Therefore, this project has been undertaken in order to analyze the strategies of improving
patient care services in different hospitals of Saudi Arabia.
1.5.1. Current Situation
The patient care surveys indicate that there have been a constant decrease in the quality
of patient safety culture in the hospitals of Saudi Arabia. The significant falls in the patient safety
culture have resulted in the decrease in the patient flow of the chosen organization. One of the
major causes behind the declination in the quality of patient care services is lack of training of
the staffs and employees of the organization (Almutairi, McCarthy & Gardner, 2015). There
have been an increase in number of medication errors by the staffs and employees of the

4
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
hospitals. These medication errors are needed to be analyzed in order to ensure effective patient
safety culture in hospitals of Saudi Arabia.
1.5.2. Desired Situation
The organizational development report aims in providing solutions to the identified
problem related to patient care. One of the major issues associated with the patient safety culture
is lack of training and knowledge related to patient safety (Bassuni & Bayoumi, 2015). The
undertaken organizational development project aims in designing and developing a training
program to the staffs and employees of the chosen hospital in order to improve the patient safety
culture in the chosen hospital. It is expected that implementation of the organizational
development project will help in improving the patient care services offered by the hospitals of
Saudi Arabia.
1.5.3. Process of Intervention
The project focuses on improving the patient care services in hospitals of Saudi Arabia.
The aim of the project is to analyze the strategies of improving patient care services. It is
anticipated that a patient safety culture training can significantly help in improving the patient
safety culture in hospitals of Saudi Arabia.
The project therefore focuses on the quality improvement of the patient care services. The
project team has been given the responsibility of managing the entire project work (Hesselink et
al., 2014). As per the need of the project, the project team will be evaluating the patient care
surveys to identify the issues associated with the delivery of effective patient safety culture in
hospitals of Saudi Arabia. Followed by that, effective strategies of improving the patient safety
culture will be identified and analyzed through this organizational development report.

5
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
1.5.4. Desired Impact
The project undertaken is expected to have a positive impact on the patient safety culture
in the hospitals of Saudi Arabia. The project is expected to improve the overall process of
operational within the chosen hospital. Patient safety culture can be improved only if the
management is keen enough to improve their services. Training the staffs and the employees of
the hospital regarding the need of implementing effective patient care services. The training
program will educate the staffs and the employees about the importance of patient safety culture.
Therefore, it is expected that the training program will have a positive impact on the patients and
the hospital management team. Furthermore, with the implementation of this project, the chosen
organization is likely to be benefited.
1.6. Aim and Objectives
The project aims in analyzing the strategies of establishing effective patient care services
in the chosen hospital. The smart objectives of the project are as follows-
SMART Objectives
SMART objectives are set in this project as those objectives are traceable. SMART
objectives help in clarifying the ideas, focus and efforts needed to perform a task. The smart
objectives identified for the project are as follows-
1. To review the staff awareness on safety culture by December 2018
2. To establish a list of safety culture barriers by reviewing the previous patient
safety culture report and improve the highest 3 domain by May 2019

6
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
3. To deliver safety culture training to all staffs of the chosen hospital by the end of
September 2019
4. To improve safety culture effectiveness by 40 percent till the end of December
2019
The project undertaken will be evaluating the above identified objectives. The project
will be successful only if the objectives of the project are met.
1.7. Role of the Student and the Team Involved in the Project
I have been given the responsibility of quality management specialist in order to identify
the issues related to patient safety culture in the hospitals of Saudi Arabia (Ulrich & Kear, 2014).
I am responsible for identification of the changes needed in the chosen organization and the
process by which the changes are needed to be implemented. I am responsible for facilitating and
monitoring the implementation of the project according to the plan.
1.8. Signpost
The chapter provides a brief overview of the project and introduces the topic to the
readers. The following chapters of the organizational development report provides an idea of the
literature review, organizational development process, planning and evaluation of the project.
This report formulates the project plan in an effective manner so that the identified objectives of
the project is met.

7
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Chapter 2: Literature Review (3500 words)
2.1. Introduction
This section of the organization change project report will review the previously
published journals and literature to collect data related to chosen organization. Patient safety
culture is intrinsically complex and is based on the organizations providing commitment of
safety from all levels. The commitment of safety by the healthcare organizations establishes the
safety culture, which encompasses certain key features which are, acknowledgement of issues
with patient safety in the organizations and determination of the safe operations of the patients
(Ulrich & Kear, 2014). The journals and literature from recent sources are reviewed in order
collect evidences related to safety culture in healthcare. The literature review chapter of the
organization change report will analyze the current knowledge of safety culture in healthcare
organization. The aim of this chapter is to discuss the patient safety culture from theoretical
perspective by evaluating the journals and literature in this field. All the discussion associated
with the literature review chapter is done based on the secondary data sources. The data collected
in this chapter will help in analysis of data collected in the evaluation chapter.
The concept of patient safety culture has originated outside the healthcare sector and
patient safety culture is based on minimization of the adverse effect of improper safety culture of
the patients (Ammouri et al., 2015). The following section of this chapter identifies the search
strategy followed for this extensive literature search related to patient safety culture in hospitals
of Saudi Arabia. By the end of this chapter, the gap in the literature will be identified, which will
be addressed in the later section of the report.
2.2. Search Strategy

8
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The literature review section is mainly based on presenting various theoretical concepts
associated with the chosen topic. In order to collect secondary data about the chosen topic, the
researcher has performed an extensive internet search to identify different research journals
related to the topic. Certain specific key words are used in the search engine in order to identify
secondary sources that contains details of patient safety culture and service quality of different
hospitals of Saudi Arabia. The key words include “patient safety culture”, “patient safety” and
“safety principles”. The researcher has mainly made use of the database “Google Scholar” to
collect the relevant literature and journals related to the chosen topic. Apart from that, the
research has evaluated recent patient safety culture of the chosen hospital in order to collect data
about the patient safety culture. The research data is mainly collected from books, journals,
literature and websites. In order to identify appropriate journals and literature in this field,
specific keywords search is done as per the research topic. The journals that were considered for
review are mostly taken by valid and credible sources. The researcher has mainly made use
certain specific research papers that provides the details of patient safety culture. The use of
recent information has made
2.3. Review of Themes
This section of literature review will provide an evaluation and of certain identified
themes related to patient safety culture in Saudi Arabia, with special focus on the chosen
hospital. The concept of patient safety culture has mainly originated outside healthcare and is
largely linked with nursing education and nursing culture. An unsafe patient culture practice can
significantly affect the cultural principles of the hospital and affect the safety of the patients. An
unsafe cultural practice can be perfectly defined by the process of providing effective services to
the patients. Patients’ safety is directed by determining the accepted practices that works in for of

9
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
assessing the safety culture of the patients. In this context, better understanding of the
components and the influencers of the culture is essential for developing the strategies related to
patients’ safety culture. The concept of patient safety culture is devised from leadership of
nursing and health services. The patient safety culture is associated with effective recognition of
patient safety culture in multidimensional environment. The patient safety culture is largely
dependent on the individual performance of the staffs and the employees of the hospital in
support to patient safety and incident management. Understanding the patient safety culture is
quite essential as it has multiple influencers. The patient safety culture is largely dependent on
the cultures in health, migrant experiences and the social economic condition of people. The
following section of the report identifies the relevant themes associated with the chosen topic.
The following section identifies the important aspects of the distinctive themes. Appropriate
understanding of the patient safety culture has multiple influencers that include patient and
family engagement, leadership and effectiveness in teamwork and communication. Safety
culture is a found to be a local problem as there are a number of perception associated with the
safety culture. Various researches prove that perception of individual providers negatively affect
the safety culture of the hospital. The organizational leadership play a significant role in
management of safety culture within a single organization. The patient safety culture of Saudi
Arabia is quite conservative and therefore effective
2.3.1. Theme 1: Principles of Patient Safety Culture
This theme related to patient safety culture will mostly analyze the principles behind the
patient safety culture in hospitals (Steven et al., 2014). It is quite essential to identify and
improve patient safety culture in hospitals. Identification of the principles of patient safety
culture will help in suggesting actions for improving patient safety culture.

