Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: All services should use quality assurance mechanisms to evaluate performance. To this end, studies have been completed in various settings including teaching clinics. Little attention has been placed on rural communities and community clinics with regards to satisfaction. This is an important aspect to investigate as these locations are valuable teaching sites. The aim of this study was to determine patient satisfaction levels at the Durban University of Technology Chiropractic Satellite Clinics (Marburg Haven Centre for the Aged [MHCA] and Narain Jeawon Vedic Centre [NJWC]). Methods: This cross sectional study (ethical approval IREC 35/15) surveyed patients with regards to their service delivery satisfaction via a researcher developed questionnaire dealing with knowledge of the clinic, environmental questions, reception and waiting area, finance, the student doctor, the assessment, treatment, overall care and future care. The study aimed to recruit the majority of patients that presented at the two clinics. The population at the was 123 files, of which 19 were active and 104 were dormant. The population at the MHCA was 237, of which 78 were active and 159 were dormant. A minimum response rate of 70% of active patients for each clinic was set for this study. This resulted in a minimum sample of 55 MHCA patients and 14 NJVC patients. The minimum response rate was achieved for this study. Data was analysed using IBM SPSS version 23. Results: The majority of patients at both clinics were satisfied although reservations were expressed regarding disabled facilities. Satisfaction was not influenced by age (p = 0.034), ethnicity (p = 0.773), gender (p = 0.169), type of visit (p = 0.355), pain rating (p = 0.058) or venue (p = 0.361). Satisfaction was influenced by the year of the student doctor (p = 0.011) and the anatomical site of injury. The overriding factor of income levels for this study neutralised the satisfaction of these patients, as the majority of patients came from poor backgrounds and were more than likely to be satisfied with the care provided. Conclusion: Patients surveyed at both clinics were satisfied. Repeated evaluations in the future would be good indicators to see if the standard of chiropractic care is upheld, and would also aid in improving facilities at both clinics. / M

Healthcare today has become a competitive industry, not only locally, but on a global level as well. In the South African economy the healthcare sector presently offers healthcare seekers two options to satisfy their healthcare needs – either through private business enterprises in the private sector or public enterprises in the public sector. Likewise, in the healthcare sector's hospital environment, patients can receive treatment from either private or public hospitals. As private business enterprises offering a relatively 'pure', but generally unsought-after service, private hospitals compete aggressively to attract patients. Patients are a hospital's lifeblood and they rightfully expect a high standard of customer service throughout the stay. With today's consumers being better informed, more sophisticated and more demanding than in the past, experts agree that the key to survival in the service industry today, almost without exception, is the quality of the service. The cornerstone of the service industry is without doubt the ability to deliver superior service quality that results in customer satisfaction. And the healthcare industry is no exception. Most consumers will experience a need for healthcare services at some time in their lives, but in South Africa, escalating medical costs in general and private hospitals in particular, have made private healthcare increasingly more expensive for the majority of the country's healthcare seekers. This situation raises the question of customer service in the private hospital industry and how patients' perceive service quality and evaluate customer satisfaction after a hospital stay. There is a growing body of empirical evidence from United States studies to show that service quality and customer (patient) satisfaction positively influence patients' behavioural intentions to reuse the hospital or recommend it to others (word-of-mouth endorsements). However, in South Africa, empirical studies to investigate these relationships have not been adequately addressed. This study was therefore an attempt to address the lack of scientific evidence and debate in the area of patient satisfaction. Against this background, the primary objective of this study was to measure patients' perceptions of service quality and customer satisfaction with a private hospital experience and to estimate the effect that each of these constructs will have on future behavioural intentions. More specifically, the present study was an attempt to assess empirically the most important dimensions of service quality and transaction-specific customer satisfaction dimensions that drive both patient loyalty and ‘overall’ or cumulative satisfaction in the South African private hospital industry. For the purpose of this study, buying intentions was used as a surrogate measure of loyalty as measured by willingness to reuse the hospital and/or willingness to recommend it to others (word-of-mouth endorsements). Initial exploratory research was conducted with the aim of assessing the views of three private hospital stakeholder groups, namely former patients, doctors and management about what the quality of service and customer satisfaction meant to each individual interviewed. A service enterprise that specialises in patient satisfaction surveys in the US provided particularly useful information during this phase of the study. Several case studies of patient satisfaction programmes, mostly at US hospitals, provided additional insights in this area. The study was conducted nationally at private hospitals owned by one of South Africa's three major hospital groups. Five private hospitals in four major centres were selected on a non-probability convenience basis to participate in the study. The hospital group's senior management and the management at each selected hospital gave their full commitment to ensure that the survey was successfully conducted in their hospital wards. Data were collected by means of a quantitative study using a selfadministered, structured questionnaire. Patients had to meet certain qualifying criteria which included being of adult age, in the hospital for an operation and at least one overnight stay. A total of 3 800 questionnaires was distributed to patients on a random basis in selected wards at the five hospitals by senior hospital staff designated for this task. From this distribution, 425 questionnaires were returned of which a final sample of 323 could be statistically analysed. To confirm the internal reliability of the measuring instrument, Cronbach alpha coefficients were calculated for each of the factors identified by the exploratory factor analysis. In order to assess the discriminant validity of the measuring instrument used to measure both service quality and customer satisfaction, the items were subjected to an exploratory factor analysis. The factors that emerged after the exploratory factor analysis were then used as independent variables in the four subsequent multiple regression analyses to assess the study's four hypothesised relationships. The findings revealed that the service quality dimensions that impact positively on both loyalty and cumulative satisfaction are Empathy of nursing staff and Assurance. The customer satisfaction dimensions to impact positively on both loyalty and cumulative satisfaction are Satisfaction with the nursing staff, Satisfaction with meals, and Satisfaction with fees charged.

