The role of leadership in healthcare service delivery at Addington Hospital.

Abstract

The Department of Health has a constitutional mandate to provide effective, efficient and quality healthcare to all of the citizens that reside in the province of KwaZulu-Natal. However, Addington Hospital, which renders both specialised and non-specialised services to thousands of patients in the Durban Metropolitan area, has been on the decline for the last two years. The hospital is inundated with various problems that are impacting negatively on healthcare service delivery, which include poor leadership; no stable management; shortage of critical staff such as clinicians, nurses and managers; outdated medical equipment; shortage of prescribed drugs; suspension of key staff members; financial mismanagement; fraud; poor infrastructure; and shortage of basic stock items such as stationery, linen, etc. The aim of this study is to investigate the role of leadership in identifying the aforementioned service delivery challenges that are predominant at Addington Hospital, and to determine the best form of leadership that could promote efficiency and organisational performance. The executive leadership of the hospital has been criticised publicly for failing to address these key challenges, which has led to threats of litigation from many patients or patients’ families, who have been affected by service delivery failures. Staff morale, confidence and productivity is low, and negative publicity and the attitude of staff towards work compounds the operational challenges that affect Addington Hospital. The key assumption of this study is that effective leadership can contribute to improving organisational performance at the healthcare facility, resulting in quality healthcare for patients. This is a qualitative research approach and purposive sampling was employed, which included various managers and employees from the setting. Data was collected through semi-structured interviews and questionnaires. Ten semi-structured interviews were conducted and thirty questionnaires were handed to participants. Thematic analysis was used for analysing the data. Various literature pertinent to leadership was consulted in order to enable a deeper level of understanding of the theoretical underpinnings of leadership in relation to public healthcare service delivery. The key findings of the study indicated that Addington Hospital is inundated with various service delivery challenges. The research findings are critical for establishing effective leader-related interventions that can address the service delivery challenges that prevail at Addington Hospital.