Analyzing the Impact of Operations Management as an Approach to Sustaining Effective Corporate Governance in the Public Health Sector in the Provincial Department of Health of KwaZulu-Natal ()
1. Introduction
The current state of operations management emerged from the era of craftsmen in the eighteenth century, with the division of production (Galindo & Batta, 2013) [1] . In that period, Operations Management (OM) was known to be Production Management and was ingrained in the manufacturing sector, until Henry Ford, in 1913, took a turn in pulling together a production line concept by introducing what can be referred to as “bringing work to men”. Since then, the management of production for operating efficiency tends to be more popular. In the middle of the 1950s and 1960s, further, incepting other concepts such as Taylorism, production planning, or inventory control, among others, proponents, fashioned a separate discipline. This was due to the fact that economies in the developed world were increasingly erratic to be service-based, similar to the corporate responsibilities, together with Product Management. At that moment, as orated by Brones, de Carvalho and de Senzi Zancul (2014) [2] , the service side opened its approach and put Product Management principles to planning, in addition to organising procedures up to the point where it was pronounced to be Operations Management.
According to Jasti and Kodali (2015) [3] , the essential point of operations management to any relevant organisation is to give support to the strategic goals of the workplace if an establishment is to understand and cover the dimensions by which the intense breakdown of work processes is taken on. In fulfilling social responsibility, organisations nowadays focus on their Operations Management (OM), particularly in maintaining their survival and what to do to build up the business life while keeping in focus the social, economic and environmental objectives. Bromiley and Rau (2016) [4] view OM as a system that entwines planning, organising, and supervising procedures and practices that can lead to improvements for greater effectiveness. Schnackenberg and Tomlinson (2016) [5] agree that where OM is encouraged, managing organisational resources will maximize the potential of any products or services that are offered by an establishment. The fundamental impact of OM can yield a prime output if the key operations areas, which consist of production, inventory, human resources and logistics, can be adequately managed (Brandon-Jones et al., 2016) [6] .
In maintaining effective corporate governance, setting up the utmost confidence in patients and the public increases trust in the services rendered by the hospitals, clinics and health departments (Yates & Evans, 2016) [7] . To contribute significantly to the management of the patients, the quality status and the conformity of the known standards that identify the areas of intervention, a survey must be carried out to examine the internal structure of the hospitals, clinics and health departments. This is to discover better ways of increasing patient and staff satisfaction regarding the services provided by line management in the health department. Prominent among the established issues experienced in the healthcare industry is linen loss. Conducts such as an obstinate method of regulating control, the age-old routine of information flow, lack of belief and a lack of team support emerge as a result of the hypocritical action of the service providers, and executive management, especially in observing the OM practices (Osborne & Hammoud, 2017) [8] . Edwards and Saltman (2017) [9] suggest that to mitigate events arising as a result of poor corporate governance when it comes to medical practices, finances and the alleviation of flaws in the aspect of healthcare, need utmost attention.
Being even-handed with other healthcare industries at international and at the national phase alike, is the province of KwaZulu-Natal, where the health sector, in the same way, encounters the unproductive effect of line management in their operations. It is high time that attention is heeded to the healthcare settings to ascertain the factors underlying the sustainability of OM despite the intervention of the South African government.
This article is designed in the following manner. After the introduction, the review of the literature to highlight the existing knowledge base gap and the reason for the study are provided, along with the theoretical framework. This is followed by a description of the research methodology, with the results section providing extraction and analysis of data obtained from the 259 surveyed healthcare workers, followed by a discussion of the key findings and related future research topics.
2. Theoretical Framework
This study is established on the theories of scientific management and human behaviour because operations management, at present, is increasingly connected with the environment and how people’s demands can be met. The rapid changes in the modern environment have posed numerous opportunities and challenges, which have resulted in the enhancement of industrial capabilities. Hence, managing a service system has become a major challenge in the global competitive environment. Operations management has been a key element in the improvement and productivity in business around the world as it reveals to people and organisations how to achieve goals with common effort. Scholars alike have explored the efficacy of operations management as an integral element of corporate governance.
