Text in English / This study investigated practices, motivations, perceived benefits and barriers to outsourcing of support services by general hospitals in Uganda. The aim was to contribute to the evidence base to increase adoption and effectiveness of outsourcing by hospitals in Uganda. An explanatory sequential mixed methods design was used. Quantitative data was collected from hospital managers in 32 randomly selected hospitals using a self-administered questionnaire. Qualitative data was collected through in-depth interviews from 8 purposively selected hospital managers using an interview guide. Quantitative data was statistical analysed (frequencies, contingency tables and Wilcoxon-Mann-Whitney tests) using SAS 9.3. Qualitative data was managed using ATLAS ti 7, coded manually and content analysis conducted to identify emerging themes, subthemes and categories. A cost benefit analysis was conducted for outsourcing cleaning services in a selected hospital using financial data provided by the managers. Quantitative findings indicate that many (72%) hospitals were outsourcing some of their support services; many were satisfied with their outsourcing (>60%). The key motivation for outsourcing was to gain access to quality service (68%). Most hospitals have a system for monitoring outsourcing (71%). Managers perceive improved productivity and better services as the main benefit from outsourcing (90%). The main barrier to outsourcing is limited financing. A key challenge encountered during outsourcing was limited number of service providers (57%). Managers perceive regulatory violations as a key risk during outsourcing (87%). Hospital location is a determinant of outsourcing (p=0.0033). Managers’ perceptions towards outsourcing have no impact on outsourcing (p>0.05). These findings were confirmed and explained by the qualitative data. Qualitative findings reveal masquerading, impersonation and extortion of patients by outsourced staff as an outsourcing risk. They reveal a concern that outsourcing may lead to job loss for community members. The cost benefit analysis indicates that outsourcing in the studied hospital for the year considered was cheaper than insourcing by UGX 669,575.00. The savings increase to UGX 48,753,689.94 when adjusted for quality differences between insourced and outsourced services. Sensitivity analysis shows that the assumptions used in the analysis were robust. Recommendations, interventions and guidelines are proposed for increasing outsourcing and its effectiveness. / Health Studies / D. Litt. et Phil. (Health Studies)

Indiana University-Purdue University Indianapolis (IUPUI) / The increase in diverse populations with unique, culturally specific needs, along with the lack of diverse healthcare providers to deliver culturally competent care, has escalated the need for non-diverse practitioners to gain the knowledge, skills, and attitudes to deliver culturally competent care. Culturally competent care cannot be offered to patients unless nurses understand how cultural values, attitudes, and beliefs impact patients' response to care. Nurses must develop cultural competence to accurately access, develop, and implement effective nursing interventions. The purpose of this exploratory, quasi-experimental, pretest-posttest study was to explore the impact of an intercultural service learning experience (domestic or international) on pre-licensure nursing students' perceived development of transcultural self-efficacy. A convenience sample of senior semester nursing students enrolled in a private, faith-based, baccalaureate degree nursing program in the Midwest United States completed the Transcultural Self-Efficacy Tool (TSET), Cultural Competence Clinical Evaluation Tool-Student Version (CCCET-SV), and reflective journals. All students were immersed in an intercultural service learning experience. Eighteen students traveled domestically and 38 traveled internationally. The data revealed that there was not a statistical difference in TSET scores based on location of the intercultural experience. However, there was a statistically significant difference from pretest to posttest for perceived Cognitive, Practical, and Affective dimensions of transcultural self-efficacy, in change scores (pretest to posttest), and pretest to posttest for pre-licensure BSN students’ perceived clinical competence behaviors (culturally sensitive and professionally appropriate attitudes, values, and beliefs) following an intercultural service learning experience.

