The methodology and the processes that are followed in the maintenance of government-operated district hospitals in the Eastern Cape Province of South Africa are outlined while the strategies that are employed to roll-out the maintenance plan have been investigated. The challenges in managing hospital maintenance are identified so that it can be improved and advice be given on the strategies currently being used. The objectives of the research were to determine the effectiveness of machinery maintenance in government-operated district hospitals. The study has been carried out by investigating 50 district hospitals within the Eastern Cape Province, with the aim of obtaining knowledge of practices in relation to the strategic plans and best practices in the maintenance industry. The following factors identified by the maintenance staff were found to be most important in maintenance management practices; realistic budgets, adherence to occupational health and safety regulations, engagement of qualified and skilled maintenance staff, good record management in relation to the equipment under maintenance, availability of tools and materials and keeping abreast with the latest technologies and trends of machinery advancement. The study also revealed that the majority of the hospitals use a combination of in-house and outsourced personnel during maintenance, the outsourced part being under contract from the National Department of Public Works Repair and Maintenance Plan (RAMP) projects. Service kits and recommended replacement parts for machinery are rarely stocked on the hospital premises while only minor spare parts that include replacement bulbs, electrical fittings, plumbing fittings and paint are readily available. In addition, the maintenance staff members have little or no input in maintenance budgeting, this aspect is controlled by hospital management. For maintenance to be effective, strategic planning that takes into account carefully thought-out maintenance management systems is the first step in the direction of setting out definite tangible objectives and goals. The real challenge lies in the implementation and sustainability of the maintenance management system and the monitoring thereof.

Risk management in hospitals is an approach intended to improve the quality of services by identifying active and latent factors that put patients at risk of physical and psychological harm when in hospital, and then acting to identify, monitor and control those risks, and effectively manage their impact. The object of this report is to describe important risk management competencies for medical practitioners working in South African hospitals, these practitioners’ current proficiency levels and the competencies with the biggest gaps in practice. The report is intended to present a risk management competency model for medical practitioners working in SA hospitals. This study was conducted in two phases of which Phase 1 was a qualitative research seeking to identify the competencies using literature review and in-depth interviews with medical experts. The second phase was quantitative, characterised by a survey utilising a questionnaire comprising competencies derived from Phase 1. The sample size for Phase 2 was 90 respondents drawn from three population groups and including medical practitioners, professional nurses and members of the hospital management team. The research identified risk management competencies that were later ranked according to their importance using weighted mean averages. A gap analysis was conducted to assess the difference between what practitioners should know and what practitioners actually do in the hospitals in relation to risk management. A new model of “risk management competencies for medical practitioners” has been developed consisting of the knowledge, skills, behaviour and attitude competency domains that have never been previously identified. This model can be used to update certification requirements for independent medical practitioners and professional development programmes for medical practitioners as well as update curricular offerings of the medical schools / Dissertation (MBA)--University of Pretoria, 2014. / zkgibs2015 / Gordon Institute of Business Science (GIBS) / Unrestricted

Magister Curationis - MCur / 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. / South Africa

Interactive version of the thesis is filed with the printed copy in the UNISA archives / The study investigated and described public hospitals in terms of management processes with reference to financial planning, organizing, leading and control in order to identify deficiencies in the financial management of public hospitals. The aim was to identify gaps in the management of financial processes and to provide guidelines and strategies to improve these. The purpose of the research was addressed within a quantitative approach applying exploratory and descriptive designs. A self-administered questionnaire was used to collect the data that fit the objectives of the research. The study population compassed all 27 public hospitals as study units in a specific geographic area, namely Mpumalanga Province with the following inclusion criteria: active patient capacity of 100 beds and more, which employ personnel such as (1) medical, (2) paramedical and (3) administrative and a working application of the BAS as financial accounting system since its interception in the year 2000. Nine public hospitals were randomly selected as the sample hospitals. Within the nine hospitals, four groups of staff were selected by means of stratified random sampling, namely management, health professionals, and financial and administrative staff. The number of staff selected within each hospital differed, from 15 to 50, amounting to a sample size of three hundred (n=300). A response rate of 66.66% v (n=182) was achieved. The sample consisted of 4 (2.27%) chief executive officers, 3 (1.70%) financial managers, 84 (47.72%) unit managers and 91 (50.00%) subordinates. The response rate of 66.66% in this study was an indication of the unavailability of the health care professionals (which include management, health professionals and financial and administrative staff) within the nine public hospitals. The major inferences drawn from this study are that the different health care professions have a poor perception of the scope of financial management in terms of financial needs, utilization of resources, the scope and function of leading and delegation, and applying appropriate financial control methods. / Health Studies / D. Litt. et Phil. (Health Services Management)