Taylor (1911) [10] , among the earliest theorists of management, found the “Principle of scientific management” to illuminate how work was implemented and the influence which common effort have on efficiency. His discoveries proved that making employees do jobs as hard as they could was not as economical as improving the way the job was done. He suggested that by properly coordinating and clarifying works, efficiency would improve. He also posited the idea that employees and leaders must cooperate instead of critiquing each other’s trivial errors. He advised that employers should compensate their employees for better productivity as this will give them the motivation to work harder.
Mayo (1945) [11] initiated human relation theory to demonstrate the value of people for output and not machines. Evidence from his findings revealed that people wish to be included among the team that contributes to progress and development. Consequently, when workers obtain concerned consideration and are motivated to take part in an activity, they consider their effort as important, and they are motivated to be more creative in a manner that produces high-quality work.
Weber (1947) [12] designed the bureaucratic management theory where he directed his attention to organising corporations in a chain of command to have a transparent policy of governance. His philosophies for devising this scheme incorporate a chain of command, vibrant division of labour, separation of personal and organisational assets of the owner, strict and dependable instructions and etiquettes, scrupulous record-keeping, the certification, collection, and preferment of workers based on their conduct and experiences. He established the idea that an establishment must need a distinct classified form of statutes, procedures and lines of power which direct it. According to Weber, bureaucracy institutes the most effective and coherent way social activities can be structured. Hence, maintaining procedures as well as coordinated plans are obligatory to retain order as this will increase competence and remove all elements of favouritism.
Fayol (1949) [13] developed administrative management theory where he observed an organisation from the outlook of the managers and the situations they might contend with, when coordinating and executing their roles in an organisation. He assumed that leaders must have six main abilities, which are the ability to plan, organise, coordinate, command, and control. In his view, these ideologies should not be inflexible. However, the managers must be able to ascertain how they will be employed to manage processes competently and successfully.
McGregor (1960) [14] presented X and Y assumptions in his book titled, “The Human Side of Enterprise,” where he resolved that people’s motivations are inspired by two types of management styles that directed the sensitivities of individuals. Managers who presume workers are unconcerned or hate their job use theory X, which is autocratic. Theory Y is employed by managers who believe that employees are accountable, dedicated, and self-ambitious. This is a participative management approach that develops into a more shared work environment, while theory X turns into micromanaging. His conclusion revealed that bigger corporations may like to implement theory X to ensure that their workers concentrate on working towards realising organisational objectives. In smaller corporations, workers tend to form a division of the decision-making practice because creativity is promoted, hence they like to apply theory Y.
Fiedler (1964) [15] also introduced a contingency model to reveal the competence of leaders in an organisation. Evidence from the author’s finding showed that there is no definite management approach that works for all corporations. Fiedler opined that a leader’s personality completely correlated to how successfully a leader runs his or her team. Based on his assertion, leadership qualities that are needed to cope with all kinds of situations must be pliable for leaders to adapt to a changing environment.
Bertalanffy (1969) [16] examined planning and management of businesses using system management theory. Bertalanffy businesses use the body system of human beings where every part that makes a whole-body function together. According to the author, businesses are like compound elements that must jointly work for an establishment to run optimally because an organisation’s success hinges on interaction, mutuality and trust between subunits that form the whole business system. Additionally, this theory emphasizes the beliefs of all systems’ organisations, regardless of their form. All systems are seen to possess six qualities: integrity, hierarchy, self-control, honesty, flexibility, and transparency. According to this approach, workers are the key elements of a firm, and work divisions or teams are all supplementary, vital aspects for success. Bertalanffy (1969) [16] advised that managers must assess designs and actions in the business to decide the most excellent management approach. Both the governed and their governor must work together on set plans to realise success.
