Healthcare is the main contributor to the well-being of the population and the country. Healthcare services ensure that the country has a healthy and productive workforce which influences economic growth. Self-employed healthcare practitioners are key role players in the healthcare system in South Africa. However they are faced with several challenges that affect their relationship with their employees and the service offered in their practises. A lack of leadership skills, professionalism, budget constraints, corruption, increased legislation, medical negligence, poor human resources and poor management are mentioned in this study as part of the challenges facing self-employed healthcare practitioners. Against this background, the primary objective of this study was to establish the level of Servant and Ethical leadership displayed by self-employed healthcare practitioners in both the Eastern Cape and Western Cape, and to investigate whether the dimensions of these leadership styles influence Job satisfaction and Perceived financial performance. In this study a quantitative approach was adopted. A form of purposive sampling called criterion sampling was used to draw the sample for this study. The sample consisted of self-employed healthcare practitioners and their employees in the Eastern and Western Cape Provinces. The survey methodology was implemented using self-administered structured questionnaires. A total of 241 questionnaires were deemed usable, and were subjected to statistical analysis. Factor analysis was used to assess the validity of the independent (dimensions of Servant and Ethical leadership) and dependent variables (Job satisfaction and Perceived financial performance). More specifically, factor analysis was utilised to conduct tests of uni-dimensionality and principal components were used as the extraction method to produce an unrotated factor matrix. Concerning validity assessments, only factors with two or more items loading on them were included for further analysis. Items that did not load were discarded and were subsequently excluded from further statistical analysis. In this study, four items intended to measure Job satisfaction all loaded together as expected. Of the six items intended to measure Perceived financial performance, five items loaded together. Only one item did not load onto this factor and was excluded from further analysis. The items measuring the dimensions of Servant leadership, namely Humility, Servanthood, Caring for others and Developing others, loaded onto the respective factors as expected. All items measuring the dimensions of Ethical leadership, namely Integrity, Ethical commitment, Ethical guidance, Fairness and Sustainability, also loaded as expected. The Cronbach‟s alpha coefficients for all variables were greater than 0.7 which provided sufficient evidence of reliability of the scales. Statistical techniques used to analyse the empirical data, which included the descriptive statistics, Pearson product moment correlations and multiple regression (MRA). T-tests were explained as the method used to determine whether significant differences existed in the mean scores of self-employed healthcare practitioners and their employees for the leadership styles (Servant and Ethical leadership) under investigation. The results of the study show that for the dimensions of Servant leadership, both the healthcare practitioners and their employees returned the highest mean for Caring for others. The majority of self-employed healthcare practitioners agreed that they adopted these dimensions. The majority of employees also agreed that the self-employed healthcare practitioners use these dimensions. Statistically significant differences were found in terms of the mean scores returned for the level of Humility and Caring for others displayed by the self-employed healthcare practitioners. No significant differences were found between the mean scores returned for Servanthood and Developing others for the two sample groups. A significant difference was reported for mean scores returned for the levels of Integrity, Ethical commitment, Ethical guidance, and Fairness. No, significant difference was reported for Sustainability for the two sample groups. The multiple regression analysis (MRA) shows that the dimensions of Servant leadership Developing others and Caring for others had a significant positive influence on Job satisfaction. The MRA results also show a significant positive influence between Fairness, Ethical guidance and Ethical commitment and Job satisfaction. Based on the findings of the study several recommendations were put forward to ensure a Servant and Ethical behaviour among self-employed healthcare practitioners.

A role description for a medical coordinator in extended and long term care facilities in British Columbia has been defined using a Delphi method. Also obtained during the study was a long term care philosophy. Three groups - nurses, administrators, and physicians took part in three rounds of the Delphi study. Thirty-five respondents were interviewed in the first round. During this interview the researcher obtained from the respondents the statements that they considered should be included in this role and philosophy description. During the second round the respondents rated the responses of the first round and in the third round those of the second round were revised after seeing the mean scores of the whole group and the three separate groups. The description of the role of a medical coordinator developed describes the role as it applies to: resident care; private physicians; planning, development and evalution of care; staffing of a facility; education; administration; and the training, experience, skills and attitude of a medical coordinator. When the description created was compared with that for the medical director in a long term care facility in the United States it was found that this study had described additional dimensions of the role, in particular the multi-disciplinary approach and the physician's knowledge, training, experience, skills and attitude. The results of the study show where there was agreement and where there were differences of opinion between the three professional groups. A long term care philosophy which was considered very important for a medical coordinator to promote, has been defined during the study. It focuses on the resident reaching his full potential, the creation of a special environment, as well as acceptance of disability, dying and death. Recommendations from the study are made for facilities which might be considering employing a medical coordinator, for planners deciding whether to provide funds for medical coordinators, for geriatric medical education and for the acceptance of a long term care philosophy in all parts of the health care system where there are long term care clients. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

