Faculty of Commerce, Law and Management

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The relative importance of branding on patient choice of private hospital in South Africa
(2014-01-14) Sim, Claire Ann
The private healthcare group in South Africa is dominated by the three major hospital brands: Netcare, Mediclinic and Life healthcare. It is important therefore to understand the factors that affect patient choice of private hospital, and the relative importance of hospital branding on patient choice There is limited research on the importance of branding on patient choice of private hospitals in South Africa. As such, the purpose of the research was to identify the factors affecting patient choice of private hospital in the South African private healthcare sector. In addition, the relative importance of branding on patient choice was investigated. A survey questionnaire was designed and then analysed using quantitative research methodology. One hundred and eighty six respondents completed the questionnaire. Confirmatory factor analysis identified 5 factors affecting patient choice of private hospital. They included hospital branding, physician recommendation, staff attitude, functional decision criteria and quality of service and the available offering. In addition, hospital branding came out as the factor with the highest eigen value and accounted for the majority of the variance explained by the variables. Therefore, hospital managers should incorporate these factors into improving the service to their patients and should recognise the importance that branding plays within the private healthcare sector.
Enablers for, and barriers to, implementing environmental sustainability initiatives in hospitals in South Africa
(2014-01-09) Dube, Samukeliso
The global threat of climate change is one of the most crucial environmental issues facing the world in modern times. Every organisation doing business has a duty to stem this tide, and the health care industry - hospitals in particular - is no exception. However, in trying to implement environmental sustainability initiatives, organisations are faced with a number of challenges, and unless drivers of and barriers to sustainability are identified, there will likely be a disconnect between the desired outcomes of policies on environmental sustainability. This study, set within the hospital industry, sought to identify what hospitals are doing to curb this environmental scourge, and in the same vein identify various enablers of and barriers to the implementation of environmental sustainability initiatives in South Africa. Following a literature review identifying some of the initiatives implemented in other industries and hospitals in other countries, and a review of factors that enable and hinder the implementation of sustainability initiatives, this thesis undertook qualitative enquiry among the private and public hospitals in the Gauteng region of South Africa. Use was made of semi-structured interviews, where a questionnaire was used to guide the researcher’s interview process. A total of 17 respondents were interviewed covering ten hospitals of which three were private institutions. Data collected was analysed using the coding technique and was compared and contrasted to the literature in a process of explanation building. It was possible to identify six categories of initiatives being implemented: policy initiatives, water conservation, energy conservation, green built environment, behavioural and organisational structure initiatives. It was also possible to elicit a total of five enablers and six barriers in the study that were all coded into themes. The five enablers were: compliance to policy (both internal and external policy); top management support; availability of suitable equipment; an enabling iii human resource strategy and availability of guidance documents. The six themes that formed barriers were: lack of demand from stakeholders; lack of a conducive organisational culture; inadequate resources; infrastructural challenges; unclear policy guidance and technical and information challenges. Furthermore, in contrast to some of the literature findings only four enablers were identified as being relevant to the study and these were organisational support, clear policy; regulatory enablers and traceability. Of the barriers, knowledge deficiency, lack of staff motivation and lack of funding emerged as the most inhibiting. The main recommendation from this study is the need to develop a policy on environmental sustainability in hospitals that will, through a consultative process, guide actions of all parties involved in sustainability. This policy should take into account the findings from this research on enablers and barriers. Further, more work needs to be done in understanding the initiatives that would work in a hospital environment, including creating models to measure the impact of any initiative or even making an investment case before such implementation. Internal strategies are needed to maintain any momentum created on sustainability, such as support from top management, a clearly communicated organisational strategy, staff motivation and, indeed, allocation of appropriate resources to the environmental sustainability cause. It is proposed that the government, especially the National Departments of Health, of Environmental Affairs and of Public Works, should promulgate enabling legislation and a framework which would encourage the implementation, monitoring and evaluation of environmental sustainability initiatives in South Africa.
