Investigation Project: Leading Change Strategic in Health Delivery

This report investigates the leading strategic changes in healthcare delivery and social service systems in New Zealand, focusing on Waitakere Hospital. The research, conducted as part of a Business Management Level 7 assignment, explores the hospital's mission, vision, and values, highlighting its commitment to accessible, compassionate, and cost-effective healthcare. The report details the hospital's structure, including its various service departments such as aged care, child care, substance abuse care, and pharmacy, as well as its marketing strategies and research initiatives. It also discusses daily tasks observed during a visit to the facility, emphasizing the importance of hygiene, sanitation, and nursing care in achieving the goals of the New Zealand health strategy. The report concludes by underscoring the hospital's role in providing quality healthcare and disability care to the community.

Running head: INVESTIGATION RESEARCH PROJECT
AN INVESTIGATIVE RESEARCH PROJECT: LEADING CHANGE STRATEGIC IN
DELIVERY OF HEALTH AND SOCIAL SERVICE
Name of the Student
Name of the University
Author note

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Table of Contents
Introduction..........................................................................................................................2
Background......................................................................................................................2
Purpose of this report...........................................................................................................3
Waitakere hospital and its background............................................................................4
Discussion............................................................................................................................7
Conclusion.........................................................................................................................10
References..........................................................................................................................12

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Introduction
Background
There is a complex network of organizations and people, who are assembled to provide a
holistic healthcare and disable care system to the fellow New Zealanders (Mossialos et al.,
2016). Each of them completes their role diligently so that a complete healthcare solution can be
provided to the people in need. Despite being one of the leading healthcare systems in the world,
the health care system has faced several reforms to be able to tackle the emerging healthcare
concerns by making a stronger merger between the public and the private healthcare system (Lal
et al., 2012). Primarily, the healthcare system of NZ was comprised of public healthcare that
used to provide improved quality of care. However, around the 20Th century, with increasing life
expectancy and emergence of several diseases, the government focused on the development and
spreading of private healthcare system so that they can work in combination with the public
health care system to achieve the quality related goal of NZ healthcare service (Ardagh et al.,
2012).
The Ministry of Healthcare of New Zealand was formed in the year 1903 by merging
different ministry of the system and used to provide funding to the public healthcare facilities.
However, in the later years, the economy suffered from tremors, due to which the healthcare
service decreased (Schoen et al., 2012). Therefore, the emergence of private healthcare facilities
in New Zealand occurred. The current structure of ministry of healthcare in NZ includes Chief
Nurse, Clinical leadership and their protective regulations, corporate related services, Maori
health, National health Board or NHB and District Health Board or DHB (Timmons,
Gooberman-Hill & Sharp, 2013). Within these, the primary role of NHB is to determine the

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effects of rising costs, increasing aged population and their demands, aspects related to the
shortage of staffs so that a sustainable healthcare system can be generated (Salmond &
Crampton, 2012). On the other hand, the role of DHB is to provide funding and other provisions
related to healthcare to each and every district of the country. There are total 20 DHBs present on
NZ and within each DHB, there are 11 board members that direct the DHB with their strategic
directions and monitor their performance (Ministry of Health, 2018). The objective of the DHBs
includes helping, improving, promoting and protecting the right of healthcare of the people of
every district of NZ. Further, it also works for the integration of different primary and secondary
healthcare system as well as meeting the local, regional as well as national needs of healthcare
(Ministry of Health, 2018). Finally, it provides the provision of quality health care and disability
care to the patients of different districts, who were primarily unable to receive any health care
service due to their location. These were the responsibility of each of the aspects of the ministry
of healthcare of NZ (Timmons, Gooberman-Hill & Sharp, 2013).
Purpose of this report
The primary purpose of this report is to determine the leading strategic changes that are
imposed on the healthcare delivery and social service systems of New Zealand. For this purpose,
all the students pursuing Diploma in Business management Level 7 were asked to visit the
Waitakere hospital so that the investigation related research project can be carried out. Further,
this investigative research was also important to provide knowledge about the health care system,
its operations, and its strategies to the students of health service specializations. In this healthcare
facility, there are four primary areas, which are being served. These are services related to child,
women, and family; services related to Asian patients and their support, services related to
Pacific support and finally the services related to WATIS interpreting. these four principles help