Text in Afrikaans / This research describes the coats of arms and emblems of hospitals and nursing colleges in the Republic of South Africa, an aspect of nursing's heritage and history have not yet been described. Data were collected by means of questionnaires. An extensive literature review on heraldics and an analysis of the meanings contained in the symbols appearing on these devices were done. The analysis resulted in the following; the uniqueness of the individual devices, the development of nursing and nursing education, the influence of values, norms, ideals, culture, religion and history on the selection of symbols. The heraldic meanings of symbols and the meanings indicated in the questionnaires were compared with the identified core concepts for nursing. The overall finding was that any congruence was purely circumstantial. / Hierdie navorsing beskryf die wapens en embleme van hospitale en verpleegkolleges in die Republiek van Suid-Afrika, 'n aspek van die erfenis en geskiedenis van verpleging wat nog nie vantevore beskryf is nie. Inligting was deur middel van vraelyste ingesamel. 'n Uitgebreide literatuuroorsig oor die heraldiek en 'n ontleding van die betekenisse van die simbole soos aangetref op die wapens/embleme, is gedoen.Uit die analisering is die volgende bevind; die uniekheid van die individuele wapens/embleme, die ontwikkeling van verpleging en verpleegonderrig, die invloed van waardes, norme, ideale, kultuur, godsdiens en geskiedenis op die keuse van simbole. Die heraldiese betekenis van simbole en die betekenis wat in die vraelyste daaroor aangedui is, is met die geidentifiseerde kembegrippe vir verpleging, vergelyk. Die algemene bevinding is dat enige ooreenkoms bloot toevallig is. / Health Studies / M.A. (Verpleegkunde)

Conflict exists in all health care settings across the world. In a profession such as nursing, where there is constant interaction among staff, conflict is a common and often unavoidable challenge. Conflict represents a state where two parties have differing views on issues considered important to each of them. There are various forms of conflict such as intrapersonal, interpersonal, inter-group and/or inter-organisational conflict. While not all conflict can be managed or requires the need to be managed, learning how to manage it, may reduce the chances of it recurring or producing negative consequences. The inappropriate management of conflict has been reported to contribute to decreased productivity, poor morale and financial loss in and for healthcare organisations. The goal of this study was to make recommendations regarding how to optimise conflict management by Nurse Unit Managers (NUMs). A qualitative, explorative, descriptive and contextual research study was conducted to explore and describe the ability of NUMs to manage conflict in the nursing units of the Nelson Mandela Bay public hospitals. NUMs working in the three (3) public hospitals of the Nelson Mandela Bay Municipality situated in the Eastern Cape Province of South Africa were interviewed using unstructured individual interviews to collect meaningful data on how the NUMs would manage conflict based on a conflict scenario presented to them. Data was directly collected from the participants. The researcher developed a conflict scenario and the model answer in consultation with experts in both nursing management and human resource management. This was done to relate the responses and themes from the data collected with what literature suggest as the appropriate management of conflict. Tesch’s method of thematic synthesis was utilised to analyse this data. Recommendations were developed for nursing practice, nursing education and nursing research. Data was collected from eleven NUMs with each of the participating hospitals represented in the interviews. Unstructured interviews were conducted. The unstructured interview consisted of one central question and probing questions. This was done for all the interviews until data saturation was reached. The data collected was then transcribed and coded yielding the themes and sub-themes for this study. The model answer was then used to gauge the responses of the participants in comparison to what literature suggests regarding effective conflict resolution and management. The three themes that emerged from the data were Nurse Unit Managers managed the conflict in an appropriate manner, Nurse Unit Managers avoided the conflict and Nurse Unit managers did not apply the accepted process to manage the conflict. Thereafter the ability of NUMs to manage conflict in a nursing unit was described based on the findings. The researcher ensured trustworthiness by using Guba and Lincoln’s criteria, namely credibility, dependability, conformability, transferability. The participants’ rights and dignity were protected and the integrity of the study safeguarded by complying with the following ethical principles: autonomy, beneficence and non-maleficence, justice, privacy and confidentiality as well as authenticity. The limitations of the study were that only NUMs from the general hospitals in the public sector participated in the study and therefore the ability of NUMs in other types of hospitals and the private sector are not known. Other levels of nursing management were not included in the study. The findings in this study could be integrated into the orientation, training and preparation of nurse managers by health care organisations and educational institutions as well as Human Resource Management practices.

