Hillsboro County Home Health Agency: Change Management Essay.

• Whether the structure of the program matches with the structure ofplanning and subsequent contract
• How far patients are engaged with coaches andhow efficiently the self management supportive activities are conducted
• Whether patients’ knowledge and self-efficiency has increased
• Whether health related behavior of the patients are changing
• Whether and how disease control are achieved and improved
• How much the rate related to adherence of the providers to guideline has increased.
• How much the patient health has improved
• How much the satisfaction of the patients and clients regarding service improve
• How much the resources utilization and health care cost are minimized yet quality of health service provided to patient are increasing

Hillsboro County Home Health Agency came into operation in 1946 as a community based home health agency. The agency rooted in the heart of Florida is a non-profit organization. The Joint Commission of Hillsboro County has accredited the organization as the only Medicare certified home health agency. The organization is popular because of the deliverance of high quality care backed by positive attitude and prudent administration (Case Study, 2017). The agency is operative broadly in three divisions, which are namely the Home Care, Private Duty and Community Health. However, in the recent periods several problems have been cropping up in the operational framework of the organization.

The paper aims to represent the problems in the operation of the organization with proper focus given upon the change management plan the agency is going to undertake in order to incorporate growth and development in the organizational performance and to increase their market share while promoting the quality of health care service as a whole.

The organization has a mission to serve the needs of healthy as well as ill and disabled people in the integrated environment of the institution. It not only aims to bring prevention to the ailments by mitigating the effects and symptoms of various illnesses but also cease any further progression. The agency has commitment towards providing excellent service incessantly and improving their performance through provision of quality nursing (Mitchell et al., 2012). Their quality further ensures the therapeutic care to the non-institutionalized disabled or sick people in community. The care system provided by the organization is generally patient-focused and it strives to provide readily accessible information (Case Study, 2017). The role of information and awareness generation is immense as it causes encouragement to the individuals, special groups, families and community people and enables them to access quality health services.

The vision of the concerned home health agency is to build a healthy society through reduction of the concentration of sick population. It also has vision to promote healthy lifestyle in the communities. For that, it has not only come up with preventive actions but has also spread awareness about different disease, their causes and probable steps to be adopted to avoid them. The core vision of the health organization is to provide protection, bring promotion and improvement in the health of population as a whole in Florida through the help of the efforts made by integrated state, county and community (Cummings & Worley, 2014).

HCHHA is a non-profit organization. It encourages and promotes the good health and through quality nursing and therapeutic care, creates disease awareness among the people in the society.  The core values of the firm can be indentified in to following aspects:

SWOT Analysis

Integrity is one the important core values of the agency that evokes adherence and accountability of the organization toward higher ethical standards.  Providing care in the mass scale is another value that the agency possesses at its heart and the organization mostly emphasizes on delivering action focused and attentive service to the needy community. Compassion lies at the core of the operations and the operational framework of the institution rightly combines the empathy and concern in order to deliver services to those who need it (Berkowitz, 2016)

The firm has gained recognition for its progressiveness that further comes from the utmost professionalism that is borne by it. The efficiency of the firm reflects in the discipline of its employees, their thought process and action, which further contributes to the professionalism of the firm. This also evokes desire of the firm to evolve and improve continuously through innovation, which is the next core value of the firm. This factor continuously encourages it to stay creative in the aspect of the solutions which it provides through wise management of resources. The accountability of the agency makes it perform its responsibilities with integrity and respect (Ashbolt et al., 2013).  Collaboration as core value, promotes teamwork to achieve common goals and to provide solution to any problem.  Serving customers and engaging partners is the mission achieved by the agency through excellence and responsiveness that further promotes quality outcomes through learning and improvement in the actions.

Strengths

• The organization has two operative locations that provide convenienceto the patients and community people in accessing the services of health agency. The existence of the firm in Hillsboro and Jasper expand the extent of the health service further and helps the same in promoting better health service for the firm (Van Durme et al., 2014).
• The firm enjoys positive reputation in providing care services to the community. The popularity of the organization lies in the prudent administration in collecting and channelizing funds, delivering high quality of services and bearing constructive attitude at the core (Berkowitz, 2016).
• The organization gathers up qualified health professionals ensuring it to become highly professional place to work. This further adds to the better quality of health care service provided by the agency.