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the Waitakere healthcare facility to achieve its nursing goals related to child care, aged care,
primary care for other communities and compliance to the Waitangi treaty so that holistic
healthcare approach can be achieved. While discussing the healthcare management system of the
Waitakere hospital, it should be mentioned that the healthcare management system and the
administrators are bound by legal as well as moral ethics that pushes them to provide quality
health care service to the fellow New Zealanders. The administrators such as the CEO of the
hospital, health informatics manager, service line administrator, and operations director. All
these authorized stakeholders work to accomplish the objective by recruiting, monitoring and
providing training to the staff of the healthcare facility so that quality of care can be achieved.
Waitakere hospital and its background
The Waitakere hospital is a general healthcare facility located in the Waitakere city of the
Auckland, New Zealand. This healthcare facility is situated in the Henderson suburb of the city
and the primarily administered by the Waitemata District Health Board or DHB that helps the
hospital to provide healthcare facilities to the approximately 560,000 people staying along the
north shore of the Auckland, New Zealand (Cullen et al., 2012). The healthcare facility was
developed in 1945 when it had a different name ‘Waitakere Maternity hospital’ and after several
years was included with strategies and services which the facility offers to the service users
nowadays (Boyd et al., 2012). Development of this hospital by the Waitemata DHB was an
important step as with the help of this, the healthcare facility now offers a 24-hour emergency
service for adults as well as pediatric wards so that holistic healthcare approach can be achieved
(Waitemata District Health Board, 2018).

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Mission, vision, and values are three string pillars depending on which, any organization
directs its resources and staffs so that their goals can be achieved. The mission of the Waitakere
healthcare service was to provide accessible, compassionate and best quality and cost-effective
healthcare service to the community residing nearby. By this means the hospital aims to promote
good health, to educate the upcoming healthcare professionals and to participate in the healthcare
or clinical; researches so that the mankind can be served with better quality services (Cullen et
al., 2012). Further, the hospital offers a set of promise to its service users that determine that
each of the staff will make its contribution count whether they work with inpatients, outpatients
or through support services to improve the healthcare condition (Waitemata District Health
Board, 2018). The purpose of this organization is to promote wellness, provide relief to the
suffering by preventing or curing the ailments of people. As the priorities of the Waitakere
healthcare service was to improve patient experience and provide them with a better health
outcome, they followed the values which focus on every aspect of a holistic healthcare
(Waitemata District Health Board, 2018). The values included everyone and determine their
preferences for every ill patient. Further, the second value they follow is a presence of
compassion in care delivery process as, without a caring clinical approach, positive
improvements will not occur. Thirdly, they determine that they are connected with their family
and are in the process of continuous improvements so that they can lead the healthcare system
process on a national level (Boyd et al., 2012).
As per the data shared by the healthcare facility, the annual budget of the Waitakere
hospital provided by the Ministry of Healthcare New Zealand is of $1.4 billion. Using this the
health care system delivers an overall health care service starting from child care, substance
abuse related care to the disabled care and psychiatric-related care as mentioned by the DHB

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Auckland (Waitemata District Health Board, 2018). Further, this healthcare facility employees
more than 7000 professional health care providers and supporting staff including the hospital
management staff so that service can be provided to each patient without any discrimination.
There are four primary healthcare service departments in the hospital such as the aged care unit,
child care unit, the substance abuse care and finally the pharmacy unit that provides the
healthcare service to patients in need. The disability care service and substance abuse care
service is the specialization services that the healthcare facility provides to its patients
(Waitemata District Health Board, 2018).
Like every organization, the primary key to reach to ultimate success is by reaching out
to the right consumers or service users and in the right time. There are several marketing
channels using which the Waitakere hospital tries to reach to its primary stakeholders that are
their patients (Froimson et al., 2013). The targeted customers of Waitakere hospitals are people
on the north shore of the Auckland and the diverse community residing there. The service of this
healthcare facility is divided into two sections such as direct and indirect services (Lovelock &
Patterson, 2015). The direct services include adult care and child care units in the healthcare
facility. On the other hand, the indirect services of Waitakere healthcare services include the
substance abuse care and the disabled care facility which can increase the morbidity and
mortality rate of the country. Therefore by swerving these aspects of health care the health care
authority contributes to its promise by supporting the major aspect of healthcare facility of New
Zealand. Besides these, the healthcare authority is also associated with several research works
that help in the improvement of healthcare strategies throughout the globe. Research of this
hospital is mainly based on observational and clinical aspects, conducting audits interviews with
the patient’s that targeted for innovation, service improvement, and other related activities. Such