Text in English / Professional nurses are regarded as the backbone of the health care system and quality patient care is linked to patient safety.The purpose of the study was to describe and explore the perceptions of professional nurses on impact of shortage of resources for quality patient care. The resources include health professionals, equipment and drugs. The study was conducted in Mankweng hospital which is a public hospital in the Capricorn district in Limpopo Province. Qualitative descriptive exploratory design was used which provided the researcher with in-depth information regarding phenomena under study. Data was collected from ten (10) professional nurses who have 5 to 20 years of nursing experience allocated in medical and surgical wards. Unstructured face-to-face interview was conducted using field notes and audio tape. Data was analysed following Creswell (2014) Tesch method. Five themes and eighteen subthemes emerged from data. The findings revealed that the shortage of health professionals and inadequate resources has a negative impact on provision of quality patient care. / Health Studies / M.A. (Health Studies)

Interactive version of the thesis is filed with the printed copy in the UNISA archives / The study investigated and described public hospitals in terms of management processes with reference to financial planning, organizing, leading and control in order to identify deficiencies in the financial management of public hospitals. The aim was to identify gaps in the management of financial processes and to provide guidelines and strategies to improve these. The purpose of the research was addressed within a quantitative approach applying exploratory and descriptive designs. A self-administered questionnaire was used to collect the data that fit the objectives of the research. The study population compassed all 27 public hospitals as study units in a specific geographic area, namely Mpumalanga Province with the following inclusion criteria: active patient capacity of 100 beds and more, which employ personnel such as (1) medical, (2) paramedical and (3) administrative and a working application of the BAS as financial accounting system since its interception in the year 2000. Nine public hospitals were randomly selected as the sample hospitals. Within the nine hospitals, four groups of staff were selected by means of stratified random sampling, namely management, health professionals, and financial and administrative staff. The number of staff selected within each hospital differed, from 15 to 50, amounting to a sample size of three hundred (n=300). A response rate of 66.66% v (n=182) was achieved. The sample consisted of 4 (2.27%) chief executive officers, 3 (1.70%) financial managers, 84 (47.72%) unit managers and 91 (50.00%) subordinates. The response rate of 66.66% in this study was an indication of the unavailability of the health care professionals (which include management, health professionals and financial and administrative staff) within the nine public hospitals. The major inferences drawn from this study are that the different health care professions have a poor perception of the scope of financial management in terms of financial needs, utilization of resources, the scope and function of leading and delegation, and applying appropriate financial control methods. / Health Studies / D. Litt. et Phil. (Health Services Management)

