Thesis: M.S., Massachusetts Institute of Technology, Sloan School of Management, 1980 / Bibliography: leaves 110-111. / by Katherine Ann Overskei. / M.S. / M.S. Massachusetts Institute of Technology, Sloan School of Management

This thesis applied the decision support mechanism, Q-Methodology, to an integrated model of issues management and strategic planning. This approach was applied at Riverview Hospital in Noblesville, Indiana in order to respond to the health care reform issue.The research approach involved the three primary stakeholder groups of the hospital: Board of Directors, physicians and managers. The three groups, representing 56 people, attended a planning retreat and identified Riverview's planning options in the form of 77 statements representing future program or service options. These 77 statements were then ranked using Q-methodology.The findings of the study included a QMETHOD computer and researcher analysis of the statements from the perspective of the total group and also the three factors.The final result was a list of statements that comprised Riverview's response to the reform issue in the form of corporate goals and objectives. The conclusions of the study show that:--The integrated approach did provide focus to the strategic planning process. The final list of objectives were all related to the health reform proposal.--Q-Methodology was an appropriate decision support mechanism. It not only provided the final list of corporate objectives but clearly identified potential support and resistance.--A viable set of corporate objectives was developed to respond to the health reform proposal.--All of the stakeholder groups unanimously approved the final list of statements (objectives) in a formal voting process. / Department of Journalism

Thesis (MPA (Public Management and Planning))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The objective of the study was to critically assess the management practices of Dr Yusuf Dadoo Public Hospital in terms of the five public management functions, namely: policy-making, planning, organising, leading and controlling. From the study it is evident that managers of the public hospitals work in a complex and dynamic environment. This is as a result of the pressure felt due to expectations of the public on the quality of service rendered in the hospitals. The primary function of public managers is to ensure that efficient and effective services are rendered to the public. Therefore, all public managers are subject to compliance to the unique guidelines of the relevant legislative framework. In the study, the five public management functions were explained in terms of the broad theoretical framework on management practices on the part of the public sector. The research approach was qualitative and the diagnostic evaluation design was used. The target population for the study included all 48 managers of Dr Yusuf Dadoo Public Hospital who occupy supervisory and higher positions. From the results in the analysis of the questionnaire it is evident that the five public management functions, namely, policy-making, planning, organising, leading and controlling were satisfactory - except the leadership function that needed attention. Public managers of hospitals are an important link between the legislature and the community who are the recipients of policy and are involved at the ground level in the execution of policy. These managers are at an advantage to identify the shortcomings in the existing policy and bring them to the attention of policy-makers. Policies and procedures at Dr Yusuf Dadoo Public Hospital were developed, interpreted and implemented. When discipline on employees was taken, relevant policies as stipulated in the Labour Relations Act, no 66 of 1995, were followed. Policies that support personal development through training and development were not implemented satisfactorily. The existing updated policy manuals were not adequately available to all the employees of Dr Yusuf Dadoo Public Hospital. The function of planning at the hospital referred to the planning processes and mechanisms that were designed to facilitate the planning work. The purpose of planning as a management function was to give guidelines to the managers of Dr Yusuf Dadoo Public Hospital on what they would do in the future. Management of Dr Yusuf Dadoo Public Hospital ensured that employees understood the vision and mission of the hospital. These employees were involved in developing the operational plan of the hospital. Management of Dr Yusuf Dadoo Public Hospital also ensured that operational plans of the employees supported the overall goals of the hospital. Recruitments, selections and appointments were done by human resource department, as was the orientation of new employees to the job. The organisational structure gave employees a clear idea of their responsibilities, the authority they had, and the person to whom they had to report. The functional structure of Dr Yusuf Dadoo