Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Community Medicine

Background: Cairo University Hospitals (CUHs) are the central referral hospitals in Egypt. This highlights the importance of leading change in the health services provided to millions of patients streaming to these hospitals. The change management model that has been used successfully in health care is the Kotter{u2019}s Model. Exploring successful change initiatives in health services provided at CUHs and identifying "facilitators of" & "barriers to" change will support future change pioneers in leading new change initiatives. Aim and Objectives: This study aimed at improving healthcare delivered in CUHs. The specific objectives were to describe change initiatives in CUHs, clarify obstacles met by the change pioneers and determine adherence of these initiatives to Kotter{u2019}s model of change management. Methods: This was done through in-depth interview of 14 awesome change pioneers and delivering a questionnaire to 50 of their team members. Both tools were driven from Kotter{u2019}s model of change. Results: It was found that initiatives followed the steps of Kotter{u2019}s model to a great extent. The change initiative vision was the most important item followed by the teamwork. The vision was enthusiastic, matched the priorities of patients{u2019} needs and was flexible. The team members were characterized by being: coherent, perseverant, and hard workers. Patient welfare was the first consideration for them. Important change strategies included: rewarding, decentralization, choosing young manpower, motivational speeches, training and consulting experts. The main barriers were: bureaucracy, financial shortage, resistance and professional jealousy. Conclusion: The initiatives were adherent to the Kotter{u2019}s model of change to a great extent in that they created urgency, gathered a powerful coalition, created and communicated the vision, drove change and celebrated short term wins

Issued also as CD