Abstract

This class assignment is an attempt to perform a complete organizational

Development (OD) process on Shfia International Hospital Islamabad for
understanding of application organizational diagnostic model followed by
development of OD model used, design and implementation strategies. In
order to stimulate the process of OD both quantitative and qualitative data
has been collected for concrete diagnosis, also it has been sure that the whole
process should be evaluated at the end after implementing the intervention
successfully for effectiveness. In order to promote the health promoting
hospital (HPH) concept at Shifa, external OD consultants carefully examine
the failure of the first attempt in order to avoid repeating the mistake again.

Table of Contents
1.

Organizational Background ................................................................................................ 4

1.1 Vision: .............................................................................................................................. 5
1.2 Mission: ............................................................................................................................ 5

2.

Organizational Development in light of Literature: ........................................................... 7

2.1 OD Process ....................................................................................................................... 7
2.2 Approach for change by Shifa:....................................................................................... 10
2.3 Feedback of the Shifas internal department: ................................................................. 11

3.

Organizational Development (OD) Process of Diagnosis ................................................ 11

3.1 Process of Diagnosis: ..................................................................................................... 11
3.2 Data niches ..................................................................................................................... 12
3.2.1 Standard 1: (Management policy) ........................................................................... 12
3.2.2 Standard 2: (Patient Assessment) ............................................................................ 12
3.3.3 Standard 3: (Patient Information and Intervention) ................................................. 13
3.2.4 Standard 4: (Promoting a Healthy Workplace) ...................................................... 13
3.2.5 Standard 5: (Continuity and Cooperation)............................................................... 13
3.3

Major findings of Diagnostic Model ......................................................................... 13

3.3.1 Limited understanding of concept of HPH .............................................................. 13

3.3.2 Shortages in funds ................................................................................................... 14
3.3.3 Community not Staff ............................................................................................... 14
3.3.4 Lack of evaluation method ...................................................................................... 14
3.4

OD Model Used: ....................................................................................................... 14

4. Organizational Development (OD) Interventions:............................................................... 15

4.1 OD Interventions Suggested: ......................................................................................... 15
4.2 Designing of OD Interventions: ..................................................................................... 16
4.2.1 Empowerment Interventions: .................................................................................. 17
4.2.2 Evaluation Interventions: ......................................................................................... 17
4.2.3 PM Interventions: .................................................................................................... 18
4.2.4 Precede-Proceed Model: .......................................................................................... 18
4.3 Implementation Strategy for OD Interventions:............................................................. 18
4.4 Challenges faced during Implementation of OD Interventions: .................................... 20
4.5 Evaluation of OD Interventions: .................................................................................... 21
5. Lesson Learnt: ...................................................................................................................... 22
2

Lesson 1................................................................................................................................ 22
Lesson 2................................................................................................................................ 23
Lessons 3 .............................................................................................................................. 23
Lesson 4................................................................................................................................ 23
Lesson 5................................................................................................................................ 24
Reference List: ......................................................................................................................... 25

1. Organizational Background
Shifa International Hospital is situated in Islamabad and was established on September 20,
1987. In the start it was started as a Private Limited Company and converted into Public
Limited Company on October 12, 1989. The first Shifa office was established at the residence
of Dr. Zaheer Ahmad in sector F-8/3 of Islamabad. Later it was moved to a rental place in
Blue Area (commercial buildings area in Islamabad), and finally the site office building was
established in January 1988.
The vision of establishing a premier health care hospital was envisaged by Dr Zaheer Ahmad
in New York USA. The purpose was to provide quality health care to the people of Pakistan.
This idea of developing a new state of art hospital facility was discussed between the initiator
and five other medical practitioner at Dr Zaheer Apartment in Brookly and the idea was
analyzed and after assessing the idea and its feasibility, the idea was finalized and the work
on project was started on December 17, 1985 under the supervision of Dr Zaheer Ahmed.
The project was completed in June 1993 in a time period of three and half years with a total
100,000 covered area with the efforts of the founder and the sponsor, the project was
sponsored by more than 400 sponsors with Rupees 500 million equity without taking a single
rupee from other source then respective sponsors.
The hospital was started on June 26 1993 with eight consultants in seven specialties, and now
it has more than 70 high qualified consultants in almost all specialties under one roof. Shifa
International Hospital offers 150 IPD beds with quality care and OPD facility in 35 different
specializations. The hospital is equipped with all of the modern medical facilities, dedicate
and devoted consultants, management and staff who work round the clock and state- of-art
medical equipments and laboratories.