Considering the above, there is a need for a good management approach for work leaders, superiors, and their employees to successfully govern the corporate establishment that they administer. Nevertheless, the impact of environmental forces caused by globalisation; rivalry, corruption in the corporate world; technological development and political instability in the corporate world has required the need of competence as a tool of controlling operations in the workplace to maintain effective corporate governance (Solomon, 2020) [17] .
3. Operations Management
A corporation converts ideas generated from the environment into productivities (Peng & Lai, 2012) [18] . Operations that work are such where an organization targets implementing the change management method. A change management methodology is an approach a company can use to tailor a change management style to its particular needs. Companies implementing change internally and externally may prepare tactics for supporting employees through the transition and collecting analytics to determine how successful a change management methodology is after implementation. To implement change properly, most companies organize, plan and structure how the change may affect current processes to minimize any challenges to workflow and productivity. Laguador (2013) [19] notes that the practical role of management relates directly to formulating products and offering essential services that can accomplish the goals of the organisation. For this reason, effective governance of operational responsibilities commits to the idea to convert resources, such as workforces and materials, to lucrative business products (Benzarti, Sahin, & Dallery, 2013) [20] .
Battistoni et al. (2013: p. 5) [21] opine that OM is the ideal formulation of strategy under which the affairs of an organisation are directed and practised, yielding maximum output. It is a management aspect concerned with planning, organising, supervising, and controlling the process of production to ensure that business operations produce efficient goods and services. The efficiency and ability of operations managers and administrators ensure that wastage of materials, energy, efforts, money, and time are prevented. It is a responsibility to see to the fact that excellence is achieved through the cost-effective use of resources and value for money realized while acceding to customers’ requests.
Furthermore, Kemunto (2016: p. 3) [22] posits operations management as the application of policies that are directed to the needs of customers and their satisfaction, based on the information acquired from them to form decisions and create new and improved goods and services. According to Kemunto (2016) [22] , OM seeks to create quality in terms of goods and services and the process that recurrently improves efforts that reduce inaccuracies, deficiencies, or unwarranted surpluses. The author suggests that the decisions made by Operations Management reform the methods that implement transformational roles to enhance customer value.
Likewise, Kozjek et al. (2018: p. 209) [23] describe Operations Management as the rational way of making higher earnings in business operations. The daily restructurings made to boost the efficiency of operations must be in support of the company’s strategic goals. Additionally, a good manager must be capable of performing the basic functions of the management process which consist of planning, staffing, supervising, organising, leading, and controlling. The application of these standard practices is what makes decision-making in Operations Management function effectively. A manager can find the bottleneck of operations in the system and improve on them by developing a creative method for achieving productivity. This can be done by the readiness of a manager to take responsibility by receiving ideas from the employees and managing their passions, studying the trend of improvement in the company’s productivity, re-evaluating the manner through which work is done, and obtaining support from the top management.
De Sousa Jabbour et al. (2019: p. 1525) [24] conclude that Operations Management as a system incorporates the central core of the management function of planning, organising and, coordinating, inclusive of control of the whole spectrum of activities within the organisation. Due to its nature, it involves the managing of people, equipment, technology, information, as well as many other resources that can aid the creation of goods and services. In other words, Operations management implements effort by changing the input of raw materials into finished goods. Examples of this are human resources, such as workers, staff, and managers; facilities and processes, such as buildings and equipment; and include materials, technology, and information. The revamping part of operations management is what makes it function as the engine room in the organisation. For this reason, it is dependably liable for many decisions and undertakings by managers to contribute to the development of product design and delivery (De Sousa Jabbour et al., 2019: p. 1527) [24] .
In light of the above, evidence from the afore-mentioned authors has proven that well-performing Operations Management requires diverse abilities for the proper execution of actions and processes. Therefore, to manage the basics of daily work or operations, the work executives, managers, administrators, and healthcare representatives must be proficient in knowledge, experience, and deeds. This is to enable them to run the affairs of their administration by absorbing the management functions of planning, organising, controlling, supervising, staffing, coordinating and leading into the unit they represent, whereby people and resources are adequately managed.