10
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Measuring patient safety culture is capable of providing insights into areas of
improvement that a hospital need to monitor.
The significant principle of patient safety culture is improving the well-being and health
status of the individuals. A recent study about the patient safety culture in the chosen hospital
indicates that the overall response score of patient safety culture in the chosen hospital is only
44% (Leotsakos et al., 2014). The figure below indicates the result of the patient safety culture
performed in the chosen hospital.
Figure 1: Representing data about patient safety culture
The data indicates that the patient safety culture of the chosen hospital. The survey
indicates that the patient safety culture needs improvement in certain field which are teamwork

11
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
climate, Safety climate, job satisfaction, perception of senior management and perception of
local management. The patient safety culture survey that is generated involves a customized
version of the survey that aimed in collection of data from the chosen hospital.
Thus, it can be observed that in the chosen hospital, there are issues related to improving
the well-being and the status of the individuals. Patient safety culture is directly linked with
nursing the patients. Researches prove that, it is essential for the nurses to acknowledge the
practices and beliefs that differ. The patient safety culture is largely dependent on the delivery of
the nursing and the health services (Vaismoradi, Jordan & Kangasniemi, 2015). Therefore in
order to ensure improvement in patient safety culture, the chosen healthcare organization need to
create a climate of open communication within the organization. Improvement in the delivery of
the healthcare services is possible only when nurses make healthy relationship with the service
users.
Another significant principle associated with patient safety culture is to develop the
delivery effective nursing services. The delivery of the health services in the chosen hospital is
needed to be made culturally safe in order to bring about the much needed improvement in
patient safety culture of a hospital. Effective nursing services can be designed by building a high
reliability teams. Trainings can be provided to the staffs and nurses to develop the delivery of
effective nursing services. Researches prove that patients feel safer if they receive a high quality
care services for the hospital. Deficiencies in the communication process and in team
communication is seen to be a frequent contributor of the adverse events. Therefore, it can be
said that delivery of the health services can be made culturally safe when the nurses are able to
make a healthy relationship with the service users (Khater et al., 2015). The implementation of
effective training programs will help the nurses to empower the process of delivery of services to

12
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
the users. It is essential for the healthcare providers to understand the concept of patient culture
in order to provide effective services to the patients. Nurses in the hospital should be able to
provide services having diverse needs related to patient care.
Another principle related to patient care is that a particular healthcare provider should
be able to make differences among the individuals who are being treated. The healthcare
providers should be able to recognize the issues and dissimilarities within the healthcare sector,
center of employment, education and social interaction. The patient safety culture is a broad
concept that encompasses employment, education and the social interaction associated with an
organization. It is essential for the healthcare providers to understand the cause effect
relationship of the service users, their views and personal experiences (Burström et al., 2014).
The Nurses principle needs to support the idea of accepting the legitimacy of the diversity and
differences in social structure. Healthcare organizations across Saudi Arabia have significantly
ramped its focus in patient safety and quality improvement. It is quite difficult to establish and
maintain the safety culture if it does not start at the highest level of a healthcare organization. A
number of governing boards, medical directors and the executive leaders of the hospital must
promote patient safety culture.
Another principle of patient safety culture that has been identified through extensive
literature search is that it becomes essential for the healthcare providers to understand the
power of healthcare on their person and families. Patient safety culture not only ends in
providing healthcare services to the patients, but also deals with delivering effective services to
the family members of the patients (Eiras et al. 2015). The patient safety culture is mainly
focused on the culture attitude and experience of the healthcare providers. The healthcare
providers need to focus on the practices that balances the power of relationship. A good team

13
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
structure is needed to establish appropriate patient safety culture in hospital. The healthcare
providers are therefore recommended to ensure that a balanced patient safety culture is achieved.
Presence of good team structures and the supportive staff members help in exercising patients’
safety in an accurate manner and therefore effective team management is recommended
(Elmontsri et al., 2017). Healthcare organizations in Saudi Arabia are striving to improve patient
safety and quality of care in hospitals of Saudi Arabia. The nurses’ principle support the idea of
accepting the legitimacy of diversity in social structure. Healthcare professional can improve
quality of service to the service providers.
2.3.2. Theme 2: Patient Safety Culture Issues and Models of Patient Safety
It is quite essential to understand the issues associated with patient safety culture in the
hospitals of Saudi Arabia. The concept of safety culture although originated outside the
healthcare sector, it is highly associated with the healthcare sector and is associated with
addressing and acknowledging the high risk nature of patient safety culture. Researches prove
that Patient safety culture is largely dependent on the accurateness with which the staffs perceive
their duty of patient care (Alayed, Lööf & Johansson, 2014). Error prevention is an important
aspect of patient safety culture. The issues in the patient safety culture is mainly measured by
carrying out surveys related to patient safety.
In this context the models of patient safety culture are needed to be identified. One of the
most effective methods of patient care that has been identified in this context is Donabedian
model. The conceptual model helps in investigating about the quality of the healthcare services
that are offered to the patients.

14
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Donabedian Model of Quality Care: This model mainly deals with measuring the quality care of
the patients. The Donabedian model is mainly based on three components that evaluates quality
care in healthcare and aims in improving the services that is offered in healthcare. The
Donabedian model of accessing the patient care is mainly used in cases when it is really
important to improve the outcomes, processes and the structure of the services provided.
Different types of measures in healthcare has different types of meaning. The Donabedian model
helps in measuring the outcomes of patient safety culture and enforces process measures,
structure measures and the balancing measures that can be imposed to ensure effective patient
care. The figure below indicates the process flow of Donabedian model of quality care.
Figure 2: Representing the Donabedian model
As indicated in the above figure, the Donabedian model is mainly categorized into three
parts, which are structure, process and outcome. The structure part is mainly used to discuss the
context in which healthcare service is delivered (Ammouri et al., 2015). It is mainly related to
the hospital building, staff, the equipment used and finance. These are the essential factors that
helps in measuring the quality of healthcare services provided. The structure phase mainly deals
with the physical and organizational characteristic of the healthcare.