1.1 Vision:
Shifa International Hospitals Limited is established to provide the highest quality medical care
to the people of Pakistan. It involves many factors:
o
Medical Expertise
o
Clinical Excellence
o
State of the Art Technology
o
Caring People
o
Preventive Medicine
o

Health Care Management

Pursuit of excellence in all areas of healthcare reinforced by a rich cultural heritage.

1.2 Mission:
To provide good quality medical care in all disciplines of medicine and surgery to all patients
in a caring and compassionate manner by an outstanding team of healthcare professionals. .

1.3 The OD intervention & the key drivers

OD is increasingly important and has been studied in various settings including that of
hospitals. Knox,Underbaake & McBride(2011) OD is a term used to encompass a series of
change in structure and system of the organization by the way of

psychotherapeutic

counseling session with groups and individuals , undertake in response to change in external
environment that seek to improve organizations effectiveness Beer and Walton (1987) in the
light of this definition to bring a planned change of health promotion it was necessary to
implement it with a proper process of organization development process where as Shifa

International has decided to introduce HPH program without consulting the core values of
organizational development. . Harrison & Shirrom (2005), noted that high failure rates
aiming the organizational change efforts are partially explained by the failure of
organizations to carry out well planned initial systematic assessments based on accurate data.
Health case is a core dimension of quality in hospital services along with patient safety and
clinical effectiveness but while promotion and incorporation of the health promoting
practices in the core values of the hospital system and key stake holder. While implementing
of Health promoting practices it was necessary to go through proper Organization change
which was not properly carried out during the case of Shifa International hospital which lead
to following hurdles of behavior from the key change stake holder and other organizational
and implementation related issues.
Hospital staff at Shifa argues that health promotion is not their function and refused to adopt
the new changes in policy and procedures of the organization.
But the concept goes much further than traditional health promotion. Hospitals are obviously
not the main agents in health promotion, but:

As institutions with a large number of workers and service users, they can reach a
large section of the population.

As centers of modern medicine, research and education that accumulate much

knowledge and experience, they can influence professional practice in other centres
and social groups;

As producers of large amounts of waste, they can contribute to the reduction of

environmental pollution and

As large-scale consumers, they can favor healthy products and environmental safety.

2. Organizational Development in light of Literature:

Development and Change (Waddell, Cummings &Worley, 2004) and Flawless Consulting
(Block, 2000). Waddell, Cummings and Worley (2004) propose a general model of planned
change which describes the practice of OD and is comprised of four major activities entering
and contracting, diagnosing, planning and implementing change, evaluating and
institutionalizing change. Blocks (2000) model echoes that of Waddell et al (2004), although
he does not speak about their fourth activity, evaluating and institutionalizing change.
Waddell et al., model in relation to the practice of OD will now be described in further detail.

