Applying OD: Reducing No-Show Rates Using HSE Change Framework

This report provides a comprehensive analysis of the organizational development (OD) process within the healthcare sector, specifically focusing on reducing 'No-Show' rates in the Internal Medicine Department of a hypothetical ABC clinic. It begins with an introduction to the healthcare landscape in the UAE and the significance of addressing missed appointments. The report critically reviews various approaches to organizational development, including Kurt Lewin's change model and Kotter's eight-step model, before justifying the selection of the HSE Change Model 2008 for its relevance and practical applicability within the Health Service Executive. The chosen model is then applied to the project, detailing the initiation, planning, implementation, and mainstreaming phases, emphasizing the importance of engaging individuals in the change process. Ethical considerations relevant to the project, including research and practitioner ethics, are also addressed. The report concludes by summarizing the key findings and proposing a structured approach to implementing an appointment reminder system to enhance efficiency and patient care within the clinic. Desklib offers similar solved assignments and past papers for students seeking additional resources.

Running head: ORGANISATION DEVELOPMENT PROCESS
1
Organisation development process
Name:
Institution:

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

ORGANISATION DEVELOPMENT PROCESS 3
3.0 Organizational Development Process
3.1 Introduction
The healthcare sector is one of the world’s most multifaceted, prevalent and fast developing
businesses. The health care structure in United Arab Emirates (UAE) is a mixed private-public
system. There is a public system for Emiratis with centralised control and financing frameworks
and there is a huge and developing private sector in the key metropolitan parts. Private health
care services are growing at swift rate each day in the UAE through the medical cities, clinical
and private hospitals. The number of private hospitals exceeds the number of the public health
care centres. This growth has been reinforced by a huge number of expatriates and foreign
personnel who normally incur a high cost compared to local individuals in the Ministry of health
amenities. Therefore, it causes a lot of attendance of private hospitals. No-shows are schedules
missed by patients, either non-attendance or failure to terminate in a suitable period for another
patient to be reserved as a replacement. Rates for missed appointments (no-shows) are especially
high in Internal Medicine Department of ABC clinic. No shows adversely affect the efficacy of
healthcare structures and also influence patient care. Patients who do not show up to their
planned clinic appointments can considerably interrupt productivity further upsetting cost-
effective healthcare, patient quality and well-being. The present no-show rates for the ABC
clinic are greater than anticipated. Therefore, appointment reminder systems are an effective
method for increasing appointment attendance and cancellations.
In the health and social care service, change has been argued as a constant feature, which has a
significant impact on the culture as a whole i.e. the way people work within the organisation, the
way they communicate with each other, the way in which services are scheduled to safeguard

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

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

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

ORGANISATION DEVELOPMENT PROCESS 7
the most regular faults managers make while trying to create change and provides an eight-step
process to overcome the blockades and carry out the organisation transformation routine
(Donnelly & Kirk, 2015). While important in specific situations, this change framework is not
chosen as the author feels that it is does not take into the account the transformation that has
happened in change management zones (Adler, 2011).
The major critics of Kotter is that the approaches is centred on an unfounded assumptions that
people will resist change and when resistance happens, there is inadequate explanation of the
reason why.Both Lewin’s and Kotter’s framework concentrate particularly on planned
transformation and it is this element becomes the target of major critics. It is assumed that their
models are insufficient in a scope of circumstances, specifically where the given transformation
is merely one of a multiplicity of change occurring within the firm (Adler, 2011).
Figure 2: (Adler, 2011).

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3.3 Rationale for OD Model Selected
Senior and Swailes (2010)
The Senior and Swailes change model successfully explores modification and how it relates to
the difficulties of organisational existence and puts an emphasis on using the theory into practice.
The model reflects a rapidly changing biosphere and deliberates in what way change has
transformed. The Senior and Swailes model considers the roots and nature of change; it expands
on matters of structuring for modification, the cultural and political contexts for transformation
and by what means to lead transformation. In addition, it addresses the more practical
considerations of designing, planning and implementing change. Even though this framework
was not chosen for this proposal it is recognised that it is very analogous to the HSE change
classical and would be very valued to use in executing change within organisations.
HSE Change Model 2008
The HSE Change Management Assets have been initiated to back all the personnel working in
the health service to have the skills, confidence and knowledge to tackle change in a direction
that advances the likelihood of a good result for the service users, patients, communities and
staff. The HSE Change Model is centred on experience of what functions in practice and place a
specific focus on the necessity of engaging individuals in the change process. The HSE change
model is the technique agreed by the HSE management group and the Joint Information &
Consultation Forum (Rowbottom, Jones & Cobb, 2015). This method to modification sets out
how to improve services as is specified in the Public Sector. The writer has decided to select this
classical as the literature study on this framework is up to date. In addition, because this model is
being developed and implemented within the HSE and agreed by HSE Management, the author
is of the opinion that it will be the best model to use.