15
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The next phase that is the process, helps in defining the transactions between the
providers and delivery of the healthcare process. Process in healthcare is quite important to
deliver a better healthcare service and can be used in increasing the interpersonal bonding
between the patient and the healthcare provider. The process phase focus on the care that is
delivered to the patients, which are services, diagnostics and treatments of the patients. The
outcome phase on the other hand is mainly used to discuss the impact of healthcare and patient
safety care on the change of health condition, the population and the behavior of the staffs. The
outcome phase therefore helps in improving the condition of the healthcare services offered. The
outcome phase basically measures the effect of healthcare on the status of patients and
populations.
2.3.3. Theme 3: Activities to promote patient safety Culture
Evaluation of a number of literature sources has helped in identifying the activities that
can be undertaken by the hospitals of Saudi Arabia to promote patient safety culture (Ulrich &
Kear, 2014). It has been observed that various determinants of safety culture is dependent on the
interpersonal relationships and various other local circumstances, leading to a change in safety
culture at a microsystem level. In the most basic form, safety culture can be described as a
process that ensure safety within the organization. The concept of safety culture although was
coined by a nuclear power industry, it is well associated with the healthcare sector as well. There
are a number of activities that are needed to be performed in order to promote patient safety
culture in hospitals of Saudi Arabia. The researches indicates that at first, it is necessary for the
healthcare organization to perform a baseline assessment of patient safety culture. The
assessment should be able to highlight the strengths and opportunities of improvements. The
chosen hospital can create a vision and improvement strategy that can be communicated to the

16
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
employees. It is quite integral for the healthcare provider to set a commitment of improving
healthcare opportunities. Appointing safety supervisor can significantly help in improving the
patient safety culture in hospitals of Saudi Arabia.
However, one of the most helpful activity that is needed to be undertaken by the hospitals
of Saudi Arabia is employee education. Employee education can be provided by arranging
training sessions as it will help in prevention of errors in healthcare activity. Prevention of the
errors becomes integral for improving the overall healthcare quality of the patients. One
significant issues associated with the healthcare is that any error from in duty of one can result in
issues in patient safety culture (Al-Mandhari et al., 2014). However, educating the employees of
the hospital is largely related to the perception of the senior management in ensuring patient
safety. The senior management of the hospital needs to focus on training and education of the
employees. A high degree of competence is needed to order to ensure effective patient safety
culture.
The improvement of patient safety culture in hospitals of Saudi Arabia is largely
dependent on the employee involvement as well. Along with the senior management it is
essential for the employees to actively participate in the process of training. An employee should
be enthusiastic enough to understand the concept of patient safety culture and potential hazard
that can be eliminated by getting trained in effective patient safety culture.
Another activity that helps in improving the patient safety culture is continuous
improvement. A number of employees need to feel the desire to offer safe patient safety culture
and only then, change in the process can be brought about. Furthermore, the process of error
reporting should be made transparent for easier identification of various opportunities of

17
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
improvement in the patient safety culture. Therefore, this theme identifies the need of improving
the patient safety perception and intervention from the higher officials of the hospital in
improving the patient safety culture of the hospital.
2.3.4. Role of Nurses and medical staffs in promoting patient safety culture
The medical professionals play a large role in ensuring patient safety culture in hospitals
of Saudi Arabia. The healthcare management needs to create a non-biased and culturally safe
place for their patient. Since the data of the recent survey performed in the chosen hospital shows
that there are issues in the patient safety culture mainly because of less trained employees. Since
the patient safety culture is linked with the nursing services provided by the healthcare
organizations, the nurses need to understand the concept of patient safety culture that helps in
designing effective healthcare strategies. Thus, it can be said that nurses need to understand the
healthcare and the patient safety culture needs to create a non-biased and culturally safe place
inside the hospital. A culturally non biased place can be developed if the nurses are properly
trained about the patient safety culture. Researches prove that the nurses and the hospital staffs
spend more time with the patients in comparison to doctors. It is observed that the patient safety
culture is largely dependent on clinical quality. The nurses are mainly trained to provide patient
care in a safe an in an effective way. An effective team of trained nurses has the capability of
improving the patient safety culture in different hospitals of Saudi Arabia. The accessibility and
visibility of the patient safety should be demonstrated by the leaders in healthcare (El-Jardali et
al., 2014). There is an increasing need of creating a purposeful connection between patient safety
and relationship between the patients and the nurses. Therefore, a cultural shift in nursing can be
considered to be one of the crucial thing associated with patient safety. This is because safety
climate is perceived according to the level of commitment of the staffs of the organization. Apart

18
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
from that, it is necessary to offer appropriate focus on the work setting, which in most of the
cases can result in bringing in certain improvements in the patient safety culture. A high degree
of competence of the nurses is needed in order to ensure effective patient safety culture.
2.3.5. Organizational change Management related to Safety culture in Healthcare
The above identified themes establishes the need of working on the attributes related to
patient care. Safety in healthcare is a process is related to attributes of quality in healthcare. The
safety problems in the hospitals of Saudi Arabia believed to arise mainly due to the violation of a
particular rule or any unintentional errors related to enforcement of patient’s safety. Researches
prove that majority of the errors and adverse events can accurately stem from a complex chain of
events. The change intervention process in hospitals of Saudi Arabia needs minimization of the
unintentional errors in providing the healthcare services to the patients. Culture and climate can
act in an interchangeable fashion, which in turn represents that approaches and the measures
associate with organizational processes. Safety climate is mainly defined as shared perceptions
related to the events, practices and the processes associated analysing the patient’s safety. The
definitions of organisational culture includes multiple and varied characteristics associated with
patient’s safety.
Apart from that, the organizational culture is largely dependent on the shared values and
common beliefs within the healthcare sector. Organizational culture is a characteristics that is
mainly manifested by the attributes such as individuals’ behaviors and attitudes. A holistic
approach in healthcare is related to the human factors related to skills, motivation, attitude and
behavior.
2.3.6. Theme 6: Measurement service quality in Healthcare

19
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The concept of improving the patient safety culture is associated with the measurement of
the service quality in healthcare. Changing technology and increasing need of patient safety
culture has increased the need of improving the patient safety culture in the chosen hospital.
Prior to that, a measure of service equality is needed to be enforced. The improvement in service
quality in healthcare is concerned with loses and profit. One of the effective processes of
improving the patient safety culture is providing appropriate training to the employees. Service
quality can only be gained by exceeding the expectations of the service users.
2.4. Implications for the Project
The patient safety culture generally has higher implications in Saudi Arabia. For that, it is
essential to ensure that the nurses are adequately trained and are aware of the patient safety
culture. It is necessary for the hospitals of Saudi Arabia to promote the patient safety culture to
create awareness among the different healthcare providers of Saudi Arabia.
2.5. Summary and Conclusion
The literature review chapter analyses the major issues and trends in patient safety culture
in a healthcare organization. Patient’s safety is considered to be one of most important aspects of
providing effective services to the patients. Simplified application of patient safety has the
capability of reducing the errors in patient culture. Simplified application of the safety culture in
healthcare can be promoted within the organization. Training the nurses and the healthcare staffs
is recommended to be an effective approach of improving the patient safety culture in hospitals
of Saudi Arabia.

