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The evaluation of an accreditation programme for quality improvement in private physiotherapy practice in South Africa

Thesis (PhD)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: "Quality" has different meanings to different people. Even quality experts do
not agree on a single definition: Juran's definition of quality revolves around
his concept of "fitness for use", Crosby defines quality in terms of performance
that produces "zero defects" and Deming defines quality as a "never ending
cycle of continuous improvement". One element, however, that is common to
all three approaches is that management must accept and demonstrate
leadership if quality is to be achieved.
Quality is rarely thought of as others perceive it. What is apparent is that if
providers of care wish to maintain leadership in defining quality, they need to
- Actively participate in the public debate about quality.
Review the way in which they have been defining quality.
Question whether their definitions are aligned with what the purchasers of
health care define as being important.
Develop meaningful measures of quality and data collection systems that
will allow them to demonstrate quality and value.
- Willingly share data not only on outcomes, and also measures that are
specific to individual procedures and service providers.
The PhysioFocus practice accreditation programme attempted to achieve the
above factors. By realising the goal of the research this was determined.
The goal of the research was to evaluate the PhysioFocus practice
accreditation programme and to make recommendations on the educational
programme for accreditation in private physiotherapy practices. This goal was
realised by means of an exploratory and descriptive research design with a
qualitative orientation. The evaluation of the PhysioFocus practice
accreditation programme was performed by means of a validated evaluation
instrument. The group interview revealed components of the PhysioFocus
practice accreditation programme that require remediation. Recommendations
included professional-ethical issues, business management and legislative issues. The recommendations will be implemented by the PhysioFocus
practice accreditation committee.
The PhysioFocus practice accreditation learning programme was evaluated
by means of a semi-structured questionnaire, containing eleven questions and
a section for comments. The general consensus was that the PhysioFocus
practice accreditation programme is essential in private physiotherapy
practice in South Africa. The implementation of the PhysioFocus practice
accreditation programme resulted in the facilitation of quality physiotherapy;
professional and personal development; monitoring of quality improvement
processes; and the evaluation and remediation of these processes. This
supported the central theoretical assumption of the research. Concerns were
voiced about the lack of standards, lack of quality improvement skills, the
public image of the physiotherapy profession and the lack of basic business
management training.
The researcher concluded that the implementation of the PhysioFocus
practice accreditation programme is essential in private physiotherapy
practice in South Africa. At present the current PhysioFocus practice
accreditation programme does not address all the needs of private
physiotherapy practices.
Recommendations based on the research included remediation of the current
PhysioFocus practice accreditation programme, formal education included
business management, professional-ethical-Iegal issues, standards and
scientific methods to analyse process variation and the development of
improvement strategies in quality improvement. Other recommendations
include informal education, physiotherapy management and structured quality
improvement activities. The issue of the image of the professional
physiotherapist was also addressed. Topics for future research were
identified.
The uniqueness of the research lies in the fact that this is the only
physiotherapy practice accreditation programme implemented in South Africa. It is also the only physiotherapy practice accreditation programme in South
Africa that has been evaluated. / AFRIKAANSE OPSOMMING: "Gehalte" het verskillende betekenisse vir verskillende mense. Selfs kenners
op die gebied van gehalte stem nie saam met 'n enkele definisie nie. Juran se
omvattende definisie is "gebruikswaarde", terwyl Crosby gehalte in terme van
produksie, naamlik "zero defek", definieer. Deming definieer gehalte as "'n
nimmereindigende siklus van voortdurende verbetering". Die een aspek wat al
drie die kenners egter gemeen het, is dat bestuur leierskap moet aanvaar en
demonstreer indien gehalte bereik wil word.