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There are many change frameworks to select from currently. In this chapter, the writer has
evaluated HSE change model both 2008 and 2018, Senior & Swailes (2010), Lewin’s change
model and the Kotter model. When selecting a change classical to start change, routine for the
selection ought to comprise that is quick to comprehend and feasible to function with, it should
adjust to the organisation as near as possible and should be adequately comprehensive to assist
the data collection without omitting crucial bits of info. Rather than articulating a model to
ensemble all situations, it is better to consent to the fact that there is a degree of disorder during
the transformation process and that managers should focus in connection and identities in the
organisation that will assist them to function with chaotic change (Haggerty, 2012). As indicated
above, the HSE change model (HSE, 2008) has been chosen for this proposal as it thoroughly fits
the organisation.
Figure 3: HSE change model (HSE, 2008)

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HSE change model 2018
HSE change model 2018 is a framework that locates on one place all of the crucial elements that
need to be emphasized on to provide change properly. These include the team’s definition of
change. This means working with individuals to comprehend their support in an ongoing
engagement. Leaders should also create culture of people and change platform, where the
change priorities that require to be worked on together build a heath environmental and culture
of transformation. The framework defines, design and deliver the change. In implementation
stage, the leader ought to measure results and support sustainability. Change outcomes should be
accountable for performance and the provision of safer healthcare and services that are worth to
the staff and public.

ORGANISATION DEVELOPMENT PROCESS 11
Figure 4: (HSE, 2018)
3.4Organisation Development Model
The HSE change framework has four main stages which comprises initiation, planning,
mainstreaming and implementation. Initiation comprises preparing to lead the transformation.
Planning is subdivided into three classes i.e. building commitment, determining the detail of
change and developing the implementation plan. The third phase is execution of the change and
the last step is mainstreaming which entails of making the change the novel way of functioning
and assessing and learning from know-hows.
3.4 The Change Process
3.4. 1 Initiation
Preparing to lead the change

ORGANISATION DEVELOPMENT PROCESS 12
Change resistance has been long been well-known as vital and essential elements that can impact
the victory of an organisation development routine. Resistance is frequently taken by managers
as an enemy of transformation. The vigor ought to be overcome if change assertions are to be
effective. Leadership is an action of pinpointing an objective, encouraging other individuals to
act and offer support and motivates to realise mutually negotiated objective (Davidson, 2010).
Leading a change such as this proposal will need the manager to engage in diverse leadership
approaches to comprehensively execute all the transformations. This is essential in order to
create crucial commitment as there are a number of diverse expertises involved in this change
routine. When dealing with over twelve thousand employees, doctors, nurses, paramedic and
administrators, a situational style of leadership will be needed. The sheer numbers of individuals
comprised in the change will definitely means that there will unmistakably be in states that will
arise that cannot be scheduled for and the manager will require taking chance of these situations
for those involved. Situational leadership is effectiveness coming from a behavioral style that is
suitable to the requirement of the surroundings and secondly on the learning to analyse that
environment (Grimm, 2010).
In order to efficiently encourage personnel and control variances, the managers need aspects of
transformational leadership as the manager ought to have competencies and qualities in the
management of self. Transformational leadership happens when managers rise and widen the
staffs’ interest by creating awareness of the team’s mission and encouraging staff to concentrate
on the good of the group as opposed to their individuals self-gain (Kelloway, Turner, Barling &
Loughlin, 2012). This type of style will be mainly prevalent when dealing with health care
professional such as paramedics, doctors and nurses. By supporting no show initiative it will