College of Health and Social Care

School of Nursing, Midwifery & Social Work

MSc Leadership and Management for Health Care Practice

Module Project Management & Methods of Inquiry for HCP

Business Case:Introduction OfPreceptorship Program For

NewGraduate Staff At KK Hospital

September 2013 cohort

Date: 29/4/2014

Student Role Number: @00350016

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Table of Contents
1.0

Proposed Project.............................................................................................. 3

2.0

Project Background.......................................................................................... 3

3.0

Aims ............................................................................................................ 5

3.1

Objictives....................................................................................................... 5

4.0

ProjectDeliverables.......................................................................................... 6

Optional
Appraisal
4.1

. 6

5.0

Project Scope.................................................................................................. 7

5.1

Project Descruption and Selection critiria ...........................................................7

6.0

Project Stakeholders and Strategic Alignment......................................................7

7.0

Project Implementation..................................................................................... 8

7.1Checking Feasible Time Scales........................................................................................9

8.0Project Risk Analysis..........................................................................................................10
9.0Cost of the Project and Finding.............................................................................10
10.0Project Evaluation..........................................................................................................10

11.0Conclusion...................................................................................................................11
Reference.............................................................................................................. 13
Appendices............................................................................................................ 17
Appendix 1 Project
Scope 17
Appendix 2: Stakeholder Analysis and their impact and communication
strategy.. 18
Appendix 2.1 Stakeholder Impact Matrix..............................................................18
Appendix 2.2: Table Showing the Internal and External Stakeholders....................................19
Appendix 3: Communication Matrix....................................................................20
Appendix 4: Risk Assessment for the Project.........................................................21
Appendix 5: Economic Cost .............................................................................................. 22
Appendix 6.0 Form of performance evaluation (English Version). 23
Appendix 6.1 Form of performance evaluation (Arabic Version)24

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00350016

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1.0

Proposed Project

This project intends to introduce a preceptorship program for new graduate staff at the
KK Hospital in Saudi Arabia. This project is designed to improve the hospitals workforce by
adapting the preceptorship model practised in Canada, UK, and the US to Saudi Arabias
healthcare context. It is intended to enhance the recruitment and training process by
improving the orientation process to boost staff morale and work satisfaction (Fuller et al.,
2013). The program will be integrated in a hospital-wide preceptorship model, but
implemented in stages, starting with nurses and eventually being rolled out to the rest of the
workforce.
2.0

Project Backgroundand Current Situation

KK hospital has 300 bed capacities and hires about 50 new nurses a year. Currently the
hospital statistically in 2013 show that the new registered nurse are leave their position in the
first-second year in their carrier life, during the last five years to reached 35% of the new
employees are leaving. According to the internal study which was conducted at the hospital,
this is due to a lack of job satisfaction and lower confidence in the work and performance and
also as a result of the shock of the transition from student to employee (kkhh annual report,
2013). Over the last few years, the preceptor model has played a significant role in reducing
the theory-practice gap in nursing (Kaviania& Stillwell, 2000).
Although Saudi Arabia has a world-class healthcare system, the provision of palliative
and curative healthcare has been hampered by the high turnover, especially among nurses and
midwives ( Al-Ahmadi H, 2006) . This turnover is partly caused by low staff morale and job
satisfaction, factors which are considered central to providing services efficiently and
effectively (Almalki, 2012).
Initiating the preceptorship program could help to achieve the organizations mission in
improving outcomes of care provided through the upgrading of staff through training and
continuing education (kkhh, 2014). The project also, meets the organizations vision to be the
first choice as a health provider of care in the region of hail (kkhh, 2014). Also, the Ministry
of Health has facilitated the adoption of the Joint Commission International Standards that
promotes excellence in quality performance (JCI, 2014).

