Chong, Ka Chun. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 125-141). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.

Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.

The purpose of the study was to describe the effects of an EMR on patient management in selected HIV clinics in Johannesburg. A quantitative, descriptive, cross-sectional study was undertaken in four HIV clinics in Johannesburg. The subjects (N=44) were the healthcare workers selected by stratified random sampling. Consent was requested from each subject and from the clinics in Johannesburg. Data was collected using structured questionnaires. Median age of subjects was 36, 82% were female. 86% had tertiary qualifications. 55% were clinicians. 52% had 2-3 years work experience. 80% had computer experience, 86% had over one year EMR experience. 90% used the EMR daily, 93% preferred EMR to paper. 93% had EMR training, 17% used EMR to capture clinical data. 87% perceived EMR to have more benefits; most felt doctor-patient relationship was not interfered with. 89% were satisfied with the EMR’s overall performance. The effects of EMR benefit HIV patient management. / Health Studies / MA (Public Health)

The purpose of this study was to determine the contribution of nursing auxiliaries towards health care services against their scope of practice. Nursing auxiliaries practising within the Elim, Letaba, Malamulele, Nkhensani, Shiluvana and Tintswalo hospitals in the Gazankulu Health Administration, in the Northern Transvaal Province, constituted the target population. The findings revealed that nursing auxiliaries are not functioning strictly according to their scope of practice. They are an essential component of nursing services in Gazankulu by rendering a major contribution towards health care services in fulfilling their scope of practice-role. Apart from their prescribed practice-role, they are also engaged in activities that should be performed by enrolled and professional nurses as well as doctors and general assistants. There appears to be a need for education for all categories of nursing staff regarding the scope of practice of nursing auxiliaries for improving the effective utilisation of this category of nursing personnel / M.A. (Nursing Science) / Health Studies

Os Centros de Saúde do Rio de Janeiro são analisados enquanto uma organização estruturada para desempenhar, na área da saúde, parte das funções do aparato burocrático do Estado brasileiro. Seu papel institucional vincula-se à emergência de novos problemas sanitários numa sociedade em processo de urbanização e de consolidação de um Estado nacional. Ao longo de usa trajetória histórica passou por situações distintas, no que se refere ao seu papel no Sistema de Saúde, articuladas a determinantes de natureza técnica e política. Enquanto fenômeno burocrático, esta organização sobreviveu às diversas conjunturas históricas interpondo resistências, que se manifestaram, principalmente, pela lentidão com que eram processadas as mudanças internas propostas. / The Health Centers in the city of Rio de Janeiro are analyzed as organizations that have been structured to execute parto of the bureaucratic duties petaining to the brazilian State, as far as health care is concerned. Their role, as institutions, is related to the solution of new problems, in their sanitary aspects, that are emerging in a society in processo f increasing urbanization and inside a process of organizing a National State. Along the course of their history, these organization have overcome various distinctive situations, dependind on technical and political determinants. As bureaucratic phenomena, this organization have survived many historical conjuntures, presenting itself as resistant to the proposed changes, mainly by slow ways of implementing these propositions.

Thesis (M. Tech. (Public Management)) -- Central University of Technology, free State, [2014] / The primary aim of the proposed study is to investigate the technical problems affecting the efficiency and effectiveness of District Hospitals in the Free State Province. The proposed research therefore stands to contribute to the existing body of evidence on the efficiency and effectiveness of health care services, with regard to the existing problems in the health sector such as high staff turnover, facilities with lack of appropriate equipment, unmanageable workload, lack of appropriate infrastructure, a high absenteeism rate and low morale of the employees in the public health institutions. Therefore the study will identify potential shortcomings that are compromising the efficiency and effectiveness of the district hospitals. The findings of the study will be used to address some of the identified problems and also to describe how progress can be measured. The outcomes of this study are intended to raise important issues and to assist management of the Free State Department of Health to address the challenges that are affecting the functioning of the district hospitals. The findings will also assist the relevant managers in planning and implementation of policies that will address inequalities and problems as highlighted in the study. It will also create opportunities for shared responsibilities that management and the staff need to resolve jointly.