Data quality is one of many challenges experienced in electronic healthcare (e-health) services in South Africa. The collection of data with substandard data quality leads to inappropriate information for health and management purposes. Evidence of challenges with regard to data quality in e-health systems led to the purpose of this study, namely to prioritise data quality challenges experienced by data users of e-health systems in South Africa. The study followed a sequential QUAL-quan mixed method research design to realise the research purpose. After carrying out a literature review on the background of e-health and the current status of research on data quality challenges, a qualitative study was conducted to verify and extend the identified possible e-health data quality challenges. A quantitative study to prioritise data quality challenges experienced by data users of e-health systems followed. Data users of e-health systems in South Africa served as the unit of analysis in the study. The data collection process included interviews with four data quality experts to verify and extend the possible e-health data quality challenges identified from literature. This was followed by a survey targeting 100 data users of e-health systems in South Africa for which 82 responses were received. A prioritised list of e-health data quality challenges has been compiled from the research results. This list can assist data users of e-health systems in South Africa to improve the quality of data in those systems. The most important e-health data quality challenge is a lack of training for e-health systems data users. The prioritised list of e-health data quality challenges allowed for evidence-based recommendations which can assist health institutions in South Africa to ensure future data quality in e-health systems. / School of Computing / M. Sc. (Computing)

Thesis (MBA)--Stellenbosch University, 2006. / ENGLISH ABSTRACT: South Africa's healthcare industry is at a crossroad as pressure in both the public and private sectors is increasing. The extent of change in the industry is overwhelming and it is seen as a very turbulent and unstable environment. Healthcare professionals must reconsider their position in the industry and adapt in this ever-changing environment. The physiotherapy profession forms a small part of the healthcare value chain, but it fulfils an important role in the healthcare system. Unfortunately the profession shows no clear direction and purpose. There also exists a mismatch between the current healthcare environment demands and the physiotherapy service delivery. If they do not adapt in this environment which is in turmoil and have a clear strategy for the way forward, they will be pushed out of the healthcare value chain and become obsolete. The aim of this research report was then to do an in depth analysis of the private healthcare industry in which physiotherapy is operating, to analyse the external physiotherapy industry and an internal analysis of the profession so as to construct a generic strategy for the physiotherapy profession in the private healthcare sector in South Africa. To achieve this aim, it was determined that qualitative, investigative research would be conducted. The research methodology used in this research report was a combination of primary and secondary research. Firstly, secondary research in the form of a literature review was conducted to provide a comprehensive insight into the provision of health care in South Africa. Thereafter, primary research was conducted through semi-structured, in-depth interviews with a purposive sample of physiotherapy industry experts to analyse the external physiotherapy Industry as well as the internal profession environment. Main findings include that the physiotherapy industry is becoming less attractive as competitive forces in the physiotherapy and private healthcare industry are moderate to strong. Deconstruction of the healthcare value chain in the private sector is increasing intra- and inter-professional competition. Government plays a major role in the attractiveness of the industry as they are restricting competitive and market forces and minimising profits through legislation. Medical schemes are trying to contain costs and managed healthcare is coming to the forefront. The physiotherapy market is stagnating and the clients' needs and requirements are changing. Opportunities that were identified we~e the expansion into new markets, involvement in other industries and broadening the scope of practice. Threats are mainly from governmental legislation and policies, vertical integration from the hospital and medical scheme industries and the threat of substitutes, especially alternative health. From the internal profession analysis a