20
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Chapter 3: Organizational Development Process
3.1. Introduction
The term organizational development can be described as an objective based approach to
implement a change within an organizational context. It is basically a planned and systematic
approach of improving the effectiveness of a company. It helps in aligning an organization to its
strategy and processes, which in turn helps in defining the integrated models of business
development. Therefore, the organization development process cab be termed as a systematic
approach that mainly helps in improving the organizational effectiveness (Benn, Edwards &
Williams, 2018). The organizational development process relates to one of the most integrated
models of development and management of a business. Organizational development process
helps in integrating the models of business development that contributes to efficient growth of
the organization. It is observed that there are a number of factors that affect the management and
implementation of a business. There are a number of factors that affect the success of
implementation of system within the project. The organizational development process is
important for a project as it enables the employers to determine the processes that can help in
improving all the business related activities. A number of problems related to patient safety care
is identified in the hospitals of Saudi Arabia that gives rise to the need of ensuring effective
organizational development. Implementation of the organizational change process is an action
oriented phenomenon that is necessary for ensuring appropriate business growth. There are a
number of factors that contribute to the success of these type of project. Organizational
development process enables and organization to identify the changes needed in an organization
in a much effective way (Al-Haddad & Kotnour, 2015). The organizational development process

21
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
is further necessary to identify the personal and the professional skills that the organization need
to consider in order to eliminate the major issues in the organization.
The organizational development process of the chosen hospital involves a number of
processes that are needed to be planned effectively in order to ensure successful project
implementation. The following section of the organizational development process identifies
different models of implementing change development in a process. The methods of bringing in
much needed change in the organization are indicated as follows-
1. Identification of the areas that can be improved or changed in an organization
2. Evaluating whether the organizational structure can be modified
3. Checking whether changes can be brought in a system
4. Reviewing the system that is being proposed
The above points indicates the steps that can help in bringing in positive changes in an
organization. The issue in the patient safety culture in the chosen hospital can be addressed by
implementing an effective change model within the organization (Kuipers et al., 2014). One of
the major processes of implementing those change include the providing effective training to the
staffs and nurses of the hospital regarding the importance of patient care and the patient safety
culture. A recent patient safety culture indicates that the chosen hospital needs to improve in a
number of categories. The following sections of the report provides a brief overview of the
organizational development process and approaches to organizational development.
3.2. Overview of Organizational Development

22
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The organizational development process can be described as the process that helps in
formulating strategies to improve the organizational processes. Organizational development
process helps in prioritizing the processes that are needed to be executed in an organization to
identify certain perceived benefits. The concept of organizational development in the chosen
hospital is linked with the need of improving patient safety culture within the hospital. One of
the most effective strategies behind improving the patient safety involves training the staffs and
nurses of the hospital about the concept as well as importance of patient safety.
It is quite necessary for a hospital to formulate effective and realistic goals that can be
fulfilled. It is quite necessary for all the hospitals of Saudi Arabia to formulate effective and
realistic goals for adopting to a long term strategy. Improvement in the patient safety culture can
only be brought about if all the employees of the chosen hospital are trained to provide effective
patient care among the hospitals of Saudi Arabia (Carnall, 2018). Providing training to all the
staffs and employees of the hospital is a realistic as well as achievable goal. The organizational
development process provides an opportunity of aligning the organizational strategies so that
customers satisfaction can be achieve.
The chosen hospital has an increasing pressure of improving the healthcare system of
Saudi Arabia The implementation of any change in the organizational development process. The
implementation of the changes is mainly associated with installation of improved patient care
services and machineries. Although the ministry of Saudi Arabia has largely invested in the
improving the healthcare services of the hospitals of the state. The chosen hospital needs to work
on their strategies in order to deliver best services to the patients (Vakola, 2014). The chosen
hospital basically needs to work on its relationship with the patients in order to establish an
effective patient safety culture within the hospital. Apart from that, it is necessary to design a

23
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
stable mode of communication among the hospital staffs and the patients to understand their
needs. The organizational development process helps in formulating strategies for improving the
patient safety culture.
3.3. Brief critical Review of the approaches to organizational development
The organizational development process within the chosen organization is dependent on
different approaches. The approaches of organizational development is based on implementing a
number of theories. These theories include change process theory, implementation theory, that
help in understanding the organizational development process. The change process theory helps
in identifying the major dynamics related to management and implementation of changes. The
change implementation theory helps in generating the changes as a guide to managing the
changes within an organization (Doppelt, 2017). The implementation theory helps in generation
of the changes associated with the actions that are needed to be take in managing the change
processes within an organization. The different theories of organizational development can be
said to be comprised of a number of individual models. One of the key differences between the
organizational development process and implementation of the change model is associated with
the dynamics of change management (Saleh, Darawad & Al‐Hussami, 2015). The change
development model provides an idea of the process that can be implemented to address the
critical issues associated with the project. It is quite essential to choose a particular model that
will help in management and execution of the proposed changes in the project. The
organizational development process is expected to bring about the necessary changes in the
organization.

24
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The probable theories of organizational development process includes utilization of the
HSE change model (Secanell et al., 2014). This is an effective model behind execution and
management of the organizational development process. This model is efficient as it states the
basic assumptions of the individual models and are guided by combination of one or more
models. The HSE model provides an analysis of the organizational development process that can
be applied to prevent a drastic change in an organization. The viability of the proposed model
can be judged on basis of review of certain modules. These modules include planned change
model that comprises of the background, the key individuals and assumptions associated with the
model, the comparison of the models, the strengths, weakness and effectiveness of the HSE
model and implication of the creation of learning organizations. The following section of the
report identifies the rationale of the model selected as a part of implementation of organizational
development process.
3.4. Rationale for Model Selected
Change is an organization is largely impacted by the thought process of the people of an
organization. The need of implementing changes arises in almost all types of business and is
mainly associated with the demand of changes of increasing the competitive advantage.
Therefore, a successful change management process within a healthcare organization is
associated with a number of factors that are needed to be considered in order to ensure that a
change is successfully executed (Stavropoulou, Doherty & Tosey, 2015). These factors are as
follows-
1. It is quite necessary to articulate a shared vision of integrated health and social care to
deliver effective healthcare services.

