Challenges facing middle managers in performance management in a public hospital in South Africa.

Abstract

Health service delivery has come under international scrutiny with harsh intolerances to financial mismanagement, inefficient services and poor quality management. The realities of public health service functioning beyond demand thresholds have strained health service organizations in public domain globally. Reduced funding envelopes have tarnished the potential of the public health service industry to perform effectively and efficiently to deliver organisational objectives, placing a large portion of this burden of challenges on middle managers. The aim of this study was to identify the challenges and influential determinants of performance management on middle managers. The representation of the middle management workforce was of 78 respondents’ from a sample population of 90. Purposive sampling method was deployed. The dominant gender profile was that of females (77%), the highest age group was between 41years and 50 years comprising 41%, whilst the age group between ages of 31 years and 40 years comprised 33%. Greater than 50 of the respondents were African (56%) followed by Indian (37%). The nursing component was the highest featuring component represented by 39.7% followed by the Medical component (19%). Greater than three quarters of the participants were working for less than 10 years. A self-administered questionnaire was utilised. The study indicated that high staff turnover, decreased staff morale and increased client waiting times were perceived challenges encountered by middle managers. Influential determinants of performance management for middle managers ranged from organizational climate, motivation and commitment factors, quality management and competencies. The study revealed that challenges were significantly negatively related to performance using the Pearson correlation analysis. It is recommended that this public hospital should focus on decreasing the attrition rates of staff, enabling conducive organizational climate with supervisory support, training and development initiatives and upskilling competencies. The study will benefit the various tiers of the organizational hierarchy in mitigation measures as deemed viable.