Thesis (MBA)--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The aim of the study was to assess the adult patients' perception of the quality of care received, following a visit to a doctor at Mthatha General Hospital Outpatients Department to establish whether it meets the patients' expectations, and to derive recommendations to improve the quality and assure that it is maintained. A cross-sectional survey was used to obtain the relevant data. A structured interview questionnaire was administered to a systemic sample of 204 adult patients attending the General Outpatients clinic at Mthatha General Hospital after a consultation with a doctor. Data was gathered and analyzed on the 204 patients' records using a Statistical package for Social sciences. This study has revealed that most patients are female (59%), aged between 16 and 70 years, with the majority in the 41 to 50 year age group. The majority of patients are unemployed (55.4%), with grade 1-8 level of education, have presence of long-standing illness or disability (54.9%), and are married (53.4%). The patients' perception of the quality of care was positive. The interpersonal aspects of care was judged by patients to be the most important, followed by technical aspects. Socio-demographic influences on perception of care were significant in those patients with long-standing illness or disability in respect of outcome aspects of care. It is recommended that patients' perception of the care provided to them be periodically assessed to ascertain if it meets their needs. / AFRIKAANSE OPSOMMING: Die doel van die studie was om die volwasse pasient se persepsie van die kwaliteit van versorgingsdiens, soos ervaar na 'n besoek aan 'n dokter by die Mthatha Algemene Hospitaal Buitepasiente Afdeling, te bepaal om gevolglik vas te stel of aan die pasient se verwagtinge voldoen is en om aanbevelings hiervan af te lei om kwaliteit te verbeter en te verseker dat dit volgehou word. 'n Deursnee peiling is gebruik om toepaslike data te bekom. 'n Gestruktureerde onderhoud-vraelys is aan 'n sistemiese monster van 204 volwasse pasiente by die algemene buitepasiente kliniek van die Mthatha Algemene Hospitaai gedoen na 'n besoek aan 'n dokter. Data uit die 204 pasienterekords is versamel en analiseer deur middel van 'n statistiese pakket vir die sosiale wetenskappe. Resultate toon dat die meerderheid pasiente vroulik (59%) en tussen 16 en 70 jaar oud is en oorwegend in die 41 tot 50 jaar ouderdomsgroep val. Die meerderheid pasiente is werkloos (55.4%), het 'n graad 1-8 vlak-opvoeding, vertoon met 'n langtermyn siekte toestand of ongeskiktheid (54.9%) en is getroud (53.4%). Die pasiente se persepsie van die kwaliteit van versorging was positief. Interpersoonlike aspekte van versorging is deur pasiente as die belangrikste beskou, gevolg deur tegniese aspekte. Sosiodemografiese invloede op die persepsie van uitkoms-verwante aspekte van versorging was betekenisvol by pasiente met langtermyn siekte toestande of ongeskikthede. Daar word aanbeveel dat pasiente se persepsie aangaande die versorging wat hulle ontvang periodiek beoordeel word om vas te stel of aan hulle behoeftes voldoen word.

Dissertation submitted in the partial fulfillment for the requirements of the Degree of Master in Public Management, Durban University of Technology, Durban, South Africa, 2015. / The challenges facing the South African public health systems, especially public clinics seem to be increasing. These Primary Health Centres are having to deliver service under difficult circumstances thereby making the “offering” of the service being perceived as poor. The way in which these centres operate is mainly hampered by infrastucture and resource allocation which is seen as sufficient to render appropriate service to the “black communities”. To the eyes of an outsider, this particular service is seen as ideal, yet the people for whom it is meant, do not fully benefit from it. Prior to 1994, South Africans were faced with poor health facilities; with the democratic elections, they thought the delivery of essential services was going to change for the better. In the White Paper for Transformation of the Health System in South Africa, one of the objectives states that various implementation strategies were to be designed to meet the basic needs of all people, given the limited resources available, but this does not seem to be the case. Research has shown a huge discrepancy in the delivery of service between rural and urban areas. Some of the findings are that one nurse will attend to a huge number of patients without any assistance, either from the doctor or other nurses. The literature review contained in this research indicates that there is still a gap between how the service delivery should be made available to the public and how it is currently administered or managed. This research, which is driven by a passion and love for good public service delivery assesses the perceived quality of service in the public clinics of Sobantu and Scottsville. Interviews were conducted within employees of both the clinics and the patients being served by these two clinics to assess the perceived quality of service received in these clinics / An electronic copy of the Thesis is currently unavailable.

