It is estimated that the failure rate of small, medium and micro enterprises in South Africa’s (SMME’s) are between 70 percent and 80 percent. As a result, millions of rand are lost on business ventures because of essentially avoidable mistakes and problems. Difficulties encountered by small business owner-managers can be described as environmental, marketing, financial or managerial in nature. The primary objective of this study was to investigate the nature and importance of problems experience by small business owner-managers in the private health sector. The design that was used in this study was qualitative, descriptive, exploratory and contextual in nature. This study fell within the broad framework of qualitative research, as interviews were employed to do the research project (Baker, 1999:247). A purposive sample was used to identify the participants for inclusion. The target population was small business owner-managers operating within the private health sector in the Nelson Mandela Metropole. The sample comprised eight business owner-managers in the health sector within the boundaries of the Nelson Mandela Metropole, purposely identified. Before doing the empirical research, a pilot study was conducted with one small business owner-manager that fulfilled the required criteria of the research population. Data was collected by means of naïve sketches and semi-structured interviews. Data was analyzed according to the framework provided by Tesch (in Creswell, 1994). Guba’s model (in Krefting, 1991) was employed for data verification. Interviews were conducted in both Afrikaans and English. iii Direct transcriptions from the tape-recorded interviews ensured that all data was gathered and saved for reference when needed during the data analysis as described by Field and Morse (1996:64). The researcher took observational, theoretical, methodological and personal notes as described in Wilson (1989: 433-435). Transcriptions from sketches and interviews served as the database for the study. Only literature pertaining to the research process was consulted prior to the data collection of the primary data, in order to establish an effective research format. The problems experienced by small business owner-managers in the health sector were discussed under four major themes and several sub-themes identified by the researcher and the independent coder. The main themes that emerged from the study were: small business ownermanagers in the health sector lacked business skills and experience; had financial problems regarding their businesses; had difficulty building a customer base; and were uncertain in terms of their businesses’ future. Conclusions were drawn from the findings of the study and limiting factors were identified and acknowledged in the report. Recommendations that could assist practitioners, educators and trainers were suggested.

Health and safety management forms part of the overall risk management of medical institutions, and deals with the responsibility of an organisation to provide a risk free environment for all who are exposed to the activities of such medical institutions. Affected people include health care workers, contractors, visitors, and patients. Medical institutions, and hospitals specifically, are uniquely distinct from other industries in that they employ highly skilled staff with specific specialised knowledge. These institutions are also increasingly making use of complex technology that requires specialist staff to operate medical machines and equipment. These specific aspects are accounted for in this research. The overall purpose of this research is to determine the need for an alternative approach to the management of health and safety in medical institutions. An appropriate model will be developed that can be integrated into the existing health and safety management system. The research methodology for this study comprises the following steps: Firstly, the health and safety environment was researched in relation to all stakeholders, external and internal, that are affected by medical institutions’ activities. The effect of these activities, and how it influences health and safety management, was evaluated in a South African context. Secondly, the overall risk management approach of medical institutions and the effect of organisational culture were researched to determine the effect on health and safety performance. Thirdly, a questionnaire was sent to selected staff of five hospitals in the Eastern and Western Cape to determine their perception and experience of health and safety management. Quantitative data on incidents in Netcare Hospitals were obtained, and a comparison of the questionnaire studies was done to determine the need for a health and safety model. The final step of this study entailed the development of a health and safety model using legislative requirements and the needs identified in the research. A proposal is made to integrate specialist functions and departments into the existing health and safety management system, in order to strengthen the managerial capabilities of such a system. The importance of improving the safety and compliance culture is indicated.

