Thesis (M.M. (Business Executive Coaching))--University of the Witwatersrand, Faculty of Commerce, Law and Management, Wits Business School, 2017. / Introduction Public hospitals are complex environments in which healthcare leaders are required to lead effectively in order to provide quality service delivery. The issue is: are clinical managers working in Gauteng hospitals competent to lead? This study measures the competency of clinical managers in public hospitals and considers how coaching can be used to close the competency gap in Gauteng public hospitals. Coaching has been identified as one of the appropriate developmental tools to enhance the skills’ gap of top managers in organisations (West & Milan, 2001). In this study, coaching has been considered to be an appropriate learning and developmental tool to enhance skills for these managers. Methods A self-administered questionnaire was used to conduct the survey among clinical managers in the hospitals in Gauteng. Participants were asked to rate the required management competencies and their proficiency levels against nine management competency categories which include: leadership, communication, life-long learning, consumer responsiveness, political and health environment, conceptual skills, results management, resource management, compliance with standards and coaching in improving management competencies .Likert-scale data was used to measure the top managers’ perceptions of the important competencies required for effective service delivery and their level of proficiency with those competencies. Results Findings show that there is significant gap in management competency of clinical managers, which indicates the need for further development of managers. Most clinical managers’ have a perception that coaching has a role in enhancing their competency gap. Literature supports coaching as a leadership development tool for closing the competency gap of clinical managers. Conclusion There is significant gap in the public health sector managers’ competency level. There is a need for appropriate and further training and development to address the skills gap. There is need to strengthen management capacity to support the strategy of improved and sustainable healthcare service delivery. Coaching is the appropriate leadership developmental and supportive tool to enhance the skills needed by clinic managers. / MT2017

Thesis (MPH.) -- University of Limpopo, 2012

D. Tech. Graphic Design / This study offers an artistic engagement with the lived, working environment of the mental healthcare providers in a ward of a psychiatric hospital. First encounters with this environment strongly suggested that the environment was not optimally aligned with the purpose and function of such an environment. The main aim of this study was to investigate, develop and establish an enhanced sense/state of wellbeing amongst mental healthcare providers at a Psychiatric Hospital by creating and introducing colour landscape images in/into their working environment.

Objective To conduct an evaluation of the pilot implementation of the World Health Organization Health Promoting Hospitals initiative and its self-assessment tool in public hospitals in KwaZulu-Natal in 2004/2005 Study design This evaluation utilised a cross-sectional design that incorporated both qualitative and quantitative research methods. Main measures Throughout the Health Promoting Hospital pilot project the opinions and responses of those with a legitimate interest in the initiative were monitored. Data collection methods utilised in this evaluation included participant observation, the World Health Organisation metaevaluation questionnaire, records of workshops and feedback meetings and secondary analysis of all data collected by the six pilot hospitals during the implementation of the project in KwaZulu-Natal. Results Major constraints were found to be time, human and financial resources, lack of training and expertise and insufficient support for the project. The self-assessment tool was found to be insufficiently adapted and not all outcomes were found to be reliable and useful. Despite this, institutional staff found the Health Promoting Hospital project to be capacity building and morale boosting. Relationships between health service levels improved. All hospitals who participated recommended that other hospitals become Health Promoting Hospitals. Conclusion If the World Health Organisation Health Promoting Hospital initiative with its selfassessment tool is to be rolled out to the rest of KwaZulu-Natal province, then substantial changes have to be made to the process. Amongst these are: further adaptation of the selfassessment tool, improved methods of data collection, provision of sufficient resources and increased and sustained provincial support for the project. In addition it is imperative that outcome and impact evaluations be done. / Thesis (M.Med.)-University of KwaZulu-Natal, 2008.

