1   Kaplan University School of Health Sciences HI215 Unit 7 Assignment Home Health Comparison Unit outcomes addressed in this Assignment:  Understand the various data sets utilized in the payment for post-acute care Course outcome assessed/addressed in this Assignment:  HI215-2: Examine the reimbursement processes of different health insurance plans. Instructions:  Go to the CMS.gov Home Health Compare website at: http://www.medicare.gov/HomeHealthCompare/search.aspx  Source: Home Health Compare. Medicare.gov. Retrieved from http://www.medicare.gov/HomeHealthCompare/search.aspx  Explore the site including the green link “About the Data” and the blue side bars “Home Health Spotlight” and “Additional Information” and answer the following questions: o List a way in which “Home Health Compare” can be utilized; o What is the difference between “process” and “outcome” care measures? o What are the current data collection periods for the home health available measures? o What is the data source for the majority of the process and outcome measures? o How is the data collected? o What is meant by the term “risk adjusted” as it relates to outcome measures? o Review the Medicare coverage for Home Health. What are the typical services covered and not covered? o What is the HHABN and how it is utilized?  Conduct a search for a home health agency in your state by using the “find a Home Health Agency” search box. Narrow your search by using the “Modify Your Results” if you choose.  Choose three agencies to compare and click “compare now.” o What type of services are provided? Are there any services not provided? o Write a 2-–3 paragraph summary of the results of the “Quality of Patient Care” results for your three agencies. Include the following:  Provide an explanation of the data and why the information is important for the selected measures. 2    How your selected agencies compare to the state and national averages for the selected measures.  Why is preventing unplanned hospital care important? Requirements  Provide the answers to the questions and your 2–3 paragraph summary in a Word document submitted to the Unit 7 Dropbox. Please be sure to download the file “Writing Center Resources” from Doc Sharing to assist you with meeting APA expectations for written Assignments. Submitting Your Work Put your responses in a Microsoft Word document. Save it in a location and with the proper naming convention: username-CourseName-section-Unit 7_Assignment.doc (username is your Kaplan username, section is your course section, 7 is your Unit number). When you are ready to submit it, go to the Dropbox and complete the steps below: 1. Click the link that says “Submit an Assignment.” 2. In the “Submit to Basket” menu, select Unit 7: Assignment. 3. In the “Comments” field, make sure to add at least the title of your paper. 4. Click the “Add Atta ...

1. 1
Kaplan University School of Health Sciences
HI215 Unit 7 Assignment
Home Health Comparison
Unit outcomes addressed in this Assignment:
post-acute care
Course outcome assessed/addressed in this Assignment:
-2: Examine the reimbursement processes of different
health insurance plans.
Instructions:
http://www.medicare.gov/HomeHealthCompare/search.aspx
from
http://www.medicare.gov/HomeHealthCompare/search.aspx

2. and the blue side bars “Home
Health Spotlight” and “Additional Information” and answer the
following questions:
o List a way in which “Home Health Compare” can be utilized;
o What is the difference between “process” and “outcome” care
measures?
o What are the current data collection periods for the home
health available
measures?
o What is the data source for the majority of the process and
outcome measures?
o How is the data collected?
o What is meant by the term “risk adjusted” as it relates to
outcome measures?
o Review the Medicare coverage for Home Health. What are the
typical services
covered and not covered?
o What is the HHABN and how it is utilized?
using the “find a Home
Health Agency” search box. Narrow your search by using the
“Modify Your Results” if you
choose.
o What type of services are provided? Are there any services
not provided?
o Write a 2-–3 paragraph summary of the results of the “Quality
of Patient Care”
results for your three agencies. Include the following:

3. important
for the selected measures.
2
averages
for the selected measures.
Requirements
–3 paragraph
summary in a Word
document submitted to the Unit 7 Dropbox.
Please be sure to download the file “Writing Center Resources”
from Doc Sharing to assist you
with meeting APA expectations for written Assignments.
Submitting Your Work
Put your responses in a Microsoft Word document. Save it in a
location and with the proper
naming convention: username-CourseName-section-Unit
7_Assignment.doc (username is your
Kaplan username, section is your course section, 7 is your Unit
number). When you are ready to
submit it, go to the Dropbox and complete the steps below:
1. Click the link that says “Submit an Assignment.”