Theses ( MPH.) -- University of Limpopo, 2021 / Background: Maternal mortality is a significant public health problem worldwide, and is a vital indicator of the functioning of a health system. The South African maternal mortality ratio is higher than other countries with same economic growth, despite people having free access to maternal health. How to develop relevant policies and programmes to reduce maternal mortality factors contributing to maternal mortality was investigated. Aims of the Study: To investigate the factors contributing to maternal mortality in public health institutions in the Sekhukhune District, Limpopo Province, South Africa. Methods: A quantitative, retrospective study was undertaken where 138 medical records of maternal mortality cases reported between 2013 to 2017 were reviewed. A simple random sampling method was used to select files that met the selection criteria from seven hospitals in the Sekhukhune District, Information was collected on maternal demographics and health service-related characteristics, including age, marital status, parity, antenatal care utilisation of services and delivery type. Inferential data were analysed using the student t-test and SPSS version 25. Results: The mean age of the women involved in this study was 30 years, with a standard deviation of 5.7. All the women who participated in the study were black African. The majority of maternal mortality occurred in hospital. The women in the majority of maternal mortality cases were unemployed, at 93.5%, while most of the maternal mortality cases involved single women (71%).The women involved in these maternal mortality cases booked their ANC care and the major health provider was a professional nurse (58.0%), while 57.2% of the participants attended their ANC at primary healthcare facilities. Most of the maternal deaths occurred after delivery (58.7%) and, in most deliveries, the Partogram was not used (66%). HIV testing occurred in 99% of the maternal mortality cases. The causes of maternal mortality were both direct (71.0%) and indirect (23.9%) causes. The leading cause of maternal mortality was direct haemorrhage (33%), followed by eclampsia (27%) and infection (16%). The leading indirect cause was respiratory causes (22%) and retro viral disease (RVD) (9%). The personal factor that contributed most to maternal mortality was delay in seeking help (62%). v Conclusion and Recommendations: The personal factor, delay in seeking medical help by the women, contributed to maternal mortality and it was further concluded that the majority of maternal mortality cases did not occur as a result of any complications in ANC and delivery. It is recommended that the training of healthcare providers in the utilisation of the Partogram be implemented to improve skills in the management of haemorrhage and eclampsia. Furthermore, the management of complications needs to be strengthened through a multi-sectorial approach. / SAMRC

Submitted in fulfillment of the requirements for the Master of Technology: Radiography degree, Durban University of Technology, Durban, South Africa, 2015. / Introduction Occupational stress has negative effects on both the organisation and individuals employed by the organisation. In the organisation it can result in high levels of absenteeism, reduced productivity and compromised levels of patient care. Furthermore individuals affected by stress may suffer from raised levels of tension, mental fatigue, insufficient sleep, anxiety, and anger. Interventions to prevent both organisational and individual effects of occupational stress may only be implemented once stressors in an occupa-tional group have been identified hence the need for the current study. Purpose The purpose of the study was to investigate occupational stress in diagnostic radiographers working in public healthcare institutions in the eThekwini District of KwaZulu-Natal using a quantitative research approach. Method A cross sectional survey using a validated questionnaire with some open and closed-ended questions was utilised. Radiographers working in public hospitals in the eThekwini District of KwaZulu-Natal were invited to parti-cipate in the study. Respondents were asked to answer 60 closed ended and four open ended questions. Open ended questions afforded the respondents an opportunity to express their opinions. Quantitative data was analysed using the Statistical Package for Social Sciences (SPSS) version 21.0. Inferential statistics included the use of reliability coefficients, correlations and chi square test at a 95% confidence level. Open ended questions were analysed using thematic analysis. Results One hundred and one questionnaires were administered and forty three were returned which resulted in a 43% response rate. The mean age of respondents was 31.7 years and 88.4% were females. The majority (67.4%) were in possession of a National Diploma in Radiography. Seventy two percent worked in regional hospitals. The majority (41.8%) were employed as chief radiographers. Most radiographers affected by stressors were those working in regional hospitals. The three main sources of stress in order of response were workload, faulty equipment and staff shortages. In addition, bullying, long and strenuous shifts as well as training of students were also found to be stressors. Physical exercises, counselling and wellness days were used to reduce stress whilst employment of more staff, attending to faulty equipment, team building, reducing workload, and improved working conditions were suggested as methods of reducing stress amongst radiographers. Conclusion Radiographers working in the eThekwini District were stressed by a number of factors in their work places. Radiographers suggested ways that can be employed to reduce stress in their departments. A close cooperation between radiographers; radiography supervisors; institutional, district and provincial managers is recommended in order to address the challenges faced by radiographers.

