Thesis (M.A.)--West Virginia University, 2000. / Title from document title page. Document formatted into pages; contains v, 48 p. : ill. (some col.) Includes abstract. Includes bibliographical references (p. 37-39).

D.Cur. / Please refer to full text to view abstract

Thesis (MEd (Human Resource Studies)) -- University of South Australia, 1990

The study set out to explore the influences of change on organisational culture in a private healthcare organisation of South Africa. The research was conducted at Life Healthcare, the largest private hospital group in South Africa. A survey questionnaire was constructed and used as a means of collecting data for the purpose of this study. The data was collected from a sample of 189 respondent managers using stratified probability sampling technique. Data analysis was conducted by applying descriptive and inferential statistical methods.

The growth of for-profit hospitals in the southern United States was researched. Two regression models were developed to analyze the spatial distribution and growth of for-profit hospitals as a function of the locational characteristics of a hospital's service area from 1970 to 1980. For the first model, the dependent variable was the market share of for-profit hospital beds in 1980. In the second model, the dependent variable was the percent rate of change in for-profit market share from 1970 to 1980. Based on this research, the for-profit hospital of the 1970's appears to express a locational preference for areas which had limited hospital competition and were becoming increasingly suburban. A detailed review of the literature on for-profit hospitals and the method of analysis is presented. / Master of Arts

This paper examines the theoretical and empirical differences between the behavior of nonprofit and for-profit hospitals. Considerations are extended to include the possibility of collusion when hospitals make strategic choices. The operating objectives of the firms take into account price, quantity, and quality. Defining the quality of hospital care is discussed and applied to the empirical work. The model predicts nonprofit hospitals will provide a higher level of quality and a lower price than for-profit hospitals. Theoretically, under a collusive outcome for nonprofits, price will increase but the change in quality is indeterminate relative to a competitive, non-collusive outcome. The empirical section offers evidence of differences between nonprofit and for-profit hospital behavior. Nonprofit hospitals do provide higher quality and a lower price when compared to their for-profit rivals. It seems the competitive forces extend to the area of quality. There is evidence that increased competition between nonprofits fosters quality competition. From the for-profit perspective, quality competition appears to be provoked in markets where the for-profit competes more directly against nonprofits. This paper provides theoretical and empirical analyses of hospital interactions and how these interactions change depending upon the type of control. / Graduation date: 2001

Thesis (M.B.A. (Rhodes Investec Business School)) - Rhodes University, 2008. / Submitted in partial fulfilment of the requirements for the degree of Master in Business Administration of Rhodes Investec Business School.

M.Cur (Professional Nursing) / This study of patient acuity level plans (PALP) to determine nursing levels for in-patients units was carried out by means of an exploratory, descriptive instrumental study within the context of a nursing situation with the literature study serving as background, a patient acuity level plan (PALP) was designed, according to accepted criteria, to find data on which to base post determination for nursing staff. This descriptive, instrumental study was done at a private research hospital in Johannesburg where all the patients and nursing staff (first- as welI as second-in-command) were involved. The patient acuity level plan (PALP) -instrument was designed by the researcher, and under supervision of the researcher it was implemented in seven nursing units in the hospital. (The instrument proved to be highly reliable i. e. 0,999). The difference between nursing post determination as recommended and determined by PALP, and nursing post determination as determined by means of a pragmatic subjective approach by the nursing service manager of the, hospital proved to be statistically insignificant. The PALP instrument showed, however, that more nursing staff were needed in four of the seven units. The quality of the nursing was not studied nor was a productivity study carried out. The grand total difference between the recommended and actual nursing hours needed for all the nursing units shows a statistically significant difference (p = 0,0001) on a 1% significance level. This instrument could also positively contribute towards a more cost-effective post determination in nursing.