current strategy was identified and a strategic intent was formulated as the physiotherapy profession wants to be the preferred and relevant health care service provider in prevention, management and rehabilitation of potential and actual movement impairments of individuals. Strengths to help build this vision included their high regard and profile, quality training, increase in research and evidence and their whole service package. Weaknesses that must be overcome include poor business, managerial and marketing skills, limited role models and leaders and the high levels of intra-professional competition leading to the demise of the profession. Having completed the analysis, major strategic thrusts with a focussed differentiated approach for the profession could then be formulated: • Define physiotherapy and the scope of practice. • Reinstate physiotherapy in the healthcare system. • Develop leadership. • Cooperate within the profession. • Maintain professional autonomy. • Develop business skills. / AFRIKAANSE OPSOMMING: Gesondheidsprofessies moet hul posisie in die industrie herevalueer en aanpas in hierdie steeds wisselende omgewing. Die fisioterapie professie beslaan 'n klein deeltjie van die gesondheidsorg waardeketting, maar dit vervul 'n baie belangrike rol in die gesondheidsorg stelsel. Ongelukkig blyk dit asof die professie geen rigting en doeleindes het waarna dit beweeg en streef nie. Verder bestaan daar ook 'n wanbelyning tussen die huidige gesondheidsorg omgewingvereistes en die dienste wat fisioterapie verrig. Indien die fisioterapie professie nie aanpas in hierdie onstuimige omgewing nie en 'n duidelike strategie ontwikkel vir die toekoms nie, staan dit in gevaar om te verval uit die gesondheidsorg-waardeketting en te vergaan. Die doel van hierdie navorsingswerkstuk is dan om 'n in diepte analise te doen van die privaat gesondheidsorgindustrie waarin fisiolerapeute funksioneer, om die eksterne fisioterapie-industrie sowel as die interne professie te analiseer; ten einde 'n generiese strategie vir die fisiolerapie-professie in privaat gesondheid in Suid Afrika te ontwikkel. Om hierdie doelwitte te bereik is daar besluit om kwalitatiewe navorsing te doen. Die navorsingsmetodologie wat gebruik is bestaan uit 'n kombinasie van primere en sekondere navorsing. Sekondere navorsing is gedoen in die vorm van 'n literatuuroorsig om 'n omvattende oorsig te gee van die gesondheidsorg dienslewering in Suid Afrika. Daarna is primere navorsing gedoen in die vorm van gedeeltelike gestruktureerde, in diepte onderhoude met 'n doelbewuste steekproef van fisioterapie-kundiges om die eksterne omgewing en interne professie te evalueer. Hoof bevindings uit die analise is dat die fisioterapie-industrie se aantreklikheid besig is om te verminder as gevolg van gemiddelde tot sterk kompeterende kragte. Dekonstruksie van die gesondheidsorg-waardeketting in die privaatsektor lei tot verhoogde intra- en inter-professionele kompetisie. Die regering speel ook 'n groot rol in die aantreklikheid van die industrie en hulle beperk natuurlike kompetisie en markkragte en minimaliseer winste deur middel van wetgewing. Mediese fondse probeer kostes beperk en besturende gesondheidsorg begin ontluik. Die huidige fisioterapiemark is besig om te stagneer en kliente se behoeftes en vereistes is besig om te verander. Geleenthede wat geidentifiseer is sluit in die uitbreiding na nuwe markte, betrokkenheid by ander industrie; en die verbreding van fisioterapie se bestek van praktyk. Bedreigings bestaan hoofsaaklik vanaf regeringswetgewing en regulasies, vertikale integrasie van die hospitaal en mediese fonds industriee en die bedreiging van plaasvervangers, veral alternatiewe gesondheid. Vanaf die interne professie-analise is daar 'n huidige strategie geidentifiseer en 'n strategiese intensie kon geformuleer word. Hierdie intensie is dat die fisioterapieprofessie die gewenste en relevante gesondheidsorg diensverskaffer sal wees in die voorkoming, bestuur en rehabilitasie van potensiele en werklike bewegingsaantastings van individue. Sterkpunte in die professie wat hierdie intensie kan ondersteun, sluit in hul goeie profiel en agting, kwaliteit opleiding, toename in navorsing en hul volledige dienspakket. Swakpunte wat oorkom moet word is swak besigheids-, bestuur - en bemarkingsvaardighede, beperkte rolmodelle en leiers en die intra-professionele kompetisie wat die professie as 'n geheel ondermyn. Nadat die analise gedoen is kon daar hoof strategiese rigtings geformuleer word met 'n gefokusde differensiasie benadering: • Definieer fisioterapie en bestek van praktyk. • Hervestig fisioterapie in die gesondheidsorgstelsel. • Ontwikkel leierskap. • Samewerking in die professie. • Behou professionele outonomiteit. • Ontwikkel besigheidsvaardighede.

