Effective leadership is essential for the achievement of any organisational success. The need for strong leadership and increased diversity is a prominent issue in today’s health service workforce. Effective leadership involves influencing others towards achieving the goals of the organisation. Leadership is the central ingredient necessary for progress as well as for the development and survival of organisations, especially in a changing environment such as is evident in South Africa. This study was undertaken to explore and describe the views of health professionals with respect to factors that promote or influence leadership effectiveness in public hospitals, with specific reference to Uitenhage Provincial Hospital. The research design of this study was a quantitative, explorative, descriptive survey. Interviews were conducted to explore and describe the views and perceptions of healthcare professionals (clinical and nonclinical), and the management of the Uitenhage Provincial Hospital, regarding leadership effectiveness in a public hospital. Firstly, a literature study was conducted on healthcare leadership generally and to identify various leadership approaches and factors that influence leadership effectiveness. More emphasis was put on the current and the most recent approaches to leadership. Secondly, an empirical study was conducted to gain the views and ideas of health professionals regarding leadership effectiveness in the institution. Lastly, the results of the empirical study were evaluated, conclusions were drawn and recommendations were made, based on the information obtained from both the literature study and the empirical study.

The research problem addressed in this study was to identify what management skills do middle managers require to manage the organisational units effectively. To achieve this objective a theoretical model of management skills required by middle managers to effectively manage a public hospital was developed, using relevant literature in which management skills are identified. The theoretical model consisted of the following categories of management skills whose correct application can promote managerial effectiveness in managing organisational units: General management skills; Technical skills; Human skills; Leadership skills; Financial management skills; Computer skills. Each category of the management skills was broken down into elements that were then analysed using literature identified during the literature study. The model was then used to develop a questionnaire to assess the degree to which managers responsible for running the clinical, nursing and paramedical departments of a public hospital in the Eastern Cape rate the elements in terms of importance. The empirical results obtained indicate that a wide variety of skills are regarded by middle managers as important to performance of their managerial roles. This resulted in the theoretical model being confirmed and the identified management skills being accepted as management skills required by middle managers to effectively manage a public hospital in the Eastern Cape.

A Dissertation in fulfillment of the requirements for the Degree of Master of Commerce by Research in Information Systems / Electronic Medical Records (EMR) systems aim to provide an integrated solution to a number of hospital processes, including supporting administrative functions such as patient billing, providing clinical guidelines, and allowing clinicians to order and view lab reports. Yet with all these possible benefits, like many other types of information systems and technologies, their impact on hospital performance has been a key area of interest and a source of debate. This study examines the extent to which EMR systems are available across South African hospitals as well as how well they have been integrated into the processes of the said hospitals. The diffusion of EMR systems means they are available in the relevant clinical units whilst their infusion suggests they are comprehensively embedded into the processes that they are meant to support. The most important question answered in this study was whether the diffusion and infusion of these systems had any impact on the performance of hospitals. Answering this question would aid decision makers on whether more effort is indeed needed to ensure their availability across units and their embedding into hospital processes. The study collected data from a number of hospitals in the private and public sector with multiple informants providing data on diffusion and infusion of these systems as well as on hospital performance. Performance measures included the hospitals’ economic efficiency, their clinical effectiveness, patient safety, and patient satisfaction. Key findings were that while there are performance benefits in the diffusion of EMR systems across units, the impacts are not always positive for some hospitals. Large hospitals were less likely to benefit from the diffusion of these systems. However the comprehensive use of these systems provided benefits for all types of hospitals, suggesting that while availability may be important, it is the comprehensive embedding of the EMR system into the hospital’s processes that is more beneficial to all types of hospitals. These results present further opportunity for research into why the impact of EMR systems is not always positive for some hospitals. / MT2017