Submitted in fulfillment of the requirements for the Master of Technology: Radiography degree, Durban University of Technology, Durban, South Africa, 2015. / Introduction Occupational stress has negative effects on both the organisation and individuals employed by the organisation. In the organisation it can result in high levels of absenteeism, reduced productivity and compromised levels of patient care. Furthermore individuals affected by stress may suffer from raised levels of tension, mental fatigue, insufficient sleep, anxiety, and anger. Interventions to prevent both organisational and individual effects of occupational stress may only be implemented once stressors in an occupa-tional group have been identified hence the need for the current study. Purpose The purpose of the study was to investigate occupational stress in diagnostic radiographers working in public healthcare institutions in the eThekwini District of KwaZulu-Natal using a quantitative research approach. Method A cross sectional survey using a validated questionnaire with some open and closed-ended questions was utilised. Radiographers working in public hospitals in the eThekwini District of KwaZulu-Natal were invited to parti-cipate in the study. Respondents were asked to answer 60 closed ended and four open ended questions. Open ended questions afforded the respondents an opportunity to express their opinions. Quantitative data was analysed using the Statistical Package for Social Sciences (SPSS) version 21.0. Inferential statistics included the use of reliability coefficients, correlations and chi square test at a 95% confidence level. Open ended questions were analysed using thematic analysis. Results One hundred and one questionnaires were administered and forty three were returned which resulted in a 43% response rate. The mean age of respondents was 31.7 years and 88.4% were females. The majority (67.4%) were in possession of a National Diploma in Radiography. Seventy two percent worked in regional hospitals. The majority (41.8%) were employed as chief radiographers. Most radiographers affected by stressors were those working in regional hospitals. The three main sources of stress in order of response were workload, faulty equipment and staff shortages. In addition, bullying, long and strenuous shifts as well as training of students were also found to be stressors. Physical exercises, counselling and wellness days were used to reduce stress whilst employment of more staff, attending to faulty equipment, team building, reducing workload, and improved working conditions were suggested as methods of reducing stress amongst radiographers. Conclusion Radiographers working in the eThekwini District were stressed by a number of factors in their work places. Radiographers suggested ways that can be employed to reduce stress in their departments. A close cooperation between radiographers; radiography supervisors; institutional, district and provincial managers is recommended in order to address the challenges faced by radiographers. / M

M. Tech. Architecture (Professional) / Herbalism has been practised by various cultures in various countries around the world, including China, India and Africa for thousands of years. South Africa is home to a rich variety of medicinal plant species. Our natural resources and existing knowledge of traditional medicines and treatments form part of our heritage and should be protected, studied, documented and further researched to ensure the safe and effective use of herbal remedies for the public and future generations. Current issues that we are facing in South Africa are the informality of traditional medicines and the concern that the industry is unregulated, misunderstood by many and that the survival of our natural plant resources is under threat as a result of overexploitation. In response, this dissertation addresses these issues through the design of a consulting healthcare and research facility for natural medicine within Hatfield, Pretoria. The facility is intended to reach and educate the urban community in an attempt to bridge the gap between formal and informal medical fields. Urban agriculture will aim to form the foundation of the learning experience by promoting public awareness for natural medicine and the conservation of our natural resources regarding medicinal plants in a practical, experimental and experiential way. The proposed facility sets out to formalise indigenous traditional medicine in order to arrive at a sustainable commodity within the African urban environment. A further aim is to draw together various natural healing practices and processes experienced in the modern world, such as herbalism, homeopathy, osteopathy, naturopathy and chiropractic. This shared facility should create a symbiotic environment where these natural medicine modalities can operate within a controlled and regulated environment. In so doing, traditional practices may safely be commercialised as a proven alternative to allopathic medicine. The target user for this project will be the middle to high income urban groups that rely primarily on formal medical practices. Evidence based design principles informed the programme of the building relating to the creation of healing environments within healthcare centres.