Thesis (MBA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: This report provides a broad overview of the health industry, and the dental industry in particular, identifying trends and searching for possible solutions to problems posed by these trends. It attempts to offer perspectives of importance to all the stakeholders in health care - the patients, the providers of care and third party payers. The current focus of healthcare industry is not actually the health of the patient. Practitioners (the providers) focus too much on treatment, while insurance companies and governments (the payers) emphasise cost containment. As national health care costs spiral, it is ironic that the main reasons for the dramatic health improvements over the last few decades are improvements in socio-economic factors and changes in lifestyle, rather than better treatment. The willingness of insurers to cover new or improved services has acted as a continuing stimulus to cost-increasing advances in medical technology and in tum to spending growth. Managed care has evolved to attempt to improve resource allocation in health care. Thirdparty private-sector regulators have wrested power from government regulators. Their gain in power relative to private practitioners has shifted the power balance from the supply side to the demand side of health care. By leveraging their power in the use of information technology, the practitioner has been forced into a defensive, reactive stance. Managed care is being implemented by profit-driven third parties that benefit from the cost savings. As health providers are the ones who have to implement the cost-savings; it is proposed that they are the ones who should manage healthcare. The ideal would be a coordinated approach with funders and service providers working toward a common goal. Financial accountability is forcing dental practitioners to evaluate their mode of practice in a critical manner. Promoting health, by educating and evoking behaviour change will create a better world for current and future generations. There is a shift in focus from the health of the individual at all costs, to the health of the population. There should be a special emphasis on the dental health of children for whom prevention offers the most gain in outcome. Evidence-based care evolved from the search for the best care, in terms of quality and price, outcome and process, and attempts to reduce variability and subjectivity in clinical decisions, by using systematic reviews of quality evidence to increase objectivity. Emphasis on improved outcomes provides earlier, more valuable, long-term improvements for a patient, than the later, short-term benefit of a cure. Because most canes and gum disease is preventable, dental health professionals should accentuate health promotion and education of patients. The benefits would be to the advantage of all stakeholders in health. A focus on prevention for children could be the ideal form of dental private practice to instil oral wellness in children. / AFRIKAANSE OPSOMMING: Hierdie verslag is 'n breë oorsig van die gesondsheidsindustrie, en van die tandheelkunde industrie in besonder om tendense te identifiseer en na moontlike oplossing te soek vir probleme wat hieruit mag spruit. Dit poog om perspektiewe aan te bied wat van belang is vir die betrokke rolspelers - die pasiënte, die diensverskaffers en die befondsers. Die huidige fokus van gesondheidsorg is nie eintlik die gesondheid van die pasiënt nie. Die die voorsieners van sorg fokus meestal op behandeling, terwyl versekeringsmaatskappye en die regering (die betalers) fokus op die besnoeing van koste. Terwyl nasionale gesondheidskostes styg, is dit ironies dat die belangrikste redes vir die dramaties verbetering in gesondheid oor die laaste paar dekades eerder verbeteringe in sosioekonomiese faktore en veranderinge in leefwyse is as beter behandeling. Die bereidwilligheid van versekeraars om nuwe en verbeterde dienste te dek, is die oorsaak van die aanhoudende stimulus vir mediese tegnologiese vooruitgang en koste stygings. Bestuurde sorg het ontwikkel om te probeer om bron toewysing in gesondheidsorg te verbeter. Derde party privaatsektor-reguleerders het die mag van regering-reguleerders ontruk. Hul invloed, relatief tot die van privaat praktisyns, het die mags-ewewig verskuif van die voorsienings- na die aanvraagkant van gesondheidsorg. Deur die gebruik van hulle voordeel op die gebied van inligtingstegnologie, het hulle die praktisyn in 'n defensiewe houding gedwing. Bestuurde Gesondheidsorg word beheer deur winsgedrewe derde partye wie baat vind by kostebesparings. Aangesien gesondheidsverskaffers die kostebesparings moet implementeer, word daar aanbeveel dat hulle gesondheidsorg moet bestuur. 