Factors that influence patient’s perception for choosing Seboche hospital as preferred choice in Makhoakhoeng (Lesotho)
(2013-10-04) Thlapane, Ramogwera Isaac
This study examines the factors that contribute to patients’ perception on hospital choice for treatment which leads to underutilization of rural Butha-buthe hospital in Lesotho. The study also sought to determine why and how rural patients bypass local referral hospital. The last factor is how they make their decision for the hospital choice. The study was conducted in Seboche hospital which is in Makhoakhoeng. For inclusion the patients had to have the following: • At least 30 kilometers away from Seboche Hospital. • Must be willing to participate in the study; and must come to Seboche hospital at least twice in one month or 8 times in six months. Data was collected by means of in depth interviews. The interviews were audio taped. Qualitative analysis of data was applied and interpreted by use of content analysis. Qualitative research was conducted through semi-structured in-depth interviews with patients that use Seboche Hospital even if it is far further while they have alternative hospitals. Review of records at Seboche Hospital was done as the first step in identifying how often a particular patient comes to the hospital and from which village. Eighteen patients from eight villages around Butha-buthe were interviewed. The sample selected was non probability sampling. For this study, purposive or judgmental sampling is used. The questionnaire was fundamentally addressing concepts which are critical on perception of hospital choice, e.g Hospital reputation, Costs to the hospital, time to the hospital and how quality is perceived. The results suggest that the hospital quality, prior experiences and the satisfaction with the service received from the local hospital, along with patients’ value of hospital size, influences patients’ hospital choice.
End Users’ Acceptance of Clinical Information
(2011-06-24) van Zyl, Jacobus Gert
Health care organisations around the world are under increasing pressure to improve the quality of care they provide without increasing cost. The use of information technology in health care offers an opportunity to address this issue, but unsuccessful implementations of information technology into this environment limit the potential benefits. The purpose of this research is to investigate the factors that influence end user acceptance of information technology in the health care environment by means of a case study. The main findings of the research were that information technology acceptance by end users in the health care environment is influenced not only by factors relating to the technology, but also by social and cultural factors. By paying attention to these non-technological issues and by focusing resources on problem areas prior to implementation, the likelihood of a successful information technology implementation into the health care environment might be increased
Queuing Problems in Pharmacies
(2011-06-09) Rhemtula, Zuleika Goolam
This research report investigated demand and supply factors affecting pharmaceutical services and assisted with making recommendations to the Steve Biko Academic Hospital management on how to reduce the mean waiting times and to improve the actual and perceived customer services at the SBAH outpatient pharmacy. The demand and supply of pharmaceutical services was investigated through a quantitative methodology, using data collection forms to quantify the factors affecting queues at the Steve Biko Academic Hospital outpatient pharmacy. The qualitative methodology observed the layout, processes and the attitude of staff, using an unstructured observation checklist; with the intention of providing clarity and explanation for the quantitative findings of this research. The findings of this research will serve as historical standards or baseline measures against which future performance can be measured. The recommendations to improve the waiting time at the Steve Biko Academic Hospital‟s out patient pharmacy were categorised into infrastructure, demand management and supply management recommendations. The infrastructure and supply management recommendations will improve efficiencies within the outpatient pharmacy however, the implementation of the demand management strategies will provide a greater impact on the waiting times of the patients at the Steve Biko academic hospital‟s out patient pharmacy
Human factors impeding strategy
(2011-05-31) Naidoo, Colin
In the current global economy successful implementation of a formulated strategy is essential to gain competitive advantage. Success in business is manifested more in the ability to implement ideas and strategies rapidly and effectively than in planning itself. Previous studies have identified that for all the energy and resources invested in the pursuit of the perfect strategy, little effort is directed towards implementation. As a result most strategies stumble in the implementation phase, regardless of merit. Due to the importance of effective strategy implementation, this research attempted to identify the human impediments to strategy implementation. It was proposed that identification of the inhibitors would result in proactive management of these human factors and ultimately result in the successful implementation of a formulated strategy. This research reports a case study which focuses on a private hospital group: Life Healthcare. The first objective of this research was to identify the human impediments to successful strategy implementation in Life Healthcare by using the Delphi technique. The second objective was to compare the findings of this research with previously conducted research. The third objective was to rank the impediments identified in the study, in order of importance. Data was gathered from the management in two rounds of the study. The first round entailed the use of a single open-ended questionnaire. The feedback from round 1 was used to construct a structured questionnaire, which was Likert based. This structured questionnaire was utilized in the second round of the study. Six notional categories of impeding factors were identified; strategy-, management-, employee, implementation models, approach and strategic control-, organisational- and knowledge and information sharing factors. The research findings confirmed the existence of the aforementioned impediment factors in Life Healthcare, as well as supported the notional categories identified in the literature. - ii - These findings were interpreted and discussed in the context of existing literature and a number of implications have been drawn. Employee factors, management factors, strategy factors and knowledge and information sharing factors were emphasized throughout the analysis of the findings. Conclusions and recommendations were drawn for Life Healthcare in light of these results.