My motivation to conduct this study was triggered by my exposure to the challenges which form the basis of this study. Being employed in the same environment as the respondents, it became natural for me to resolve to investigate the challenges facing these Health Professionals with the purpose of not only establishing what the challenges are but simultaneously propose remedial solutions to mitigate their impact. This study is both qualitative as well as quantitative to make sure that both the numerical as well as the social issues which impact these professionals‘ work were captured in the study. The assumptions from which the study moved were largely confirmed by the respondents. The recommendations which the researcher proposes to mitigate the challenges are informed by her own experience as well as the responses which were elicited from the respondents. While the study does contribute in a way to the body of knowledge, it is cautioned in the concluding chapter that recommendations made must be considered with this caution in mind as the study was limited to a specific environment – the OR Tambo District Health Municipality.

Thesis (MPH.) -- University of Limpopo, 2017 / Background: Since the introduction of optometry services in 1994 in Limpopo hospitals there is a need to improve the eye care services. Hospital records revealed that most of the spectacles worn by health professionals were not issued by the hospital optometry department. Those who were issued with spectacles when they were newly employed had not renewed from the hospital’s optometry department after the recommended two years. The aim of this study was to determine perceptions and attitudes of public healthcare workers towards optometry services in Zebediela. Limpopo Province, South Africa Methods: A quantitative descriptive cross-sectional study design was used. Participants were public healthcare professionals in Zebediela hospital and clinics in Zebediela sub-local municipality. Following the ethical approval and informed consent, a self-administered questionnaire with closed-ended questions was used to collect information on the perceptions, attitudes and socio-demographic factors. Data were analysed using IBM SPSS statistic 23 software. Results: The majority of participants had negative perceptions (78.7%) and 76.4% had positive attitudes towards the optometry department. There was significant association between perception according to profession of participants (P=0.025). There was significant association between attitude according to profession (P=0.001), as well as years in institutional employment (P=0.035). There was no significant association between either perceptions or attitudes and age group, gender as well as employment experience Conclusion: The health professionals held negative perceptions but favourable attitudes towards the optometry staff and the optometry service but needed more information for themselves and the general patient. The health professionals were not impressed by the type of spectacles issued and optometry service delivery aspects. Awareness campaigns by optometrists, need to be increased to the public and also inter professional relationships need to be strengthened to reduce negative perceptions through peer cross professional education in the health system.

Thesis (MPA)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The research was undertaken during 2009/2010 and focused on the Western Cape Department of Transport & Public Works (DPW) programme for the provision of land for the construction of new state health facilities (hospitals, community health centres, clinics) in the province. The purpose of the study was to determine whether the Department has instituted proper policy to deliver the required land, and whether this policy is implemented successfully. The study was thus, in essence, an evaluation of a government policy programme. The following are the overall findings and conclusions, per chapter: •Chapter 1 provides an introduction, with reference to the main research question and related questions. •In Chapter 2 important theory on policy evaluation is presented, and a Policy Documentation Template (PDT) developed, capturing the essential principles and elements for effective public policy documents. •In Chapter 3 important selected sections of the existing conceptual/theoretical body of knowledge on policy implementation are explored and analysed by the researcher, leading to identification of critical implementation principles/lessons as well as the Policy Implementation Monitor (PIM). •In Chapter 4 the DPW‟s set of policy documentation related to land provision for new state health facilities is studied, described, analysed, and compared with the PDT. It is found that an effective and enforceable annual