M.Comm. / Organisations could previously succeed on the basis of having customers, but now customers are more educated and aware of their rights. This makes them demanding in their service expectations and affect their perceptions of the service rendered. Physical evidence is one of the 7 P’s in marketing a service. The service that is to be marketed has to be developed according to demand by market segment. Marketing the service is essential to differentiate the organisation’s service from other similar services, using the correct competitive advantage. Physical environment in a health care setting have a significant effect on customer satisfaction, perceived service quality, intention to re-patronize and willingness to recommend. Physical evidence is the servicescape and consists of the interior and exterior environment in a facility Hospitals and hospital environments are dependant on the physical evidence in their facilities and this is often the deciding factor when it comes to choice of a facility. Although the independent doctors play a role in South Africa when it comes to choice of a facility, it is often the patient that chooses the facility on their perceptions of previous experience and word of mouth. Service quality is the difference between expectations and perceptions of the outcomes experienced by the customers. Service quality is essential for customer service and customer services are an essential part of services in the hospital and hospital environment. Although physical evidence was chosen as the dimension for the research, physical evidence is only one dimension of service quality. Other dimensions include reliability, responsiveness, assurance and empathy. A questionnaire was formulated based on the five above dimensions of the SERVQUAL developed by Parasuraman to evaluate the perceptions of patients in a maternity unit in a hospital setting to determine the effect by changing the physical evidence. The outcome of the study identified important aspects that can be utilized in managing an organisation in the health industry. It was identified that adequate seating around a bed is always important for patients in any circumstances, noise levels must be acceptable at all times, the décor in a maternity does influence the perception of service quality, patient’s records kept up to date by the nursing staff are seen as adequate in any physical environment and patients perceive the nurses as having their best interest at heart. This study has shown its importance through the use of a Quasi-experiment that physical evidence is an important dimension in the perception of service quality for patients in a maternity unit in the private health sector. This should be considered by management for future planning in the strategies of an organisation in the healthcare industry.

Thesis (M.A. (Social Work)) -- University of the North, 1981 / Refer to the document

The purpose of this study is to gain information about the social service needs and demographic characteristics of patients admitted to Providence Hospital's emergency room during the hours a social worker is not available. The emergency room staff requested the information in order to utilize it in planning emergency room services

Thesis (M.Cur.) -- University of Limpopo, 2015 / The purpose of the study was to investigate the experiences of families towards psychiatric state patients during LOA. A qualitative, phenomenological, exploratory, descriptive and contextual design was used. Non-probability sampling of the purposive type was used to explore and describe the experiences of families towards psychiatric state patients during LOA. Data were collected from ten (10) families by using semi-structured face-to-face interviews. Data were audio recorded and field notes were also written. Trustworthiness was ensured by applying credibility, transferability, confirmability and dependability. Transferability was ensured by utilizing purposive sampling to include participants. Confirmability was ensured by collecting data from the participants who have experience on the problem studied. Data were analysed qualitatively by using Tech’s open coding method. Results from the study shows that families experiences uncontrolled and disruptive behaviour from the psychiatric state patients during LOA. Guidelines for the study include: Families of psychiatric state patients should receive counselling and be involved in family therapy prior and after the psychiatric state patient’s LOA. Family members of psychiatric state patient experience emotional pain, therefore they need support from multidisciplinary team members to assist them to facilitate promotion, maintenance and restoration of their mental health as an integral part of their health. Recommendations include improvement of aspects in nursing practice, nursing education and nursing research. Key words: Experiences, family, psychiatric state patients, Leave of absence. DEFINITION

This thesis covers research around the Medical Emergency Team (MET) system, describing its development, evaluation and other related research that evolved as a result of the MET concept. The basic problem that prompted development of the MET system was related to the inadequate care given to the seriously ill in acute hospitals. This thesis contains background research on some of the reasons why a MET system may be useful, including the limited skills and knowledge of medical training and the sort of acute problems encountered in a hospital at night. Research then describes how the MET system works, including published data on when and how often the team is called, the type of patient the team is called to, the interventions performed by the team, and the outcome of patients on whom a MET was called. At the same time research was being performed around outcome indicators used to measure the effectiveness of the MET system, resulting in the use of cardiac arrests, deaths and unanticipated admission to the Intensive Care Unit (ICU) as common end-points for research in this area. Further research demonstrated that potentially preventable antecedents were common before serious illness The thesis then concentrates on how effective the MET system was in reducing death and serious adverse events. The first study compared a hospital where a MET system had been implemented to two control hospitals and found there was a reduction in admissions to the ICU but after adjustment, not for deaths and cardiac arrests. The second study used a cluster randomised methodology, enrolling 23 hospitals across Australia, comparing the three end-points described above. The study found no difference between both groups. It did highlight some interesting areas around the importance of effective implementation in determining the effectiveness of systems in health. Other publications have described the importance of developing effective ways of caring for the seriously ill outside traditional areas such as ICUs. The MET system, or variations on it, is now implemented in many hospitals in Australia and around the world and there have been two international MET conferences held in North America and international guidelines on the MET concept established.