4. 2. In the “Submit to Basket” menu, select Unit 7: Assignment.
3. In the “Comments” field, make sure to add at least the title of
your paper.
4. Click the “Add Attachments” button.
5. Follow the steps listed to attach your Word document.
To view your graded work, come back to the Dropbox or go to
the Gradebook after your
instructor has evaluated it. Make sure that you save a copy of
your submitted project.
Unit 7 Assignment Grading Rubric = 65 points
Assignment Requirements
Points
possible
Points
earned by
student
Paper answers the following questions:
Compare” can be utilized;
“process” and “outcome” care
measures?
the current data Collection

5. periods” for the home health
available measures?
0–5
0–5
3
majority of the process and outcome
measures?
k
adjusted” as it relates to outcome
measures?
home health.
o What are the typical services
covered and not covered?
o What is the HHABN and how it
is utilized?

6. 0–5
0–5
0–5
0–5
0–5
0–5
Paper includes search results and lists:
Are there any services not provided?
0–5
Paper includes a 2–3 paragraph summary of
the results of the “Quality of Patient Care”
results for three agencies and include the

7. following:
information is important for the
selected measures.
to the state and national averages
for the selected measures?
0-10
4
preventing unplanned hospital
care is important?
0–5
0–5
Total (Sum of all points) 65

8. Points deducted for spelling, grammar,
and/or APA errors.
Adjusted total points
Instructor Feedback:
Management Services
Spring 2015
Sustaining change in
manufacturing companies
By Bob Lillis and Marek Szwejczewski
W
hy do changes stick in some organisations, while
in others they peter out and decay? A fter all, for
most companies, it is a strategic imperative to
sustain change and its associated performance improvement.
Sustainability means th a t the new working practices and the
improved performance persist fo r an appropriate period of
time. The change has become the norm. It is 'how we do things
around here' and is not a one-off or a temporary improvement
but is on-going. Unfortunately, the failure rate o f change
initiatives is high - 70-90% are believed to fail.

9. While studies have focused on the factors th at minimise
initiative failure and help ensure the successful implementation
o f the change, far less is understood about how to sustain
the initiative once the initial implementation period is over.
For example, research into change initiatives specifically in
manufacturing organisations, have tended to cohere around
either how to implement total quality management (TQM)
successfully or the success factors affecting the process o f lean
production implementation. However, the most comprehensive
study into how to sustain any organisation's change initiative
once it has been successfully implemented, was th a t carried
out by Buchanan et al (2005). Their thorough review of what
is known and w ritten about sustaining organisational change
identified a set o f 11 common factors. The outline definitions
of
these factors are shown in Table 1.
For example, the influence o f Leadership is commonly
accepted as im portant in successfully sustaining change. This
factor would include facets such as, has the senior leadership
team established a clear and consistent vision? Is the Leadership
also leading the change once the implementation phase is
over? Considering the factors in Table 1 and outline definitions
at face value, w hat is missing is any understanding o f the
Management Services
Spring 2015 41
FACTOR DEFINITION
Leadership Setting the vision, goals and leading the change
Individual Employees' individual commitment
Managerial Managerial style, approach, and behaviours

10. Financial Balance of costs and benefits
Substantial Perceived centrality, scale, fit with organisation
Organisational Policies, procedures, system, and structures
Cultural Shared belief, norms, and values
Political Stakeholder and coalition power and influence
Processual Implementation methods used
Contextual External conditions and threats
Temporal J Timing and pace of change activities
Table 1: Buchanan et al (2005) factors w ith definitions.
Respondents'
Job T itle
N um ber
o f Years
in Role
N um ber o f
Employees
A ffe c te d by
th e Change
Program m e
D u ra tio n o f
th e Change
Programm e
(in years
and all
o n -goin g)
M a n u fa c tu rin g
Sector___ _________
Operations site