Public Private Partnership Agreement Management:
(2011-05-06) Khanyile, Patricia Nonhlanhla
Public Private Partnerships (PPPs) are seen as a way of enabling the government to gain access to private expertise and funding in order to improve service delivery without the necessity of borrowing. The Folateng (the private arm of the Johannesburg Provincial Hospital – the Charlotte Maxeke Hospital) PPP initiative was established with the goal of delivering quality medical services to the public at a profit while retaining essential skills. The purpose of this research was to establish the best practices for effective contract and relationship management within the PPP, to maximise benefits to all stakeholders with particular reference to the healthcare sector in South Africa. The data were collected during in-depth interviews with specially selected respondents involved in the healthcare sector, the PPP unit in the Department of Treasury and the Folateng PPP initiative at the Charlotte Maxeke Hospital. A research interview guide was used for the interviews, which were recorded by audiotape and accompanied by extensive handwritten notes. The data were subsequently content analysed. The findings of this research were that setting of goals and objectives was seen as the top priority in ensuring effective contract management, followed by appointing a project officer with the best fit for the specific undertaking, along with selecting a project team of the most appropriate profile. Project monitoring and administration were regarded as the next most important issues for effective contract management. With regard to effective PPP relationship management, communication was found to be a top priority in this research, followed by corporate governance and dispute resolution. The mutual benefits of an effectively managed agreement were found to be firstly keeping to the budget and generating a profit. The iii second benefit was providing or obtaining quality services. The final mutual benefit was delivering the project on time to assure service delivery. There are imperatives that must be in place from the conception to the termination of a PPP agreement to ensure effective management and ultimate success
The readiness of Gauteng Department of Health to institutionalise Monitoring and Evaluation
(2011-04-19) Mtshali, Sipho Solomon
Monitoring and Evaluation is a planning tool that is used to review progress made, the challenges experienced as well as take corrective measures where necessary to assess the value of development programmes. The first step towards designing, building and sustaining a Results-Based M&E System is to conduct readiness assessment. The purpose of this descriptive study was to evaluate the Gauteng Department of Health readiness to institutionalise M&E. The findings indicated that the department’s strategy was not translated into desired results of programmes implementation, the resources allocation was inadequate, the management infrastructure was not satisfactory, and department’s corporate culture and ability to monitor progress was not ready for the results focus
KEY SUCCESS FACTORS
(2011-04-01) Diliza, Nandi
Context This research is a study of a Public Private Partnership (PPP) in a South African public hospital using the Inkosi Albert Luthuli Central Hospital in Durban as a case study. An investigation of the challenges facing the PPP as well as the key success factors for this PPP, as expressed by interview respondents, will be determined. Based on findings made in these investigations, a proposal for key success factors for PPPs in South African public hospitals will be made. A brief statement of the problem The researcher has investigated what the challenges are for PPPs in South African public hospitals. Thereafter key success factors for PPPs are determined. The method of data collection In-depth interviews were conducted to elicit responses to the research problems. A set of interview questions were prepared prior to the interviews and were posed to the respondents. This ensured that the interviewer got responses to similar questions so as to be able to get information on the research problems. The key findings Several challenges are facing the PPP being studied. These are a perceived high cost of the PPP as well as doubts about value for money in the partnership. The other challenges are dissatisfaction by some of the managers, on the client’s side, about the functioning of the help desk, response to logged calls and application of the penalty clause. ii Failure by the state to appoint a dedicated, full time, appropriately qualified and skilled contract manager was cited as the main weakness in the management of the PPP. Key success factors of the PPP were that the service provider was in a position to provide the state with a high quality package in all the areas under the PPP; these are Facilities Management, Information Technology and Medical equipment. There had been adequate stakeholder participation during the planning phase of the partnership and even now there are various forums at which the service provider meets with the client at various areas of management and at operational level. The key message PPPs in the South African public sector are a fairly new concept that is providing some lessons to be learnt. Although PPPs provide required capital to enable the state to venture into high value massive public health sector projects, there are challenges facing PPPs and every effort needs to be made to ensure that the challenges and risks are avoided or, at least, mitigated against. Key success factors have been identified in this case study and, ensuring that these are factored into future PPPs in the health sector will definitely assist government in planning and implementing successful partnerships.

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