Geen twee persone ervaar gehalte eenders nie. Indien diensverskaffers
leiding wil behou ten opsigte van gehalte-definiëring, sal hulle verplig wees
om:
aktief deel te neem aan openbare debat oor gehalte;
die aanvaarde definisie van gehalte te herevalueer;
die aanvaarde definisie van gehalte op te weeg teenoor dié van die
mediese hulpfonds-administrasie;
gehalte- en data insamelingsisteme te ontwikkel om gehalte en waarde
te bewys; en
gewillig alle data te deel - nie net uitkomsdata nie, maar ook data wat
spesifiek op individuele prosedures en diensverskaffers van toepassing
is.
Die PhysioFocus praktyk-akkreditasieprogram het gepoog om bogenoemde te
bereik. Die navorsing het gerealiseer deurdat die doelstelling bereik is.
Die doelstelling van die navorsing was om die PhysioFocus praktykakkreditasieprogram
te evalueer en aanbevelings te maak vir 'n leerprogram
vir die akkreditasieprogram. Die doelstelling het gerealiseer deur "n
verkennende en beskrywende navorsingsontwerp vanuit 'n kwalitatiewe
oriëntasie. Die evaluering van die PhysioFocus praktyk-akkreditasieprogram
het deur middel van 'n gevalideerde evalueringsinstrument geskied. Die
groepsonderhoud het areas van die PhysioFocus praktyk- akkreditasieprogram wat remediëring benodig, geïdentifiseer. Aanbevelings
het professionele-etiese aspekte, besigheidsbestuur en wetlike aspekte
ingesluit. Die aanbevelings sal deur die PhysioFocus praktykakkreditasiekommitee
geïmplementeer word.
Die evaluering van die PhysioFocus praktyk-akkreditasieleerprogram het deur
middel van 'n semi-gestruktureerde vraelys met 11 oop vrae, tesame met 'n
afdeling vir opmerkings, geskied. Die algemene aanname was dat die
PhysioFocus praktyk-akkreditasieprogram noodsaaklik is in privaat
fisioterapiepraktyk in Suid-Afrika. Die implementering van die PhysioFocus
praktyk-akkreditasieprogram het gehalte fisioterapie, professionele en
persoonlike ontwikkeling, die monitering van gehalteverbeteringsprosesse,
asook evaluering en remediëring van hierdie prosesse, tot gevolg gehad. Dit
het die sentraalteoretiese aanname van die navorsing ondersteun. Daar was
egter kommer oor die gebrek aan standaarde, die beeld van die
fisioterapieprofessie, asook die gebrek aan besigheidsbestuuropleiding.
Die navorser het tot die gevolgtrekking gekom dat die implementering van die
PhysioFocus praktyk-akkreditasieprogram noodsaaklik is in privaat
fisioterapiepraktyk in Suid-Afrika. Die huidige PhysioFocus praktykakkreditasieprogram
voldoen nie aan al die vereistes van privaat
fisioterapiepraktyk in Suid Afrika nie.
Aanbevelings vanuit die navorsing sluit die volgende in: remediëring van die
huidige PhysioFocus praktyk-akkreditasieprogram; formele opleiding,
insluitende profesionele-etiese-wetlike aspekte; standaarde; wetenskaplike
metodes om die praktykprosesveranderinge te analiseer; en die ontwikkeling
van 'n gestruktureerde gehalteverbeteringstrategie. Die beeld van die
fisioterapieprofessie is ook aangespreek. Onderwerpe vir toekomstige
navorsing is geïdentifiseer.
Die navorsing is uniek omdat die PhysioFocus praktyk-akkreditasieprogram
die enigste akkreditasieprogram vir fisioterapie in Suid Afrika is. Dit is ook die
enigste fisioterapie-akkreditasieprogram wat in Suid Afrika geëvalueer is.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/52525
Date11 1900
CreatorsBowman, Winifred Edna
ContributorsKapp, C. A., Van der Merwe, T. D., Stellenbosch University. Faculty of Education. Dept. of Sport Science.
PublisherStellenbosch : Stellenbosch University
Source SetsSouth African National ETD Portal
Languageen_ZA
Detected LanguageEnglish
TypeThesis
Format221 p. : ill.
RightsStellenbosch University

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