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Bridging the healthcare quality, patient safety, and competency gaps in South Africa: a study of clinicians and quality managers
Author(s)
Moleko, Winnifred
Date Issued
2026
Type
doctoral thesis
Publisher
Cape Peninsula University of Technology
Abstract
Background: The public health sector in South Africa faces significant challenges rooted in poor governance, inadequate management capacity, and ineffective administrative systems alongside socio-political factors, resulting in inequitable funding, resource shortages, and misaligned skill distribution. These systemic issues undermine healthcare quality and compromise patient safety. Quality improvement methodologies offer a practical approach to address these challenges; however, access to formal quality improvement training remains limited for the healthcare workforce. Enhancing competency through targeted training is essential to empower healthcare professionals, improve system performance, and ultimately ensure safer, higher quality care for all patients. The objective of the study is to bridge the competency gaps in healthcare quality and patient safety among clinicians and quality managers by training them using levels 1 and 2 of the Kirkpatrick model of evaluation. This study investigates the effectiveness of a hybrid model training intervention to address competency gaps in healthcare quality and patient safety amongst clinicians and quality managers. Methods: A quantitative and qualitative analysis was implemented to analyse the preand post-assessment survey data. Levels 1 and 2 of the Kirkpatrick model were used to evaluate the effectiveness of the training intervention to close the healthcare quality and patient safety competency gaps amongst clinicians and quality managers. A onesided T-test was conducted to compare the levels of understanding of key quality management principles pre-and post-training. The data collected from participants’ responses was analysed using Microsoft Excel and R Version 4.0. Results: The results showed significant gaps in formal training on healthcare quality and patient safety, with the majority of respondents citing insufficient resources and challenges in organisational culture as barriers to quality improvement. Despite these challenges, key findings indicate that targeted training initiatives significantly enhanced understanding of quality management principles, emphasising the critical role of competency development in healthcare delivery. All nine hypotheses yielded pvalues less than 0.05, indicating that the training significantly improved the participants' understanding of key quality management principles. Conclusion: The study demonstrates that a hybrid model training intervention effectively addresses competency gaps in healthcare quality and patient safety among clinicians and quality managers. The application of Levels 1 and 2 of the Kirkpatrick model confirmed significant improvements in participants’ understanding and engagement. These findings underscore the importance of formalised training programmes in enhancing workforce competency and advancing sustainable quality improvement in healthcare.
Additional information
Thesis (Doctor of Public Administration)--Cape Peninsula University of Technology, 2026
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