'n Gesonde samewerkings ooreenkoms tussen befondsers en diensverskaffers is wenslik. Finansiële verantwoordelikheid dwing tandartse om hulle praktyke krities te evalueer. Daar is 'n fokus verskuiwing vanaf die gesondheid van die individu, ten alle koste, na die gesondheid van die bevolking. Besondere klem behoort geplaas te word op die mondgesondheid van kinders, vir wie voorkoming die meeste baat inhou. Bewys-gebaseerde Gesondheidsorg het ontwikkel uit die soektog na die beste sorg in terme van kwaliteit en koste, uitkoms en proses, en pogings om wisselvalligheid en subjektiwiteit in kliniese besluite te verminder. Klem op beter resultate gee vroeër, meer waardevolle langtermyn verbeteringe vir die pasiënt, as die later kort-termyn voordele van genesing. Omdat tandbederf en tandvleissiektes voorkombaar is, behoort tandheelkundiges die bevordering van mondgesondheid te beklemtoon. Voorkoming by kinders word gesuggereer as die ideale vorm van privaat praktyk om mondgesondheid te bevorder.

Thesis (MBA (Business Management))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: By understanding the costs of HIV/AIDS, businesses can understand the incentives for preventing and treating the disease better. This report primarily investigates whether there is a difference in the relationship between HIV/AIDS prevalence rates and related costs in different sectors in South Africa. With an HIV prevalence ratio of approximately 10:1 for the mining and financial sectors, it is difficult to motivate that more research should be done on the impact of HIV/AIDS on the financial sector. However, if the study indicates a higher cost ratio between the two sectors it could increase the priority of the epidemic in the financial sector, giving rise to a bigger incentive to fight the epidemic. The estimated HIV/AIDS-related cost of an infected manager is R120 000 compared to the cost of R4 600 for an infected unskilled employee. From this analysis it is estimated that the HIV prevalence ratio between highly skilled and semi- and unskilled labour is 1:2.5, while the HIV cost ratio between the different skill levels is 1:0.2. This clearly indicates that there could be a significant difference between the HIV prevalence ratio and the HIV cost ratio for different levels of skills. From the Absa and AngloGold average salary information reviewed, the assumption was made that the Absa employees are more skilled than the AngloGold employees. With the knowledge of this difference in skill levels between the two companies in the different sectors, and the information above regarding the difference in HIV/AIDS-related costs for different skill levels, it is possible that the HIV/AIDS-related costs in the financial sector could be in line with the costs in the mining sector. Using HIV prevalence as an indication of the impact of the disease on the financial sector, a high-level cost estimate could be R150.9 million, compared to R3 985 million if the difference in the relationship between HIV/AIDS prevalence and related costs are taken into account. These materially different estimates could cause companies in the financial sector to make incorrect decisions regarding HIV/AIDS budgets for HIV/AIDS prevention and treatment, as incorrect indicators of the impact of the epidemic on the profit of the organisation are used. / AFRIKAANSE OPSOMMING: Deur die koste van MIV/vigs te verstaan, kan besighede die dryfvere vir die voorkoming en behandeling van MIV/vigs beter verstaan. Die verslag ondersoek hoofsaaklik of daar ’n verskil is in die verhouding tussen die voorkomsyfer en verwante koste van MIV/vigs in verskillende sektore in Suid Afrika. Met die MIV-voorkomsverhouding van ongeveer 10:1 vir die mynwese en finansiële sektore, is dit moeilik om verdere navorsing oor die impak van MIV op die finansiële sektor te regverdig. Indien hierdie studie egter ’n