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Theses and dissertations (Management Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/14

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    Organisational change management framework for hospitals : a comparative case of St Mary’s, Marianhill, South Africa and St Joseph’s, Adazi-Nnukwu, Nigeria
    (2024-05) Anusi, Happiness Ifunanya; Mutambara, Emmanuel
    Change management in healthcare organisations is a complex task considering the continuous changes in global demography, technology, strategies, clinical communication, information transfer, and disease burden. The current global pandemic highlighted the need for healthcare organisations to continue implementing measures that adequately respond to health challenges towards patient satisfaction. Many organisations find it difficult to implement organisational change successfully. Unsuccessful change programmes can be attributed to the lack of employee training and development, poor leadership, inadequate communication, poor organisational culture and inadequate resources (Mosadeghrad & Ansarian, 2014). However, change programme implementation and its impact depend largely on the ability of managers to adopt and adapt the change programme techniques in their organisations. Agboola & Salawu's (2010) identified that the introduction of change produces a variety of reactions due to the intrinsic uncertainty or the alteration of employee behavioural patterns, including status quo, anxiety and lack of tolerance, amongst others. The greater the impact on the existing culture, the greater the amount of resistance likely to emerge and the more difficult it will be to implement change. The study of Organisational Development (OD) can serve as a learning paradigm for academic research by enhancing student knowledge about how change management can enable hospitals to create effective responses to changes. The main purpose of this study was to explore organisational change management practices in hospitals in Nigeria and South Africa and proposed a conceptual framework for the change management process for hospitals in a developing context. Employees are one of the most critical elements in any organisational change. Research objectives guided this study to determine the influence of driving forces of change on employee performance in St Mary's Hospital, Marianhill and St Joseph's Hospital, Adazi-Nnukwu; to examine the impact of organisation culture on the practical implementation of change in St Mary's Hospital, Marianhill and St Joseph's Hospital, Adazi-Nnukwu; to determine the influence of practical implementation of change on patient satisfaction in St Mary's Hospital, Marianhill and St Joseph's Hospital, Adazi-Nnukwu; and to establish if drivers of change influence resistance to change during the implementation process in St Mary's Hospital, Marianhill and St Joseph's Hospital, Adazi-Nnukwu. This study provided information on resisting forces and stakeholder attitudes towards the change. And thus, assisted in restructuring the health system for greater efficiency through structural reforms that bring healthcare closer to the people, foster greater accountability and promote community participation. A case study research design was adopted for this study. An explanatory mixed-method approach was adopted with the observed hospitals. The target population and sampling frame were the employees and management from different organisational levels at both hospitals. The total number of employees and final sample size for the study was 132 for St Joseph's Hospital and 150 for St Mary's Hospital. The researcher designed two sets of questionnaires for all employees, a survey for quantitative and an open-ended questionnaire for qualitative. The Statistical Package for Social Sciences (SPSS) 28.0 and NVivo 12 were used to analyse the data. The analysis results for objectives one, two, three and four revealed a significant relationship between drivers of organisational change and employee performance. Organisational culture significantly impacted the practical implementation of change. Practical implementation of change showed a significant relationship with patient satisfaction. However, a non-significant association was found between drivers of change and resistance to change. The study found that both hospitals were successful in their change programmes. This can be attributed to proper employee training and development, good leadership, effective communication, strong organisational culture and adequate resources. Technology and organisational policy have been documented as key drivers of organisational change and performance. The study recommends that the management of the two healthcare organisations continue to implement technological changes with appropriate and required training. Management should continue to improve the adopted communication system, participative leadership and motivation system to enhance the implementation of change and promote team-building exercises to improve staff attitudes.
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    The use of social media as a relationship enhancement communication tool between medical practitioners and patients at Hlabisa Hospital
    (2022-11) Sikhakhane, Jacqueline T.; Lekhanya, Lawrence Mpele
    Communication is a broad concept it is essential in both human and patient care relation and includes all possibilities in which people can exchange information with each other. Good medical practitioner and patient communication have the potential to help facilitate comprehension of medical information and allow for better identification of patient's needs, perceptions, and expectations. Poor communication by healthcare medical practitioners contributes to physical and psychological suffering in patients living a serious disease. Communication breakdowns are global in medicine and lead to a variety of medical errors and patient harm. This study explores the use of social media as a relationship enhancement communication between medical practitioners and patients. It intends to connecting/link positively and constructively the medical practitioner and patients via social media by considering medical ethics. The research will collect data from focus-groups and will include academic journals, books, newspapers, and Reports. The data will be analyzed using the computerized NVivo Software (version 12. Pro) and thematic analysis. The aim of this chapter is to provide an overview of the research methods and population study used with intention of investigating the use of social media as a relationship enhancement communication between medical practitioners and patients. Qualitative approach was used in this study to attain its objectives, 8 participants were used for the sample study of which 4 were patients and 2 were medical practitioners. For the main study 12 participants were used which included 8 patients and 4 medical practitioners. Participants from the sample study were not included in the main study. To conduct this research study non probability sampling will be used mainly because of convenience and cost effective. this study found that WhatsApp and Facebook are the most suitable or used social media platforms to be used at Hlabisa hospital to facilitate communication between medical practitioners and patients as well as an important medium to advertise significant wellness events. whoever will be responsible for the Hlabisa hospital social media platform must be strategic, be well informed, authentic and strategic. use listening skills to check understanding, understand cultural differences and how they might impact communication. Be empathetic toward the patients.
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    Investigation of factors influencing non-compliance with procurement practices : a case study of head office supply chain management directorate and hospitals within eThekwini District, KwaZulu-Natal
    (2023) Mkhize, Sithembile Gadiosa; Dorasamy, Nirmala
    Regardless of the reforms and the employment of Supply Chain Management (SCM) as a strategic tool, South Africa still faces immense challenges in its procurement practices. Non-compliance with public procurement guidelines cannot be ignored because it has a significant cost to the government and the public as taxpayers. This study investigated the factors influencing non-compliance with procurement practices within the Kwa-Zulu Natal Department of Health. The Auditor General’s reports for the financial year 2017/2018 and 2018/2019 confirmed that this Department had received qualified audit opinions for two consecutive years for incurring irregular expenditure on procurement and contract management following non-compliance with procurement guidelines. A mixed-method of data collection was employed on this study to gather information from the relevant decision makers including officials in finance and SCM components. The results of this study demonstrated that unavailability of SCM staffing norms, shortage of staff, lack of supervision, shortage of skills, unavailability of E-procurement system, and negligence are major determinants for non-compliance. These findings have relevance for the Kwa-Zulu Natal Department of Health and also for the South African Public Sector as it strives to achieve clean audits on procurement and contract management. Furthermore, this study acknowledges the policies and the guidelines on public procurement and contract management. However, it argues that policies and guidelines alone cannot prevent irregular expenditure. Public procurement and contract management policies and guidelines need to be complemented by human resources, appropriate skills, updated technologies, implementation of consequences management, and monitoring and evaluation. Furthermore, this study presented the researcher’s proposed model for addressing non-compliance with procurement and contract management policies, as shown in Figure 4.2. Moreover, this model could play a crucial role in reviving and supplementing the public procurement and contracting objectives thus enhancing compliance.