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2009. / Objective: The majority of information available on chiropractic patients originates from private practices in developed countries. However, recently reports describing chiropractic patients in South Africa have emerged, reporting on private practices and teaching clinics. Therefore, the overall purpose of this study was to determine the characteristics of patients presenting to a public chiropractic facility at the Kimberley Hospital Complex (KHC) in South Africa; and compare to the local and international private practices and teaching clinics. Methods: The period prevalence was three months in which information was extrapolated from patient files of the patients that presented to the KHC Chiropractic Clinic (KHCCC). Information that was collected included demographic data, common presenting complaints, patient history and common management protocols. Results: Data for 157 patients were recorded. The mean age of patients was 47.5 years, majority of the patients were female (70%), comprised of coloured and black patients (85%), where the greater part had a primary education level. Less than half the patients were employed in manual type of occupation, whilst almost one quarter of the patients were pensioners. By far, the greatest reason that patients visited chiropractors within the public health care sector at the KHCCC in South Africa was for chronic musculoskeletal complaints (68%). Majority presented with spinal complaints of the lower back (n=144), the most common diagnosis made was sacroiliac syndrome (48%). X-rays were the most common special investigation requested by KHCCC. The most common co-morbidities reported were hypertension, followed by diabetes and allergies. More than half the sample had undergone previous surgery. Thirty seven percent of patients received treatment for fewer than six visits. Contraindications to chiropractic treatment were indicated in only three patients. The treatment protocols that were predominantly used at the KHCCC were joint manipulation, followed by dry needling, kinesiotape and soft tissue therapy. Two thirds of all patients that were referred to the KHCCC were referred from within the medical profession. With regards to the chiropractic patients globally, similarities respect to patients in the public sector in South Africa to all sectors both locally and internationally, include factors such as majority female patients, top five anatomical locations of complaint, common usage of x-rays as a special investigation, similarities with co-morbidities including cardiovascular and endocrine, the repeated number of visits for the same complaint and manipulation remained treatment of choice. Conclusion: Although this was purely a demographic and descriptive study in nature, it gave a better understanding of patients that presented to a public hospital in a developing country like South Africa. With this demographic and descriptive information obtained in this study, it confirmed that although there is a unique population utilising chiropractic services within the public sector of South Africa, meaningful similarities have been found between patients in the different sectors in South Africa and internationally.

<p>Aggressive and violent behaviour in inpatient mental health facilities is found worldwide and is a frequent and serious clinical and nursing care problem. Despite the importance of international research findings and recommendations, it appears that patients perceptions of the possible contributing factors toward aggressive and violent behaviour in mental health facilities is an area of enquiry that has not been widely explored in South Africa in general, or in the Western Cape, in particular. It is against this background that this study endeavoured to investigate the external and situational contributing to patients aggressive and violent behaviour in mental health facilities in Cape Town, as seen from patients perspectives.</p>

Knowledge and safer practices regarding occupational exposure are crucial to all employees working in healthcare facilities, especially Tuberculosis (TB) hospitals. This study aimed to explore and describe the knowledge and practices of employees working in three specialised TB hospitals regarding occupational exposure to TB. The results of the study will be used to make recommendations to the Eastern Cape Department of Health (ECDOH) and hospital managers that could assist in reducing the prevalence of occupational TB. This quantitative, descriptive and contextual study was conducted in three specialised TB hospitals in the Nelson Mandela Bay Health District (NMBHD). Convenience sampling was used to select the research participants. The knowledge and practices of 181 employees towards occupational exposure to TB and infection control was measured through a self-administered questionnaire. The questionnaire covered areas such as the knowledge of TB and infection control, the infection control policy, infrastructure as well as patient transportation. The whole population was targeted and out of a potential 253 employees, 181 were on duty during the stage of data collection and agreed to willingly participate in the study. The data was analysed descriptively using MS excel and MS word. This study revealed that 69% (n=124/181) of employees in the three specialised TB hospitals in the NMBHD have adequate knowledge of infection control. However, only 10% (n=18/181) of employees reported appropriate infection control practices, while almost half of the participants 42% (n=76) apparently practice infection control poorly. The majority (78%, n=141) of the employees in the three specialised TB hospitals in the NMBHD reported knowing about the availability of an infection control policy in their respective hospitals, however only 42 % (n=76) have reportedly read the policy. In conclusion, knowledge and practices regarding occupational exposure in specialised TB hospitals in the NMBHD is not optimal. It is however, important to note that the majority of employees have knowledge about the TB disease itself and its symptoms. Recommendations were made in order to improve infection control knowledge and practices. These include the development of a plan for purchasing of equipment to address infection control, development of a curriculum specific for non-nursing personnel and the establishment of a plan to ensure the availability of patient consultation rooms and dining halls. A further recommendation deemed important by the researcher was isolation glass as a compulsory specification when purchasing patient transportation vehicles, in order to provide protection for the drivers transporting patients to and from the hospital.