hoër kosteverhouding tussen die twee sektore aantoon, kan dit die prioriteit van die epidemie in die finansiële sektor verhoog, wat sal lei tot dryfvere om die epidemie te beveg. Die beraamde MIV/vigs-verwante koste van ’n besmette bestuurder is R120 000, vergelykend met die koste van R4 600 vir ’n besmette ongeskoolde werknemer. Uit ontledings kan beraam word dat die MIV-voorkomsyfer tussen hoogs geskoolde en half- en ongeskoolde werknemers 1:2.5 is, terwyl die MIV-kosteverhouding tussen die verskillende vlakke 1:0.2 is. Die inligting toon dat daar beduidende verskille tussen die MIV-voorkomsverhouding en die MIV-kosteverhouding vir verskillende vlakke van geskooldheid kan wees. Volgens Absa en AngloGold se inligting oor gemiddelde salarisse is die aanname gemaak dat Absa-werknemers meer geskoold is as AngloGold-werknemers. Met die kennis van hierdie verskil in vaardigheidsvlakke tussen die twee maatskappye in die onderskeie sektore en die inligting hierbo rakende die verskil tussen MIV/vigs-koste vir verskillende vaardigheidsvlakke, is dit moontlik dat die MIV/vigs-verwante koste in die finansiële sektor in ooreenstemming met dié in die mynwesesektor kan wees. As MIV-voorkoms as ’n aanwyser van die impak van die koste op die finansiële sektor gebruik word, kan ’n hoëvlak-kosteberaming R150.9 miljoen wees, vergelykend met R3 985 miljoen, as die verskil in die verhouding tussen MIV/vigs-voorkoms en verwante koste in berekening gebring word. Die wesenlik verskillende beramings veroorsaak dat maatskappye in die finansiële sektor foutiewe besluite rakende MIV/vigs-begrotings vir MIV/vigs-voorkoming en -behandeling maak, aangesien foutiewe aanwysers van die impak van die epidemie op die wins van die organisasie gebruik word.

Thesis (MBA)--Stellenbosch University, 2007. / ENGLISH ABSTRACT: This study provides an overview of the medical aid industry in South Africa and highlights the impact of the formation of the Council for Medical Schemes through the implementation of the Medical Schemes Act of 1998. The regulatory framework that governs the medical aids in South Africa is analysed. In this study. different medical aid funds are compared in terms of administration costs, required solvency levels and membership numbers relative to the acceptable industry averages. The main cost drivers of medical aid funds that could also threaten the future of private medical care are identified, as these services may not be affordable to most South Africans in the future. The new vision of government in terms of healthcare is outlined, and the regulations that will be implemented to transform the healthcare sector into a Social Health Insurance system, and ultimately into a National Health Insurance system. are analysed. The proposed mechanisms, such as the Risk Equalisation Fund, the Government Employees Medical Scheme and lowincome medical schemes, are discussed, highlighting all their advantages as well as the associated risks for the sustainability of private medical care. The proposed new legislation and the potential negative financial impact on the private medical industry are analysed with detailed reference to the Medical Schemes Act of 1998 and the Medicines and Related Substance Control and Amendment Act of 1997. The implications of fundamental changes proposed in private health insurance, such as community risk rating versus the traditional individual risk rating, are discussed. The negative impact of prescribed minimum benefits (which include HIV/Aids) on the financial sustainability of the medical aid industry is highlighted. The impact of HIV/Aids on the sustainability of the medical aid industry is discussed and some conclusions and recommendations are made regarding the financial sustainability of the medical aid industry and hence the future of private medical care in South Africa. / AFRIKAANSE OPSOMMING: Hierdie studie is 'n oorsig van die mediesefondsbedryf in Suid·Afrika, en beklemtoon die impak van die totstandkoming van die Raad van Mediese Skemas deur die impJementering van die Wet op Mediese Skemas van 1998. Hierdie regulatoriese raamwerk, wat mediese fondse in SuidAfrika tans reguleer, word in die studie ondersoek. In hierdie studie word van die grootste mediese fondse in tenne van administratiewe koste, voorgeskrewe fondsreserwes en lidmaatskapgetalle