2.1 OD Process
Waddell et al. (2004) describe three theories of planned change Lewins change model the
action research model and contemporary adaptations to the action research model. Based on
these, they propose a general model of planned change, which refer to as the OD Process,
which is made up of the four basic activities already noted:
1. Entering and contracting
2. Diagnosing
3. Planning and implementing change
4. Evaluating and institutionalizing change
Waddell et al., (2004) suggest that while these activities typically occur in the sequence
listed, there is considerable overlap and feedback between them. Each of the activities is
summarized below. Entering and contracting. According to Waddell et al., (2004), this first
step of the planned change process occurs when one or more key managers or
administrators sense there is either a need for improvement or a problem needs to be
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addressed in their organization, department or group. Entering is made up of three steps

clarifying the problem or opportunities, identifying who the relevant client is and choosing an
OD practitioner. The organization may be specific about what the presenting problem is,
such as absenteeism or a change in market conditions, or it may be more general such as a
need to be more effective. Sometimes the presenting problem is stated in the form of a
solution, such as needing team building.
The presenting problem may just be a symptom of underlying issues. Clarifying the issue
may involve preliminary data collection, in the form of interviewing key members and
examining company records. Identifying the relevant client normally those who can directly
impact the change is important at this stage of the process. This ensures there is buy in from
them to enter into an OD process. Choosing an OD practitioner requires the organization to
find out about the practitioners experience and competence both technical and interpersonal.
It needs to check whether the practitioner approaches the organization with openness and
requires a diagnosis phase, or whether the practitioner has a program that he or she applies to
all organizations. The practitioner is also responsible for ensuring there is a match between
themselves and the organization and its problems. Contracting may be formal or informal,
and includes three areas clarifying what each party expects to gain from the OD process,
committing resources to the process and establishing the ground rules for working together,
such as confidentiality.
The decision about whether to proceed or not with the OD process occurs here. Diagnosing
is described by Waddell et al., (2004) as the process of assessing the functioning of the
organization, department, group or job to discover the sources of problems and areas for
improvement. If this is done well, it points towards the interventions required to improve the
organizations effectiveness. It involves collecting and analyzing data about the current
operations and feeding information about problems and opportunities back to managers and
8

organization. Planning and implementing change. According to Waddell et al. (2004) this
stage of the OD Process is a joint activity conducted between the OD practitioner and the
organization. They design interventions that suit the organization and the change agents
skills and make plans to implement these interventions. Waddell et al., (2004) suggest
interventions fall into four major categories:
1. Interpersonal interventions, which describe interventions associated with human processes
2. Techno structural interventions, which focus on the organizations structure and
technology, meaning job design.
3. Human resource management interventions, which are designed to integrate people into
organizations to improve member performance and wellness and
4. Strategic interventions, which focus on linking the the internal functioning of the
organization to the larger environment and transform the organization to keep pace with
changing conditions.
This stage of the OD process includes managing the change process which requires the OD
practitioner to work with the resistance to change, create a vision of the desired future state,
gain political support for these changes and manage the transition of the organization
towards them. Evaluating and institutionalizing change. Evaluation of the OD interventions
implemented is a two-fold process: the first is evaluating and feeding back to the
organization, the effectiveness of the implementation of the intervention is the intervention
being implemented as intended? The second checks to see whether the expected results are
being achieved or not. With this information, decisions about whether the changes should
continue, be modified or stopped can be made (Waddell et al., 2004). Change is

institutionalized by reinforcing successful changes through feedback, rewards and training

(Waddell et al., 2004).

2.2 Approach for change by Shifa:

Group Dynamics provides a useful paradigm which could ensure sustainable change within
the community. Taking the lead from the work of Khan (2008) and Katie (2010) this research
will explore the efficacy of the group as unit of analysis to bring about change sustainable
development. Sustainable change arises from within and reconstruct attitudinal predisposition
prelude for behaviour change. Manifestation of behaviour requires internalized norms. These
norms are developed in social context rather individual centred approaches. In this respect
group centred approaches in Organizational development is an effective mechanism (Khan
2008)
This approach is developed in the back drop of this premise and assumes that the interaction
approach is relatively more conducive to develop norms and values which, in turns,
determine desired social behaviour using group dynamics as an effective tool for
Organizational development.
In this respect OD using group dynamics provides a mechanism where people through
process of continuous interactive, without any social prejudices generate a social dynamism
which is prerequisites to form desired norms and values, which in turn create a culture where
respect and dignity of other are as important as ones own self in order to advances the good
of the community (Khan, 2007). Internalization of these transcendental norms and values are
critical to transform a community/society into a democratic and achieving entity. The earlier
researcher in social marketing have, by and large, focused on generating market dynamism
10

for marketing social products and services through persuasive strategies and one way
communication rather to bring about sustainable desired behaviours change. This structure
approaches to bring about change has also resulted social consequences (Khan, 2007).

