Performance management : a case study of the emergency medical and response services in Limpopo province

Abstract

The concept of performance management system (PMS) is fairly new within the South African public service system. It was introduced into the public sector in 2001 as a tool to assist, measure, develop and monitor the performance of public service employees in an effort to drive service delivery. The effective use of PM system has many benefits and contributes greatly to successfully managing the Emergency Medical and Response Services (EMRS). Thus, it is likely to result in improved quality of care and accountability in the provision of health services. This is as desired by national objectives and as stipulated by the national development plan and other national government goals towards improving public services. This research was conducted in order to assess the current state of performance management and development system in the public sector in South Africa. The research focus was on the implementation of the system in Limpopo Emergency Medical Response Services. The research approach adopted in this study was a mixed method. Interviews and questionnaires were used as primary data collection tools. Five districts were selected as a purposive sample for the study out of a total 64 stations in the Province, under the department Health. These are Capricorn, Mopani, Sekhukhune, Waterberg and Vhembe. For the sample, 10% of operational staff members from the post establishment of each district were identified to participate in the study by filling in questionnaires distributed to them. Supervisors/Managers from respective units were sampled to participate in the interview, although only those the researcher judged to be knowledgeable about the topic under study were interviewed. Research design and method For the primary study, a sequential cross-sectional mixed-methods research design was employed, which was divided into two phases. The first phase consisted of a quantitative study, which was a cross-sectional descriptive survey. A self-administered questionnaire was used to collect data from 190 employees and shift managers. The second phase was a qualitative study; through purposive sampling, semi- structured interviews were conducted with 7 managers. Both phases were conducted at five districts of the Limpopo Province South Africa. Results The research results revealed that the current performance management and development system is not effective. The study further demonstrates that some employees are demotivated and have lost confidence and trust in the appraisal system. The results reveal that supervisors/managers are biased in managing and implementing the system. Supervisors used the system as a compliance rather than management tool. The study shows that employees are no longer motivated to perform and they suggested that the current system needs to be adjusted or amended in order to close the current gaps and challenges resulting from the bias and lack of commitment from managers. Findings from the scoping review revealed that PM systems methods may differ across various countries; however, the practices that are deemed effective for PM system are shared, and so similarities between countries were noted. For the primary study, both the quantitative and qualitative findings of this study confirm that the PMDS has been implemented to a certain extent. However, there exist major gaps and flaws in its implementation that threaten its usefulness within the EMRS. It was evident that the perception exists that Performance management is unfairly and poorly implemented. This, consequently, has a negative impact on staff motivation, team collaboration, employee-supervisor relationship and performance. Practical/Managerial implications The PMDS should not be implemented in isolation; instead, it should be utilised as part of a systems approach to drive effective staff performance to promote quality care within the EMRS settings. Evidently, the PMDS is flawed in its current state. Thus; the PM system is arguably unintentionally impacting negatively on staff morale, job satisfaction and the provision of quality care. Instead, its methods and practices should be improved to include the appraisal of attributes that are key to health outcomes, such as the provision of patient-centred care and promoting quality of care.