25
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
2. It is necessary to ascertain effective utilization of the different resources that supports
the organizational development process. The chosen hospital needs to support effective
utilization of different resources to support the organizational change development process.
3. The organizational change model helps in measuring the amount of performance that
helps in ensuring accountability at all levels.
4. The organizational change model is expected to acknowledge the needs of the
organization to ensure effective planning and decision making.
The chosen organization is associated with the use of HSE change Model. This model is
particularly developed with an aim of improving the efficiency of the employees in an
organization, improving the experience of the patients and the relatives of the patients and by
promoting a consistent approach of implementing and managing change within a system (Taylor
et al., 2015). The experience of the patients and the relatives of the patients can be improved by
managing the patient safety culture. Change is constant feature in health and social care. The
management of an organization involves addressing the various cultural aspects of an
organizational development process.
3.5. Choice of Model (HSE change Model)
It is evaluated that the HSE change model can be effectively used by the chosen
organization to improve the patient safety culture. As discussed earlier, change is a constant
process in health and social care. The HSE change model is considered for delivering the
necessary healthcare services mainly because this model prioritize a person-centered care. The
public service is mainly accountable in delivering a top notch healthcare service (Tobiano et al.,
2015). The HSE model has been accepted and put to use particularly because it is related to

26
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
development process of the chosen hospital. The recent patient care survey that has been
performed in the chosen hospital indicates that change is a constant feature of health and social
care service. Particularly in Saudi Arabia, the chosen hospital needs to improve their basic
patient care framework. The management of the organization need to make sure that certain
changes in the healthcare service is implemented so that the issues with the patient safety culture
in those organizations are addressed. This section of the organizational development report
discusses the core principles of the chosen model and the various steps that are involved on the
HSE change model. The core principals of the chosen model are discussed in the following
section.
Core principals of the chosen Model
The HSE change model involves development of commitment of ensuring the needs of
service users and communities. Change is an essential feature of health and social service
delivery. However, in order to ensure that the change is successful, it is necessary to clearly
articulate the shared vision of the integrated health and social care service (Ulrich & Kear, 2014).
HSE change model works for providing effective solutions to the healthcare issues faced by the
organizations. HSE change model is able to make sure that the organization in which the change
is applied are provided with an enriched user experience that is capable of fulfilling the issues
related to the HSE model. The core principles of the HSE model that can be used to bring in
changes in the patient care of the chosen hospital are as follows-
1. The core principle of the HSE change model is to ensure that the needs of the service
users as well as the local communities are fulfilled. This proposed model is therefore capable of
bringing about the needed change in the chosen hospital.

27
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
2. HSE model places particular emphases and focus on partnership and team working,
which is capable of bringing about the needed change in the organizational process.
3. The HS change model is capable of prioritizing the long and sustainable change in a
particular organization (Vincent & Amalberti, 2016). This in turn helps in improving the
organizational effectiveness.
4. The HSE change model focuses on knowledge transfer within the organization, that
helps in management of the organizational change process that is proposed.
5. The different organizational learning process is promoted through the maintenance of a
regular feedback program that can help an organization to keep a tab on the development
processes.
6. The HSE change model ascertains that the management provides an ample importance
to the long term sustainable change within an organization (Vlayen et al., 2015). Change within
an organization can be implemented only if the management is keen on increasing the
organizational effectiveness.
7. The HSE change model is associated with collection of regular feedback that enables
and organization to keep a tab on the organizational development process.
8. The HSE change model is proposed for the chosen hospital particularly because it
enables the management to work on a long term sustainable change.
9. The HSE change model helps in establishing proper communication and integration of
the different works associated with the change management process.

28
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The HSE change model is mainly divided into four phase that helps in considering the
different types of organizational development process (Wagner et al., 2014). The four stages of
organizational change model includes initiation, planning, implementation and mainstreaming.
The HSE change model in indicated in the figure below-
Figure 3: HSE Change Model
The each phase of model is discussed in the following section.
3.5.1. Initiation of the Model
The initiation stage is the earliest stage of the HSE change management process. This
phase prepares and organization to lead the change that is proposed in an organization.
Implementation of change management process creates readiness within an organization to
establish a sense of responsibility of the management. Assessing the readiness and the capacity
of the change in essential for implementing changes in the project. It is quite vital to attend the

29
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
organizational politics prior to the implementation of changes in the selected hospital. This is an
essential stage that ensures that changes in the project are implemented by aligning the same
with the organizational politics (Weller, Boyd & Cumin, 2014). The initiation stage of the HSE
model further identifies and leverages the opportunities associated with the implementation of a
change in the project. The initiation phase of HSE change model is divided into a number of
steps which are indicated as follows-
1. Identifying the drivers and degree for change: This model is mainly driven by the
vision of improving the current condition of an organization. The main guiding context of the
implementing change within an organization at individual levels. The initiation model provides
an unifying and consistent direction of implementation of a change across the system. . The
changed needed in improving the safety culture can be linked to an increase in the error rates.
Since it is identified that the selected hospital is in need of improving their patient safety culture,
it was essential to choose the model that can help in enforcing the patient safety culture in the
hospital.
2. Clarification of the leadership Roles: The HSE change model is associated with the
clarification of the roles of different leaders. The senior managers need to clarify the roles of
different leaders within the organizational context. The senior management of an organization
mainly has a responsibility of improving the services that are promised. The leadership role is
needed to be communicated well to ensure that changes in the project are correctly identified and
implemented as per the needs of the stakeholders.
3. Assessing the readiness and capacity of the impending change: The HSE change
model mandates the identification of key influencers and leaders in the change management

30
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
process associated with the development of an organization. It is essential to assess the readiness
and capacity of the hospital in which the change is being implemented. This is particularly
important because a number of organization might pre-empt resistance to increase the potential
of the effective change (Zohar, 2014). This is essential particularly because the capacity to
change is related to different levels of organizational commitment to resource the change that is
occurring within an organization. The organizational readiness is an important motivation factor
that influence an employee to accept the changes associated with an organization.
4. Participation in organizational Politics: It is needed for the people to understand the
organizational politics and political dynamics within an organization. There are a number of
cultural and political factors that have positive and negative impact on the success of the change
in behavior. The organizational culture indicates the relationship between people at different
levels and therefore assessing the organizational culture and environment is quite essential for
bringing in certain changes in the patient safety culture of the hospital.
5. Identification of the points for providing opportunity: Leverage points can be
described as places within the organization that is capable of producing different kinds of efforts
in a system. HSE change model highlights the need of continuously scanning the environment to
identify the type of change that is needed within an organization. This type of change is
particularly effective in bringing about the change in a medical organization.
6. The need of performing a primary assessment of the impact of change: It is quite
necessary to identify the impact of the change process within an organization. The initial impact
analysis can possibly help in providing a powerful insight of the impact within an organization.
The personal and the team development process is concerned with bringing in the needed change

31
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
within the organizational context and for that analyzing the impact of the change within an
organization is quite necessary.
7. Outlining the initial objectives and the outcome of the change: It is essential for the
management to identify the initial objectives and the outcome for the change. This is particularly
because the objectives that are set for the change management process within the organization is
needed to be communicated. It is quite essential to work on the objectives of the organization
inn order to successfully implement a change. The information that is gathered throughout the
initiation phase of the HSE change model helps in identifying the major issues related to patient
safety culture in the chosen hospital. This information can help in improving the proper
functioning of business and further helps in outlining changes that the organization need to
implement. The information that is gathered is mainly used in bringing in clarity in the process
of outlining the major activities and outcomes within the project.
8. Agreeing on the Initial resource requirements: The management team of the
organization need to consult with the stakeholders and the employees of the organization to get a
clear view of the resources required in an organization. The changes that are proposed mainly
includes bringing on certain improvements in the patient care services proposed. The resource
requirements that are identified to bring on the needed change in the chosen organization include
modification of the equipment of the hospitals, upgrading to modern resources and well-trained
human resources to make the necessary advancements in the business. Agreeing on the initial
resource requirements provides an effective solution for the structural changing process within
the organization.