In the past several years, the subject of health care delivery has assumed increasing importance as a public issue. Congressional hearings, public and private commissions, and task forces have investigated the functioning of the health care system in depth, reporting that access to the system is impeded by financial barriers and by inefficiency of the delivery system. Medicare and Medicaid have attempted to surmount the financial barriers for, some segments of the population, and more inclusive health insurance proposals are being considered in Congress. The Healthright program, under the Economic Opportunity Act, has stimulated efforts to improve the delivery system as it relates to low income persons, and some of the health insurance proposals also have the goal of improving the delivery system.

Total quality management [TQM] is an approach to improving the competitiveness, effectiveness and flexibility of the whole organization through the improvement of the organizational processes and those who perform them. There has been a rising interest among public sector professionals in examining the applicability and usefulness of TQM methods to public organizations. This research provides descriptive information about the experience of three health care organizations that vary in terms of ownership, whether being publicly or privately owned, with implementing TQM. Participants at these organizations were interviewed, and/or surveyed and observed. The study provides a narrative description of each organization's experience with TQM (their Quality Story) and it compares the implementation of TQM in the three organizations. Moreover, the study explores what role, if any, does ownership have on the implementation of TQM. Finally, the study presents some lessons that could be derived from the experience of these organizations. Conclusions are drawn that TQM could be successfully implemented in both sectors, provided that the process of implementation follows the specific guidelines and principles established in the field. Moreover, difference in ownership between public and private organizations, though important, is not the major factor influencing the implementation and any possible outcomes of a TQM innovation effort. It is rather the involvement and commitment of top management that seem to have the upper hand in influencing the implementation and any possible outcomes of TQM, in public as well as private organizations. However, the research suggests that public sector organizations are more challenged in implementing TQM, due to the multiplicity of their customers and more scrutiny of the tax payer and the media.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This thesis investigates the complexities involved in Health Information Systems. The focus is on the factors of a) efficiency and b) usability. A case study is made of a recently implemented system in Charlotte Maxeke Johannesburg Academic hospital. The first objective of the research was to gain a deeper understanding of the complexities of Health Information Systems, and secondly to evaluate the situation at Charlotte Maxeke Johannesburg Academic Hospital. In Chapter 1 a detailed introduction of the thesis is offered. This includes, explaining what triggered the research, the objective of the research and the methodology used to conduct the research. In Chapter 2 the focus is on a literature review of Health Information Systems, system fundamentals and planning and implementation. It is clear that without a methodology, systems development becomes haphazard and subsequently a risky and expensive undertaking. While change is pervasive, introducing operational efficiencies sometimes may necessitate reviewing of information systems and business strategy, knowledge management and process orientation. In Chapter 3 the issue of usability is investigated. Several healthcare institutions have implemented information systems but evaluations of the usability of these systems are still under debate. For purposes of this research an evaluation method for system usability and survey questionnaires were developed. In Chapter 4 the case study of Charlotte Maxeke Johannesburg Academic Hospital is reported. The chapter also describes the data collection design, research limitations and delimitations, survey findings and interpretations. In Chapter 5 the implications and applications of Health Information Systems are discussed. After analysis of the survey results, it appears that the impact and benefits of the new Health Information System are only positive or realized in the patient administration division. The rest of the health professionals continue to manually capture clinical notes and other management information on pieces of papers, spread sheets and word documents. The thesis comes to the conclusion that despite widespread use of technology in other sectors, clinicians in hospitals do not use implemented automated systems. Implementation of systems is complex and problems associated with usability are not resolved and that traditional systems implementation methodologies may not apply. / AFRIKAANSE OPSOMMING: Die tesis ondersoek die faktore wat Gesondheidstelsels (HIC) ingewikkeld maak. Die fokus is op a) doeltreffendheid, en b) bruikbaarheid (uit gebruikersoogpunt). ‘n Gevallestudie word gemaak van ‘n stelsel wat onlangs by Chalotte Maxeke Johannesburg Akakdemiese Hospitaal in gebruik geneem is. Die eerste doelwit van die ondersoek was om die ingewikkeldheidsgraad van sodanige stelsels te probeer bepaal, en tweedens om die situasie in die hospitaal self te evalueer. In hoofstauk 1 word die agtergond en aanleiding tot die ondersoek uiteengesite, woel as die metodologiese keuses wat gemaak is. Hoofstuk 2 bied ‘n oorsig oor relevante literatuur ten ospigte van HIC. Dit is duidelik stlselontwikkeling riskant, onnodig duur en koersloos is as dit sonder ‘n duidelike metodologie geïmplementeer word. Verandering vind voortdurend plaas en die implementering van oprasionele doeltreffendheid mag vernadering in besigheidstrategie, informasiestelsels, kennisbestuur en processoriëntasie noodsaaklik maak. In hoofstuk 3 word bruikbaarheid ondersoek. Verskeie mediese instellings het soortgelyke stelsels in gebruik geneem, maar die bruikbaarheid daarvan is steeds onseker. Vir die doeleindes van hierdie tesis is ‘n eie evaluasiemetode ontwikkel en ‘n vraelys op grond daarvan opgestel. Hoofstuk 4 rapporteer die gevallestudie in Charlotte Maxeke Johannesburg Akademiese Horspitaal hospital. Datakolleksie, navorsingsafbakening en – beperkinge, sowel as vraelysresultate word aangebied. Hoofstuk 5 bespreek die implikasies en toepassings van HIC. Dit blyk dat die voordele van die stelsel slegs deur die pasiëntadministrasieafdeling geniet word. Alle ander afdeling gaan steeds voort met papiergebaseerde inligtingstelsels, aangevaul deur ad hoc gebruik van Excel en woordprossering. Die tesis kom tot die gevolgtrekking dat kliniese personeel avers is teen die gebruik van geoutomatiseerde informasiestelsels.