Weaknesses

• Since the organization mostly deal with health care services having interest, regarding this sector is mandatory as it shapes up the base of policies designed and implemented. It has been noticed that the board of directors committee severely lack the physician interest in its serviceand are business minded.
• Over the years, there has been decline in the overall financial performance of the organization. The fading financial performance takes down the reputation of the firm that affects its market share.
• The advantage or benefit derived from the Jasper office is not identified. The core reason behind the expansion of the location was to extend the health care service, which is not met in reality.
• There arelots of differences in the perspectives of different board members. This is one major weakness as it creates confusion on part of the policymakers stopping them to agree and conclude to one point (Van Durme et al., 2014).
• Another important issue is poor productivity of the employees who are serving for many years and has become somewhat reluctant in their job roles.

Opportunities

• The opportunity of the health home agency lies in the extended service of it taken up by various firms mostly, insurance companies and other health care organizations which have showngrowing interests to access and make partnership with the home care services of Hillsboro Home (Daley, 2012).
• The asset valuation of the Middleboro office is worth 1.3 million. This brings forth enough opportunities of the efficient allocation as well as utilization of resources.
• There is immense opportunity for the organization to invest into advertising as one of the marketing strategy (Mitchell et al., 2012). The marketing has lot of potential and strategic improvement is required for the health agency to attract more customer base as well as to capture a greater market share.
• The community faces a dire need of Medicare certified hospice, which raises the attractiveness of this agency in the market since this is the only accredited and Medicare certified health care agency in the county. This lead to concentrated customer base adding to the size of its clientele and the magnitude of revenue earned bythe firm (Van Durme et al., 2014). The community also generates huge demand for adult day care. The agency has provision of catering service to adult day care patients, which further expands the limit of the organization in providing health services.

Threats

• The biggest threat faced by the health agency is increasing competitors and growing competition in the home-care service sector. Huge numberof firms is growing in the county, which provide equivalent or even better services than Hillsboro Home county even though there are not Medicare certified. The quality issue cropping up in the organization has created the ground for the concerned firm to lose market share (Ashbolt et al., 2013).
• The market for the home care services experiences changes in the reimbursement system, which causes a threat for the health home agency. The greater challenge the agency is exposed to is the difficulty in arranging re-certified physicians for Medicare patients in every 60 days.

The identification of strength, weakness, opportunity and threat of the Hillsboro Home County Health Agency allow it to draft a strategic plan that will be operational in coming time. The plan is expected to culminate into providing quality to its clientele, taking inputs from the service providers, staffs, board members, leadership team, community members and partners. The agency broadly focuses upon increasing number of associations with meaningful clients and nurturing the family engagement by taking proper care of family wants and health needs. While meeting mass health care needs is the core vision of the home, it is the open, harmonious and respectful approach of the institution that forms its strategic pillars (Wheelen & Hunger, 2017).

There is the construction of a four-strategy plan of the firm lying at the core of its operational tactics that is going to be implemented. The first strategy targets the aspect of making the health home more attuned to the patients and client base. This can be ensured by delivering quality and building partnership, which can take the firm closer to its mission of empowering people through a healthy life and creating the possibilities of independence. Building strategic partnership and collaboration with other service providers is expected to help the agency achieve solutions to systematic challenges, which might be difficult to achieve on its own and this brings forth second important strategic plan that promotes more connectivity (Berkowitz, 2016). Enriching effective partnership and fostering new ones is expected to ensure more connectivity among the service care providers thereby enabling them to deliver quality and responsive care along with assurance of relevance to evolve into a fast growing health care system. The third strategy pertains to bringing out more inspired solutions, which is possible through tapping into the underlying expertise and energy of the staffs, tech-savvy partners, service providers. This if implemented appropriately is expected to help in driving best practices to ensure improved client experience through delivering sustainable and equitable solutions to the mass community people. The fourth and the last strategy focus upon monitoring the outcome and quality of services of the health home.

