Masters Degrees (Nursing and Midwifery)

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Browsing Masters Degrees (Nursing and Midwifery) by Author "Adams, Shahnaz"

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    The experiences and perceptions of clinical staff about transformational change management at an emergency centre
    (Stellenbosch : Stellenbosch University, 2017-12) Adams, Shahnaz; Van der Merwe, Anita; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : Background: The Community Health Centre - A primary health care facility in the Western Cape that provides a comprehensive package of care, including a 24-hour emergency and maternity services, faced several systemic challenges that attracted an investigation by the Public Protector’s office in 2009. The investigation revealed substantive evidence in support of claims of poor service delivery, bad staff attitude and poor disciplinary conduct, deficient management & control systems, poor team cohesion and low staff morale. In an effort to address these organisational challenges, an improvement strategy based on a transformational change philosophy was initiated in the Emergency Centre. Aim: To explore the clinic staff’s experiences and perceptions of the transformational change management approach introduced in a Community Health Centre. Methods: A qualitative descriptive phenomenological research design was used. Semi-structured interviews and a focus group discussion with 18purposively sampled Emergency Centre staff members. A follow-up focus group discussion done in 2016 to confirm the perceptions of the participants held overtime. The interviews and focus group discussion were transcribed verbatim and analysed manually. A thematic analysis was done and the findings were organised in Donebedian’s framework of structure, process, and outcomes. Results: The results revealed that systems align the structural and processional aspects resulted in the achievement of better outcomes. These outcomes relate to improvement in working environment, the management of critical resources, employee confidence, morale, discipline, commitment, and teamwork. This ultimately led to the creation of a positive work environment, improved service delivery, enhanced quality of care and positive patient outcomes. The role of visionary leadership was deemed key to the transformation process. Conclusion: The study confirmed that transformational change occurred through a strong leadership, which promoted a sense of ownership, the empowerment of workers and capacity building. The transformational change led to the adoption of a shared vision, team learning, and professionalism, which resulted in the delivery of quality emergency care The findings supports the principles espoused by a learning organization. The recommendations include strengthening of values-driven leadership competencies and fostering a learning organization with emphasis on shared vision, systems thinking, personal mastery, and team learning.