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The initial stages of any career for any health practitioner are challenging and often involve
dealing with new environments and concepts. A quality preceptorship program ensures the
best beginning, and allows older and more qualified individuals to assist new graduate staff in
settling in their new roles (Marks-Maran et al., 2013). In the long-term, this ensures greater
continuity in the hospital environment. This translates to increased staff morale, lower labour
turnover, and most importantly enhanced patient care (Myrick et al., 2012).
A preceptorship is a period of transition for newly qualified health staff. During the transition,
the newly qualified practitioner is supported by a preceptor, essentially a qualified
practitioner. The process allows the student to gain confidence in their new roles, and refine
their knowledge, skills, and values (Marks-Maran et al., 2013). Preceptorship allows the staff
to understand their roles and what is expected of them. It provides a structured preparatory
activity or series of activities that provide participants with the perfect environment for
enrichment, reflection, and engagement (Myrick et al., 2010). This can happen through
various training methods such as meetings, discussion forums, research, and shadowing.

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3.0

Project Aims

Introduction of a preceptorship programme in KK hospital through preparing 15 qualified

nurses to become preceptors.

3.1Objectives
SMART tool (Myrick et al., 2012)is used in setting the following objectives:.

To increase the preceptors satisfaction, knowledge and understanding of their role by

50% within 1 year.

To increase nursing performanceby monthly measurement of staff performance

checklist.
To evaluate whether preceptorship program is beneficial for the team to perform their

role, new registered staffand KK hospital.

To reduce staff turnover in KK hospital.

4.0Project Deliverables
At the end of the project, KK hospital will have:

Qualified preceptor team comprising of individuals who clearly understand the

preceptor role.
The program is thus expected to increase the performance in the nursing
department by drawing on the multiple academic and professional experiences of

the older staff (Baltimore, 2004; Myrick, et al., 2010).

The hospital will also benefit invariably from higher staff motivation which
translates to better reputation and an improved standard of care.
4.1 Optional Appraisal

For evaluating the exact cost of the program, looking for alternative option for delivering the
program is required (McLaughlin, 2004). However, updating the orientation program for new
nurses in KK hospital could be one of the option that can be taken on consideration, on the
other hand the option of not taking step toward replacement of this program could be
predictable.

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4.0

Project Scope

Scope is a term use to show the component of any project by determined

what will be delivered or not (Lewis, 2007).The scope of this project is to achieve a
clear understanding of preceptor role and increase workforce efficiency and motivation by
introducing the team to the preceptorship concept and role for new graduate staff. Also, to
provide a viable alternative to orientation programs at KK Hospital in cooperative with
College of Nursing and Health Scienceswithin the second half of 2014 for 15 nurseswith
experience that meets the selection criteria, (see appendix 1).
5.1 Project Description and selection criteria
Instituting the preceptorship model in Saudi Arabias main hospital would require a concerted
effort between the health practitioners, the Ministry of Health and hospital administration,
and all members of the supply chain to deliver healthcare to the client. The synergy expected
from these stakeholders will be necessary for the successful implementation of the program.
At the bare minimum, nurses will have to have 5 years of experience in their area of
expertise. They should also have a bachelor or mistral education level. They must also have a
considerably high performance evaluation (Steffan & Goodin, 2010). The preceptorship
administrator will review the potential preceptors staff file in the hospital records, looking
for qualifiers such as motivation, attendance record, and work ethic. Individuals who are to
be selected for the program must be of high ethical standards and be optimistic, responsible
and disciplined (Seislove, 2011).

6.0 Project Stakeholders and Strategic Alignment

Stakeholder management is the element key to the success of any project by
engagement of the right people in the right way, also project team need to identify internal
and external stakeholder so that will be easy to recognize the project needs and expectation
(Johansen et al.,2014).Thestakeholders may also have a direct impact on the
project team members and deliverables. According toJohansen et al., (2014),
engaging the right stakeholders in the project earlier could prevent
conflict and possible delays.
The key stakeholders of this project are the preceptors, the collaborators representing the
training organisations, the newly recruited staffand representatives of the hospital
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administration and the Ministry of Health. Other stakeholders are the training organisation, to
be based in collaboration with the university. The success of this project is dependent on clear
communication and strategy within the team as illustrated in Appendices 2 and 3. Appendix 2
shows the communication strategy and the impact of the different stakeholders, while
Appendix 3 is a communication matrix showing the criticality of information flow for each
level. Appendix 2.1 shows the stakeholder impact matrix, breaking down the different power
levels, such that a proper prioritisation model or mode can be derived. These stakeholders are
shown in Appendix 2.2 which shows the internal and external stakeholders.
If possible, preceptor can be added as a required element in the job description or
among the criteria for pay increases and clinical advancement (Alspach, 2008). In either case,
the preceptors will be required to cover a wide range of new staff as the program is more
general than the traditional facultymode (Turnbull, 2010). The program will further extend to
students enrolled in the education programs. The one-on-one engagement between the new
graduate staff and the preceptor will be vital in assisting the formers settling into their new
roles (Budgen & Gamroth, 2008). Every effort must be made to have a 1:1 graduate staff-topreceptor ratio.

