Master of Public Health - MPH / Background: The appointment system learning initiative (ASLI) was introduced in 2016 as a way of implementing appointment systems in the City of Cape Town, in response to lengthy waiting times at PHC facilities It was intended as a safe space for learning, and piloted facility-generated planning in which knowledge was shared in workshops over 18 months. Variability in how well appointment systems had taken root was noted at the second feedback workshop. Currently, there is little information on the experiences, perceptions and roles of managers with regard to the initiative, or what unforeseen issues may have had an impact. Aim: This study aimed to reach an understanding of how the Appointment Systems Learning Initiative approach and its implementation was experienced by participating facility and PPHC managers at City Health facilities in Cape Town. This includes an exploration of the roles and experiences of health managers, including their perceptions of the benefits and challenges of the process. Methods: A qualitative, exploratory design was used. Individual, semi-structured interviews were conducted with a sample of twelve facility managers and two PPHC managers. Manager’s roles were analysed deductively according to Mintzburg’s 2009 framework, while other data analysis was inductive. Ethical clearance was obtained from UWC BMREC prior to commencement. Informed consent was obtained from participants and confidentiality was preserved at all stages of research. Results: Managers viewed the learning experience positively and felt that facility-generated planning was preferable to hierarchical imposition of programmes. They found it motivating to learn how other facilities had solved problems and designed their systems. Contextual changes to the health system affected ASLI by increasing the pace and prescriptiveness of implementation, and impeded the capacity for PPHC managers to offer support. Facility managers fulfilled critical leadership roles according to Mintzberg’s model, but the way in which they carried out roles such as delegation, team building or communicating may have affected implementation. Challenges included issues with human resources, insufficient time available for managing implementation, lack of preparation beforehand, insufficient support and contextual changes. Benefits included shorter working hours for staff, better organisation in facilities, shorter waiting times and improved satisfaction for end-users.

Magister Public Health - MPH / Long waiting times have, for many years, been synonymous with primary health care in South Africa, and this is evident by the long queues and consistent client dissatisfaction. There are multiple contributing factors that exacerbate waiting time in Primary Health Care (PHC) facilities such as shortage of health care providers, increase in the uninsured population and South Africa’s quadruple burden of diseases. Health establishments have initiated numerous strategies to reduce long waiting times with varying degrees of success. These strategies have mostly been quantified and linked to indicators to measure their level of success in relation to quality healthcare. This research explores the clients’ perception of one such intervention, which is the implementation of an appointment system in primary care facilities in the City of Cape Town. Qualitative, exploratory descriptive methods were used to gain understanding of the impact the appointment system has had on the clients’ experience of attending health care services. The researcher also explored how clients perceive their role with regard to the shaping of their clinic’s appointment system. Semi-structured in-depth interviews were conducted with fifteen purposively sampled clients from five City Health clinics, who have implemented an appointment system through the guidance of the Appointment System Learning Initiative (ASLI). Maximum variation in sampling ensured the inclusion of small, medium and larger facilities within different geographical settings. Data analysis was done using a thematic coding approach, the themes were derived from the emerging data and were used to guide the researcher in gaining a rich picture of the clients’ experiences within the clinics. Ethical approval was requested and received from both the University of the Western Cape (UWC) and City Health prior to engaging any participants.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / In the management of port terminals, a common problem has been evidenced, high traffic of trucks and long waiting times given the variability of trucks arrival. This is a significant challenge for ports. This situation has given the opportunity to investigate in this matter and make use of a Truck Appointment System (TAS) together with other tools corresponding to industrial engineering for the optimization of truck service processes within a port terminal in Peru. To do this, a diagnosis is made of the company object of study and through a simulation of discrete systems, the technical viability of the proposal is validated. It was demonstrated that a procedure of attention based on appointments, Last in, First Out (LIFO) management for containers and development of visual management within the container yard; it is a highly viable option to shorten waiting times and unproductive movements of containers.