11. director
human resources
director
3.5
5
800 3.5 Food processing
Deputy vice
president
5 100 1.5 Engineering
European
operations director
3 18,000 1.5 Metals
Production manager 15 80 1.5 Petrochemical
Regional operations
manager
4 100 2.5
Chemicals
(detergents)
Production manager
Managing director
2
10
50 3
Chemicals
(Coatings)

12. General Manager 3.5 300 3.5 Semiconductors
Head of integration
compliance
4.5 200 3.5 Telecommunications
Service director 6 400 3.5 Machinery
Global environment
manager
4 55,000 4.5
Chemicals (paint/
coatings)
Operations director 4 170 4.5 Cement
Plant controller 4.5 200 4.5 Car accessories
Managing director 6 50 6.5 | Plastics
Table 2: Respondents' identification and interview sample.
relevance of all 11 factors in different contexts and the
respective influence th a t each individual factor may have
on encouraging sustainability. For instance, does employees'
individual commitment to sustaining the change outweigh the
managerial style, approach and its behaviours? Is Leadership
more im portant than the Financial factor to sustaining change?
In other words, do some factors have more impact than others
on successfully sustaining change? In this article, we report
preliminary findings from stage one o f a tw o stage research
project which sought to answer these questions.
Research study
We divided the study into tw o separate but interconnected
empirical stages. The first consisted o f in-depth interviews
w ith executives from 13 manufacturing companies which

13. had sustained a change initiative in their business. During
this stage, we investigated the relevance o f the 11 factors.
Several propositions were developed, some o f which are
reported here. Stage tw o seeks to test these propositions in
three manufacturing companies, one o f which is Maserati in
Italy. We w ill be reporting the results o f the second stage in a
subsequent issue.
The interviewees in stage one came from a sample of
individuals who had attended one o f our courses at Cranfield
School of Management. In seeking an interview w ith a
particular manufacturing manager or manufacturing director,
we knew in advance th at the potential respondent's business
had undergone a change initiative, although the length o f the
change period was unknown to us at the tim e o f the interview
request. Table 2 provides a list o f interviewee job titles, how
long the job holder had spent in th at role, the number of
employees in the company affected by the change initiative
and the manufacturing sector o f the business.
The duration o f the change initiative varied from a minimum
o f 1.5 years to 6.5 years and all were still ongoing. We fe lt
these periods o f time would be o f an appropriate duration to
justify a change initiative being called 'sustained'.
Stage one findings
E xtent o f
fa c to r's
influence
SUB
Strongly
influential
throughout

14. Strongly
influential at the
start becoming
less influential
as change was
sustained
Not influential
at the start
becoming
more strongly
influential as
the change was
sustained
Did not appear
to influence
or arise as
significant
13 1 4 10 1
7 3
7 6 7
6 3 6
12 13
Findings suggest th at most o f the factors had a role to play in
sustaining change, but th eir influence varied depending on the
stage o f the change programme. Four types o f influences were
gleaned which are shown in Table 3. These were:
i) The factor was strongly present at the start o f the change and
throughout the change period.

15. ii) The factor was strongly present at the start o f the change
but its influence waned as the change continued.
iii) The factor was not strongly present at the start o f the
change but became more influential as the change
continued.
iv) The factor was not seemingly influential at any point in the
change or appears not to have arisen.
The research results o f stage one indicated th a t 10 o f the 11
factors identified by Buchanan et al (2005) had an impact on
the sustainability o f change initiatives. The analysis o f the
interview data indicated th a t the Temporal factor (the tim ing
Table 3: Frequency o f influence o f the 11 factors across the 13
companies.
M anagement Services
Spring 2015
and pace o f the change initiative) did not appear to contribute
to sustainability in our sample and is therefore not included in
Table 3.
The interviews suggested th a t factors differed in when they
had most influence. Based on the analyses, several propositions
were developed. The fo ur propositions we consider to be of
most interest were:
P1 Leadership [setting the vision, purpose, goals, and
challenges]
remains strongly influential throughout the duration o f a
sustained change programme