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as formation of clinical libraries, conducting research related to Maori health, researching about
the healthcare process in nearby places and so on (Weinstein, 2013). Therefore, the research
method the healthcare facility uses for conducting of researches is primary research that provides
concise and unbiased results after the conduction of such researches (Froimson et al., 2013).
Discussion
While visiting the Waitakere healthcare facility for our Business Management Level 7
assignment, we were told about the four daily tasks that were carried out in the healthcare
facility. These tasks were general and were related to the health and hygiene of the patients and
the facility because we were not allowed to enter most of the sections in the peak hour. The first
activity I noticed was cleaning and sanitation-related work. As the objective of the healthcare
facility is to determine the safety and security of the patients within the healthcare facility,
maintenance of the healthcare facility’s hygiene and sanitation was an important daily task that
the workers were carrying out diligently. Further, it was also important to save the patients
having the weaker immune system from hospital-acquired infections. As per the goals and
objective so the New Zealand health strategy, it was important for the healthcare facilities to
support the policies and other infrastructure related aspects so that the authority can ensure that
the patients and their families are provided with a safe environment, hygienic supporting and
clear and clean drinking water so that the goal of a healthy physical environment can be
achieved. Further, it also helps in removing the environmental hazards that can lead to hospital-
acquired infections. Further, I noticed that there is a complete sanitation team in the hospital
which work under the supervision of the sanitation supervisor (Servant leader). The management
of sanitation program was inclusive of the grading system and after the completion of sanitation-
related work, it was the duty of the supervisors to evaluate the cleanliness and prove the workers

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with grades so that their performance can be evaluated, that made this entire process effective.
This team worked as a unit to determine the hygiene level of the facility.
The second daily task I observed was related to the nursing professionals in the pediatric
wards. I observed that in the pediatric ward, the nursing professionals were conducting daily
routine check-ups and provided the patients with medications. Further, it was also complying
with the objectives of the healthcare facility in which it promised to provide compassionate and
holistic care to the patients, thereby indirectly linking to the healthcare facilities objectives. This
task required high performance with values and therefore it was observed by an advanced
practice nurse of the facility so that she can determine the presence of medication error in the
system. Further, the APN was motivating the other nurses and the children for their assessment,
therefore, she was a type of motivator or coach that led the nursing professions that worked to
provide high-quality care to the patients. Therefore by complying to the child care related daily
monitoring, the healthcare facility complied to the goal of healthcare strategy which mentions
that the healthcare facility should include appropriate child care services in its pediatric care unit
and the care process should be accessible. Form the given description of the hospital staff, I was
able to determine that the childcare unit of this hospital used to work proactively so that the care
can be provided to a larger section of the population.
The third aspect which I noticed as a daily task was helping people with smoking
cessation, which was the indirect facility provided to the population of nearby areas. I observed
that there is a section of the healthcare facility where people are provided with education related
to smoking-related health care problems that can affect the morbidity and mortality rate of New
Zealand. This daily session was people-powered and they were enrolled for a 30 days education