32
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
9. Marking the initial business case for the change: This phase is the last phase of HSE
change model as it is based on outlining the major business case within an organization. In line
with the identified project management methodology that will be implemented in management of
change within an organization. It is essential to mark the business case of the change that is being
proposed in order to ensure that the proposed change in the medical organization is achieved.
With this step, the initiation phase of the HSE change model is successfully completed.
3.5.2. Planning of the Model
The next step of the HSE change model is the planning stage. The planning stage of the
HSE change model is associated with the building of commitment, determination of detail of
change and development of the implementation plan. The main purpose of the planning stage is
to determine the major details associated with a change in order to create and support the process
of change. Some of the most critical aspects of planning phase of HSE change model are
indicated as follows-
1. The HSE change model enables an organization to create a shared vision of the
change.
2. The planning phase of the HSE change model will help in designing the major change
related to the designing of the future state of the hospital. The change implementation process
will enable bringing in the much needed improvements in the chosen hospital.
3. The planning phase enables the management of the hospital to negotiate with the
stakeholders and the management in order to create the plan for implementation of this project.

33
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The planning phase of the HSE change model is associated with a number of integral
phases which are highlighted as follows-
Building shared Vision: It is quite essential to build a shared vision of the project that is to be
implemented in order to ensure easy access to details needed in implementation of the project. A
shared vision is to be developed for analysing the changes that are to be implemented in the
project. It is quite essential to develop a shared vision that can help in better implementation of
the project that is being undertaken. The process of translating and adapting to the vision of the
project is related to communication of a better sense of viability in a project (Golder et al., 2017).
This step is quite important as it provides an idea of the vision that is needed to perform better
and to achieve the desired result.
Communication of the business vision: This is another essential process of change
implementation as the employees of the chosen organization need to be aware of the changes that
are undertaken and implemented in a project in order to get an idea of the various aspects of
organizational development process.
Increase in the readiness and capacity to change: It is essential for an organization to prepare
for the capacity and the readiness of the change in order to check whether the management is
keen on accepting the proposed changes.
Showing that the change is ongoing: one of the most important aspects of implementation of
the change control process is to make sure that the employees of the organization are convinced
about the proposed change within the organization.

34
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Determination of the change details: The key tasks related to the change details involves
gathering the necessary information associated with designing different actions of bringing about
the needed change within the organization
The chosen hospital needs to undertake the above discussed phases as a part of planning,
to determine the readiness of the organization and its capacity to change.
3.5.3. Implementing the Model
The implementation phase can be considered as one of the most crucial phases of HSE
change model as it involves accuracy and professionalism in implementing the proposed change
within the organization. The main factors associated with the implementation model are as
follows-
1. Clarity of commencement of the dates of implementation
2. Acknowledgement of the changes that are being proposed
3. Supporting the new behaviors
4. Continuous scanning of the changes that are implemented to ensure that no new risk
arises.
5. The implementation phase ensures that the managers and the staffs of the project are
continuously available to solve the difficulties faced by the employees.
The evaluation phase of the project is expected to bring about certain major changes on
the patient safety culture of the chosen hospital by following the above mentioned steps.
3.5.4. Mainstreaming the Model

35
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The last step of the HSE model is mainstreaming. This stage mainly focuses on attention
of the success to change along with effort to integrate the sustaining new ways of working within
the team. The mainstreaming process will mainly be delivered by the organization in a number of
different ways, which are indicated as follows-
1. In order to ensure successful execution of the change development within an
organization, the individuals and the team need to understand the process of work.
2. The major issues that contributed to improper patient care practices should be
discontinued. This include the use of ineffective equipment and other software.
3. The mainstreaming phase mainly deals with ascertaining that the change that was
proposed to be implemented was completed successfully.
4. The mainstreaming phase further aims in reducing the minor issues in the workplace
with grater efficiency. The main deliverables of the mainstreaming stage is therefore,
achievement of the desired vision and supporting the understanding to work together in a best
possible way. The temporary change structures is needed to be identified in order to assess the
extent to which the change in the selected hospital is implemented in a successful manner. This
stage is associated with the acknowledging the success of the project that is being implemented
3.6. Ethical Considerations
Ethical considerations are considered to be major aspects in implementation of change
management within an organization. Since this organizational development project is associated
with the implementation of the change within an organizational context, collection of primary
data in this regard is quite essential (Clark, Ahten & Macy, 2014). One of the major ethical

36
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
considerations is associated with this organizational development process is maintaining data
confidentiality. There are certain legal considerations associated with the project as well. The
confidentiality of the individuals involved with this organizational development project is to be
maintained, which is another major ethical considerations.
3.7. Summary and Conclusion
The chapter identifies and analyses the organizational development process that are
needed to be implemented in the chosen hospital. It has been established earlier that certain
reforms in the patient safety culture of the chosen hospital is needed to be brought and for that a
better understanding of the HSE model is required. The chapter identifies the various factors and
the stages of HSE change model that can be implemented in the chosen hospital of Saudi Arabia.
The chapter establishes the basic understanding of the HSE change model that can be
implemented in the chosen hospital (Reio et al., 2017). The HSE model has shown a specific
way of planning and implementation of change within an organization.

37
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Chapter 4: Evaluation
4.1. Introduction
The previous section of the report has given a basic idea of the organizational
development model. The data obtained from the previously published literature has considerably
helped in identification of the basic issues related to patient safety culture persisting in the
chosen hospital of Saudi Arabia. The aim of this organizational development project is to
identify the various strategies that contribute to the effective implementation of a particular
project. The changes involved in a project include a number of techniques and processes, which
if implemented in an effective manner can help in improving the patient safety culture within the
organization. The evaluation chapter of the report will provide a detailed analysis of the process
of data collection and the process by which the data was analyzed. The significance and the need
of healthcare evaluation in Saudi Arabia is discussed in the following section.
4.2. Significance of Healthcare Evaluation in Saudi Arabia
The economic condition of Saudi Arabia largely contributed to the development of the
country. In the last two decades, there have been a significant change in health services offered
by different hospitals of Saudi Arabia. The researches prove that Ministry of Saudi Arabia is
known to provide healthcare services to almost 60 percent of the people while the rest 40% is
mainly shared with the other agencies and private sector. One of leading factors behind this rapid
development of Saudi Arabia includes good quality hospitals, trained manpower and good
quality infrastructure. However, recently, certain issues are faced regarding delivery of the
healthcare services in the chosen hospital (Moldovan, 2016). The improvement in the healthcare
processes in different hospitals of Saudi Arabia is subjected to a number of challenges.

