Business process analysis of a South African state-funded health care facility

Abstract

The environment in South Africa has changed dramatically with regard to health services during the past five years especially for state-funded hospitals in the public sector. At the Johannesburg Hospital the admittance of chronic patients has increased considerably over the past five years, thus increasing the workload for the physiotherapists. In spite of the increased workload the staff complement of the Physiotherapy Department has decreased from forty-one to eighteen staff members due to the severe budget constraints. This investigation was initiated to determine whether the department was operating optimally under present conditions, and what the major problem areas were. This document describes the methods used and results obtained during the investigation. Several known techniques such as the brainstorming and nominal group technique were used during the facilitation of workshops. Timesheets were completed over a six-month period and interviews were held with the personnel in the department. The approach followed with the statistical analysis of the timesheets was to use confidence intervals to compare the standard treatment times with the actual treatment times. Hypotheses testing were used to determine whether it would be possible to standardise on similar treatments in different treatment areas. The required capacity was calculated based on the amount of time spent on direct patient care by the physiotherapists during the six-month period of the investigation. Several major issues were identified during the workshops that need to be addressed. Important conclusions drawn were that there was indeed a shortage of staff in the physiotherapy department. It also became clear that standardisation of treatments in different treatment areas is not possible. There is a need for a recognition system and teambuilding exercises, which should have a favourable impact on the motivation of employees. A maintenance plan for equipment needs to be implemented and interdepartmental communication needs to improve.