Strategic Plan

The strategic priority of Hillsboro Health Home is to carve out the specialties it posses and become the leader in providing health service to the county of the community by serving their diverse needs. To provide best-organized, client-driven and client-oriented service care, getting idea of mass need, feedback of family members of the patients and general voices are important. This requires more accountability in addressing the unique needs of different strata of clients; provide high quality of comfort and care equally to all the clients. Formation of partnership is expected to help in developing integrated health care model through introduction of advanced and innovative ways that delivers best possible solutions with efficiency (Wheelen & Hunger, 2017).

To improve care experiences shared by the clients and family caregivers, engaging them effectively plays important role. Specialization in child-care unit is one important priority which has been recently targeted by the agency in order to come up with care services to meet the complex needs of the cognitive impaired people.  Keeping relentless focus on improving quality, increasing care in delivery, client safety and evidence-based practices are key strategies the home care agency is expected to implement. To deal with the patients suffering from chronic diseases, the agency focuses upon developing self-management approaches and integrated services models creating more freedom in providing treatments.

The market size is crucial element in market competition as it decides the market power each organization has. Industry mergers are also one of the possible scenarios in such cases. The environment of financial restraints facing the firm compels it to identify new efficient ways to promote growth in the business and streamline process. This should consolidate the investment in training, research and development of program so that care provided to the clients and their families contain quality as well as cost effectiveness and efficiency. One of the important strategies to consolidate this is to build strategic partnership with eminent and quality service providers in the market as it has importance in market competition (Austin & Pinkleton, 2015). Mergers as partners with other home-care service providers can provide better solutions without curtailing each other’s revenue in the market or hampering the market share.

This makes the firm design the collaborative models and integrated care structure that focuses upon improving the outcome and firm experiences. In order to bring innovation in the solution process it is necessary to keep connections with various other service providers operating in the different sectors like academic, industry, business and even health care to gather up new knowledge and come up with innovative and safe care services. The rationale behind increasing connectivity in the sector is to expand the nursing capacity of the health agency across other counties of Florida as well as USA (van Wijngaarden, Scholten & van Wijk, 2012). Expansion of the charitable functions are also one of  the core reason behind this partnership strategy as it helps to share information and helps in collecting funds and building up robust networks, which in turn may facilitate in providing target solutions to people in need.

Strategic Priority-1: Increased Attunement

The maximization of overall efficiency and shaping up the best experience and outcome of the care service depend upon the amalgamation of right talent as well as application of technological advances. In order to bring about inspired solution, considerable amount of investment is mandatory for the improvement of the workers as well as in their outlook, skills, necessary tools effectively (Wheelen & Hunger, 2017). The quality in the services provided by the staffs comes further from the satisfaction they derive as worker, which in turn puts in the forefront the efficacy of the management team as well as board of members. The self-satisfaction of the firm paves way towards higher quality of the care services with positivity present throughout the client experiences, innovation and productivity.

The better quality and expansion in service can be delivered if the workforce is inspired to be engaged in ensuring best practices. The quality of their service helps in creating a better workplace, which further determines the quality of the care services. To meet the complex need of the clients and focus of the population the competencies of the staffs need to be boosted. Technology needs to be leveraged in order to uncover the efficiency and increase productivity. Enhancing communication and accessibility to resources can ensure the same. Innovation in service delivered can be achieved by improving the usage and collection of quality indicating data, outcome data of client, all of which further helps in better decision-making promoting evidence-based clinical practices (van Wijngaarden, Scholten & van Wijk, 2012).

Success of all the other strategic plans depend on the monitoring aspect of the organization, which is the strategy of keeping track of the effectiveness of the strategic plan implemented by the same.  Monitoring plays important role in measuring the deviation in the outcome from the targeted strategic plans and the same thus helps in keeping up as well as protecting the accountability of the agency toward its clients, partners, fund providers and various other organizing bodies. Quarterly performance reviewing is one of the progressing monitoring, which is expected to be applied by the home care agency.

The key concern facing Hillsboro County Home Health Agency management team is the design and implementation of change management. Bringing a change depends upon proper management of the same, which again further depends upon the handling of the complex process of the change. The changes demand the professionals to be obliged in acquiring expertise meeting the need as well as enhancing the quality of the service though improved competencies. Managing a change comes with steps of proper planning first, implement and then evaluate in the end, all the planned and implemented strategies, thereby ensuring that the changes are worthwhile and relevant for the health home (Cameron & Green, 2015). This dynamic process requires combined effect of all the choices pertaining to technology and orientation of people.