7.0 Project Implementation

The first step is to constitute a preceptor administration team in the form of a
residency advisory committee. McClure and Black (2013) recommend that the individuals in
the committee include qualified medical personnel with training experience and hospital
administration. The administration committee should also include representatives from the
Ministry of Health and the Ministry of Education, the latter represented by members of the
relevant university faculty. The inclusion of these stakeholders is essential for the
implementation process, as they represent different interests that will play a critical role in the
execution of the project (Haggard, 2011).
;;;;;The committee will form the core implementation team, and can be regularly changed to

suit the realities among the staff and other stakeholders. According to Myrick et al. (2012),
preceptorship programs are more successful if they are inclusive. The team will be divided
into different departments, mainly to manage logistical and scheduling issues. The team
members will then be trained and prepared to perform their specific clinical and professional
training tasks (Hickey, 2009). The latter part of the training will involve a specialised training
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organisation or faculty such as the College of Nursing and Health Sciences. The committee
will then create awareness to attract resident nurses and other healthcare practitioners to the
preceptor role. The committees scope entails developing a team consisting of qualified
hospital personnel from different departments to be preceptors. Their brief would entail
assisting new postgraduate and graduate staff augur into their new roles.
7.1 Checking Feasible Timescales
Timescales enhance to measure the effectiveness of development and requirement that project
objective need to be met (Natpact.info, 2014).The milestones on this project are based on
SMART Objectives tools as outlined by Shahi and Mahbod (2004).
Mileston

What (Specific, Measureable,

Who (Achievable,

When

e
1

Achievable)
Initiating the preceptorship

Realistic)
KK Hospital, and Ministry

(Time)
1st and 2nd

steering committee within KK

of Health

Month

Hospital.
Initiating the recruiting process

Steering Committee

2nd Month

draft curriculum.
Evaluating the job records of

Steering committee and

3rd month

potential preceptors.

human resource

Training preceptors on how to

department.
Steering committee

4th and 5th

handle the orientation process

Introducing preceptor to new

Human resource

Month
5th Month

graduated staff to practise

department

for preceptors. Drawing up a

3

preceptorship role concept and

6

expectations.
Conducting the preceptorship

Steering committee and

5th, 6th

process/Matching preceptors

preceptorship team.

Month and

and new staff

Evaluating the program for

Hospital Quality assurance

continuing
7th Month

quality and effectiveness

team/Steering

and

committee/Hospital

continuing

administration.

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8.0 Project Risk Analysis

It is important to evaluate the risks accompanying any business case proposal (Myrick, et al.,
2012). This is necessary as a foundation to a risk management strategy to ensure that the
project is successful and effective. The grid provided as Appendix 4 shows the different risk
factors, likelihood, effects and solutions. These range from bureaucracies, mismanagement
and lack of qualified staff. The highest risk in this project is that the hospital administration
may refuse to approve the project on the basis of its impact on the budget and the staffing
schedules. The preceptorship program will take significant resources from the human
resources already in the hospital. Even with proper scheduling, it is impossible to determine
just how extensive the impact will be, and the hospital administration would be concerned
with just whether the benefits exceed the costs.
9.0 Cost of the Project and Funding
The

full

costofany

projectis

important

because

itidentifiessourceswhichproject needsto include (Lock, 2007). The cost of

this project includestwo representatives of the university and one external
preceptor for teach and training as well as project manager and
informational materials.
According to Barker and Cole ( 2012), project manager could design the resources table in
two different way by having the cost and time scale fixed but modulation the deliverables or
fixed the deliverables and modulation the cost and time scale.
The project cost is a presumed at 475.000 S.R which is equalto 75.000.
(See appendix 5 for cost analysis).