M.Cur. (Occupational Health Nursing) / Despite the available research findings, information, international recommendations, commission reports, political leadership, government commitment and the Occupational Health and Safety Act (Act no. 85 of 1993), as well as the legislative framework, there are still challenges with regard to the implementation of selected sections and regulations of the Occupational Health and Safety Act (Act no. 85 of 1993) (OHS Act). This is evidenced by the occupational injuries and illness claims registered with the compensation fund (SA Department of Labour, 1993). The purpose of this study was to determine the extent to which the OHS Act was implemented at an academic hospital in Johannesburg, from the senior professional nurses and nursing managers’ perspective, and to describe recommendations in order to facilitate the implementation of the Act. A contextual, quantitative, exploratory and descriptive survey was conducted. A purposive sampling method was used to select the wards, senior professional nurses and nursing managers who met the inclusion criteria. A structured, Likert scale questionnaire was used to collect data (Brink, 2011). Stata version 12 was used to analyse the data. Cronbach’s alpha, with a cut-off point of 0.7 was used to test for internal consistency. Ethical considerations were in accordance with those of the Faculty of Health Science Higher Degree and Ethics Committee (2005). Results are presented in the form of graphs for demographic information, and frequency distributions for selected sections and regulations of the OHS Act are displayed in Tables. The study revealed that from the selected sections and regulations of the Occupational Health and Safety Act (Act no. 85 of 1993), 95.4% of section 8; 100% of section 14; 75% of both sections 17 and 19 were not implemented, while 100% of all four regulations were also not implemented. Furthermore, the study revealed that overall there is 93.3% no implementation of the selected sections and regulations of the OHS Act, where 42 of the 45 items were not implemented. These results have serious implications on the health and safety of employees in the workplace. The recommendations made in the study will assist to facilitate the implementation of the selected sections and regulations of the Occupational Health and Safety Act (Act no. 85 of 1993), at an academic hospital in the Johannesburg.

D.Cur. (Nursing Science) / A cost centre in a hospital setting was an identifiable department; such as a nursing care unit, where a nurse manager was also assigned the responsibilities of assuming the duties of a cost manager, e.g. managing the expenditure of that unit and being accountable for the costs. The cost centre was assigned an account number in the hospital accounting system for the purpose of controlling clinical and administrative costs, as well as accumulated expenses by that department (Cleverley & Cameron, 2003:437). The South African National Treasury prescribed expenditure control measures in Section 38 to ensure that expenditure should be accounted for, by appointing an accounting officer (South Africa: 1999). In the particular tertiary hospital complex environment, accounting officers were the appointed cost centre managers who were also the unit nurse managers of these nursing care units. These managers experienced difficulties in fulfilling their dual role in a cost centre management environment for which they had not received training. The purpose of the study was to develop a training programme for nurse managers also appointed as cost centre managers at a tertiary hospital complex in the Limpopo Province. In this study, a qualitative, descriptive, exploratory and contextual design was used. Homogenous purposive sampling was conducted from a population of thirty six (36) nurse managers appointed as cost centre managers. A focus group interview session in which nine (9) cost centre managers participated and twelve (12) cost centre managers participated in one-on-one unstructured interviews were conducted until saturation of data was reached. The central question posed was: “How is it for you as a cost centre manager in your nursing care unit executing dual role for CCMT and providing quality care to patients?” Participants were given an opportunity to describe their experiences about being appointed as cost centre managers in their working situation and while providing care to patients. Adapted phases of the development process of Meyer and Van Niekerk (2008) were used in developing the programme. The survey list of Practice Oriented theory of Dickoff, James and Wiedenbach (1968:434) and Malcolm Knowles’ adult learning (Graig, 1996:253) served as the point of departure for developing a context-specific training programme. Malcolm Knowles’ adult learning theory (Graig, 1996:253) acknowledged that adult learners had specific learning needs when compared to other learners.

South Africa is experiencing a brain drain of doctors. It is estimated that about 5000 doctors have left South Africa since 2003. Lack of job satisfaction has been identified as one of its causes. The purpose of this study was: To provide an overview of relevant literature concerning job satisfaction. To determine, by means of an empirical survey, whether doctors in the public sector experienced any factors, which were affecting their job satisfaction levels. To make recommendations as to how the job satisfaction levels of doctors in public sector hospitals could be increased. For the empirical study a survey, with a questionnaire as data collecting tool, was conducted among 59 permanently employed doctors at the Dora Nginza Hospital in Port Elizabeth. The questionnaire focused on biographical information, personality-job fit, job content factors and job context factors. For Section B, C and D of the questionnaire, the response options were structured according to a Likert-type scale. Respondents had to indicate the extent to which they agreed with each statement in the questionnaire. The responses obtained from the survey were presented and analysed. The researcher observed in this study that doctors were just satisfied with their jobs. Apart from the personality job fit factor of job satisfaction where excellent scores were recorded, there seemed to be problems with job content and job context factors. Management of Port Elizabeth Hospitals Complex has a challenge in improving job satisfaction of their doctors in these areas. The researcher recommends that management of Port Elizabeth Hospitals Complex should look into the satisfaction level of doctors in their employment. Doctors’ satisfaction level should be improved from being just satisfactory to being excellent.