2.3 Feedback of the Shifas internal department:

There were a significant positive change in the behaviour of participants, in start behaviour of
the members was not serious as the interaction session advances, the attitude and behaviour
of the participant change into seriousness and become focused. Every participant is putting
their views and show positive behaviour.
1. Respect for the opinions increases within the members which was not observed in
earlier interactions.
2. Motivation for learning increased within members, words and actions were almost
matching and pointing out new things in discussion.
3. The awareness level of the members as sessions advances, corporation within the
group was high and looking for a mutual understanding and solving of the community
problems.
4. Members show a great deal of tolerance and sincerity with causes censuses on
different aspect of the interactions.

3. Organizational Development (OD) Process of Diagnosis

3.1 Process of Diagnosis:
It is known that organizational diagnosis is a process based upon behavioral science for
entering an organizational system, collecting valid data, and feeding that information back to
the system to promote increased understanding of the system by its members. The need of
11

diagnosis process in shifa international hospital is must so to resolve the issues occurring in
implementation of HPH. Therefore it was decided to use organizational level diagnostic
model which covers important organizational functions including the external environment
impact on internal operations as well as those elements which affect the complexity of
relationship in organizational systems. OD professional have suggested, diagnostic data
collection guided by theoretically supported models.
Diagnostic methods and measures:

Both qualitative and quantitative data is being used.

Three major techniques for gathering data,

interviews

Secondary data

questionnaires

3.2 Data niches

3.2.1 Standard 1: (Management policy)

It is the main aim of the corresponding standards, for which a policy is being developed by
management for health promotion targeted at staff, patients and relatives. There are a number
of challenges most hospitals face (Kontaxis, 2008) in managing policies and procedures, the
fragmented organizational structures found in many hospitals present the greatest challenge.
Responsibility for managing hospital compliance tends to be distributed across several
entities within the organization
3.2.2 Standard 2: (Patient Assessment)
The indicator measures whether patients were assessed for generic risk factors. Patient
Assessment- procedures performed to find out what is wrong with a patient on which
decisions about emergency medical care and transport will be based.
12

 Performed on every patient-the key to all medical care

Use a Systematic, constant approach to Patient Assessment
The first step in caring for any patient is a good Initial Assessment.
3.3.3 Standard 3: (Patient Information and Intervention)
A high volume of care provided is for patients with chronic conditions.
3.2.4 Standard 4: (Promoting a Healthy Workplace)
Health Promoting Hospitals have committed themselves to become a smoke-free setting, and
hence the proportion of staff smoking is a single indicator reflective of the promoting health
workplace. 0ccupational safety and health can contribute to improving the employability of
workers, through workplace (re)design, maintenance of a healthy and safe work environment,
training and retraining, assessment of work demands, medical diagnosis, health screening and
assessment of functional capacities; occupational health is fundamental to public health, for it
is increasingly clear that major diseases (e.g. AIDS, heart disease) need workplace
programmers as part of the disease control strategy.
3.2.5 Standard 5: (Continuity and Cooperation)
Cooperation, collaboration and communication results in continuity, therefore chronic
patients require continuous follow up care, however, in many contexts there is insufficient
communication between the providers of health and social fare.