10.0 Project Evaluation

The success of this project is dependent on whether or not it is effective. Given the
high impact on resources, particularly the time of professional, experienced healthcare staff,
as well as the financial costs, it is essential that it yield results as early as possible (Billay &
Myrick, 2008). The evaluation for this project will be implemented using questionnaires and
interviews with the preceptors and the graduate staff. The data collection methods will be
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designed to collect information important in evaluating the project. For the evaluation of
nursing performance the staff performance checklist method will be collect monthly from the
head nurses of the department (see in appendix 6.0 , 6.1 )which is designed by Ministry of
Health.The KK hospital measure staffing turnover monthly by using this formula:
Monthly turnover

Number of separations duringthe month

Avarage number of employees during the month 100

The monthly turnover ratio made by the human resources department in KK hospital for
monthly statistical report.
Although, other data points such as attendance, staff motivation, and workplace
satisfaction will be used to complement the data. The different data sets will provide
information on whether the role of preceptors is effective, and how best new staff can be
made responsive to the process (Budgen & Gamroth, 2008). This model was used in (Myrick,
et al., 2010) to establish the effectiveness of preceptorship programs among new nursing
staff. The comprehensive approach ensures a concise view that can be used to further assure
the quality of the program (Alspach, 2008).
The preceptors role includes facilitating the transition between a graduate student to a
registrant who is an effective team member, and confident in his or her practice. They will
also be providing honest, objective, and positive feedback as and when needed. Each group
of new staff graduating from the preceptorship program will be required to fill in a
questionnaire and provide feedback on their experience. The preceptors will also evaluate the
new staff participation and satisfaction, and these will go into staff files to provide a critical
starting point for the human resource department. The relevant committee will work with the
relevant administration department to evaluate quality of care and nursing performance.
These have internal key performance indicators that will be compared with staff/preceptor
feedback to derive information on how the program can be enhanced to maximum
effectiveness (Myrick, et al., 2012).
11.0 Conclusion
This project outlines the project details for a preceptorship program for KK hospital. It
incorporates the current realities of the hospital into one model to show that the project is
feasible and will have far-reaching and positive effects on the hospitals workforce. Once all
key stakeholders are involved in the project, it will be imperative that a steering committee be
constituted to provide a curriculum and oversight for the program, which will not be a
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replacement of the orientation program currently in place. In the end, however, the success of
the program and its long term benefits can be used to institute it in place of orientation, as
innovative elements such as team preceptorship are further considered for inclusion.

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Reference
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Management. United Kingdome: Pearson Education Limited .pp 65-81.
Allison, M. & Kaye, J., 2005.Strategic Planning for Nonprofit
Organizations.Second Edition ed. New York: John Wiley and Sons.
Lewis, J.P (2007). Fundamentals of Project Management (3rd Ed.). New
York: American Management Association.

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Almalki, M. (2012). Quality of work life and turnover intention in primary

healthcare organisations: A cross-sectional study of registered nurses in
Saudi Arabia.
Johansen, A., Eik-Andresen, P., Ekambaram, A. and asivakumar,
(2014).Stakeholder Benefit Assessment--Project Success through
Management of Stakeholders.Procedia-Social and Behavioral Sciences,
119, pp.581--590.
Johansen, A., Eik-Andresen, P., Ekambaram, A. and asivakumar,
(2014).Stakeholder Benefit Assessment--Project Success through
Management of Stakeholders.Procedia-Social and Behavioral Sciences,
119, pp.581--590.
Marks-Maran, D., Ooms, A., Tapping, J., Muir, J., Phillips, S. and Burke, L.
(2013). A preceptorshipprogramme for newly qualified nurses: A study of
preceptees' perceptions. Nurse education today, 33(11), pp.1428--1434.
Natpact.info, (2014).Project Management Tools. [online] Available at:
http://www.natpact.info/qof/assessortraining/dwn2/21157/index.htm
[Accessed 28 Apr. 2014].
Mind Tools. (2012). Risk Analysis: Evaluating and managing Risks.
http://www.mindstool.com/pages/article/new/TMC_07.htm
Lock, D. (2007). Project Management (9thedit.). Gower Publishing Ltd.
Alspach, G., 2008. Calling All Preceptors: How Can We Better Prepare and
Support You?.Crit Care Nurse, 28(5), pp. 13-16.
Alspach, J. G., 2000. From staff nurse to preceptor: A preceptor
development program. 2nd ed. Aliso Viejo, CA: AACN.
Baltimore, J., 2004. The hospital clinical preceptor: essential preparation
for success..J ContinEducNurs., 35(3), pp. 133-40.
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Beecroft, P., Hernandez, A. M. & Reid, D., 2008. Team Preceptorships: A

