VALUING VOLUNTEERS IN SEMI-RURAL HOSPITAL HEALTH CARE DELIVERY

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1 VALUING VOLUNTEERS IN SEMI-RURAL HOSPITAL HEALTH CARE DELIVERY G U I N L O U R E N S R U R A L R E S E A R C H D A Y S T H I S R E S E A R C H W A S F U N D E D B Y F I R R H

2 WHEN HOSPITAL HANDS ARE NOT ENOUGH Hotchkiss & Fottler (2009:127) found a positive relationship between volunteerism and hospital cost saving but suggested a need for further research

3 PAARL HOSPITAL PAARL HOSPITAL, A SECONDARY LEVEL PUBLIC SEMI-RURAL REGIONAL HOSPITAL, IMPLEMENTED A VOLUNTEER PROGRAMME IN 2007 AS A RESPONSE TO THE RAPID CHANGES BROUGHT ABOUT BY HOSPITAL REVITALISATION AND THE RESULTANT EXPANDED SERVICES.

4 ETHICS The ethical norms of qualitative research writing, which generates insights from study participants, will include accuracy, non-maleficence and dissemination of results in terms of the right to know (Denzin, 2000:902). There is an ethical obligation to disseminate research findings and to share information, thereby reciprocating the trust of study participants and returning the benefits of the research to the individuals and the widest possible community that has contributed to the insights gained (Ulin, Robinson &Toley, 2005:1976). SU ETHICS APPROVAL N13/05/061

5 INNOVATION Innovation in service delivery and organisation is defined as novel ways of working that are directed at improving health outcomes, administrative efficiency, cost effectiveness or users experience and that are implemented by planned and co-ordinated action.

6 1953 Tower block with 6 floors of wards with new specialist OPD under construction in front

7 AIM The study aims by its exploration of the innovative strategies in a public sector semi-rural hospital, in terms of volunteerism, to produce information towards this economically viable programme implementation

8 1953 Tower block with 6 floors of wards with new specialist OPD under construction in front

9 VALUE The value of volunteers is viewed through the lens of impact on efficacy and quality of care, which stands to benefit public health management.

10 METHODOLOGY A case study design, applying qualitative methodology to individual interviews with purposively sampled key informants with content analysis and thematic coding was utilized. Case studies are used when there is a new phenomenon about which little is known (Brink, 2010:110) and hospital volunteer programmes in operational areas as a response to hospital revitalisation are a relatively new phenomenon in South Africa.

11 MINDMAP OF THEMES Paarl Hospital as a place of opportunity -Social obligation -Service call -Passion for service o o Locum work Job opportunities Economic transition Sense of purpose Unemployed retrenched on UIF o o o Training opportunities Work experience Testimonial Rewarding Take years, perseverance o o CV skills Job interview role-players

12 MINDMAP OF THEMES Paarl Hospital as a place of opportunity 14 full time staff / day =hours Pre-invest Funding Finances o External o Hospital Board o Need for co-ordinator admin Placements o Right person o Right place with o Right possibility o Quality person Relationships o o o o Ostracized by permanent staff Don t feel valued Staff rude Exploited by staff

13 TENACITY

14 SENSE OF PURPOSE We are in a people business. People are the essence. Give and take, not a high profile job, but purposeful. Being out there is difficult. (II 3 pg 2) If you want to learn, people can t stop you. (II 3 pg 3) I got purpose. (II 3 pg 5) People can influence your destiny, but they cannot determine it. (II 3 pg 8)

15 GETTING DIRECTION

16 SENSE OF BELONGING -- I was a motivated. Feel acknowledged. Makes you feel that you belong. (II 3 interview notes pg 3) - Ek wil net byvoeg as mens volunteer dat stel jy jouself bekend aan die personeel. Hulle begin gewoond raak aan jou en dit is ook een van die voordele. As jy in die gebou instap, die mense aak gewoond aan jou, hulle sien jou daagliks. (II 4 pg 3) - Daily visibility - you become known and seen (II 4 interview notes pg 2) - I feel that I belong. (II 3 pg 8)

17 POWER OF POSSIBILTY

18 INSPIRING POSSIBILITY The power of possibility kept volunteers coming back Ek kan net vir die mense sê as hulle wil volunteer, daar kan net iets goeds van kom. Dit wat jy insit sal jy uitkry. Wat jy saai sal jy maai. Jy moet bereid wees om in te sit en jou hart moet reg wees. (II 4 pg 2) Toe ek voorgestel was aan Me. Alexander het sy my pertinent aangedui dat dit n program is waar geen beloftes gemaak word nie. Dit is n vrywillige diens, maar dit kan voortspruit vir n permanente werk posisie by die Hospitaal. (II 3 pg 1)