relatief tot die aanvaarde bedryfsnonne met rnekaar vergelyk. Die belangrikste koste-items vir mediese fondse wat die voortbestaan van privaat gesondheidsorg kao bedreig, word ontleed cmdat hierdie dienste in die toekoms vir die rneeste Suid-Afrikaners onbekostigbaar kan word. Die regering se nuwe visie vir gesondheidsorg word uiteengesit. asook die regulasies wat germplementeer sal word om die gesondheidsektor na 'n sosiale gesondheidsversekeringstelsel en uiteindelik na tn nasionale gesondheidstelsel te transfonneer. Die voorgestelde meganismes, seos die Risiko-egalisasiefonds, GEMS en laeinkomste-mediesefondse word bespreek, met al die relevante voor- en nadele, tesame met die geassosieerde risiko's vir die voortbestaan van privaat mediese dienste. Die voorgestelde wetgewing en die gevolglike negatiewe finansiele impak op die privaat gesondheidsbedryf, met spesifieke verwysing na die Wet op Mediese Skemas van 1998 asook die Wet op die Beheer van Medisyne en Verwante Middels van 1997, word ondersoek. Die implikasies van fundamentele veranderinge wat in terme van gesondheidsversekering voorgestel word, soos gemeenskapsrisikogradering teenoor individuelerisikogradering, word bespreek. Voorgeskrewe minimum voordele (wat MIV insluit) wat nou ingevolge wetgewing ten volle deur fondse betaal moet word, se potensiele negatiewe impak op die finansiele lewensvatbaarheid van mediese fondse word beklemtoon. Die potensiele negatiewe impak van die MIV-epidemie op die lewensvatbaarheid van die mediesefondsbedryf word bespreek en gevolg deur aanbevelings om die fmansiele lewensvatbaarheid en toekoms van die privaat gesondheidsbedryf in Suid-Afrika te verseker.

This descriptive case study of the transformation in medical care at the community level was carried out with a triangulation approach. Data from documents and surveys using both semi-structured and unstructured interviews were gathered to evaluate and explain how medical care delivery changed from a primarily public system to one predominantly private.

The purpose of this study was to examine the leadership characteristics of respiratory care program directors and determine the relationship between the director's leadership style, effectiveness, faculty satisfaction, extra effort, and program outcomes. Differences between the directors' perceived leadership style and faculties' perception of the directors' leadership style were also examined. Directors' leadership styles were measured by the Multifactor Leadership Questionnaire (MLQ). Director, faculty and program information was measured with a researcher-designed questionnaire. CoARC accredited program directors (n=321) and their full and part-time faculty (n=172) received an e-mail and a web link to obtain demographic information. All participants received an e-mail from Mind Garden, Inc. with a web link to complete the MLQ. Regression analysis and t tests were used to analyze the data. The results found a significant relationship between faculty satisfaction, extra effort, and perceived director effectiveness and each of the predictors transformational, transactional, and passive/avoidant leadership behaviors. There was no relationship between program director leadership style and program outcomes. This study found no difference between the directors' and the faculty's perception of the directors' transformational and transactional leadership behaviors. However, there was a significant difference between the directors' and the faculties' perception of the directors' passive/avoidant behavior. / by Nancy L. Weissman. / Thesis (Ph.D.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2008. Mode of access: World Wide Web.

Nursing care is considered a primary predictor of patient assessment of the overall hospital experience. Yet, quality nursing care remains difficult to define. Limited research about nurse or patient perspectives on what constitutes quality nursing care in hospital settings prevents the identification of a shared description or insight into their possible interrelationship. Research about nurse and patient descriptions is needed to establish behaviors, attributes, and activities associated with quality nursing care to improve the health and well-being of hospitalized patients. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection