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Reinventing Management Harvard Business

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The change that is required in the hospital consists of implementing safety procedure for the children. This is mainly because the hospital takes care of children and aim at providing them with the best is so that they can region the society after being fit. The vision is to ensure that none of the children suffers from harm during the stay at the hospital and the scope is to provide assistance in terms of convincing the employees about the need for change. The change implementation can help hospital to gain an opportunity of success in the hospital sector in Riyadh.

Key drivers and mandate for the change

The key drivers for the change are the stakeholders. The Hospital stakeholders are the healthcare providers. A Just Culture survey was conducted to the employee, the most lowest domain was the Perceptions Of Senior Management. That made the improvement of patient safety cultureneed to be mandated by the hospital leader to. This can help in making the change legal and ensure that the employees abide by the rules and regulations that are to be imposed after the implementation of the changes at the hospital.


Purpose, objectives and outcomes of the change

The purpose of the change is to ensure that the hospital patient remain safe from any type of harmful activities that may cause severe health issue or injuries.

The objective mainly amid to provide a safe healthy environment in which children can be diagnosed so that they can reclaim their health and become a normal member of the society. The expected outcome of the change is that the hospital can improve its reputation as the safest hospital in Riyadh. It can increase the profit of the hospital and ensure that parents of the children trust in the hospital for any type of emergency needs.

The SMART Objectives:

  • Increase the staff’s knowledge and skills of hospital’s safety culture assessment to 96% by end of 2018.
  • Improve the hospital’s safety management effectiveness which relates to patient safety culture to 50% by the end of 2018.
  • Increase the safety healthcare service practice to 95% by end of 2018.
  • Promote management effectiveness to 90% by the end of 2018.

Stakeholder analysis and key leadership roles

The hospital stakeholders includes the hospital leader, employees and patients. The key role of the stakeholders is to ensure that the hospital continue to improve and assist the people so that they can be cured of any disease in a safe manner. In this regard, the leaders play the most vital role in ensuring the implementation of changes and providing high level of satisfaction about the safety of the hospital. The senior management need to take up the leadership role in the form of democratic leadership style so that opportunities for suggestion of improvement can be welcomed from all stakeholders.

Implementation Details

The shift to a more constructive “Just Culture” from the traditional “Blame Culture” can have different types of tangible benefits that will play a key role in the overall safety culture in the hospital by focusing on two crucial, concepts:

  • As humans will monitor the situation errors can be inevitable which may lead to problems. Therefore continuous monitoring must be in place to ensure that such errors are given proper attention
  • Different individuals are accountable for the actions if they purposely continue to violate the safety procedures and policies

Therefore, the Implementation should mainly focuses on creating and implementing a Just or Accountability Culture policy.


The sequenced actions required for implementation

The sequence actions required for implementation of the change is that the hospital leaders need to support the implementation of Just Culture policy.

The following are the sequenced actions required for implementation:

  • Developing a Just Culture policy:

It is important to establish policy and procedures setting the organization's expectations in employing a Just or Accountability Culture in managing patient safety events and determining fair and consistent courses of actions toward staff involved in such events, to promote an atmosphere of trust and confidence among all levels of employees in the hospital.

  • Improving Error Reporting:

In order to reduce the different legal complications that are involved in reporting, the two most important issues that have been identified are as follows:

  • Securing the employee against disciplinary actions if they report incident
  • Keeping in place a regulatory legal framework that adheres to the reporting of each and every incident. Some of the first steps of errors include;
    • The current legal situation is not taken care of or is seen in a small viewpoint
    • Discussing the different ways of whether any kind of change is actually possible or feasible enough.
    • Discuss with the officers involved in the operations department on what changes in the legal policy they think would improve incident reporting.
  • Review the Incident Report Policy and Procedures

It is important that the following issues are said to be in accordance to the reviewing the incident report policy:

  • Confidentiality of reports.
  • Leader commitment to Patient Safety and No Blame culture concept.
  • A certain degree of independence must be granted to the Risk Management Department.

Who is responsible for these actions?

The hospital leaders are the most responsible group in implementing the changes is the. This is mainly because it is the duty of the leaders to ensure thatthe changes are brought about properly without the intervention of any external or internal factors. It is also the responsibility of the employees to ensure that the changes are implemented is sustained in a proper manner so that advantage can be gained in the hospital. At the same time, the duty of the patients and their caregiver is to ensure that they are taught about the importance of discipline and the fact that they need to abide by the rules of the hospital for getting a proper treatment.

What is the timeframe for completion of the actions?

The timeframe that will be required for the completion of the action can be 7 months. This is mainly because the reason for the implementation of changes needs to be communicated with the employee and need to be discussed about its implementation. At the same time, it is also necessary that the resources required for implementing the changes be collected. Therefore, based on these tasks 7 months can be enough to complete and implement the changes that are required for success in thehospital (please refer to the time table in the relevant information section).

Where in the organization the actions will occur

Since the patient safety is everyone’s responsibility, the actions need to be applied and communicated to all the patient care area (inpatient, outpatient, and ancillary areas).

Performance and Quality Measures

The performance measurement can be done by assessing the contribution of the employees and the effectiveness of the change undertaken after every six months. This can help in analysing the changes and make proper rectifications in the case of errors. At the same time, quality of the change can be brought about by the implementation of total quality management so that cleanliness of the hospital can be maintained. This can lead to the improvement of change in the hospital and ensure that the effectiveness of the hospital can exist.

The team will focus on the project’s ability to achieve its objectives, mentioned earlier. The evaluation will be determined by the ability of the change to achieve the objectives intended, hence making the objectives the tools for measurement of performance which will be determined by every project members’ attitude, skill and knowledge besides overall teamwork effort being given to the project’s success. Also, it will focus on ensuring that the strategies and methods used are either formulated or changed or that they are completely different from those used earlier. They will simply be evaluating the change’s failures and success rates by accessing its ability and capability of achieving its objectives and purposes in general. It should therefore be able to increase and improve the patient safety culture in the hospital hence making the patients more comfortable.



Measurement tools


Increase the feedback of incident report to 100%

Internal Auditing


Increase just culture to 90%

Safety culture survey


Increase the staff’s awareness and skills of safety practice to 90%

Patient Safety Culture Survey


Increase the staff’s satisfaction of safety management  to 90%

Patient Safety Culture Survey


Increase the staff’s compliance of incident report protocol to 90%

Internal Auditing


Reduce the rate of mortality cause from advent events to  5%

Morbidity and Mortality Committee 


Reduce the rate of advert event to 4%

Safety Reporting System database


Reduce the  rate of morbidity cause from advent event and medical errors to 10%

Safety Reporting System


Increase the quality standards of the services offered to 96%

Patient Safety Culture Survey


Increase the accountability rates for the actions taken by the hospital’s staff

Quality and Patient Safety committee Action Plan

Resource Requirements

Resources form an important part for the change management process. The presence of proper resources and a proper flow of the resources supply is helpful for the success of the project plan in this particular case.

Resource needed for the change

As mentioned earlier the absence of appropriate resources will affect the hospital the reputation to be the safest hospital in the region. The presence of proper resorces is essential for the following project. The first and foremost resource in the form of human resource is the selection of the appropriate leader to carry forward the following task. The leader who will be selected must have a detailed idea of the hospital and should get the detailed description about the actual changes needed. The second resource in these regards is the appointment of different employees who will be engaged in completing the total project properly. Apart from this the management of the change must also ensure the reallocation or the transformation or in some cases the development of the existing systems of security within the hospital which can help in savings. The other main resources needed for the implementation of this particular project is the financial resources and the installation of a cultural training program within the policies of the organization.  


Project Cost

The estimated project cost along with an estimated budget surplus has been provided in the list below;


Jan 2019

Feb  2019

Mar 2019





Sources for income




Government grant




Loan from bank
















Human resource expenditure








Technical expenses




Implementing Change




Risk management expenses




Total expenses




Budget surplus




Indication of the main risks that may impact on the change


Likely Risk and it Causes

Preventive Actions

Developing a Just Culture policy

It requires adequate time and persistence to try and change the safety attitudes of the people and the behavior of the people.

The maintenance of the motivation of the personnel set with the task of the improvement of the safety reporting can act as one of the greatest obstacles

Commitment of the management-

Raising proper awareness of the senior  management to ensure sound and safety nature

-Involving the senior level management to the reporting process to show that the company has the belief of the just culture

Improving Error Reporting

challenge to create and formulate a Just

Culture will be to change the employee concept that they will be blamed if they report incidents.


To state clearly in the Just Accountability Culture policy:

-If an employee believes he/she has been subjected to inappropriate disciplinary measures as a result of self-disclosure, the individual may file a grievance complaint.


Human resource

Shortage of human resource generally undermines new services in the community:

Ø  Lack of people in the training facilities

Ø  Insufficiency to recruit locally

Urgent attention must be provided to workforce plan

Working with local partners to promote opportunities for the different kinds of local people

Communication and Engagement Plan

The communication and the Engagement Plan is necessary for the following project as because a proper and effective communication and engagement planning will help to ensure the success of the following project. The main goals of the communication management plan will be to;

Goal 1- Increase stakeholder and public awareness

Objective 1: Building stakeholder and broader public understanding of the different mission and vision of the developmental project undertaken by the management of the organization.

Objective 2: The increase in the stakeholder and public understanding of how employees engaged in the project can participate and separate their works accordingly

Goal 2- Increase stakeholder and public participation

Objective 1: Provide the stakeholders with early, timely and meaningful opportunities to provide input on the project and any developments on the project.

Objective 2: Identify and address the different potential barriers and threats to the effective management of the following process in the project undertaken by the organization.


Other relevant information

A timeline of the following project will be the best information that will help to complete the following project.







Discuss the action plan with the governing body




coordination with required authorities




Format the team for the change




Set the Strategies for change




Get the approval on the project Final Strategic plan and implementation plan




Implementation Date




Conduct Just Culture Survey




Analysing the Survey Data




Monitor the project Effectiveness


Table No 1: Timeline of the Development Project



  • Buckingham, M., & Goodall, A. (2015). Reinventing performance management. Harvard Business Review, 93(4), 40-50.
  • 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.
  • Carnall, C. (2018). Managing change. Routledge.
  • Hayes, J. (2018). The theory and practice of change management.
  • Kerzner, H., &Kerzner, H. R. (2017). Project management: a systems approach to planning, scheduling, and controlling. John Wiley & Sons.
  • 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.
  • Laudon, K. C., &Laudon, J. P. (2016). Management information system. Pearson Education
  • Van Dooren, W., Bouckaert, G., &Halligan, J. (2015). Performance management in the public sector. Routledge.
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