3.3 Major findings of Diagnostic Model

The result of organizational diagnosis showed that there were problems to be overcome:
3.3.1 Limited understanding of concept of HPH
Shifa had established the health promotion policy but with insufficient information and
communication with the staff always due to the limited understanding of the concept of the
HPH on the managerial level it was difficult to achieve goals
13

3.3.2 Shortages in funds

In term of resources the Shifa was short of space in hard ware equipment lack of specialized
department to spread head the coordination of hospital promotion man power.
3.3.3 Community not Staff
In term of health promotion activities the hospital paid considerable attention to the patient
and the community and minimize the importance of staff and organization.
3.3.4 Lack of evaluation method
Due to the lack of the evaluation method the hospital fails to further the assessment of the
resources and evaluation of the effectiveness of the program, for this reason the quality of the
health promotion activities could not be monitored.

3.4 OD Model Used:

[

The diagnosis model used for the process of application of HPH is based on open system
model. This model covers wide range of diagnostic elements which shifa should consider.
After application of this model it was found that the data collection model demanded:
a) The considerable amount of time and man power resulted in increase the staff
work load.
b) Also staffs providing the data were worried about potential negative effects.
c) In order to prevent staff refusing to take part in the data collection shifa
should clarify the staff about consultants and why the data being collected
what the data gathering will involved and where the data will be used.

14

4. Organizational Development (OD) Interventions:

4.1 OD Interventions Suggested:
Organization's today are moving with ever-changing speed and changes. The success factors
of organization like people, task, structure and technology are highly open and flexible in
approach (Cameron & Quinn, 1999). Organization demands changes to be inspired in every
step and dimension so that a unique image and market leadership leading to organization
success and growth can be achieved.

Based on diagnostic model used for the assessment of problem involved in implementing
HPH concept at Shifa International hospital Islamabad, OD consultants suggested
interventions at strategic level:

Effective Interventions may help community initiatives to:

Use a combination of interventions of varying intensity (e.g., providing information

versus modifying policy) that target multiple levels of influence on behaviors (e.g.,
individual, family, organizational and social environments) (Kreuter, & Young, 2000,
cited in, Aydin, & Ceylan, 2009).

Avoid wasting limited resources by implementing popular interventions that have

repeatedly failed to demonstrate effectiveness (Merzel & D'Affliti, 2003; Mitchell,
Florin, & Stevenson, 2002, cited in Aydin, & Ceylan, 2009).).

Tailor interventions to target at-risk populations and improve intervention

effectiveness (Johnston et.al., 1998, cited in Cameron & Quinn, 1999).

Use limited resources in an efficient manner that also complements existing programs
(Chien, 2003).

15

Interventions that are multi-component (education with skill-building, creating access with
campaigns for awareness, etc.) go beyond the audience acquiring new knowledge and toward
building skills and practicing the desired behaviour (Bucker & Poutsma, 2010). So after
careful joint diagnosis between OD consultants and Shifa International, following strategic
interventions suggested:
1. Empowering employees
2. Participative management (PM) initiatives
3. Evaluation with better effective controls
OD consultants at Shifa International made sure that interventions should match to fit needs,
objectives, and context, which is critical for the success of community change and
improvement efforts.
Along with the interventions mentioned above, it has decided to employ a model for
successful implementation of HPH. From range of models available, on the basis of best
practice Precede-Proceed model decided to employ.

4.2 Designing of OD Interventions:

Strategy Formulation includes planning and decision-making involved in developing
organizations strategic goals and plans (Bucker & Poutsma, 2010). Strategy Formulation
requires a great deal of initiative and logical skills. So at designing stage both OD consultants
and Shifa Hospital agreed on best course of action after considering organizational goals,
organizational strengths, potential and limitations as well as the external opportunities.
Below are the designed interventions with suitable course of action:

16

4.2.1 Empowerment Interventions:

Empowerment

is

based

on

the

idea

employees skills, resources, authority, opportunity, motivation,

responsible

and accountable for

outcomes

of

as

their actions,

that

giving

well holding them

will contribute to

their competence and satisfaction (Cameron & Quinn, 2011).

Contributing to the therapeutic relationship

Building on the person's point of view and strengths

Encouraging and supporting the decision-making process

Helping to broaden the person's possibilities

Facilitating the learning experience

4.2.2 Evaluation Interventions:

Evaluation provides OD, technical assistance combining state-of-the-art knowledge and
extensive experience to strengthen management systems and leadership practices in
Monitoring & Evaluation (M&E) units (Cameron & Quinn, 1999).