The size of the promoted change is dependent upon the structure of change management strategy adopted by the firm.  The agency is popular for its comprehensively managed health care programs provided to the community including Clinical and Nutrition Service, Community Health Planning and Service, Environmental Health, Emergency Preparedness, Response and wellness programs to cover different infectious disease. The agency looks for implementing various new programs that would broadly take care of the people lying outside the care coverage of Medicaid and Medicare. To ensure the planned implementation of the changes and their efficient working, partnership with local government body of Hillsboro County is extremely important.

The major tractable impact on the community as a whole is growing concentration of the clients taking service of this organization. More specifically people prefer Community health Care Centers over hospital clinics which is evident in the increased client base for Hillsboro Health Home. Moreover, the changed plan including the enhanced child and old care benefitted the greater ratio of old age population of the county as well as the new born. On an average, the birth rate of the county improved with recorded good health of both children and mother.

The broader vision of the organization is to bring transformation into the system so that it would be organized more around the need of specifically defined group. An innovative structure is going to be introduced so that the people are encouraged to take participation in the primary health services of the agency. This has led the firm to tie up with District health board that would provide funding as well as take up the responsibility to supervise the firm. The approaches of the agency include maintenance and improvement of health services provided to mass population. Inclusion of practitioners and service providers in the decision making process of the organization is another strategy which has been revised and improved. The organization has been a profit targeting one so far and yet has faced fading financial gain over time. The change management plan introduces strategy to transform the organization into a non-profit one, which will make it adopt more public oriented policies and programs (Cameron & Green, 2015). Instead of stringent policies, memberships of the practitioners are expected to be made voluntary and qualified service provider is expected to be encouraged to participate in the service provision of the organization. Increased number of doctors per patients with better equipments and techniques are expected to exert a combined positive effect, which in turn is expected to promote better quality of treatment in the agency.

The importance of the change management lies in growing need for health care service in the Hillsboro County especially after little disaster the society faces. The presence of various other health care organizations providing diversified range of services makes the role and responsibilities of Hillsboro County Home Health Agency immensely significant. Capacity expansion is the new call facing the business of the health home (Perrin, 2014). This requires not only expanding locations and services of the agency but also arrangement for staff training programs in order to ensure that adequate employees are available for the organization to meet the extended demand of the community.

Importance of communication plan in change management plan is immense as it keeps the stakeholders aware of all sorts of information regarding the business and its growth over time. It is a policy driven approach that formally outlines the segments of people in relevance and the information, which is supposed to be given to them. It also determines the time and communication channel of information delivery (Austin & Pinkleton, 2015). Since the change management plan focuses upon massive structural change, including expansion of service centers and service cares, staff training program etc, this is expected to require lot of investment, which can be provided both internally through the stakeholder’s contribution and can be derived externally. These events require proper planning and communicating those planning and information to not only the people associated with Hillsboro County Home Health Agency but also to the people in society who are who are part of the system, including the customers and the potential clientele too. Role of communication plan is also important for making people aware of the systemic changes, which further help the agency gain success in its change management. It is the responsibility of the Home Care management team to address and communicate important information regarding operation of the organization. The dissemination of information is mostly done with the help of websites, presentation, printed reports and emails.

The resistance management in real life projects, follow no systematic rules but is largely driven by situation and time. In the process of change, it is mandatory that one receives resistance prevention applied through proper anticipation, reaction and management of it. There are three important channel of dealing with the resistance in order to minimize the negative impact of it. These are; resistance prevention, proactive and reactive resistance management.

This is one of the important components to apply change management effectively through the follow up of the structural process and with the help of the set of tools required for managing the changes in client side in order to achieve positive business outcome. It involves sponsors to remain engaged actively in the change and communication process. It focuses upon establishing tailored and clear communication and information plan that targets specific audiences (Cameron & Green, 2015. The resistance prevention of Hillsboro Health Agency depends upon the managers whose ability to advocate changes is important. Group of service providers has to receive appropriate and timely training. Proper prevention of resistance comes from integration of change management with project planning.