operational plan does not exist, rendering successful policy implementation and monitoring impossible. •In Chapter 5 the implementation of the policy documents is described, and critically analysed. The PIM and lessons learnt from policy implementation theory are applied to DPW‟s implementation practice. Serious shortcomings are found in the implementation of the land provision programme – especially regarding ineffective cooperation between the Provincial Departments of Public Works and Health – resulting in delayed delivery of land for new state health facilities. •Chapter 6 contains the researcher‟s conclusions and policy recommendations. The researcher produces the following recommendations for consideration by the Minister, to address the problems in the DPW land provision policy programme: A. Appointment of a policy think tank (group of independent expert professional individuals with high-order management skills) with the following tasks: •Facilitate the establishment of a Health Facilities Partnership Contract (HFPC) between DPW and the Provincial Department of Health by 31 March 2011. •Ensure that the HFPC contains the essential elements on functioning of the partnership, and includes the mutually agreed new state health facility projects, of which construction must start over the next three financial years (2011/12 – 2013/14); also initiate an electronic management cockpit to be used by the Minister for real-time (24 hr) monitoring of progress with the priority land/facility projects. •Document a broad policy and strategic framework for innovative asset management approaches and models that will maximise revenue streams for DPW, and increase the value of the asset base of the Western Cape Provincial Government; this policy framework should include reference to inner city renewal in Cape Town, as well as asset-based urban regeneration and economic development in other larger towns of the Western Cape (e.g. George, Mossel Bay, Oudtshoorn, Hermanus, Paarl/Wellington, etc.). •Make recommendations regarding updating of the asset register of DPW, including reference to effecting and conclusion of the transfer of various real estate properties that have not been transferred to DPW yet, and regarding sophisticated information/communication technology (ICT) solutions that will modernise DPW‟s asset management to international best practice standards. B. The „policy think tank‟ (Ministerial advisory group) should have experts from outside DPW as members, but will have to engage with the DPW top management (Head of Department; Chief Director of Property Management; Director of Property Development) in a partnership context in order to have the HFPC established. / AFRIKAANSE OPSOMMING: Die navorsing is onderneem gedurende 2009/2010 en fokus op die Wes-Kaap Departement van Vervoer & Openbare Werke program vir die voorsiening van grond vir die konstruksie van nuwe staatsgesondheidsfasiliteite (hospitale, gemeenskap gesondheidsentrums, klinieke) in die provinsie. Die doel van die studie was om vas te stel of die Department behoorlike beleid ingestel het om die vereiste grond te lewer, en of hierdie beleid suksesvol geimplementeer word. Die studie was dus, in wese, 'n evaluering van 'n regeringsbeleidsprogram. Die volgende oorhoofse bevindinge en gevolgtrekkings word gemaak, per hoofstuk: •Hoofstuk 1 beslaan die inleiding, met verwysing na die hoof navorsingsvraag en verwante vrae. •In Hoofstuk 2 word belangrike teorie oor beleidsevaluering voorgehou, en 'n Beleid Dokumentasie Patroonplaat (BDP) word ontwikkel, wat die wesenlike beginsels en elemente vir effektiewe openbare beleidsdokumente bevat. •In Hoofstuk 3 word belangrike geselekteerde dele van die bestaande konseptuele/teoretiese kennispoel oor beleidsimplementering ondersoek en ontleed deur die navorser, wat lei na die identifikasie van kritiese implementering beginsels/lesse, asook die Beleid Implementering Monitor (BIM). •In Hoofstuk 4 word die Departement se stel beleidsdokumente rakende grondvoorsiening vir nuwe staatsgesondheidsfasiliteite bestudeer, beskryf, ontleed en vergelyk met die BDP. Dit word bevind dat geen effektiewe en afdwingbare jaarlikse operasionele plan bestaan nie, wat suksesvolle beleidsimplementering en monitering onmoontlik maak. •In Hoofstuk 5 word die implementering van die beleidsdokumente beskryf en krities ontleed. Die BIM en lesse uit die beleidsimplementering teorie word toegepas op die Departement se implementeringspraktyk. Ernstige tekortkominge word gevind in die implementering van die grondvoorsiening program – veral rakende die oneffektiewe samewerking tussen die Departemente van Openbare Werke en Gesondheid – met vertraagde lewering van grond vir nuwe staatsgesondheidfasiliteite die gevolg. •Hoofstuk 6 bevat die navorser se gevolgtrekkings