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and intervention plan so that their smoking-related habits can be modified. Therefore, this
complied with the institutions objective as it helps to improve the quality of life of the people
who are addicted to such habits. This task was supervised by a motivational coach who used to
provide a rationale to the patients so that using facts and data, they can be convinced to quit their
smoking habits and then provide them with medical interventions so that achieving the target
becomes easier for them. This daily work also satisfied the national healthcare strategy as it has
the provision of providing the community with population health objectives related to their
smoking or other substance abuse can be reduced or treated to provide them with improved
quality of life.
The fourth daily task I observed on the healthcare system was a maintenance of the
pharmacy and the allocation of the medication to the patients. This was one of the toughest work
of the healthcare facility to maintain the accurate dose of the medications as mentioned by the
clinician to prevent the massive healthcare medicational errors. The primary objective of the
healthcare facility was to provide accurate and compassionate care to the patients so that the
interventions can become successful in treating the patients. In this aspect, the healthcare facility
appointed a chief medical officer with a team of pharmacologists that used to assess the medical
prescriptions and then used to provide healthcare intervention to those substance abusers.
Further, after witnessing all these daily works in the Waitakere healthcare facility it was
determined that if change management is implemented in these tasks, few of them will be
compromised and others will be able to improve its status (Senior & Swailes, 2004). Change
management in cleaning and smoking education related daily task would have been improved the
quality of care (Iles, 2005). For example, if the workers allocated for cleaning related works are

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divided into shifts so that while commencement of every shift, healthcare departments are
cleaned and sanitized, it would improve the quality of care process (Burnes, 2004). On the other
hand, if the smoking-related education interventions were provided in the community, or at a
community center, it would have influenced multiple amounts of patients so that they can quit
their smoking-related habits (Johnson, Scholes & Whittington, 2002). However, if the change
management plan is implemented in the pharmacy or childcare related practices, it would have
affected by increasing the number of medication errors, falls, and spillage in the child care units
of the healthcare facility.
Further, in all these care processes, the Waitakere healthcare facility maintained the
Treaty of Waitangi for the Maori community of New Zealand. It should be mentioned that the
area of Waitakere healthcare facility is populated with 10% of Maori community therefore it is
necessary for this hospital to provide culturally safe healthcare facility to the patients of Maori
community. In this healthcare facility I observed that staffs were kind and polite to the Maori
community people and they were provided with interpreters so that communication with this
community can be done properly. Therefore, as per my observation, I witnessed that the
Waitakere hospital was able to comply with the Maori communities Waitangi treaty.
Conclusion
The aim of visiting the Waitakere hospital in Auckland was basically in order to fulfill
the requirement of this semester for all the student who is pursuing a diploma degree in business
management in level 7 with specialization in health services. The requirement needed the
students to investigate and perform a research on an ongoing project that focuses on the strategic
change in the delivery of health services pertaining to the consideration of the social factors. The

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students chose to visit the Waitakere hospital in order to understand the medical service delivery
operating in New Zealand and also interact closely with the healthcare professionals in order to
understand the trend of operation by the Pacific health team.
The experience of the hospital visit was quite an informative one, however, the limitation
that can be identified with the experience would be the time constraint which was not enough to
carry out the investigation in an efficient way. Another limitation that can be identified would
include the restrictions imposed on the students pertaining to the allowance of noting down
important information or recording the testimony of any health care worker in the hospital in
order to maintain confidentiality. It is also important to take note of the fact that most areas of
the hospital were not allowed by students to visit because the professionals said that the areas
were extremely crowded and busy with patient care. On account of the time constraint, it was not
possible for the students to find out accurate information about the number of wards, or the
number of specialists working in the organization or the employee strength in the organization.
The hospital setting is based on the compliance to the treaty of Waitangi as the nurses
working in the hospital are all trained with respect to the norms of cultural competency as the
professionals were seen treating many indigenous patients s with care and explaining them the
procedure of their treatment in a compassionate manner.
Recommendations would include organizing the hospital visit preferably on a weekday as
it is seen that during the weekend the hospital wards are extremely crowded and if the hospital
authorities could come with an informative presentation to enlighten the students pursuing the
research work on the hospital operation then it would serve as an extremely informative tool for
all the students to note the important facts and figures that they can incorporate in their project

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work in an elaborate manner and also it would help in maintaining the confidentiality of the
employee information, thereby preventing any issues pertaining to the breach of privacy norms.
Also, the university prior to organizing the hospital visit could officially obtain a permission
from the authorities so as to uphold the concern associated with the observance of ethical issues.

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