4. Corporate Governance
A different viewpoint from scholars has been used to connote corporate governance. Osei (2014) [25] defines corporate governance as an approach by which corporations are administered and organised. According to Osei (2014), the primary aim of structuring corporate governance by many establishments is to attain the corporate visions that promote respectable value standards where people’s decisions and judgements are treasured, based on the fairness, transparency, and accountability they deserve. The author suggests that corporations can accomplish their strategic objectives if they are visibly defined. Additionally, success can be attained by employing competent hands possessing a wide range of skills, in-depth experience, and knowledge. Furthermore, the core function of an organisation can be effective where the committee principally embarks on oversight, and fiduciary, strategic and legal obligations. Lastly, by allowing employees to practice what they learnt regarding fulfilling social responsibility without much supervision, the management can enable staff to determine their level of competence and adjust where skills are deficient (Osei, 2014) [25] .
In the opinion of Majeed, Aziz, and Saleem (2015) [26] , corporate governance is a means by which a corporation regulates itself in terms of policy, procedures and processes. Due to business scandals characterised by the effect of the misappropriation of resources, idleness and favouritism, people these days have begun to mount pressure on corporations for their negligence and place demands on the extent to which corporate leaders can continue capitalizing on shareholders’ profit. Equally, incorporating corporate governance into an institution often involves an action plan to put performance measurement and corporate disclosure into activation, where the operative style can provide long-term execution for the company. According to the authors, a negligent approach to corporate governance can cast doubt about a company’s reliability, accountability, integrity, and transparency, the effect of which can bring indefinable consequences to the reputable image of an establishment.
Jaimes-Valdez, Jacobo-Hernandez, and Ochoa-Jimenez (2017) [27] agree that corporate governance represents a system or progression that authenticates the assets and resources of the corporation. Moreover, it can be referred to as the method of maintaining constancy in power that influences conduct and behaviour in the direction and control of organisational structures, along with the decision-making process, as it pertains to the collective activities, especially when protecting people’s rights in a transparent form. In the same vein, it can otherwise be deemed to embody the environment, where the rules of law and risk management are placed on the standard of control within which the internal structure and operations of the firm are overseen, to build trust and moral values. For organisations to have the chance of being acknowledged and impact positively on society, they need to be transparent and accountable for their activities (Jaimes-Valdez, Jacobo-Hernandez, & Ochoa-Jimenez, 2017: p. 166) [27] .
Goel (2018) [28] concludes that corporate governance is a methodical approach that enables a firm to make better quality decisions in a controllable way that offers an improved service to the society or environment. Corporate governance goes beyond accountability because it structures relationships that control the corporation’s bearing and performance. It stimulates the efficiency of business structures and creates the extension of services towards social and environmental responsibility. Sustainable, effective corporate governance increases confidence in a firm and creates an ethical environment that allows room for returns on investment. It also guarantees the extent to which a corporation can responsibly submit to rules towards society and the environment. The author also found that a lack of transparency and poor disclosure of procedures lessen the value of corporate governance.
The above discussion demonstrates that corporate governance forms a fundamental basis for corporations to excel in their work endeavour. For the health sector and corporate organisations to function efficiently, the health units and health representatives must embrace transparency, fairness, accountability, teamwork, integrity, and risk management as an entity.
5. Methods
This study aimed to uncover the influence of the practice of Operations Management on the manner of Corporate Governance within the KwaZulu-Natal Public Health Sector. In unfolding the qualities, a descriptive design was selected for this study as it outlined features of present facts and determined solutions to the subjects under investigation. The entire KwaZulu-Natal Public Health Sector constituted the target population for this survey. A probability sampling design was used to ensure Healthcare managers and operatives had a known and even opportunity for selection, while simple random sampling was employed to provide every population member a fair chance of assessment. The 259 responses were dispersed accepted; this comprised this study’s sample size. The findings of the evaluation were extracted from these replies. The tool for this research was a structured questionnaire with a 5-point Likert. The questionnaire was valuable because the information supplied by respondents was collected cost-effectively.
