Case study: Dr Jabu Masondo had been a medical practitioner for over 20 years and had vast knowledge of the medical industry. After this illustrious career, he decided to enrol for a management course with the intention of branching into hospital administration. His view was that hospitals are being managed by individuals who had no medical background at all. He continued to practice medicine after he graduated from the course but was keen on the administration side of the industry. Dr Masondo heard of an opportunity to lead an ailing hospital in Kimberly. He was keen on the opportunity but realised that it will be a huge sacrifice for him and his family, given the fact that they resided in Johannesburg. The family was supportive of him for the move. He applied for the job, and after several rounds of interviews and tests, he emerged as a strong candidate. He then relocated with his family to Kimberly. On his first day, he received a warm welcome from the staff members. Many were hopeful that he will bring a turn around to the hospital. He then had a meeting with his direct reports to assess the situations. The meeting turned into a gripe session, with less tangible factors on the table. The managers were blaming the previous administration for all the current problems. Dr Masondo could not obtain anything that he was looking for from that meeting. On the second day he decided to do walk-arounds in the hospital. He was accompanied by his management team. They visited the wards, the kitchens, the theatre rooms, and doctors' rooms to mention a few. The conditions of the facilities were in a dire state. It was clear that no proper maintenance was carried out for a long time. In some situations, the machines needed to be refurbished. The queues in the reception area were quite long and noisy, small babies were crying. No one was managing the situation. Some patience would even go home unattended. He then had a meeting with the management team to discuss the findings of the walk around. His main priority was to solve the problems. He asked the team about the state of maintenance. It emerged that there were five contracts the hospital had for the maintenance, and these were led by five project managers who worked with contractors. He then decided to interview the project managers on their respective contracts. It was clear that the terms and conditions of the contracts were not structured properly. Dr Mabuza made a recommendation to enrol the project managers and some of the managers on a contracts management course so as to enhance the skills and make the organisation more effective and efficient. The staff members all passed the course. One of the wards was being maintained by a contractor and the project came to a dead end because of a dispute. The project manager from the hospital claimed that the contractor did not perform the job well, and the maintenance manager complained that the equipment in that ward will be very difficult to maintain based on what the contractor did. The contractor indicated that he performed tasked based on the scope of work. When the scope of work was revisited, it turned out that it was not even signed at the time, and also the contract did not have all the required signatures, some were missing. In realising this Rosemary Majola, the project manager, approached the lawyers to sue the contractor for the damages. The hospital's case was not strong, given the fact that signatures were missing in some of the important documents. The ward could not be usable though, some of the work had to be demolished, therefore a new project needed to be initiated. Another project that was for refurbishing the kitchen, also had many problems. The contractor's performance was substandard and also taking too long. However, the claims from the contractor were too much, but this could not be translated to completed work. The contractor appraisals were very subjective, and no one could point out what they were really paid for. The terms of the contract were again loosely defined. Peter Ross, the project manager could not pin down the contractor. At times he would make a payment because he feared a case of litigation. Project funds were getting more depleted, with the risk of not finishing the kitchen refurbishment. Moreover, if the project is left unfinished, the kitchen could become a "white elephant". Such challenges were crippling the hospital and Dr Mabuza really needed to make big changes to turn situations around. He decided to hire your team to help with the ailing hospital.

Question : Provide recommendations that will ensure hospital effectiveness and efficiency together with managerial implications for implementation.