FINAL GROUP PAPER

Medical Technology and Hospital Equipment

Appreciative Inquiry

Gilbert Iskandar 01616170006

Submitted to:
Dr. Cyruz P. Tuppal, PhD, DNS, MSN, MASPED, MHA, MBA, MSc,
PgDipRDM, RN, RM, LPT, FISQua, FRIHC

INTERNATIONAL EXECUTIVE MASTER OF MANAGEMENT

UNIVERSITAS PELITA HARAPAN
The Appreciative Inquiry Implementation for
Attention-Deficit Hyperactivity Disorder/Attention Deficit Disorder

BACKGROUND
Attention-Deficit Hyperactivity Disorder/Attention Deficit Disorder is a brain disorder
marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes
with functioning or development. ADHD/ADD is estimated to affect approximately 6-7% of
people aged ≤18 years of age when diagnosed by DSM-IV criteria. When diagnosed with
ICD-10 criteria in this age group is estimated at 1-2%. Boys are twice as prevalent than
women. Although there was no global consensus on the prevalence of ADHD/ADD in
children, meta-regression analyses had estimated the worldwide prevalence at between 5.29%
and 7.1% in children and adolescents. ADHD/ADD in Indonesia (2004) is 2,892,995. If left
untreated, ADHD/ADD may interfere with school and work, as well as with social and emotional
development.1,2,3

APPRECIATIVE INQUIRY
Appreciative Inquiry has been used as an organisational change tool by a number of
corporations and non-profit organisations. Appreciative Inquiry is described as a change from
more conventional problem-solving approaches to organisational improvement that tend to
focus on what is not working, or what is wrong. Such approaches can include strategic
planning, restructuring, redesigning work, and project management.4
Whitney and Trosten-Bloom (2003) and other authors describe several principles that
inform Appreciative Inquiry. A summary of the five ‘foundational principles’ is provided in
Table 1. These principles are derived from social constructionism, image theory and
grounded theory. From social constructionism comes the notion that social reality is
constructed and maintained through language and communication. From image theory comes
the notion that people’s decisions are influenced by the images they hold of their future. And
from grounded research comes the notions that participants hold the key to understanding
their culture or reality, and that any research is also an intervention (Whitney & Trosten-
Bloom, 2003).4

Principle
The Constructionist Principle
The Simultaneity Principle
The Poetic Principle
The Anticipatory Principle
The Positive Principle
Definition
Reality is socially constructed through
language
Change begins from the moment a question
is asked
Our choice of what we study determines
what we discover
Our image of the future shapes the present
Positive questioning leads to positive
change
The Principle of Awareness is described as fundamental when applying the Appreciative
Inquiry 4-D Cycle (see below) to self-development and the development of inter-personal
relationships.4

The four phase (4D’s):

 In the Discovery stage, participants are asked to identify what is best about their group
through appreciative interviews.
 The Dream stage involves “the creation of a vision that brings to light the collective
aspirations of stakeholders” that emerged in the Discovery stage.
 In the Design stage people work together to put a structure, or social architecture, to the
Dream elucidated above.
 Destiny/Delivery is the final stage and is about the commitment of individuals and the
group to achieve their aspirations.

AI IMPLEMENTATION
Due to a lot of cases of ADHD in Indonesia, I think that Ciputra Medical Center (CMC)
has potential to be psychiatric center excellence (with brand name Mind and Behaviour Clinic).
CMC already have psychologist, psychiatrist, and strategic clinic location (also inside a mall).
Mind and Behaviour Clinic is the big four service that CMC can offer after Health Screening,
General Practitioner, and Dental Clinic. CMC could expand the business in treating ADHD
and promoting for increasing the quality of life of ADHD patients. CMC had one of the latest
treatment for ADHD which is neurofeedback to control the brain waves. As healthcare
providers, it is our duty to give promotive, preventive, treatment, and rehabilitative for
community. The possibility design to achieve the dream is integration between electronic
medical records, e-health application (smart mobile application) and mobile neurofeedback
equipment. Therefore, CMC destiny is aiming to
provide rehabilitative services with integrated smart
mobile application. Technology and health
integration is a good innovation that in a long term
could also have positive effects for the stakeholders.
Psychiatrist could more accurately see real time
patient’s brainwaves, patients could monitor
constantly their own health condition, CMC also
gains benefits in providing efficiency and effective performance with quality services that is
lower in budget.
Because only few psychiatrist/psychologist who uses this new concept in Indonesia,
it may be go well (or I hope can become a Blue Ocean) to be implemented. This will increasing
the quality of life of ADHD/ADD patients and everyone around them. Moreover in the future,
this neurofeedback technology could also potential to be implemented to geriatric patient to
prevent dementia.
Based on the theory above, Mind and Behaviour Clinic proposed the EHR with an
integrated mobile application. Thus, we are able to monitored the development of brain wave
of the patients and deliver better services; not only in a form of treatment but also in term of
rehabilitative of the diseases.

REFERENCES
1. Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a
systematic review and metaregression analysis. Am J Psychiatry 2007; 164: 942-948.
2. Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-
analytic review. Neurotherapeutics 2012; 9: 490-499.
3. US Census Bureau, International Data Base, 2004
4. Cram F. Appreciative Inquiry. Research Gate. 2010. 1-13. Retrieved from
https://www.researchgate.net/publication/231135895_Appreciative_Inquiry