A proactive way of managing resistance involves operation based upon the foresight of management and project team members. The anticipation of resistance and its management should be incorporated proactively into the change management plans (World Health Organization, 2012). Anticipation can be developed with the help of thorough review of organizational history and the relevant effective changes can be brought forward with the identification of higher risk factors of impacted groups.

Reactive resistance Management:

The resistance process can act as natural reaction to changes and hence it can allow application of proper change management plan. It allows the health home agency to anticipate potential problems in transferring and expanding location and its aim of targeting greater population of the county for the purpose of provision of its services (Cameron & Green, 2015). This section let the firm come up with reactions and plans for resistance posed to expected changes being proposed.

The organization has aimed to bring about changes in its health programs that further cover more of old population with improved health care services in the county. The health care administration introduces few programs that mostly targets to inject the combined foundation of medical administration along with understanding of solid groundwork in computer application and accounting knowledge. Moreover, the new programs are expected to focus on enlightening the workers and staffs with proper human resource management and organization management as well.

Hence, the training plan plays important role in the outcome of the service plan of the health home agency. The training plan includes various workshops that primarily focus upon demonstrating newer technology and techniques applied and the various new fold equipments brought to the service range of the organization (Hill, Jones & Schilling, 2014). The essence of the training lies in empowering the staffs and health service providers on their varied respective roles and responsibilities of services.

Not only the ground staffs but also the quality of service emitted from the doctors, physicians and other health service providers have to be well structured and executed in an efficient and timely manner in order to provide the excellence planned. The training confers enough experience and career boost to its associated receivers of training.

The health service of the health agency depends upon a cohesive teamwork that performs in an integrated way and gears up to deliver best quality of services to the entire county. The teamwork would help the agency achieve excellence, and for achieving, the same, different teams are expected to be designed and allocated with varied tasks and responsibilities. This division of task would allow individual to focus on one job at a time and this further brings out concentrated and best quality work. Hence, importance of high performing multi team system designing for patient care is immense (Slack, 2015).

It is not possible to deliver teamwork in the absence of a properly defined team. Hence, the first step towards implementation of teamwork is to provide a team structure or enhance the already existing one. The team structure followed by the organization depends upon the long-term values that mostly focus upon team as task work unit delivering improved performances and facilitated by best leadership techniques and qualities. The health care agency rightly promotes an environment that is conducive to the effective team functioning that promises further mutual collaboration, acknowledgement, recognition, accountability and professional respect. The end result of effectively designed team work and cumulative effort is the outcome in terms of effective leadership, mutual support, strict monitoring and better communication network build within the network of the organization (Austin & Pinkleton, 2015)

 Operative team structure in the Hillsboro County Home combined with effective strategies ensure safety for the patients reducing possibility of errors through taking into account performance, attitude, skills and knowledge of individual members in the team.

The change management plan focusing more into the quantity and quality of service provided to people of Hillsboro County makes inclusion of various incentive plans to motivate staff workers as well as practitioners and physicians. There are several methods and modes through which various incentives in the health care service can be provided. It works as a driving element of motivation and greater performance targeting overall improvement in the service-providing framework. One of the important incentives provided by the organization is Pay for Performance system (Borland & Schiller, 2012). Under this system, the targeted beneficiaries are compared among themselves based upon set of performance indicator. The individuals who achieve higher levels in terms of the performance indicator, are rewarded financially. The system mainly focuses upon rewarding high-end performances that boost the workers to continue delivering higher quality in the service. The indicators are assessed in light of every individual’s performance (Jean-François, 2014).

The organization holds annual meet where it reviews and revisits the key achievements, changes received by the organization as a whole as well as the staffs, workers and service providers. The annual celebration also includes the program of rewarding the deserving members for their achievements and produce motivation as a whole.

The market for health care in the Hillsboro County is tending toward tough competition in presence of many growing agencies that deliver quality. Market demand for the health services in this county is also increasing that requires expanded service providers. Expanding centre location and starting new set up is time consuming and a minimum time span of six months are required in order to shape up the new services.