The assembled information was captured and evaluated through the Statistical Package for Social Sciences (SPSS) version 26. Equally, the applicable quantitative implements were utilized to construct descriptive and inferential statistics. Examples of these are frequencies, percentages, and cross-tabulations. Also, measures of central tendency and dispersion were used to give the gathered facts a wider opportunity of assessment. With respect to inferential statistics, T-tests and Analyses of Variance (ANOVA) were applied to obtain necessary facts and generate results from the information under study.
6. Results and Conclusions
In this section, we articulate and discuss the results on the basis of data retrieved from 259 healthcare managers and workers about their knowledge of management functions of planning, organising, controlling, supervising, staffing, coordinating and leading and their retort to being conscious about their working environment.
Many respondents expressed that with management function of planning, they can make a remarkable impact in their workplace and the accomplishment of set objectives. This ability has helped them to envision the possible risk factors and develop plans that can assist them to reach the intended destination of their organisation. With proficiency in planning, they could rectify their areas of weakness in their area operations and improve their efficiency. This is supported by view of Gilson and Agyepong (2018) [29] who explain that planning expands beyond decision-making practices and the management of time. Initially, it enables the managers to remain concentrated on a goal and helps to decide how to substitute action that might be facilitated, postponed, or accomplished. This gives the criteria against which real performance is quantified. When leaders who have creative problem-solving skills have a plan of what they want to achieve, it is easier for them to predict problems (Jarrahi, 2018) [30] . Umar, Hasbi, and Yusriadi (2019) [31] note that the essence of a clear directive to workers is to certify that they wholly understand what they need to do in the line of their responsibility. Giving clear directives in an organisation comforts the worker’s spirits, allays their lack of confidence, and assists them to check their beliefs, so that they can be content, free and productive in their operations. Setting goals will not eradicate all the issues but can decrease the number of issues that may come as a complete shock (Atasoy, 2020) [32] .
To maintain orderliness in operations, Kerzner (2017) [33] explains control as what must be achieved and what to value as proficiency, so that performance takes place according to plans. Control enhances the operations of the organisation. It helps it to be steadier, positive, and opens up new opportunities. Palstam, Törnbom, and Sunnerhagen (2018) [34] note that job-related stress may be triggered by weak job regulation, bad work patterns, and unfulfilling operating terms. However, when workers recognise exactly how their task suits the organisation’s objectives, they are more likely to participate and support. They will, as well, create a sense of control over their job functions, which may help them cope with anxiety intensities.
To lead or supervise a corporate establishment successfully, Renčíková, Guščinskienė, and Španková (2017) [35] observe that leaders can gain the devotion of the employees by exhibiting concern for their employees’ well-being and health. Also, permitting the workers to freely express their concerns and ideas, as well as acknowledging them for a job well completed and letting them make important decisions, develops this loyalty. Work leaders must initiate constant, honest communication with their personnel to prove to the workers that they are dependable (Palstam, Törnbom, & Sunnerhagen, 2018) [34] . When employees are permitted to make key decisions, they feel more committed and ready to work and be loyal to their organisation (Ramano & Buys, 2018) [36] . In the event that mistakes are committed, personnel or their leader must learn to acknowledge their fault. When people admit to their fault, they reveal to all about the extent to which they can create trust and exhibit integrity. Individuals acknowledging that they are wrong indicate they are mindful of and consequently learn from their mistakes (Pelster & Hofmann, 2018) [37] . Moser and Korstjens (2018) [38] note that mentoring helps workers to realise their full capacity. The managers of the guided personnel gain from the greater output that ensues in workplaces. When staff members look to their leaders for guidance, they tend to make fewer errors; hence, reducing losses for the organisation.