19 RELATIONSHIPS CAN BE TENUOUS They will stand talking to each other, and the volunteer will do the work and that is a challenge for their manager, because that manager needs to manage their people together with the volunteers, but sometimes is does not work so well. II 1 pg 4)

20 PLACE OF OPPORTUNITY/POSSIBILITY The hospital enjoys the status of being seen as a place of opportunity Paarl Hospital a place of opportunity (II ) He is so valuable for me, because now if we want to place volunteers, we place them with him and he trains them because he knows what it was like when he was a volunteer. (II 1 pg 2)

21 SUCCESS STORY The one very big success story must surely be that of the amount of volunteers who were subsequently permanently employed, both here at Paarl Hospital and at other institutions such as Tygerberg Hospital and the private sector. Seven people were employed as porters, eight people as general assistants, seven people as clerk, five people were food service department, one person in the linen bank and six people wemployed in our ere employed as Pharmacy assistants, two at our institution and the others at other institutions. We also have many people working as locums, six in the pharmacy, 20 as general assistants and one as a porter. Agency placements 40+

22 ECONOMIC DRIVERS-HOSPITAL Economic sustainability Cost-benefit: o 14 full time staff per day benefit o External funding (Hospital Facility Board) o Need for co- ordinator o HR Pre-investment

23 ECONOMIC DRIVERS-VOLUNTEER Economic transition Unemployment to employment Work experience Testimonial Training opportunities/learning CV writing skills Job interview role-players Tedious process

24 ALTRUISM Regard for others as a principle of action Oxford Self-sacrificing Collins Public-spirited Collins Thesaurus

25 ALTRUISTIC DRIVERS-HOSPITAL Place of opportunity status Empowerment of locals Community based employment opportunities Pre-investment in future human resources

26 ALTRUISTIC DRIVERS-VOLUNTEER Sense of purpose Rewarding Social obligation Service call Passion for service Becoming visible

27 MASLOW We are not in a position in which we have nothing to work with. We already have capacities, talents, direction, missions, and callings. Abraham Maslow Rewards: What the organisation needs to reward; What the organisation pays, both in real terms and psychologically; What circumstances make the VOLUNTEERS feel rewarded or punished? Maslow s hierarchy of needs applied to diagnose the fit between the formal reward system and perceived reward system.

28 MASLOW S HIERARCHY OF NEEDS NEEDS DESCRIPTOR FINDINGS RECOMMENDATIONS SURVIVAL FOOD/SHELTER ECONOMIC TRANSITION SECURIT/SAFETY SAFE AT WORK ACCESS TO EMERGENCY CARE+ OCCUPATIONAL HEALTH SOCIAL/ BELONGING STATUS/ESTEEM SELF ACTUALISATION TO BELONG/ BE ACCEPTED PRIDE/ ACHIEVEMENT MAXIMISE POTENTIAL VISIBILITY PURPOSE JOB CREATION/ TRAINNIG+ DEVELOPMENT JOB CREATION OPPORTUNITIES PROVIDE OCCUPATIONAL HEALTH+SAFETY ACCESS MANAGE RELATIONSHIPS ACKNOWLEDGE+ PRAISE-GIVE RESPONSIBILITY TRAINING+CAREER OPPORTUNITIES

29 FINDINGS The study s findings indicate that a volunteer programme requires co-ordination and some secure funding to remain sustainable, but that it has huge benefits in terms of human resource supplementation, organisational development, as well as gainful employment and development of previously unemployed volunteer programme participants.

30 RECOMMENDATIONS Practical implementation recommendations, based on the success and challenges which emerged from the data of the Paarl Hospital volunteer programme could be useful to health facility managers

31 RECOMMENDATIONS

32 RECOMMENDATIONS Relationship resilience Perfect placement of the right person in the right place with the right possibility Perseverance

33 RECOMMENDATIONS Secure external funding Co-ordination / admin essential Value and acknowledge volunteers Manage staff / volunteer relationships Prevent volunteer exploitation Place right person in right place with right possibilities

34 QUESTIONS?

35 ACKNOWLEDGEMENTS PAARL HOSPITAL WESTERN CAPE GOVERNMENT HEALTH FIRRH FUNDING OPPORTUNITY FROM STELLENBOSCH UNIVERSITY