The change management includes many shifts in the operational outlook of the agency. Expanding the service of the organization requires lot of budget because it not only includes opening new centers in other locations but also includes arrangement of abled staffs, providing training to them, making them advanced in providing service and so on. This would require the health agency to incur lot of expenses and most of the fundings are going to come from the partnerships and tie ups with district health bodies as well as other eminent health service providers. Overall, the structural change is going to cost near about US$ 0.05 million (Kelly, 2015).

A plan regarding evaluation is integrated with grant proposal of a real project through provisioning of information that brings improvement in the implementation and development phase of the project. For small projects, the evaluation plan is designed and executed by the Vice President of any organization. Evaluation plan consist of detailed information regarding an evaluation that is going to be undertaken within operation of an organization. The object of evaluation, the process going to be adopted with proper specification of tools and approaches and the time of conducting evaluation are well organized into an evaluation plan.

The change management plan of Hillsboro County Home Health Agency is neither a small nor a big project and hence the Vice President along with the board of members, designs the evaluation plan of the organization (Borland & Schiller, 2012). The evaluation plan of Hillsboro County Home Health Agency makes clear identification of detail information and the interest of the stakeholders, further making evaluation of the programs people are curious to know and about what they want the information. For this purpose, a formative or summative type of evaluation is best suited. Evaluation questions bring out the efficacy of the organizations in introducing changes in its operation. The evaluation includes decisions regarding questions to be answered, measures to be applied and required data collection. Addressing such evaluation process before the project gets finished derives important decision regarding the design proposing success to the project itself.  

The clarification of purpose for evaluating understanding lies at the short term and long-term focus of the organization. Limited resources and unlimited want of services in the society leads to the need for proper allocation of the scarce resources, which further depends upon setting priorities.  A biggest criterion for evaluation depends upon the credibility of the process and its resonance with success. The Health Home undertakes the structural change in its operation based on different funding and grants obtained from district health boards as well various investors including the stakeholders.  Such programs, which are granted the funds, are mostly critical to success and its sustainability. Assessment of the impact of program objectives is a better way to demonstrate the value of the project as well as to monitor the progress of the program towards achieving its goal. The evaluation also includes the identification of best practices and lessons derived from the change management execution.

The importance of evaluation lies not only in deriving the impact of the changes but also in integrating the findings into the program so that desired level of performance can be achieved. The evaluation helps in supporting the self-management in the delivery program (World Health Organization, 2012). Assessment of program’s success can be executed in line of the following aspects:

Conclusion:

The importance of Hillsboro County Health Home Agency Inc in the said county is immense, especially in presence of newer organizations providing health services and growing demand of it by the old population. The fading financial performance, competition and lowering level of performances push the firm to make plans of introducing new strategies and follow a proper change management plan to execute and achieve the proposed changes. The evaluation plan in the end justifies the efficacy of the change management conducted by the agency in meeting the target of expansion of business and provision of services with greater quality.

Reference:

Ashbolt, N. J., Amézquita, A., Backhaus, T., Borriello, P., Brandt, K. K., Collignon, P., ... & Lawrence, J. R. (2013). Human health risk assessment (HHRA) for environmental development and transfer of antibiotic resistance. Environmental health perspectives, 121(9), 993.

Austin, E. W., & Pinkleton, B. E. (2015). Strategic public relations management: Planning and managing effective communication campaigns (Vol. 10). Routledge.

Austin, E. W., & Pinkleton, B. E. (2015). Strategic public relations management: Planning and managing effective communication campaigns (Vol. 10). Routledge.

Berkowitz, E. N. (2016). Essentials of health care marketing. Jones & Bartlett Publishers.

Borland, I., & Schiller, A. (2012). Building a Bridge Between the School of Occupational Therapy and School of Professional Psychology Clinic.

Briscoe, R. V., Mowery, D., & Austin, D. A. (2014). Behavioral Health Outcomes: Strength-based Strategies with Black Communities. In Encyclopedia of Primary Prevention and Health Promotion (pp. 461-479). Springer US.

Cameron, E., & Green, M. (2015). Making sense of change management: A complete guide to the models, tools and techniques of organizational change. Kogan Page Publishers.