Clarity of organizational vision

Comprehensive strategic planning

Effective organizational structure (with key systems in place and functioning)

Strong governance structure

Well-developed leadership capacity (teamwork, change management)

Strong management and human resource capacity (business planning; marketing

strategies and practices; financial management systems; human resource management
processes)

17

4.2.3 PM Interventions:
A process in which subordinates share a significant degree of decision-making power with
their immediate superiors (Chien, 2003).

Gives employees sense of ownership: accountability, responsibility and authority over

work

Simple tools for employees for improve work performance

Providing environment where employees needs are recognized and met.

4.2.4 Precede-Proceed Model:

It follows 'Backwards' approach leads to thorough problem analysis. Detailed evaluation
process. Good for community-based intervention due to emphasis on individual engagement.
A considerable body of knowledge has accumulated about the most effective ways of
developing, implementing and evaluating health promotion programs. Often referred to as
'best practice', the term is usually associated with health promotion planning or logic models.
Health promotion planning models describe a process of problem definition or needs
assessment, that allow for collection of information about need from a range of sources.
These planning models also enable solution definition, identifying the type of intervention
that will bring about the desired effect. Information to design and plan interventions is
sourced from evidence; the experiences of practitioners or service providers, and includes the
community or target group of the population that are involved.

4.3 Implementation Strategy for OD Interventions:

Implementing a strategy or strategy implementation is defined as "the translation of strategy
into organisational action through organisational structure and design, resource planning and
the management of strategic change". Matching intervention strategies to fit needs,
objectives, and context is critical for the success of community change and improvement
efforts (Cameron & Quinn, 1999).
18

Analysing the definition, it becomes obvious that strategy implementation is somewhat

complex. Therefore, the successful implementation of a strategy would be how well the
various components in carrying it out are successfully integrated and interact.
To identify significant problems encountered in implementing a new strategy in a business, a
critical look at the components to be applied in implementing the strategy would be a good
pointer. These are considered below:

Organisational structure and design

Strategy implementation

Translating the strategy into organisational action by using the structure of the organization
will also be dependent on the type of structure in use in the organization. This is so because
the needs of a multinational organization are different from those of a small business. It is
also possible that the extent of devolution or centralisation can influence strategy
implementation.
OD consultants at Shifa International underlined four premises on which strategic
interventions going to base on:
1. There must be clear view within an organization of the strategy to be followed.
2. Change will not occur unless there is a commitment to change
3. The approach to managing strategic change should be likely to be context dependent.
4. Change must address the powerful influence of the paradigm and cultural values and
norms.
In order to empower staff at different level and promotes participative management, many
changes brought at managerial and leadership level. Started with paradigm shift from
traditional approached to contemporary approached of management practices. Secondly
empowerment implementation plan worked on following points:

Start at the bottom by taking needs of employees

19

Model empowered behaviours for the employees

Build teams to encourage cooperative behaviours

Encourage intelligent risk taking

Trust people to perform

While considering improvement in evaluation methods or effective measuring controls, it was

decided to target 3 major areas here:

Process measures: these tell you about what you did to implement your initiative;

Outcome measures: these tell you about what the results were; and

Observational system: this is whatever you do to keep track of the initiative while it's
happening.

Many conferences and seminars had been held to address positive outcomes of implementing
HPH concept. In addition to this a group of HPH professionals had been hired to train and
inform staff on HPH through small training workshops, one day training programs and
inter/intra department trainings. They also helped in successful implantation and evaluation
of HPH. Along with this a staff team had visited India to experience the working and feeling
of HPH in practice.