The study aimed to explore and described the assessment of patient’s satisfaction with the quality of health care services rendered by the Crossroads Community Health Centre (CHCC). The target population comprised of adult male and female patients who have attended the clinic more than once. One hundred and twenty patients participated in the study. The convenience sampling method was used to select the respondents. A questionnaire was used to collect data. Validity and reliability were ensured. The Chronbach’s alpha reliability test was used to measure the internal consistency of the likert scale questionnaire items and was less than 0.4 for sections B-F, and 0.675 for section E. Descriptive and inferential data analysis was conducted using the Statistical Package for the Social Sciences 16.0 for Windows, release 16.0.1 with the assistance of a statistician. The findings indicated a positive perception of the quality of health care services rendered by the Crossroads CHCC. It was concluded that despite a positive perception of the health care services, there was a percentage of the respondents that rated the quality of the service as poor in relation to environmental cleanliness, staff attitudes, long waiting times, medications shortage, the complaints system reporting and health care service drainage to other CHCC where patient’s resided. The issue of quality improvement in these aspects was noted to be crucial and recommendations were made to improve the quality of the health care service at Crossroads CHCC. / Healh Studies / M.A. (Health Studies)

The study aimed to explore and described the assessment of patient’s satisfaction with the quality of health care services rendered by the Crossroads Community Health Centre (CHCC). The target population comprised of adult male and female patients who have attended the clinic more than once. One hundred and twenty patients participated in the study. The convenience sampling method was used to select the respondents. A questionnaire was used to collect data. Validity and reliability were ensured. The Chronbach’s alpha reliability test was used to measure the internal consistency of the likert scale questionnaire items and was less than 0.4 for sections B-F, and 0.675 for section E. Descriptive and inferential data analysis was conducted using the Statistical Package for the Social Sciences 16.0 for Windows, release 16.0.1 with the assistance of a statistician. The findings indicated a positive perception of the quality of health care services rendered by the Crossroads CHCC. It was concluded that despite a positive perception of the health care services, there was a percentage of the respondents that rated the quality of the service as poor in relation to environmental cleanliness, staff attitudes, long waiting times, medications shortage, the complaints system reporting and health care service drainage to other CHCC where patient’s resided. The issue of quality improvement in these aspects was noted to be crucial and recommendations were made to improve the quality of the health care service at Crossroads CHCC. / Healh Studies / M.A. (Health Studies)

This study aimed to explore existing quality improvement activities in primary health care setting in South Africa. Two sets of questionnaires were used to collect data from both patients and nurse managers. Findings indicated that clinics were generally acceptable and affordable to patients, but should operate for longer time-periods, that sorting of patients and long waiting times, coupled with short consultation time-periods, warranted immediate remedial actions. Only five of the fourteen listed quality initiatives were satisfactorily practised. It was concluded that despite many obstacles and difficulties as mentioned by respondents, the issue of quality-improvement in primary health care is receiving attention, but should still be improved to a greater extent. / Health Studies / M.A. (Advanced Nursing Sciences)

This study aimed to explore existing quality improvement activities in primary health care setting in South Africa. Two sets of questionnaires were used to collect data from both patients and nurse managers. Findings indicated that clinics were generally acceptable and affordable to patients, but should operate for longer time-periods, that sorting of patients and long waiting times, coupled with short consultation time-periods, warranted immediate remedial actions. Only five of the fourteen listed quality initiatives were satisfactorily practised. It was concluded that despite many obstacles and difficulties as mentioned by respondents, the issue of quality-improvement in primary health care is receiving attention, but should still be improved to a greater extent. / Health Studies / M.A. (Advanced Nursing Sciences)

Department of Advanced Nursing Science / MCur

The purpose of the study was to describe and explore the provision of quality care in the primary health care clinics of Limpopo within the framework of the Batho Pele principles' service standards by determining the level of implementation of these principles. The aim was to improve compliance with the Batho Pele principles. The researcher conducted a quantitative, exploratory and descriptive study in four selected primary health care clinics. Data collection was done using structured questionnaires for interviews and observation. Two groups of respondents participated in the study, namely patients (n=185) and nurses (n=21). The study highlighted the level of implementation of the Batho Pele principles in four primary health care clinics in the Capricorn District, Limpopo. The findings revealed that the Batho Pele principles were regarded as important criteria to assess quality care. Recommendations were made to improve the level of implementation of some of the principles. / Health Studies / M. A. (Health Studies)