en beleidsaanbevelings. Die navorser produseer die volgende aanbevelings vir oorweging deur die Minister, om die probleme in die Departement se grondvoorsiening beleidsprogram aan te spreek: A. Aanwysing van 'n beleid denkgroep ('n groep onafhanklike deskundige individue met hoë orde bestuursvaardighede) met die volgende take: •Fasiliteer die vestiging van 'n Gesondheidsfasiliteite Vennootskap Kontrak (GFVK) tussen die provinsiale Departemente van Openbare Werke en Gesondheid, teen 31 Maart 2011. •Verseker dat die GFVK die wesenlike elemente bevat betreffende funksionering van die vennootskap, asook die wedersyds ooreengekome projekte vir nuwe staatsgesondheidfasiliteite waarvan konstruksie 'n aanvang moet neem oor die volgende drie finansiële jare (2011/12 – 2013/14); inisieer ook 'n elektroniese bestuurskajuit vir gebruik van die Minister in die konstante (24 uur) monitering van vordering met die prioriteit grond/fasiliteite projekte. •Dokumenteer die breë beleid en strategiese raamwerk vir innoverende batebestuur benaderings en modelle, wat die inkomste strome vir die Departemente sal optimaliseer, en die waarde van die bate basis van die Wes-Kaap Provinsiale Regering sal vergroot; hierdie beleidsraamwerk moet verwysing na middestad-vernuwing in Kaapstad insluit, asook bate-gefundeerde stedelike en ekonomiese ontwikkeling in ander groter dorpe in die Wes-Kaap (soos George, Mosselbaai, Oudtshoorn, Hermanus, Paarl/Wellington, ens.). •Doen aanbevelings rakende die opdatering van die bate register van die Departement, insluitende verwysing na die uitvoer en afhandeling van die oordragte van verskeie vaste eiendomme wat nog nie oorgedra is na die Departement nie, asook rakende gesofistikeerde informasie/kommunikasie tegnologie (IKT) oplossings wat die Departement se batebestuur sal moderniseer tot internasionale beste-praktyk standaard. B. Die „beleid denkgroep‟ (Ministeriele adviesgroep) moet deskundiges van buite die Departement as lede hê, maar sal in gesprek moet tree met die Departement se topbestuur (Hoof van Departement; Hoof Direkteur van Eiendomsbestuur; Direkteur van Eiendomsontwikkeling) in 'n vennootskapskonteks, sodat die GFVK tot stand kan kom.

Thesis (MBA (Business Management))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Purpose – The health care industry is faced with numerous challenges ranging from rising medical costs, poor state of hospitals, deteriorating health care services and an increasing number of hospital deaths. All these disparities present tremendous challenges for the health care managers in charge of the health care services. As a result, they are forced to try new management methods that will assist their organizations to remain cost effective and efficient. Total Quality Management (TQM) constitutes an appropriate response to these challenges and it has become the strategy of choice to improve organization’s performance and patient satisfaction. However, in practice the implementation of TQM is often unsuccessful. Certain barriers have been identified which prevent the successful implementation of TQM in other industries as well as in the health care industry. The main aim of this research is to investigate the barriers to the successful implementation of Total Quality Management in Kraaifontein health care service organization in the Western Cape Province, 2008. Design/methodology/approach – The study employed a quasi-qualitative and quantitative case study. For the quantitative section a questionnaire with a 5–point Likert style scale was used to quantify the response (strongly disagree=1; strongly agree=5). For the qualitative section a focus group discussion was conducted to verify the results obtained from the questionnaire which addressed the challenges of TQM implementation. The statistical population of this research consisted of all health care workers working the pharmacy department who were involved in the implementation of TQM in their organization. Data was analyzed using appropriate statistical procedures. The mean score of each of the dimensions was used as a representative performance indicator and the coefficient of variation (CV) was used as a general measure of standardized skewness on the performance of each dimension. A high means score indicated desired outcomes while low scores indicated poor outcomes. Findings – Major barriers that were encountered during the implementation of TQM in this case study included the lack of top management active involvement and full commitment in the initiative, rigid organizational structure, culture towards quality changes that inhibited communication between management and employees which in turn hindered employee empowerment. Other obstacles that were encountered were lack of continuous improvement processes and initiative, improper