Health Studies / D. Litt. et phil. (Advanced Nursing Sciences)

The purpose of this study was to examine the extent to which human resources capacity of the Ministry of Health and Social Services (MoHSS), Namibia, influences health care services delivery to the Namibian population. A qualitative research model using exploratory and descriptive study designs was adopted. Data were collected through semi-structured interviews with 46 health workers from two referral hospitals and two directorates in Windhoek District. The study found that there is severe staff shortage in the MoHSS, which has resulted in high workload and poor health care. Health worker migration, new services and programmes, emerging diseases, and population growth were reported to have contributed to staff shortage and high workload in the MoHSS. Study findings suggested a need to create more posts to accommodate emerging needs, and to introduce an effective retention strategy to attract and retain health professionals with scarce skills, and those working under difficult conditions. / Public Administration & Management / M. Tech. (Public Management)

Thesis (MPA (School of Public Management and Planning))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The purpose of this thesis is to determine the perceptions and expectations of employees at regional offices about the service delivered to them by central head office. A further objective is to establish what employees at regional offices expect from head office, attempting thereby to establish the current position of the head office (perceived image) in relation to their expectations (ideal image). The method of data collection is quantitative with a survey design technique in the form of questionnaires to be completed by all employees at regional offices in order to assess their perceptions and expectations. The basis of the theoretical and legislative framework of this research is service delivery. It is within the context of service delivery that internal customer service within the organisation, in particular, is conferred. The legislative framework is also dedicated to Batho Pele and the eight principles to highlight public service delivery. These principles should equally be applied when it comes to internal customer service. The main findings from this study are that employees and the four regional offices per se have different perceptions and expectations about the internal service delivered by central head office. This must be taken cognisance of because perceptions can be the core element of most organisational behaviour and the expectations that employees hold is important for the morale and effectiveness of organisations. The following objectives were achieved: A review of the policies, documents and annual reports to determine to what extent the central head office delivers an internal service to the regional offices. An evaluation as to how internal service delivery is being perceived. An evaluation of the ideal central head office. Established the shortcomings of the current internal service being delivered. It is also recommended that future research can be to ascertain how those negative feelings impacts on job satisfaction and commitment to the organisation and how it affects employee turnover. / AFRIKAANSE OPSOMMING: Die doel van hierdie tesis is om die persepsies en verwagtinge van werknemers by die streekkantore, oor die diens wat aan hulle verskaf deur sentrale hoofkantoor, te bepaal. 'n Verdere doel is om vas te stel wat werknemers by die streekkantore verwag van hoofkantoor. Sodoende probeer om vas te stel wat die huidige stand van die hoofkantoor (waargenome beeld) in verhouding tot hul (werknemers) verwagtinge (ideaal beeld) is. Die metode van data-insameling is kwantitatief met 'n opname ontwerp in die vorm van vraelyste. Hierdie vraelyste sal deur alle werknemers by die streekkantore voltooi word, om hul persepsies en verwagtinge te assesseer. Die basis van die teoretiese en die wetgewende raamwerk van hierdie navorsing is dienslewering. Dit is binne die konteks van dienslewering wat interne kliënte diens binne die organisasie, in die besonder, toegeken word. Die wetgewende raamwerk is ook toegewyd aan die agt beginsels van Batho Pele en dus openbare dienslewering te versterk. Hierdie beginsels moet ook toegepas word wanneer dit kom by die interne kliënte diens. Die belangrikste bevindings van hierdie studie is dat die werknemers en die vier streekkantore as sulks het verskillende persepsies en verwagtinge oor die interne diens gelewer deur die sentrale hoofkantoor. Dit moet kennis geneem word want persepsies kan die kern element van meeste organisatoriese gedrag wees en die verwagtinge wat werknemers hou is belangrik vir die moraal en doeltreffendheid van organisasies. Die volgende doelwitte was bereik: „n Hersiening van die beleid, dokumente en die jaarlikse verslae om te bepaal tot watter mate die sentrale hoofkantoor „n interne diens aan die streekkantore lewer. „n Evaluering oor hoe interne dienslewering waargeneem word. „n Evaluering van die ideale sentrale hoofkantoor. Die tekortkominge van die huidige interne diens wat gelewer word is vasgestel. Dit word aanbeveel dat toekomstige navorsing toegewy word om vas te stel hoe negatiewe gevoelens impak op werkstevredenheid en verbintenis tot die organisasie en ook hoe dit werknemer omset beïnvloed.