New Approach for Precepting New Nurses. Journal for Nurses in Staff
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Billay, D. & Myrick, F., 2008. Preceptorship: an integrative review of the
literature..Nurse education in practice ,8(4), pp. 258-66.
Boyer, S. A., 2008. Competence and Innovation in Preceptor Development:
Updating Our Programs. Journal for Nurses in Staff Development, 24(2),
pp. E1-E6.
Budgen, C. &Gamroth, L., 2008.An overview of practice education
models.Nurse Education Today, 28(3), pp. 273-283.
McLaughlin, J. (2004). Wining project approval: Writing a convincing
business case for project funding. Journal of Facilities Management, 2(4):
330-337.

Fuller, P. D. et al., 2013. Residency preceptor development and evaluation:

A new approach. American Journal of Health-System Pharmacy, 70(18),
pp. 1605-1608.
Haggard, A., 2011. Is Precepting a Good Thing?.Journal for Nurses in Staff
Development - JNSD, 27(1), pp. 48-49.
Hickey, M., 2009.Preceptor Perceptions of New Graduate Nurse Readiness
for Practice.Journal for Nurses in Staff Development - JNSD, 25(1), pp. 3551.
McClure, E. & Black, L., 2013. The role of the clinical preceptor: an
integrative literature review..J Nurse Educ, 52(6), pp. 335-41.
Myrick, F. et al., 2012.Putting the Evidence into Preceptor
Preparation.Nursing Research and Practice, Volume 2012, pp. 1-7.

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Myrick, F., Yonge, O. &Billay, D., 2010. Preceptorship and practical wisdom:
a process of engaging in authentic nursing practice. Nurse Education in
Practice, 10(2), pp. 82-87.
Seislove, E., 2011. Mentoring: A meaningful collaboration between two
people.Journal of Trauma Nursing, 18(3), pp. 139-141.
Shahin, A. &Mahbod, M. A., 2004. Prioritization of key performance
indicators: An integration of analytical hierarchy process and goal setting.
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Evaluation Tool Used During Nursing Orientation.Journal for Nurses in Staff
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Kkhh.med.sa, (2014).King Khaled Hospital in Hail - powered by Infinity.

[online] Available at: http://www.kkhh.med.sa/ [Accessed 28 Apr. 2014].
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[Accessed 28 Apr. 2014].

Appendices
Appendix 1 Project Scope

What

Is

Is not

Action

To introduce the team

Initially as preceptorship

Review the project after

to the preceptorship

for the nursing department

implementation to see

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concept and role for

new graduate staff. To
provide a viable
alternative to
orientation programs.
Where

only.

whether it can be extended

Not a replacement to
training programs for

to other departments and

faculties.

advanced staff (Alspach,

2000).

The KK Hospital,

A program for other

Search hospitals and other

Saudi Arabia and yet

hospitals.

healthcare contexts that

to be

have utilised the model

determinedCollege of

before.

Nursing and Health

Sciences.
When

Who

Scope

Initially, within the

Earlier than June 2012.

To review the evaluation

second half of 2014,

forms in December and

from June to

determine the sustainability

December 2014.

and impact of the program.

15of nurses with

All new staff recruited into

To build the team by

experience that meet

the hospital workforce

review staff file in the

the selection criteria

(Beecroft, et al., 2008).

hospital records

To achieve a clear understanding of preceptor role and increase workforce

efficiency and motivation.

(NHS Institute for Innovation and Improvement, 2008)

Appendix 2: Stakeholder Analysis and their impact and communication strategy

High
Power Satisfy
Manage

Low
Power

Opinion formers. Keep them satisfied

with what is happening and review
your analysis of their position
regularly.

Key stakeholders who should be fully

engaged through full communication and
consultation

Monitor

Inform

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This group may be ignored if time and

resources are stretched.