Public Hospital grouped together similar or related occupational classes. Expectations were clearly explained by supervisors to subordinates when assigning tasks. Activities and functions were organised and managers allocated responsibility commensurate to authority when delegating tasks to subordinates. Personnel expenditure at Dr Yusuf Dadoo Public Hospital did not impede service delivery. The hospital needed strong leadership to survive and overcome challenges that managers faced. The leadership function at Dr Yusuf Dadoo Public Hospital related to the way management defined what the future of the hospital would look like, to align people with the vision and inspire them to make things happen. Not enough was done by the management of the hospital in this area. The management of Dr Yusuf Dadoo Public Hospital should do everything it could to train and develop managers and those employees who show potential in this area. The five public management functions, namely, policy-making, planning, organising, leading and controlling are executed in a complex and dynamic environment. It is necessary to assess, regularly, the management practices of public hospitals, focusing on the five public management functions. It is also necessary for public managers of Dr Yusuf Dadoo Public Hospital to ensure that the public management functions are carried out, to realise the set goals of the hospital. / AFRIKAANSE OPSOMMING: Die doel van die studie was om die bestuurspraktyke van Dr. Yusuf Dadoo Openbare Hospitaal krities te assesseer in terme van die vyf openbare bestuursfunksies, naamlik beleidmaking, beplanning, organisering, leiding en beheer. Uit die studie is dit duidelik dat bestuurders van openbare hospitale in ’n komplekse en dinamiese omgewing werk. Dit is die gevolg van die druk wat ervaar word vanweë verwagtinge van die publiek ten opsigte van die gehalte van dienslewering in die hospitale. Die primêre funksie van openbare bestuurders is om te verseker dat doeltreffende en effektiewe dienste aan die publiek gelewer word. Derhalwe is alle openbare bestuurders onderworpe aan voldoening aan die unieke riglyne van die betrokke wetgewende raamwerk. In die studie is die vyf openbare bestuursfunksies verduidelik in terme van die breë teoretiese raamwerk vir bestuurspraktyke aan die kant van die openbare sektor. Die navorsingsbenadering was kwalitatief en die diagnostiese evalueringsontwerp is gebruik. Die teikenpopulasie vir die studie het al 48 bestuurders van Dr. Yusuf Dadoo Openbare Hospitaal wat toesighoudende en hoër posisies beklee, ingesluit. Uit die resultate van die ontleding van die vraelys het dit geblyk dat die vyf openbare bestuursfunksies, naamlik beleidmaking, beplanning, organisering, leiding en beheer, bevredigend is – behalwe die leierskapsfunksie wat aandag moet geniet. Openbare bestuurders van hospitale is ’n belangrike skakel tussen die wetgewer en die gemeenskap wat die ontvangers van beleid is en op grondvlak betrokke is by die uitvoering van beleid. Hierdie bestuurders het die voordeel dat hulle die tekortkominge in die bestaande beleid kan identifiseer en onder die aandag van beleidmakers kan bring. Beleide en prosedures by Dr. Yusuf Dadoo Openbare Hospitaal is ontwikkel, vertolk en geïmplementeer. Wanneer dissiplinêre stappe teen werknemers gedoen is, is toepaslike beleide gevolg soos voorgeskryf in die Wet op Arbeidsverhoudinge, no. 66 van 1995. Beleide wat persoonlike ontwikkeling deur opleiding en ontwikkeling ondersteun, is nie bevredigend geïmplementeer nie. Die bestaande bygewerkte beleidshandleidings is nie toereikend vir al die werknemers van Dr. Yusuf Dadoo Openbare Hospitaal beskikbaar nie. Die funksie van beplanning by die hospitaal verwys na die beplanningsprosesse en meganismes wat ontwerp is om die beplanningswerk te vergemaklik. Die doel van beplanning as bestuursfunksie is om riglyne aan die bestuurders van Dr. Yusuf Dadoo Openbare Hospitaal te verskaf oor wat hulle in die toekoms sal doen. Die bestuur van Dr. Yusuf Dadoo Openbare Hospitaal het seker gemaak dat werknemers die visie en missie van die hospitaal verstaan. Hierdie werknemers was betrokke by die ontwikkeling van die bedryfsplan van die hospitaal. Die bestuur van Dr. Yusuf Dadoo Openbare Hospitaal het ook seker gemaak dat bedryfsplanne van die werknemers die oorkoepelende doelwitte van die hospitaal ondersteun. Werwing, keuring en aanstelling word deur die menslikehulpbron-departement gedoen, asook die oriëntering van nuwe werknemers. Die organisasiestruktuur gee aan werknemers ’n duidelike idee van hul verantwoordelikhede, hul gesag en die persoon aan wie hulle moet rapporteer. Die funksionele struktuur van Dr. Yusuf Dadoo Openbare Hospitaal groepeer soortgelyke of verwante beroepsklasse saam. Verwagtinge word duidelik deur toesighouers aan ondergeskiktes verduidelik wanneer take toegewys word. Aktiwiteite en funksies is georganiseerd en bestuurders wys verantwoordelikheid in ooreenstemming met gesag toe wanneer take aan