No description available.

Managed care became the dominant model for moderating healthcare costs in the 1990's. The later half of this past decade witnessed early signs of a return to escalating premiums. Providers and consumers have reacted negatively to perceptions of health plan micro-management and restriction of choice.

Thesis (M. A. (Nursing)) -- University of Limpopo, 2020 / Background: Long patient waiting time for services is demonstrated by daily long queues of patients in Primary Health Care (PHC) and hospitals Outpatients departments. Aim: The aim of the study was to determine the factors contributing to long waiting time at Blouberg Health Centre (BHC), Capricorn District, Limpopo Province. Methods: A quantitative, descriptive and cross-sectional research design was used to describe factors contributing to long waiting time. The study population consisted 31356 patients in the financial year 2017/2018. Simple random probability sampling was used to select 395 respondents. Data were collected using self-developed questionnaire. All questionnaires were completed and returned. The 395 questionnaires were then analyzed using the Statistical Package for Social Sciences (SPSS, version 25). Descriptive statistics were used to analyze and describe and summarized data. Findings: The findings were presented in the form of distribution graphs and tables. Inferential statistics were used based on probability and allowed judgement to be made about variables. The study revealed factors considered most important were lack of commitment; full time study leaves at the same year; workshops; sick leaves; increased population; sitting in tearoom for hours; many foreign national without passports; staff shortages; laissez faire working style and transfers or escorting patients, while the nearby Hellen Franz Hospital (HFH) also transfer to the same hospitals, leading to mismanagement of budget reduced manpower and increased death rate. Recommendations: The study recommends that all Primary Health Care (PHC) settings should use numbers for patients when entering facilities to monitor the queuing and prevent dissatisfaction that can result from long waiting. Conclusion: It is of paramount importance to provide clearer, transparent information to the recipients of the Primary health care services that they might receive. The provincial coordinators are accountable to the waiting time management with the assistance of the PHC specialist nurse and Nursing Management.

Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

Health Studies / D. Litt. et Phil. (Advanced Nursing Science)