Thesis (MCur)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The critical care nurse works in an environment where patient need often shifts the parameters within which she or he practices. It is expected of a skilled critical care nurse to be able to make independent decisions and take action regarding patient care based on her or his knowledge and skills without discounting the parameters of her or his scope of practice. Practice experience has indicated that the critical care nurse is often uncertain about whether her or his clinical activities are protected by the regulations provided by the Nursing Council. This is more specifically true in the private hospital industry where medical advice or assistance is not always easily available. This situation led to the following research question: Do the available professional and legal guidelines provide an appropriate foundation to guide the practice of the registered critical care nurse in the private hospital sector critical care environment? A non-experimental descriptive study with a qualitative orientation was conducted in 19 private hospitals in the Western Cape. Through nonprobability, random sampling, 71 registered critical care nurses were included in the study. A questionnaire was designed and validated to collect the data. Quantitative data was analysed through Excel® while qualitative data was analysed thematically. It was found that the legal and professional guidelines in place at present do provide a foundation for the clinical activities of critical care nursing in the private hospital sector. It is suggested that it is rather the critical care nurses’ interpretation of the Scope of Practice (No.R.2598 of 30/11/1984 as amended) that limits their practice as opposed to the wording of the regulations. It is recommended that critical care nurses must determine nursing care parameters based on patient need, using the regulations as a foundation for critical, analytical and reflective practice rather than as a set of rules to be followed. Key words: Scope of practice, critical care practice, ICU nursing care, private hospital nursing practice. / AFRIKAANSE OPSOMMING: Die kritiekesorgverpleegkundige werk in ‘n omgewing waar pasiëntebehoeftes gereeld die parameters waarin sy of hy praktiseer, verskuif. Dit word van ’n bekwame kritiekesorgverpleegkundige verwag dat sy of hy onafhanklike besluite en aksies met betrekking tot pasiëntesorg, gebaseer op haar of sy kennis en vaardighede, sal neem sonder om die parameters van haar of sy bestek van praktyk te oorskry. Praktykondervinding het getoon dat die kritiekesorgverpleegkundige dikwels onseker is oor watter van haar of sy optredes deur die Regulasies, soos deur die Raad op Verpleging gespesifiseer word, beskerm word. Dit is nog meer spesifiek van toepassing in die privaathospitaal-industrie waar geneeskundige advies en bystand nie altyd maklik beskikbaar is nie. Die situasie het tot die volgende navorsingsvraag aanleiding gegee: Voorsien die beskikbare professionele en wetlike riglyne ’n geskikte grondslag om die praktyk van ’n geregistreerde kritiekesorgverpleegkundige in die privaatsektor- kritiekesorgomgewing te rig? ’n Nie-eksperimentele, beskrywende studie met ’n kwalitatiewe oriëntasie is in 19 hospitale in die Wes-Kaap onderneem. Deur nie-waarskynlikheids-, toevallige steekproefneming is 71 geregistreerde kritiekesorgverpleegkundiges in die studie ingesluit. ’n Vraelys is ontwerp en gevalideer om inligting in te samel. Kwantitatiewe data is deur middel van Excel ontleed terwyl kwalitatiewe data tematies ontleed is. Daar is gevind dat die wetlike en professionele riglyne wat tans beskikbaar is, ‘n grondslag bied vir die kliniese aktiwiteite van kritiekesorgverpleegkundiges in die privaathospitaal.. Dit word voorgestel dat dit die kritiekesorgverpleegkundige se interpretasie van die Bestek van Praktyk (No.R.2598 of 30/11/1984 soos aangepas) is wat hulle praktyk beperk, eerder as die bewoording van die regulasie self.

The quality of service from a hospital is the number one factor that will either turn a customer/patient away or make one for life. More and more hospitals are competing for greater shares in the market and customer-driven quality management is becoming the preferred method for improving their performance. Awali hospital is a private hospital in the Kingdom of Bahrain. It is a small 35-bed hospital that offers private medical services to the public. The hospital was originally built to serve the Bahrain Petroleum Company (Bapco) refinery workers but later opened its doors to the public. With the introduction of private patients came higher expectations of quality and higher demands on the overall services. A number of service quality shortfalls were identified over the years but never identified quantitatively by a patient evaluation survey. An English and Arabic version of the questionnaire based on SERVQUAL (Zeithaml, Parasuraman and Berry, 1988) was developed and placed in Awali hospital to test these service quality shortfalls. This study intends to evaluate these areas by answering questions about the relevant areas of service provided by the hospital. It measured patient satisfaction by looking at human aspects of service (responsiveness, reliability, empathy and assurance) with only one factor of the instrument being devoted to the non-human aspect of care rendered (tangibles). The SERVQUAL instrument has five dimensions that were measured by 21 pairs of item statements. One statement from each pair reflects perceptions, the other expectations. Measurement was accomplished by subtracting expectation from perceptions resulting in a service quality score. Positive or zero scores would reflect ideal or adequate service quality offered by the hospital. A negative score would be indicative of a service experience that did not meet customer expectations. Using the SERVQUAL questionnaire provided, quantifiable reasoning to the research questions in each dimension could be obtained so that precision, objectivity and rigour replaced hunches, experience and intuition as a means of investigating problem areas. Customers were first asked to supply some additional demographic information, for example gender, number of hospital visits, nationality, patient type (Bapco worker, general practitioner referred or private) and type of visit (inpatient, outpatient or both). They werethen asked to rate the hospital service on a 7-point Likert scale ranging from Strongly Agree (7) to Strongly Disagree (1). At the end of the questionnaire was space to write open comments. In total 600 paper questionnaires were distributed in the hospital, 300 English and 300 Arabic. Another 150 electronic questionnaires via emails were sent to refinery workers. Of the total 750 questionnaires distributed 162 were returned of which 156 (or 21.6%) could be statistically analysed. The empirical data results showed that the perception scores were significantly different at the p < 0.05 level from expectation scores. All the service quality differences (SQ=P-E) were negatively scored. This indicated that patients were not satisfied in all five dimensions of services offered by the hospital. Of the five dimensions responsiveness had the largest difference with assurance and reliability following with no significant differences between them. The demographic information revealed some interesting differences between the groups. Of all the demographic groups the most significant differences were between groups, “patient types” and “types of visit”, which showed differences between private patients and refinery workers and patients who used the hospital only as an outpatient and patients who used both services, outpatient and inpatient. In terms of the managerial implications, it was recommended that Awali hospital look to closing Gaps 1-4 of the SERVQUAL gap model which would result in closing the consumer gap, Gap 5. A process model for continuous measurement and improvement of service quality was recommended that looks at asking questions about how the hospital is performing. By adopting some of the recommendations identified in the research questions, Awali hospital could improve their quality of service, and as a consequence, their customer satisfaction and loyalty.