4.4 Challenges faced during Implementation of OD Interventions:

There were many challenges and issues to be resolved during implementation on strategic
interventions. Some worth mentioning are:

The main significant problem encountered through the usage of organisational aspect
in strategy implementation is the fact that some of the employees started leaving the
firm because they felt that they will be 'used' in actual fact if they are not motivated.
Also they had a fear that senior management will impose the strategy on them.

20

Another problem encountered at Shifa International was the way and manner
information is passed down or up the ranks. If there is a blockage which impedes the
flow of information processes it means that decisions would be made based on
outdated or obsolete information (Cameron & Quinn, 1999).

The next challenge faced was resource planning and competences required to
facilitate the process of interventions implementation successful.

The problem here at Shifa International was the non-uniformity in the times needed
for the various activities was next challenge to be faced, it makes difficult to know
where to start. A detailed examination of the timing was missing if production and its
marketing wants be a success; as well as the allocation of funds for this undertaking.

One of the major challenges faced was managing change based on misinformation, or
lack of information, education and communication style.

Last challenge which was back holding interventions implementation was strong
values and norms shared among staff of Shifa International.

Nevertheless, since implementation of any interventions involves the controlling of others

behaviours and sometimes perceptions and culture, most problems would be human-related
and probably possible solutions would be dependent on management style and behaviour of
the leadership in terms of structure and availability and allocation of resources (Cameron &
Quinn, 2011).

4.5 Evaluation of OD Interventions:

Irrespective of the type of intervention applied the affectivity and outcome in form of desired
change acceptance on part of employees and employer always depend on a wise judgment at
every stage right from selection of consultant to informing the employees about the same or
the method of selection .At every stage it becomes the prime

responsibility of both

21

management and employees to extend their full co-operation in order to accept changes by
way of intervention so that organization dream of bringing positive change in organization
can be fulfilled.

For this purpose evaluating an OD intervention by

observation,

behavioural change,

attitude change,

productivity improvement,

level of motivation,

sound Industrial relation,

industrial harmony,

are some of indicators which help in perceiving that intervention has brought changes
desired.

5. Lesson Learnt:
The assignment was full of learning new things from practical aspect. In this assignment we
had learned overall application of an organizational development model and carrying and
assessing flaws on every stage of the implementation of OD change intervention without
proper diagnosis and incorporating of proper Organization development planned change
elements.

Lesson 1
The first and the foremost lesson that we learned from this project was that change is not
possible without the proper educating of the key change partners about the purpose and
22

results of the change process. As in this case this of Shifa Hospital while incorporating of
health promoting practices with in the core values of the hospital the key partners i-e the
hospital staff and other managerial staff were not properly educated with the concept health
promotion policy and its core elements which developed a sense of apathy in the mind of key
change partner in implementing health promoting policies.

Lesson 2
The second lesson that we had learned from the project was that identifying the key stake
holders in the change process is critically important as it became not viable to bring the
change without identifying and taking in accordance of the change process as in this case of
health promoting policy in shifa hospital they had not properly engaged staff and other key
organization members which make intricate the proper application of health promoting
practices.

Lessons 3
One of the main steps for the entry process for the development of the organization is to
allocation of enough funds for the process of planned change. In the case of Shifa Hospital
the organization was facing difficulties in terms of resources the Shifa was short of space in
hard ware equipment lack of specialized department to spread head the coordination of
hospital promotion man power.

Lesson 4
Sense of inclusion of the key change stakeholder was an important factor for the successful
change process which was lacking in the case of shifa international case during the
incorporation of Health promoting practices due to which the key stake holders i-e staff and
doctors were reluctant to accept the change.

23

Lesson 5
One of the many lessons that we had learnt during our project is that not proper following any
single step of change can lead to the failure of overall change process. While doing any
change process after the application of interventions it is necessary to evaluate and assess the
change process for a continuous change and better and to assess the effectiveness of the
program. During our OD project it was noticed that Due to the lack of the evaluation method
the hospital fails to further the assessment of the resources and evaluation of the effectiveness
of the program, for this reason the quality of the health promotion activities could not be
monitored.

24

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