Text in Afrikaans / This research describes the coats of arms and emblems of hospitals and nursing colleges in the Republic of South Africa, an aspect of nursing's heritage and history have not yet been described. Data were collected by means of questionnaires. An extensive literature review on heraldics and an analysis of the meanings contained in the symbols appearing on these devices were done. The analysis resulted in the following; the uniqueness of the individual devices, the development of nursing and nursing education, the influence of values, norms, ideals, culture, religion and history on the selection of symbols. The heraldic meanings of symbols and the meanings indicated in the questionnaires were compared with the identified core concepts for nursing. The overall finding was that any congruence was purely circumstantial. / Hierdie navorsing beskryf die wapens en embleme van hospitale en verpleegkolleges in die Republiek van Suid-Afrika, 'n aspek van die erfenis en geskiedenis van verpleging wat nog nie vantevore beskryf is nie. Inligting was deur middel van vraelyste ingesamel. 'n Uitgebreide literatuuroorsig oor die heraldiek en 'n ontleding van die betekenisse van die simbole soos aangetref op die wapens/embleme, is gedoen.Uit die analisering is die volgende bevind; die uniekheid van die individuele wapens/embleme, die ontwikkeling van verpleging en verpleegonderrig, die invloed van waardes, norme, ideale, kultuur, godsdiens en geskiedenis op die keuse van simbole. Die heraldiese betekenis van simbole en die betekenis wat in die vraelyste daaroor aangedui is, is met die geidentifiseerde kembegrippe vir verpleging, vergelyk. Die algemene bevinding is dat enige ooreenkoms bloot toevallig is. / Health Studies / M.A. (Verpleegkunde)

Thesis (MBA)--Stellenbosch University, 2004 / ENGLISH ABSTRACT: The Western Cape Health Department is implementing a comprehensive Hospital Information System (HIS) with the vision of establishing a platform of information systems, supporting an on-line, real-time, fully integrated Electronic Patient Record (EPR). This HIS project consists of three phases, of which phase 1 has now been completed. An opportunity to evaluate the project management aspects of the first phase of this project was seen as an ideal opportunity to compare an actual project with theoretical principals of project management. In order to do this the theoretical methodology and organisational structures, supportive of project management are explored. An evaluation of phase 1 was conducted by way of reviewing documentation, conducting interviews and using a questionnaire. The results of this evaluation showed that team member responses were equally divided into groups of very characteristic; undecided or not characteristic aspects of project management utilised. This evaluation highlights the value of project management criteria used in the project to achieve greater success. The criteria highlighted indicate areas within management, which require more attention to promote a better project management approach. Finally, the attributes of a successfully managed project approach are explored with the view to encouraging greater success in phases 2 and 3 of the HIS project. / AFRIKAANSE OPSOMMING: Die Wes Kaap Departement van Gesondheid is besig met die implementering van 'n omvattende Hospitaal Inligting Sisteem (HIS), met die oogpunt om 'n platform te skep vir 'n inligting sisteem wat aanlyn, intyds, die geïntegreerde Elektroniese Pasiënt Rekord (EPR) ondersteun. Hierdie HIS projek bestaan uit drie fases, waarvan fase een reeds voltooi is. 'n Geleentheid om projekbestuur beginsels van hierdie eerste fase te evalueer is gesien as die ideale geleentheid om 'n bestaande projek te vergelyk met die teoretiese beginsels van projekbestuur. Om dit te doen is die teoretiese metodiek en organisasiestrukture wat projekbestuur ondersteun, ondersoek. 'n Evaluasie van fase 1 is gedoen met behulp van dokumentasie hersiening, die voer van onderhoude en die gebruik van 'n vraelys. Die resultate van hierdie ondersoek toon dat spanlid-antwoorde gelykop verdeel is in groepe van baie karakteristiek, onbeslis en nie-karakteristieke beginsels van projekbestuur wat gebruik was. Hierdie evaluasie benadruk die waarde van projekbestuur beginsels wat gebruik kan word in hierdie projek, om groter sukses te verkry. Die beginsels wat benadruk is wys na areas in bestuur wat verdere aandag benodig, om beter projekbestuur te verkry. Ten laaste, word die vereistes ondersoek van suksesvolle projekbestuur met die oog op groter sukses in fases 2 en 3 van die HIS projek.