本研究在探討目前臺北市高中圖書館人員具備專業資格之情形，以及學校相關人士對高中圖書館人員任用之意見，藉此分析高中圖書館人員任用資格及職系的適切性，以提出高中圖書館人員任用及專業知能提昇上之建議。本研究對臺北市28所公立高中圖書館進行問卷調查，瞭解各校圖書館業務分組、人員專業資格與任用之現況；並透過訪談瞭解學校人員對高中圖書館專業人力配置、人員任用、學校職系規劃、職員輪調制度及專業知能提昇之看法。 研究結果顯示，高中圖書館人員之主要任務為支援教學及協助學習，甚具專業性；人力的專業性在圖書館之經營管理上具有顯著差異，而積極與熱忱的個人特質更是為圖書館人員深化服務之要素。為達成核心任務、健全教學資源中心發展，實應明訂高中圖書館之分組編制及配置圖書資訊專業人員，但法規制度的不夠周延造成目前高中圖書館仍嚴重缺乏專業人力配置，且分組受限、職務權責劃分亦造成資訊人力配置之現況難以深入支援教學資源中心之發展。在人員任用方面，學校主管認為圖書館組長及職員應比照主任，具有專業知能規範，且圖書館專門科目20學分提供了教師兼任圖書館工作者獲得專業知識及資格之重要途徑；高中學校需落實圖書資訊職系設立，且不宜參與學校一般行政人員之輪調，以期專才專用，發揮人才培育的價值。在提昇專業知能方面，繼續教育之型態未來可朝向數位課程發展，以突破人力不足及進修管道缺乏影響人員專業知能提昇之困境。 最後建議，為解決高中圖書人員任用困境，現階段紓解專業人力資源不足之可行方式如下：透過人力資源整合，集眾人之力使知識技能互補而多元；善用數位學習方式及適時搭配實體課程，提供多元圖書資訊進修管道，並鼓勵圖書館工作人員參與進修、組織學習社群，以提昇專業知能、促進專業成長。而更積極的作為是：加強與校長進行溝通，使其瞭解圖書館的功能與價值，以獲得校長對圖書館專業發展的支持；最重要的是能由法規政策進行專業資格制度、圖書資訊職系設立的落實，以獲得圖書資訊專業人力的資源；考量高中圖書館的專業發展，未來建立認證制度以作為專業能力的證明將有其必要性。 / The purpose of reserach is to discuss the librarian’s qualification of senior high school in Taipei city and the current school staff’s opinion on librarian appointment of senior high school, so as to analyize the qualification and job relevance of librarian of senior high school then to make suggestion on librarian appoinment and their professional knowledge improvement. The research implements questionnaries to libraries of twenty eight national senior high schools to realize the library grouping, staff ‘s professional qualification and the appointment of each school; meanwhile, through interviewing and investigating school staff’s opinion on human resource arrangemnt , employment, grade planning, personnel rotation system and professional knowledge improvement. The result shown librarian’s major task is to support teaching, help learning, which combines profession, the professions of human resource in the library management have significant difference and the positive and sincere individual personality is the factor that deepens the service of librarian. For achieving core task and completing the development of teaching resource center, to set up a professional personnel arrangement in the library is needed; however, the regulation is not complete which causes the insufficient professional staff arrangement in the senior high school library; moreover, the current arrangement of information human resource is not able to develop in the supporting learning resource center due to limited grouping and job responsibility division. From personnel appointment; currently, school staff think librarian director and the staff should follow the precedent of director to have professional knowledge; furthermore, the library specialized subject of 20 credits provides teachers who also work at library an important access to obtain professional knowledge and qualification; it is necessary to set up a library and information job system and which is not allowed to have job rotation so that specialized staff can elaborate their profession well and the value of human resource can be developed. In the part of enhancing professional knowledge, further education could be developed toward to digital courses so as to break through the difficulty of insufficient human resource and the access of further education. The classified results suggest, in order to resolve the problem of librarian appointment of senior high school; currently, the available method are as followings: from integration of human resource to combine the power of the general public which enables the knowledge skill to be more complementary and diversified; making the best of digital learning method and properly collocating with substantive course to provide diversified further education accesses of library and information and also to encourage librarian to participate in further study and learning group to enhance their professional knowledge and facilitate their professional growth. The more positive ways are: to strengthen the communication with the school principal to make him more understand the function and value of library then to obtain his support to develop the profession of library; the most significant is to carry out the profession system and job system of library and information so as to obtain the professional human resource of library and information; to consider the professional development of library and to set up a certification system for certificating the profession in the future would be necessary.

En la gestión de terminales portuarias se ha evidenciado un problema común, alto tráfico de camiones y largos tiempos de espera dada la variabilidad en la llegada de camiones. Este es un desafío importante para los puertos no solo en los países emergentes, sino también en los más desarrollados. Esta situación ha dado la oportunidad de investigar en esta materia y hacer uso de un Sistema de Citas para Camiones (TAS, por sus siglas en inglés) junto con otras herramientas correspondientes a la ingeniería industrial para la optimización de los procesos de atención de camiones dentro de una terminal portuaria en Perú. Para ello, se realiza un diagnóstico de la empresa objeto de estudio y mediante una simulación de sistemas discretos se valida la viabilidad técnica de la propuesta. Se demostró que un procedimiento de atención basado en citas, gestión Último en Entrar, Primero en Salir (UEPS) para contenedores y desarrollo de la gestión visual dentro del patio de contenedores; es una opción altamente viable para reducir tiempos de espera y movimientos improductivos de contenedores. / In the management of port terminals a common problem has been evidenced, high traffic of trucks and long waiting times given the variability of trucks arrival. This is a significant challenge for ports not only in emerging countries, but also in the more developed ones. This situation has given the opportunity to investigate in this matter and make use of a Truck Appointment System (TAS) together with other tools corresponding to industrial engineering for the optimization of truck service processes within a port terminal in Peru. To do this, a diagnosis is made of the company object of study and through a simulation of discrete systems, the technical viability of the proposal is validated. It was demonstrated that a procedure of attention based on appointments, Last in, First Out (LIFO) management for containers and development of visual management within the container yard; it is a highly viable option to shorten waiting times and unproductive movements of containers. / Trabajo de Suficiencia Profesional