Case Study: Hillsboro County Health Home Agency Inc. (2017). Hillsboro County Health Home Agency Inc., 3(2(1), 275-395.

Chowdhury, P. P. (2016). Surveillance for certain health behaviors, chronic diseases, and conditions, access to health care, and use of preventive health services among states and selected local areas—Behavioral Risk Factor Surveillance System, United States, 2012. MMWR. Surveillance Summaries, 65.

Cummings, T. G., & Worley, C. G. (2014). Organization development and change. Cengage learning.

Cummings, T. G., & Worley, C. G. (2014). Organization development and change. Cengage learning.

Daley, D. M. (2012). Strategic human resources management. Public Personnel Management, 120-125.

Eden, C., & Ackermann, F. (2013). Making strategy: The journey of strategic management. Sage.

Ford, J. K. (2014). Improving training effectiveness in work organizations. Psychology Press.

Goetsch, D. L., & Davis, S. B. (2014). Quality management for organizational excellence. Upper Saddle River, NJ: pearson.

Greathouse, K., & Low, J. (2014). Promoting Aging In Place Through Community Networks.0058

Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: the implementation of change in health care. John Wiley & Sons.

Hayes, J. (2014). The theory and practice of change management. Palgrave Macmillan.

Hill, C. W., Jones, G. R., & Schilling, M. A. (2014). Strategic management: theory: an integrated approach. Cengage Learning.

Hitt, M. A., Ireland, R. D., & Hoskisson, R. E. (2012). Strategic management cases: competitiveness and globalization. Cengage Learning.

Jean-François, E. (2014). Financial sustainability for nonprofit organizations. Springer Publishing Company.

Kelly, J. M. (2015). Performance budgeting for state and local government. Me sharpe.

Kerzner, H. (2013). Project management: a systems approach to planning, scheduling, and controlling. John Wiley & Sons.

Mazzocato, P., Holden, R. J., Brommels, M., Aronsson, H., Bäckman, U., Elg, M., & Thor, J. (2012). How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden. BMC health services research, 12(1), 28.

Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C. E., ... & Von Kohorn, I. (2012). Core principles & values of effective team-based health care. Washington, DC: Institute of Medicine.

Municipality, M. L. (2012). Integrated development plan 2012-2017. Found at www. westerncape. gov. za/text/2014/April/eden-draft-idp-2014-15. pdf (accessed 26 September 2014).

Nancarrow, S. A., Booth, A., Ariss, S., Smith, T., Enderby, P., & Roots, A. (2013). Ten principles of good interdisciplinary team work. Human resources for Health, 11(1), 19.

Perrin, K. M. (2014). Essentials of planning and evaluation for public health. Jones & Bartlett Publishers.

Salas, E., Tannenbaum, S. I., Kraiger, K., & Smith-Jentsch, K. A. (2012). The science of training and development in organizations: What matters in practice. Psychological science in the public interest, 13(2), 74-101

Schiavo, R. (2013). Health communication: From theory to practice. John Wiley & Sons.

Slack, N. (2015). Operations strategy. John Wiley & Sons, Ltd.

Thompson, L., & McCabe, R. (2012). The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review. BMC psychiatry, 12(1), 87.

Van Durme, T., Macq, J., Anthierens, S., Symons, L., Schmitz, O., Paulus, D., ... & Remmen, R. (2014). Stakeholders’ perception on the organization of chronic care: a SWOT analysis to draft avenues for health care reforms. BMC Health Services Research, 14(1), 179.

van Wijngaarden, J. D., Scholten, G. R., & van Wijk, K. P. (2012). Strategic analysis for health care organizations: the suitability of the SWOT?analysis. The International journal of health planning and management, 27(1), 34-49.

Wheelen, T. L., & Hunger, J. D. (2017). Strategic management and business policy. pearson.

World Health Organization. (2012). Global plan for insecticide resistance management in malaria vectors.

World Health Organization. (2013). Global action plan for the prevention and control of noncommunicable diseases 2013-2020.

Yoder-Wise, P. S. (2014). Leading and Managing in Nursing-E-Book. Elsevier Health Sciences.