Patients often fall into this category. It

may be helpful to take steps to increase
their influence by organising them into
groups or taking active consultative work.

Low impact/stake holding

High impact/stake holding

(NHS Institute for Innovation and Improvement, 2008)

Appendix 2.1 Stakeholder Impact Matrix
High
Power

Hospital Administrator

Hospital Administrator

Ministry of Health Staff

Experienced nurses and other healthcare

professionals.

Department Heads

Preceptorship Committee

Human Resource Department

New Graduate Staff

Low
Power

Patients
Patients

Students in healthcare professions

Ministry of Education
Relevant Healthcare Faculty in Local
Institution
Low impact/stake holding

High impact/stake holding

(NHS Institute for Innovation and Improvement, 2008)

Appendix 2.2: Table Showing the Internal and External Stakeholders

Internal

External

Preceptors

Patients

Administration

University Faculty

Ministry of Health

External Preceptors

Other Departments

Other service users.

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Programme leaders

Appendix 3: Communication Matrix

Development
of project

Administrato
r

Project
Implementatio
n Committee

Project lead

Constant
Awareness
meetings and and
discussion
communicatio
n, training

Definition of Facilitating
Through
project aims
the program meetings
through policy
and logistics.
Sharing
plan

Progress
reporting

00350016

Preceptors

Centre of the
program.
Avail them to
the process.

Graduate
Staff

Other
Hospital
Departments

Newly
recruited,
orientation
process.

Simulation
lead
to
feedback
in
meetings

Target of the
program.
Orientation
training.

the Meeting,
Regular project Regular
Regular
discussion,
meetings
meetings with meetings.
email,
and
the new staff.
internal
memos.
Email updates

Regular project Evaluation

meetings
Procedures

Page 21

Evaluation
procedures

Feedback to
and from the
preceptorship
team.

Evaluation
results

Use
evaluation
report to make
policy
changes.

Share
evaluation
report
with
Trust links

Future service Improvements

changes
to policy and
program
details.

Improved pay
and
compensation.

Will benefit Copy of the

from
evaluation
experience as report
a
preceptorship
recipient once
they
are
themselves
more
experienced,

(NHS Institute for Innovation and Improvement, 2008)

Appendix 4: Risk Assessment for the Project

(Adopted from Mind Tools 2012)
Risk Factor

Likelihood

Effects

Solution

Hospital

High

Project will not

Convince them of the

begin.

importance and benefits of

administration
may refuse to

preceptorship program. This

implement the

will include case studies from

project.

countries that have

implemented such programs.

Bureaucracies in

High

Project will be

Establishing good relations

administration

delayed or not

with government officials and

and government

initiated at all.

hospital administration. It is

bodies.

also necessary to create some

independence for the
preceptorship committee.

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Resident nurses

Medium

with sufficient
academic and

Staff

professional

1 lecturer.

experience may

1 Teaching
not be interested
assistance.

in the project.
1
External
Mismanagement
Preceptor.

of the project

Project
manager.

May lead to

Create awareness of the

of the importance
of the project to
Projectoverworking
Related Staffing
Cost
few willing
hospital operations,
and
Duration
Total
participants, or
include the relevance of

Monthly Salary

10.000 S.R /
delay the project
month.

altogether.

8.000 S.R/
month.

Medium

120.000 S.R

preceptorship to promotions, as
96.000 S.R

well as the accompanying

Over

The project, even

11.000
after a successful
S.R/month.

start, can wither

10.000
S.R/month.and die off due to

mismanagement.

1 financial
year. rewards.
132.000 S.R

Institute key performance

120.000 S.R

indicators and others forms of

TOTAL

evaluation to maintain high

management468.000
quality, S.R
involvement, and sustainable
decision-making.

Appendix 5: Economic Cost

Materials
Type

Cost

Duration

Total

Projector.

4.000 S.R

6 months

4.000 S.R

Paper.

2.000 S.R

6 months

2.000 S.R

Ink for
printers

1.500 SR

6 months

1.500 S.R
TOTLY
7.500 S.R

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Total estimation of project cost = 475.000 S.R

Appendix 6.0: Form of performance evaluation (English Version ).

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Appendix 6.1: form of performance evaluation (Arabic Version).

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