evaluation, the lack of a recognition and reward system for team work, poor collection and analysis of data that resulted in difficulty to convert this data into meaningful information to improve quality. The absence of an integrated performance measurement system also exhibited a problem as employees were not aware what was being assessed during performance appraisals. Lack of evidence based decision making, poor communication and inflexible organizational structure and culture were also viewed as barriers. Research limitations/implications – Although conducted in Kraaifontein health care facility, it is expected that the results of the study may be relevant on a broader scale to other health care departments and facilities. The results could assist the health care managers to develop a plan that addresses the barriers and challenges faced during the implementation of TQM, yielding fruitful results which allow TQM to be implemented easily, effectively, efficiently and successfully in health care facilities. / AFRIKAANSE OPSOMMING: Doel – Die gesondheidsorg sektor het vele uitdagings wat wissel van stygende mediese kostes, lae standaarde in hospitale, die agteruitgang van gesondheidsorg dienste, en die toename in sterftes in hospitale. Hierdie en ander probleme stel groot uitdagings aan diegene verantwoordelik vir die lewering van gesondheidsorg, met die gevolg dat diesulkes nuwe bestuursmetodes moet vind om te verseker dat hulle organisasies steeds koste-effektief en doeltreffend funksioneer. Totale Gehalte Bestuur (TGB) is ‘n geskikte en toepaslike alternatief om genoemde probleme aan te spreek, en word toenemend as oplossing gesien om organisasies se dienslewering te verbeter, en pasiënt-tevredenheid te verseker. Die implementering van TGB blyk egter nie altyd suksesvol te wees nie. Daar is spesifieke struikelblokke geidentifiseer wat as redes aangevoer word vir die onsuksesvolle implementering van TGB in verskeie sektore, insluitend die van gesondheidsorg. Die hoof doel van hierdie navorsing was om die struikelblokke te ondersoek wat verhoed dat TGB suskesvol toegepas word in Kraaifontein gesondheidsdienste in die Weskaap, 2008. Ontwerp/Metode/Benadering – Die studie was ‘n kwasi kwalitatiewe en kwantitatiewe gevallestudie; vir die kwantitatiewe komponent is ‘n 5 punt Likert tipe skaal gebruik om die response (verskil beslis = 1; stem beslis saam = 5) te kwantifiseer. Die kwalitatiewe komponent het ‘n fokusgroep bespreking behels, waartydends die resultate van die vraelys geverifiëer is, wat die uitdagings van die implementering van TGB uitgewys het. Die statistiese populasie vir hierdie navorsing was al die gesondheidsorg werknemers in diens van die aptekers-departement, wat betrokke was in die implemetering van TGB in hulle organisasie. Die data is geanaliseer met toepaslike statistiese metodes. Die gemiddelde telling van elkeen van die dimensies was gebruik as ‘n verteenwoordigende aanduiding van prestasie, en die koëfisiënt van veranderlikheid was gebruik as ‘n algemene maatstaf van die gestandardiseerde skeefheid soos gemeet op elkeen van die dimensies. ‘n Hoë gemiddelde telling was ‘n aanduiding van die beoogde uitkomste, en lae tellings aanduidend van swak uitkomste. Bevindinge – Belangrike uitdagings wat ondervind is tydens die implementering van die TGB in hierdie gevallestudie sluit in, die gebrek aan aktiewe betrokkenheid en toewyding van die topbestuur vir hierdie inisiatief, rigiede organisatoriese strukture, die kultuur teenoor gehalte veranderinge wat kommunikasie tussen bestuur en werknemers belemmer, wat op sy beurt werknemer-bemagtiging verhoed. Ander struikelblokke wat geidentifiseer is, was ‘n afwesigheid van voortdurende verbeteringsprosesse en inisiatief, swak evaluering, ‘n gebrek aan ‘n sisteem vir erkenning en vergoeding vir spanwerk, swak data insameling en ontleding, wat tot probleme gelei het om die data in betekenisvolle inligting te verwerk wat kon lei tot ‘n verbetering in gehalte. Die afwesigheid van ‘n geintegreerde prestasie-beoordeling sisteem is ook as probleem geidentifiseer omdat werknemers nie ingelig was oor wat die prestasie-beoordelings behels nie. Die gebrek aan navorsingsgesteunde besluitneming, swak kommunikasie, en onbuigsame organisatoriese strukture en kultuur, was ook gesien as struikelblokke. Navorsing-beperkinge/implikasies – Alhoewel die studie in Kraaifontein gesondheidsorgfasiliteit gedoen is, word dit aanvaar dat die bevindinge van hierdie studie ook van toepassing is op ander gesondheidsorg departmente en fasiliteite. Die resultate kan gesondheidsorgbestuurders help om die uitdagings en struikelblokke te identifiseer in die implementering van TGB. Hierdie identifikasie kan lei tot ’n meer effektiewe en suksesvolle implementering van TGB in gesondheidsorgfasiliteite.