ondergeskiktes gedelegeer word. Personeeluitgawes by Dr. Yusuf Dadoo Openbare Hospitaal belemmer nie dienslewering nie. Die hospitaal het sterk leierskap nodig om uitdagings waarmee bestuurders te doen het, te oorleef en te oorkom. Die leierskapsfunksie by Dr. Yusuf Dadoo Openbare Hospitaal hou verband met die manier waarop die bestuur die toekoms van die hospitaal gedefinieer het, die belyning van mense met die visie en die inspirasie van mense om dinge te laat gebeur. Nie genoeg is deur die bestuur van die hospitaal op hierdie gebied gedoen nie. Die bestuur van Dr. Yusuf Dadoo Openbare Hospitaal moet alles moontlik doen om bestuurders en daardie werknemers wat potensiaal op hierdie gebied toon, op te lei en te ontwikkel. Die vyf openbare bestuursfunksies, naamlik beleidmaking, beplanning, organisering, leiding en beheer, word uitgevoer in ’n komplekse en dinamiese omgewing. Dit is noodsaaklik om die bestuurspraktyke van openbare hospitale gereeld te assesseer deur op die vyf openbare bestuursfunksies te fokus. Dit is ook noodsaaklik dat openbare bestuurders van Dr. Yusuf Dadoo Openbare Hospitaal verseker dat die openbare bestuursfunksies uitgevoer word om die gestelde doelwitte van die hospitaal te verwesenlik.

In supporting the projection of bed requirements for Newfoundland to 1986, an extensive literature review was conducted to identify small area population projection methods and bed prediction models. A bed prediction model was developed for this study. For each health region, projected morbidity for diagnostic (bed) clusters was calculated by: projecting the age-sex population; holding 1976 age-sex cluster morbidity patterns and length of stay constant; projecting the base and flow referral morbidity patterns of four health regions and finally the projected morbidity patterns were combined and translated into beds and adjusted for occupancy. The population projection method was the Short Ratio. The diagnostic clusters were medical-surgical, obstetrical, pediatrics and psychiatry. The prediction of beds utilizing this model was compared with a bed to population rate method. It was demonstrated that bed requirements do change in respect of age-sex population changes. The requirements are stated for each region. This study suggests that the model used for bed and population projections are useful planning tools in Newfoundland because of ease in use. The elemental problem of supplying a population data base for each hospital district by age and sex was solved and is expected to be extremely useful in years to come. The usefulness will come from an evaluation of these methods and their acceptance as first steps in the planning process. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

China is engaged in the largest healthcare construction program in history, expecting to build more than 2,000 hospitals and a large number of healthcare facilities at all scale over the next few years. This once-in-a-lifetime construction boom provides a valuable opportunity to rethink Chinese hospital design, and especially to consider how to design modern hospitals that are effective and efficient in delivering care, and are responsive to the cultural needs of the Chinese people as well. This dissertation seeks to rigorously define these issues and develop metrics that link design to key healthcare processes. This study uses a range of concepts and analysis tools drawn from cross-culture organizational communications, evidence-based design, space syntax and other research traditions. This thesis develops and refines metrics for four main drivers of nursing unit design: space economy, staff efficiency, natural light and cultural preferences for communication. Communication among Chinese healthcare workers is strongly influenced by cultural preferences for patterns of authority and decision-making reflected in organizational culture and rooted in Confucian principles of hierarchical social structure (Dengji), social network (Guanxi) and face (Mianzi). While the dissertation builds on a longstanding tradition of research focusing on healthcare space economy and staff efficiency, new measures for cultural preferences are proposed and tested. Based on emerging theories of cross-cultural organizational communication by Hofstede and other scholars, and space syntax, this study particularly explores how cultural preferences for face-to-face communication are reflected in the design of Chinese nursing units. Based on the proposed metrics, the dissertation analyzes six pairs of Chinese and US nursing units, matched on layout type. While the Chinese nursing units appear Western, deeper quantitative analysis of their layouts reveals significant national differences in the application of unit typologies in China when compared to those in the U.S. It shows that Chinese hospital design is rooted in cultural preferences such as for positive energy (qi) based on Fengshui theory, and in Confucian principles of hierarchy, social networking and face.