The aim of the research was to analyse the organisational dynamics surrounding a health care reform implementation process associated with the introduction of coordinated care, which is an Australian Government initiative to introduce structural changes to the funding and delivery of health-care in response to rising health care costs. A longitudinal case study of an implementation team was studied. This included the perceptions and experiences of individuals and institutions within hospitals, the general practice community and Divisions of General Practice. Furthermore, the case study explored organisational structures, decision-making processes and management systems of the Project and included an examination of the difficulties and conflicts that ensued. The broader context of health care reform was also considered. The study found that an effective change management strategy requires clarity around the definition of primary task in health care delivery, particularly when the task is complex and the environment uncertain. This requires a management and support structure able to accommodate the tensions that exists between providing care and managing cost, in a changing and complex system. The case study indicated that where tensions were not managed the functions of providing care and managing costs became disconnected, undermining the integrity of the task and impacting on the effective facilitation of the change process and hence, the capacity of stakeholders to embrace the model of co-ordinated care. Moreover, the micro dynamics of the project team seemed to parallel the macro dynamics of the broader system where economic and health care provision imperatives clash. Through its close analysis of change dynamics, the study provides suggestions for the improved engagement of stakeholders in health care change.

BACKGROUND White vulva! skin lesions may be due to various conditions, including benign and non-benign causes. The dilemma faced by the clinician with such a patient is the aetiology of the lesion, as well as the approach to management. AIM To establish the aetiology of white vulva! skin lesions in patients attending the gynaecology clinic and to evaluate the role of Collin's test and vulvoscopy. SETTING R. K. Khan Hospital, which is a secondary level hospital in Durban, KwaZulu Natal. METHOD Sixty-two patients with white vulva! skin lesions whom consented to the study were recruited. The investigations consisted of Pap smear, colposcopy of the vulva [Vulvoscopy], perineum and where appropriate, vaginoscopy and colposcopy; Collin's test and biopsy of all abnormal areas detected by these tests. RESULTS Pruritus vulvae was the commonest presenting symptom [70%1. No vulvoscopic abnormalities were detected in 97% of patients, whilst 3% had acetowhite areas indicative of Human papilloma virus infection. Collin's test was positive in 40% of patients, although, histologically these areas were benign. All patients in the study had benign lesions on histology. CONCLUSION All patients in this study had benign causes of white vulval skin lesions. However, this cannot lead us to conclude that there is no role for doing Vulvoscopy and Collin's test, as premalignant and malignant lesions should be detected by these tests had they been present. / Thesis (M.Med.)-University of Natal, Durban, 1998.

The purpose of this Heideggerian phenomenological study was to understand the meaning of the lived experience of seclusion in a psychiatric hospital. Five people with a long standing mental illness who had spent time in a locked seclusion room in a psychiatric hospital were asked to describe their experience in seclusion.Consistent with the method, purposive sampling was used in order to obtain an understanding from those who had lived the experience of seclusion and could articulate their experience. Interviews were audiotaped and the data were transcribed by the researcher. Audiotapes were destroyed when the study was completed. Transcribed data were shared with other researchers who were familiar with Heideggerian phenomenology and hermeneutics for the purpose ofgaining insight into the interpretations. When data were shared, names of participants and other identifying information were removed. Sharing of data for purpose of interpretation is inherent in the Heideggerian method as described by Diekelmann, Allen, and Tanner (1989). Data were analyzed using Diekelmann, Allen, and Tanner's (1989) seven stages. The following patterns emerged constituted pattern- Seclusion, A Paradox Being Powerless yet Hopeful with the supporting themes of 1.) Being Punished, 2) Being Abandoned, and 3) An Opportunity for Reflection and Self Growth. / School of Nursing

No description available.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2008. / Typescript. Includes bibliographical references (leaves 104-106).