DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS
5.3 OBJECTIVE 1: THE HUMAN RESOURCES COMPONENT
Potentially, the most important problem at St Apollinaris is understaffing (Health Systems Trust, 2002). A cumulative percentage of 83.6% agreed that understaffing was a problem at St Apollinaris. 51%of the general employees stated that they had experienced understaffing everyday, with another 26% experienced more than once a week.
58.7% of the general workers stated that they had considered resignmg from St Apollinaris, with 33.7% of the general employees already in the process of looking for other jobs.
Approximately 8% of the employees at St Apollinaris Hospital identified the lack of career pathing as a reason for dissatisfaction, working at St Apollinaris Hospital. Of the general employees that had stated that they thought of resigning from St Apollinaris
Hospital, 14% stated that they were waiting for better job opportunities. While we are unable to calculate the percentage of interviewees who stated that career pathing was a suitable incentive, it had the forth highest frequency.
A possible recruitment strategy would be to:
• If management could implementing a recruitment strategy aimed specifically at the employing the types of people who would stay at St Apollinaris Hospital, management would have lower rates of staff turnover, and improved support and training for junior staff. The characteristics of potential employees should ideally be:
'Y Black females
'Y In the age group 30-39
'Y Are from the surrounding community
'Y Have worked previously in disadvantaged areas
'Y Are looking to work in St Apollinaris as they wish to make a difference to the population this institute services
• Promotions should be given to persons already working at St Apollinaris Hospital to foster a feeling of improved career pathing. This would also add to better training and support structures within the staffing component.
However, this recruitment strategy would take a long period of time to implement or have any impact on the short term needs that the institute currently faces. Other strategies like allowing employees to work overtime would be a suitable interim measure (Noe, et al., 2006). Additional overtime should not be offered to individuals outside the permanent staff workforce. There are multiple reasons for the above statement, based on the researcher's perceptions while working at the St Apollinaris Hospital:
1. The employees outside the institution earn more compensation for overtime than do permanent employees due to the pension and other contributions that the permanent employee makes.
2. The permanent employees have the perception that they give more to the hospital as permanent workers in terms of goodwill than outside individuals and as such should be able to earn additional compensation from the hospital rather than it going to an external individual.
3. The outside, temporary employees do not have the same commitment to the hospital as the permanent employees do. They view themselves as simply having a position to fill for a few days. Outside temporary employees do not see the consequences of their potentially incorrect patient management.
44% of the general staff indicated that they believed that there were individuals they had worked with that were incompetent. A limitation of the study was that the researcher was unable to determine the amount of workers that the general workers thought to be incompetent. However, 48.5% of the general employees stated that acts of incompetence were witnessed by themselves at least one time a month. This lack of skills development could be due to the high rates of staff turnover with 77% of the general employees agreeing with this statement.
A possible solution to improving the above problem is to improve the levels of knowledge amongst all the general workers in the hospital. Allowing people to attend educational courses is not feasible as the knowledge gained by the few that are able to attend would not be disseminated to the larger work force. One also has to consider that St Apollinaris Hospital is not well staffed and the absence of just a few staff members may adversely affect work loads for those that are not on course.
The most viable way of improving skills at St Apollinaris Hospital is to hold weekly skills development courses on site within the hospital. These courses should be held
every week, for approximately an hour in the afternoons (so as to prevent minimal disturbance to ward/departmental functioning). Each doctor should be allocated an area of interest and he/she should disseminate information about these topics on a weekly basis to different members of staff. While it would be impractical to have an entire ward staff attend these training sections, a maximum of 2 ward staff members should be allowed to attend at any given time. The enhancement programmes should be actively promoted by all members of top and middle management with people receiving certificates for attendance and presenting information and demonstrating skills during these courses.
There seems no viable sustainable way to improve the social conditions at St Apollinaris Hospital as the budget is constantly exceeded. However, the managers could start social clubs that the staff could attend. Each staff member could be asked to contribute a monthly fee towards the club which would go towards organising social events. These social events could range from anything like sporting tournaments to social suppers.
Accommodation is also a long term problem which seems to have no real solution.
Approximately 70% of the workers stated that they were not satisfied with the accommodation at St Apollinaris. However, a large amount of capital would have to be outlaid to improve this. The best recommendation is that top management make a special application for additional state funding to construct adequate new accommodation.