Haselhuhn, Wong, and Ormiston (2017) [39] note that designating employees with responsibility for a task does not just relieve a leader of a burden but can assist the subordinate to become competent. When delegation is initiated appropriately, it can influence work productivity positively and motivate employees to work harder. Delegation of duty, authority and task can go wrong, leading to confusion and inefficiency when instructions are not clear. For leaders and their teams to succeed, they must delegate strategically. In the observation of Khoza (2016) [40] , technology can improve productivity as well as save overhead costs, and time, and magnify business abilities. Workers who do not possess technology skills will fall behind in the digital upheaval. An absence of technological skills or knowledge in an individual or organisation can lead to an institution being less productive. Respondents recognized that their computer knowledge has decreased their chores, and heightened their job efficiency.
The pros of moral behaviour in operation include assisting the business to gain the loyalty of people and prevent legal complications, attract and keep exceptional personnel (Comer & Schwartz, 2017) [41] . Work morale is inherent in promoting better efficiency and collaboration among the workers. It assists in affiliating the beliefs of an organisation with those of the employees (Amos, Zhang, & Read, 2019) [42] . Reaching this alignment requires the leaders to foster coherent conversations about the morals of the organisation, which enhances the public attitudes, honesty, and candour among the employees. Morals enable the workers to understand the powerful link between their values and that of the organisation. They express such thoughts through better productivity and inspiration (Eissa, Lester, & Gupta, 2020) [43] . Healthcare administrators affirmed that they coordinate and train their employees on how to maintain their attitude for the betterment of my organisation and encourage them to correct the areas where their weaknesses can be harmful to the development of the establishment.
The operations management, as suggested by Stolzer, Sumwalt, and Goglia (2023) [44] , in today’s corporate environment, calls for the cooperation of both the leaders and the followers to keep people and work issues under control and equip them with the knowledge to enable them to be self-sufficient. It can be concluded that:
i) Gender objectivity is on the way to realization as the large number of female healthcare operatives now exceeds the male colleagues.
ii) This study further uncovered that youth are actively committed to operational management and approach of governance in KwaZulu-Natal health centres, which is a great push to diminish the problems of joblessness.
iii) The operatives were able to promote agreeable ties with the people in their service centres.
iv) Training, according to the research participants, is of great benefit to the operatives as it has enhanced their rational thoughts on the knowledge and skills required to govern their operational pursuits.
v) The healthcare workers can now recognise the problems that take place in their respective units that are adversely affecting their duties.
vi) The knowledge and use of information technology have made the personnel more effective, able to preserve bulk amounts of operational data, able to organise operational activities and reduce operational costs.
vii) The influence of the healthcare sector is now providing the opportunity to improve the living conditions of people in society by meeting their health demands.
viii) The operatives are not yet adhering totally to ethical procedures that affect the performance level of task fulfillment in the establishment. However, evidence from correlation (r) between the introduction of good moral behaviour can help healthcare unit improve substantially and obeying the occupational ethical conduct can boost the efficiency of their job administration.
7. Recommendations
Based on the outcome of this study, the following recommendations are made to the healthcare representatives.
To address the issue of “Awareness of impairment”, in the healthcare system in the Province of KwaZulu-Natal, healthcare operatives should be proficient with knowledge. This is to enable them to run the affairs of their administration by imbibing the management functions of planning, organising, controlling, supervising, staffing, coordinating, and leading into the unit they represent, whereby people and resources are adequately managed. Knowledge and awareness will not only enable each worker in every unit of the healthcare system to be cognizant of knowing what to do in terms of fulfilling obligations, but also to observe each ethical code that drives their establishment to do what is just. People will be free from presumptions and preconceived notions and able to build better relationships.
Healthcare units and representatives must embrace transparency, accountability, fairness, and integrity to establish corporate values that all employees will emulate. In doing so, they will be able to encourage learning and instill good moral conduct that can generate a successful and flourishing corporate establishment.
The introduction of good moral behaviour can help the healthcare unit improve substantially and boost the efficiency of their job administration.
To ensure improvement in healthcare systems, the administrators must lead others by exhibiting good conduct that people can see, believe in, and replicate. In addition, they must understand that their conduct and behavioural attitude are a representation of the organisation they belong to. Hence, they must represent their profession and work system well while exemplifying good conduct by practicing what they preach.