38
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Mitigation of those identified challenges is an essential mitigation strategy of improving the
healthcare services in Saudi Arabia (Abdulghani et al. 2014). The challenges that are needed to
be mitigated are as follows-
1. The financing of the health services is one major risks associated with delivery of
effective healthcare services in Saudi Arabia.
2. The chosen hospital is identified to possess certain administration issues that are
needed to be addressed
3. Development of effective organizational structure within the hospital is another
effective strategy that contributes to improvement in the patient care services provided.
Therefore absence of a well-structured organizational structure in a hospital is one of the most
significant challenges.
4. A number of issues have been identified which is associated with the process by which
the chosen hospital provides treatment to their patients. The issues in the patient care are needed
to be addressed and strategies for improving those issues are needed to be identified.
4.3. Evaluation
4.3.1. Aims
The chapter aims in evaluating the process of successful implementation of change
management in the chosen hospital. The change management and implementation is necessary in
order to improve the organizational performance
4.3.2. Methods and Measures

39
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The methods and measures section of this report identifies the general theoretical
perspective of the study along with the details of the activities that are undertaken in the study.
Along with the theoretical data, this project is associated with the collection of primary data as
well. The collected data will undergo both qualitative and quantitative data analysis. The use of
both qualitative and quantitative data analysis method has helped in accurate evaluation.
The fundamental planning process of the project is associated with effective planning of
the project. This study is particularly based on collection of both primary and secondary data.
This organizational change development model is based on collection of both primary and
secondary data. Both qualitative and quantitative methodologies are considered in order to
achieve the set objectives of the project.
Qualitative Methodology: The use of both qualitative and quantitative methodology is necessary
to fulfill the identified objectives of the change development project. The qualitative
methodology is mainly associated with theoretical knowledge. This methodology is although
associated with the theoretical aspect, it has the ability of clearly recognizing the different layers
of the issues that are being studied.
Quantitative Methodology: The quantitative methodology is associated with collection of
primary data along with the statistical analysis of the collected data. The quantitative data
analysis process helps in proving the hypothesis and rationale of the project. The quantitative
data analysis method is associated with systematic approach of investigating the numerical data
that is being collected.
Methods Used: The investigator has made use of different models of business to plan the change
implementation process within the organization. The model that is finalized to be used include

40
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
the HSE change model. The other models that were considered for the proposed change include
the Three Step Model and PSDA cycle. The three step model is mainly used to provide quality
inputs for effective organizational development. The HSE change model that is proposed for the
chosen organization involves implementation of a planned changed within the organization.
The objectives that were set at the initiation stage of this project, were fulfilled by
considering a planned process of implementation of change development within the organization.
The proposal of making use of HSE change model in the selected organization. The use of HSE
change model have been quite beneficial particularly because it helped in determining the
process of change analysis within the organization. The fulfillment of the objectives is associated
with a strict observation of the same over a certain period of time.
The Approach to the organizational development process: The approaches that are used in this
organizational development project has helped in formulation of an effective strategy in
improving the change processes within an organization. The examiners are able to identify the
objectives of the study quite effectively and therefor has worked on analyzing the strategies that
can help in bringing on certain improvements in the organizational development process. The
examiner of this study is quite capable of understanding the basic objectives and the questions
associated with the study. This study has been conducted by making use of a deductive approach.
This approach is mainly based on transformation of a number of generalized information to a
more specific form of information. The inductive approach is not considered for this particular
project as it is time consuming approach which can automatically increase the time required to
conduct a particular study. Therefore, the use of deductive approach is considered to be justified
for this project.

41
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
The Design: Identification of the design of the study helps the examiner in attaining proper
shape in a study and further helps in increasing the scope and effectiveness of the study. The
design that are mainly used in the research study includes exploratory research design,
explanatory research design and descriptive research design. An exploratory research design is
mainly associated with the testing of the hypothesis and study of the objectives and the question
of the research. The explanatory research design on the other hand provides the examiners with
different kinds of opportunities, that explains the reason behind the phenomenon. The
implementation of the explanatory study however, enables the examiner to predict the future
occurrences of the phenomenon. The design study that is proposed for the project is descriptive
study that helps in clear description of the characteristics of the study. With an aim of collecting
data from the primary sources, 50 employees of the chosen hospital is surveyed.
4.3.3. Results
The data collection process helped in identification of a number of distinctive factors related to
patient safety culture. The data collection process has highlighted certain issues related to the
patient safety culture. The data suggests that use of a better technology and modern equipment
can significantly help in improving the patient safety culture within the chosen hospital. Another
issue that was highlighted from the survey is associated with the maintaining the data
confidentiality. There was a lack of effective information storage within the organization.
Maintaining the confidentiality of the data is an important aspect of organizational management.
The major issues identified from the survey are discussed in the following chapter. The data
obtained from the survey indicates that there are certain organizational and administrative issues
as well that contributed to the decrease in quality of patient care. However, the main data that is

42
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
obtained from the survey indicates that the staffs and the employees of the hospital are needed to
be trained about the concept of patient safety culture.
4.3.4. Dissemination Plan
Any scientific study is mainly based on four advanced form of studies, that include the
case study, action study, survey and different kinds of interview. The case study is mainly
important to highlight the real life factors associated with the chosen topic. Case study is quite
important to analyze the behavior of the individuals related to a particular topic. Action study on
the other hand mainly deals with different issues associated with the study that has been
undertaken. One of the major advantages of action study is that solutions to the study is provided
at the time of conducting the study. The survey is a strategy that is associated with collection of
data from the sources who have strong knowledge about the subject. The examiner of this study
has chosen to make use of survey to collect primary data and has performed a quantitative
analysis of the collected data.
In collection of primary data, a sample size of 50 respondents are chosen. The collected
data has undergone quantitative analysis to fulfill the objectives identified for this project.
Ethical Consideration:
Since the research is based in collection of primary data, there are certain ethical
considerations associated. The examiner is bound to work on those ethical considerations in

43
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
order to conduct the study in a successful manner. The list of ethical considerations are as
follows-
1. It is necessary to maintain the privacy and confidentiality of the respondents of the
research.
2. It is necessary for the investigator to maintain the integrity of the data.
3. Safety of the respondents should be prioritized as a part of major ethical consideration.
4. All the work produced by the examiner should be genuine.
4.4. Summary
The evaluation chapter has provided the details of the methodology and the measures that
are taken up by the examiner to complete this study. The chapter provides the details of the data
collection process along with the data analysis process with an aim of fulfilling the identified
objectives.

44
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Chapter 5: Discussion (3000 words)

45
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
References
Abdulghani, H. M., Shaik, S. A., Khamis, N., Al-Drees, A. A., Irshad, M., Khalil, M. S., ... &
Isnani, A. (2014). Research methodology workshops evaluation using the Kirkpatrick’s
model: translating theory into practice. Medical teacher, 36(sup1), S24-S29.
Al-Haddad, S., & Kotnour, T. (2015). Integrating the organizational change literature: a model
for successful change. Journal of Organizational Change Management, 28(2), 234-262.
Al-Mandhari, A., Al-Zakwani, I., Al-Kindi, M., Tawilah, J., Dorvlo, A. S., & Al-Adawi, S.
(2014). Patient safety culture assessment in Oman. Oman medical journal, 29(4), 264.
Almutairi, A. F., Gardner, G. E., & McCarthy, A. (2014). Practical guidance for the use of a
pattern‐matching technique in case‐study research: A case presentation. Nursing & health
sciences, 16(2), 239-244.
Almutairi, A. F., McCarthy, A., & Gardner, G. E. (2015). Understanding cultural competence in
a multicultural nursing workforce: Registered nurses’ experience in Saudi
Arabia. Journal of Transcultural Nursing, 26(1), 16-23.
Ammouri, A. A., Tailakh, A. K., Muliira, J. K., Geethakrishnan, R., & Al Kindi, S. N. (2015).
Patient safety culture among nurses. International nursing review, 62(1), 102-110.
Bassuni, E. M., & Bayoumi, M. M. (2015). Improvement critical care patient safety: using
nursing staff development strategies, at Saudi Arabia. Global journal of health
science, 7(2), 335.
Benn, S., Edwards, M., & Williams, T. (2018). Organizational change for corporate
sustainability. Routledge.