16. P2 Political [stakeholder, coalition power and influence] is at
its most influential in the early stages o f a sustained change
programme
P3 Managerial [managerial style, approach, behaviours] is at
its most influential in the later stages o f a sustained change
programme
P4 Individual [employee's individual commitment] is at its
most influential in the later stages o f a sustained change
programme
Our data analyses in stage one also provided some interesting
interactions between the various factors. So fo r example, at
company 2 in the engineering sector, whose change period
at the tim e o f interview had been 1.5 years and affecting
100 employees (Table 2), the factors Substantial, Financial,
Leadership, Political, Processual and Contextual were strongly
present at the start o f the change programme and had
remained so throughout its duration. Four o f the factors
namely.
Individual, Managerial, Organisational and Cultural were not
strongly present at the commencement o f the change but
became more influential as the change continued.
In addition, we were also interested in whether the company
had replaced its Managing Director or Chief Executive Officer
at the commencement o f the change programme. We believed
th a t this could have been an im portant factor in sustaining
the change. It transpired th a t 7 o f the 13 companies were so
affected and on the basis o f these statistics, we consider the
impact o f replacing a company's MD or CEO on sustaining a
change programme is inconclusive and requires further research.
Conclusions

17. Sustaining change is not a simple procedure. Our research
findings suggest th at managers need to put emphasis on
different factors at different stages o f the change. It has long
been recognised th a t Leadership is im portant at the start o f
the
implementation process. Our research supports this view but in
addition points to just how critical it is later in the life o f the
initiative. The leadership cannot afford to reduce its efforts
once
the change initiative has been successfully launched. If it takes
a
back-seat and hands over to the management team, such action
w ill invariably lead to sustainability failure.
The influence in sustaining change o f the political aspect is
often forgotten. It is assumed th at having good Leadership is
more important. However, concern w ith the political aspects
o f the change initiative is vital if it is to be sustained. In the
interviews, most o f the senior managers pointed to the fact
that
they had obtained obvious and visible support fo r the initiative
from various stakeholders at the start o f the implementation.
The research also suggests th a t getting the commitment of
the Individuals in the organisation at the start o f the change
process may not be as im portant as some claim. However, to
succeed, the Leadership needs to get the commitment from
most
o f the Individuals once the implementation is complete in order
to sustain the change. A successful initiative launched can be
achieved w ith o u t the vast m ajority being committed.
However,
once the implementation phase is over, if the vast majority
o f Individuals are not committed then the initiative is likely
to peter out and fail. The Managerial factor is also im portant

18. in sustaining the change initiative but only at the later stage
o f the process. Managers have an im portant role in helping
the leadership team to ensure th a t the new ways o f working
introduced by the change initiative are adhered too.
The research is still ongoing in stage two, w ith one case study
completed and a further tw o currently being conducted.
Therefore,
it is too early in the study to categorically state the respective
influences of the various 11 factors on sustaining change in
manufacturing companies. We hope the research, by indicating
which factor to focus on during the various stages o f the
change
programme, will ultimately prove helpful to those
manufacturers
keen on making change initiatives in their organisation stick.
References
Buchanan, D, Fitzgerald, L, Ketley, D., Gollop, R, Jones, J L,
Sharon Saint, L, Neath, A and Whitby, E (2005). 'No going
back:
A review o f the literature on sustaining organizational change',
International Journal o f Management Reviews, Vol 7, No 3, pp
189-205.
A bout the Authors
Dr Bob Lillis is senior lecturer in service operations
management
at Cranfield School of Management, Cranfield University
Dr Marek Szwejczewski is professor o f operations strategy
at Cranfield School o f Management and Director o f the UK's
Best Factory Award Scheme. To find out more about sustaining
organisational change, email [email protected]
mailto:[email protected]

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