46
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Burström, L., Letterstål, A., Engström, M. L., Berglund, A., & Enlund, M. (2014). The patient
safety culture as perceived by staff at two different emergency departments before and
after introducing a flow-oriented working model with team triage and lean principles: a
repeated cross-sectional study. BMC health services research, 14(1), 296.
Carnall, C. (2018). Managing change. Routledge.
Clark, C. M., Ahten, S. M., & Macy, R. (2014). Nursing graduates' ability to address incivility:
Kirkpatrick's level-3 evaluation. Clinical simulation in nursing, 10(8), 425-431.
DiCuccio, M. H. (2015). The relationship between patient safety culture and patient outcomes: a
systematic review. Journal of patient safety, 11(3), 135-142.
Doppelt, B. (2017). Leading change toward sustainability: A change-management guide for
business, government and civil society. Routledge.
Eiras, M., Escoval, A., Monteiro Grillo, I., & Silva-Fortes, C. (2014). The hospital survey on
patient safety culture in Portuguese hospitals: Instrument validity and
reliability. International Journal of Health Care Quality Assurance, 27(2), 111-122.
El-Jardali, F., Sheikh, F., Garcia, N. A., Jamal, D., & Abdo, A. (2014). Patient safety culture in a
large teaching hospital in Riyadh: baseline assessment, comparative analysis and
opportunities for improvement. BMC health services research, 14(1), 122.
El-Jardali, F., Sheikh, F., Garcia, N. A., Jamal, D., & Abdo, A. (2014). Patient safety culture in a
large teaching hospital in Riyadh: baseline assessment, comparative analysis and
opportunities for improvement. BMC health services research, 14(1), 122.

47
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Elmontsri, M., Almashrafi, A., Banarsee, R., & Majeed, A. (2017). Status of patient safety
culture in Arab countries: a systematic review. BMJ open, 7(2), e013487.
Golder, V., Morand, E. F., & Hoi, A. Y. (2017). Quality of care for systemic lupus
erythematosus: mind the knowledge gap. The Journal of rheumatology, 44(3), 271-278.
Hesselink, G., Zegers, M., Vernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M., ... & Suñol,
R. (2014). Improving patient discharge and reducing hospital readmissions by using
Intervention Mapping. BMC health services research, 14(1), 389.
Khater, W. A., Akhu‐Zaheya, L. M., Al‐Mahasneh, S. I., & Khater, R. (2015). Nurses'
perceptions of patient safety culture in J ordanian hospitals. International Nursing
Review, 62(1), 82-91.
Kuipers, B. S., Higgs, M., Kickert, W., Tummers, L., Grandia, J., & Van der Voet, J. (2014). The
management of change in public organizations: A literature review. Public
administration, 92(1), 1-20.
Leotsakos, A., Zheng, H., Croteau, R., Loeb, J. M., Sherman, H., Hoffman, C., ... & Duguid, M.
(2014). Standardization in patient safety: the WHO High 5s project. International journal
for quality in health care, 26(2), 109-116.
Moldovan, L. (2016). Training outcome evaluation model. Procedia Technology, 22, 1184-1190.
Reio, T. G., Rocco, T. S., Smith, D. H., & Chang, E. (2017). A critique of kirkpatrick's
evaluation model. New Horizons in Adult Education and Human Resource Development, 29(2),
35-53.

48
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
S. Alayed, A., Lööf, H., & Johansson, U. B. (2014). Saudi Arabian ICU safety culture and
nurses’ attitudes. International journal of health care quality assurance, 27(7), 581-593.
Saleh, A. M., Darawad, M. W., & Al‐Hussami, M. (2015). The perception of hospital safety
culture and selected outcomes among nurses: An exploratory study. Nursing & health
sciences, 17(3), 339-346.
Secanell, M., Groene, O., Arah, O. A., Lopez, M. A., Kutryba, B., Pfaff, H., ... & Garel, P.
(2014). Deepening our understanding of quality improvement in Europe (DUQuE):
overview of a study of hospital quality management in seven countries. International
journal for quality in health care, 26(suppl_1), 5-15.
Stavropoulou, C., Doherty, C., & Tosey, P. (2015). How effective are incident‐reporting systems
for improving patient safety? a systematic literature review. The Milbank
Quarterly, 93(4), 826-866.
Steven, A., Magnusson, C., Smith, P., & Pearson, P. H. (2014). Patient safety in nursing
education: contexts, tensions and feeling safe to learn. Nurse Education Today, 34(2),
277-284.
Taylor, N., Clay-Williams, R., Hogden, E., Braithwaite, J., & Groene, O. (2015). High
performing hospitals: a qualitative systematic review of associated factors and practical
strategies for improvement. BMC health services research, 15(1), 244.
Tobiano, G., Marshall, A., Bucknall, T., & Chaboyer, W. (2015). Patient participation in nursing
care on medical wards: an integrative review. International Journal of Nursing
Studies, 52(6), 1107-1120.

49
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Ulrich, B., & Kear, T. (2014). Patient safety and patient safety culture: Foundations of excellent
health care delivery. Nephrology Nursing Journal, 41(5), 447-456.
Vaismoradi, M., Jordan, S., & Kangasniemi, M. (2015). Patient participation in patient safety
and nursing input–a systematic review. Journal of clinical nursing, 24(5-6), 627-639.
Vakola, M. (2014). What's in there for me? Individual readiness to change and the perceived
impact of organizational change. Leadership & Organization Development
Journal, 35(3), 195-209.
Vincent, C., & Amalberti, R. (2016). Safety strategies in hospitals. In Safer Healthcare (pp. 73-
91). Springer, Cham.
Vincent, C., & Amalberti, R. (2016). Safety strategies in hospitals. In Safer Healthcare (pp. 73-
91). Springer, Cham.
Vlayen, A., Schrooten, W., Wami, W., Aerts, M., Barrado, L. G., Claes, N., & Hellings, J.
(2015). Variability of patient safety culture in Belgian acute hospitals. Journal of patient
safety, 11(2), 110-121.
Wagner, C., Mannion, R., Hammer, A., Groene, O., Arah, O. A., Dersarkissian, M., ... &
DUQuE Project Consortium. (2014). The associations between organizational culture,
organizational structure and quality management in European hospitals. International
Journal for Quality in Health Care, 26(suppl_1), 74-80.
Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: overcoming barriers
to effective teamwork in healthcare. Postgraduate medical journal, 90(1061), 149-154.

50
HEALTHCARE ORGANISATIONAL DEVELOPMENT PROJECT
Zohar, D. (2014). Safety climate: Conceptualization, measurement, and improvement. The
Oxford handbook of organizational climate and culture, 317-334.