MBA-HCM Theses and Dissertations (2024)

Permanent URI for this collection

http://hdl.handle.net/11071/15552

Browse

Now showing 1 - 8 of 8

Value of clinician - patient communication on patient satisfaction and net promoter score in private healthcare centers in Kenya
(Strathmore University, 2024) Wahome, C.
Healthcare services remain one of the basic and fundamental services to humanity. The attainment of the United Nations Sustainable Development Goal 3 and Kenya Vision 2030 blueprint will require a healthy nation. In the quest for the provision of good healthcare, the health service provider-patient engagement, interaction and communication are critically important. This study sought to determine the value of clinician-patient communication on net promoter score for private healthcare enterprise and impact on patient satisfaction in Nairobi Kenya. The specific objectives were to determine the influence of quality clinician-patient communication on patient satisfaction and to determine the effect of clinician-patient communication on Net Promoter Score of private healthcare enterprise in Nairobi Kenya. The study was anchored by the diffusion of innovation theory and supported by convergence theory. This study adopted a positivism research philosophy and descriptive survey method as the research design. The target population was 6,466 patients/caregivers with sample size of 377 patients/caregivers. A questionnaire was used to collect primary data. Data analysis was carried out using SPSS Version 21 and entailed descriptive and inferential statistics. The descriptive statistics comprised frequencies and percentages. Inferential statistics involved simple linear regression to determine the influence of quality clinician-patient communication on patient satisfaction and net promoter score of private healthcare enterprises. It was established that patient-clinician communication is positively and significantly correlated with patient satisfaction in private health care enterprises (β=1.496, p-value=0.000). In addition, patient-clinician communication is positively and significantly correlated with net promoter score in private health care enterprise in Kenya (β=1.743, p-value=0.000). The study concluded that patient-clinician communication influences patient satisfaction and net promoter score. The study recommends training clinicians on proper verbal and non-verbal communication to foster a deeper interaction and relationship with patients. Thus, the study recommended the establishment of an effective feedback communication loop between clinicians and patients to avoid instances of ambiguity and miscommunication. Key words: clinician-patient communication, net promoter score, patient satisfaction, private healthcare enterprise, Nairobi Kenya
Relationship between personality traits and work engagement in medical doctors at the M.P Shah Hospital
(Strathmore University, 2024) Tanaguza, C. Y.
Personality traits are what make each of us unique, and it also determines how we handle different situations in our daily lives. Work engagement is characterised as a fulfilling, active-motivational state indicative of positive work-related well-being. Physicians who are work-engaged are less prone to experiencing burnout and exhibit dedication and energy in their professional endeavours. It gives businesses the ability to appraise worker efficiency. The job of a medical doctor is largely reliant on their response to medical situations presented to them on a day-to-day basis, usually under stressful conditions because these decisions usually determine the overall outcome of the patient. Knowledge of their personality traits could aid in improving the delivery of quality healthcare services to patients, as well as determine the success of their careers. This study, therefore, sought to assess how the five personality dimensions influenced the work engagement of medical doctors at the M.P Shah Hospital. The research was based on the trait theory of personality. It was a cross-sectional analytical study. Convenience sampling of doctors was primarily used in the study. Primary data was collected using a single online questionnaire that was administered to a sample of 62 licensed medical doctors practicing at the M.P Shah Hospital. Data was analysed with the use of the SPSS version 26.0. The results showed that majority of the medical doctors scored high for agreeableness, conscientiousness, neuroticism, and openness traits like openness and conscientiousness demonstrated significant positive correlations with work engagement, other traits like extraversion, agreeableness, and neuroticism showed weaker and non-significant relationships. The regression analysis underscored the prognostic significance of openness for work engagement, indicating that individuals with a greater inclination toward new experiences are highly likely to demonstrate elevated levels of engagement in their professional responsibilities. However, the limited influence of other personality traits implied that other factors not considered in the study contributed to doctors' levels of engagement at the hospital. The study findings suggested that policymakers could incorporate personality tests in the process of recruiting and retaining personalities best fit for certain jobs and optimize working conditions. Academicians could determine the professions that would best fit them by examining the five traits of personality, faculty development, and career planning could be tailor-made to medical doctors ‘personality traits.
Clinical errors—the unclassified diagnosis; application of TeamSTEPPS tool to examine the impact of teamwork on clinical errors at Gulu Hospital
(Strathmore University, 2024) Abacha, G. O.
Clinical error continues to highlight the shortcomings of the healthcare system, particularly the Healthcare ergonomics and the human system. If it were to be a disease, it would rank the third-leading cause of deaths in the population. They are latent or active events that occur as a result of structural, process, or outcome-based actions ranging from failing of an action on intended objective to using erroneous policy, procedures, processes, and practices in patient care. Healthcare institutions are investing significant resources to reduce the incidence and severity of clinical errors in patients through collaborative team structures and effective communication in order to promotes safe, patient-centred, and equitable healthcare. However, in Uganda and elsewhere the notion of teamwork to reduce clinical error incidence and severity have been low due to poor safety culture, punitive leadership, poor communication ethics, and lack of mutual team support. This study aimed to examine how team structures, leadership and management, mutual support, and communication impacts on the incidence and severity of clinical errors at Gulu Hospital. The study was anchored on two theories and models: Human Error and system error theories and TeamSTEPPS Model and System Engineering Initiatives for Patient Safety (SEIPS). A mixed-method cross-sectional study design using structured and unstructured questionnaires developed from the Team Strategies and Tools to Enhance Performance and Patients Safety (TeamSTEPPS) framework were used to collect primary and secondary data. The collected data were analyzed using Spearman’s Rank Correlation in SPSS Version 10. The result showed that conflict management and effective team communication significantly improves clinical error reporting, resolution, and deaths, however, no significant relationship with team structures, team leadership, and mutual team support. Furthermore, the findings showed clinical error deaths are not significantly related to the different teamwork themes studied except team conflict management. In conclusion, though clinical error is not a classified diagnosis by standard, the results indicate that teamwork may reduce the incidence and severity of clinical error at Gulu Hospital. The study recommends hospital, policy institutions, and healthcare providers to embrace teamwork as an innovative approach to strengthen team collaborations especially in promoting quality of care and patient safety culture in healthcare.
Social accountability of health facility committees in delivery of primary health care services in Nyandarua County, Kenya
(Strathmore University, 2024) Muriithi, B. M.
Despite Health Facility Committees being recognized as a useful mechanism of social accountability, they remain inherently unprepared for their role. The study sought to determine the social accountability of health facility committees in the delivery of primary health care services in Nyandarua County, Kenya. Specifically, the study sought to document sources of information used by HFMCs, the role of existing formal and informal guidelines on the functioning of HFMCs, the influence HFMCs community participatory processes and to assess the decision-making processes regarding primary health care service delivery in Nyandarua County. The study adopted the social contract theory, stakeholder theory and Bove Model. The researcher adopted a mixed-method correlational research design. First, the study adopted a descriptive quantitative approach to determine the relationship between variables using dispensaries and health centers in Nyandarua County as the unit of analysis A total of 32 Health Facility Management committees and 32 health administrators were sampled and included in the study using a stratified random sampling approach. The study collected primary data using questionnaires and focused group discussions. Participants for the focus group discussions were purposively sampled from each of the 32 health facility committees using a criterion that ensured heterogeneity in terms of gender, age, and years of working experience. Data analysis included descriptive analysis of means frequency and percentages using Statistical Package for Social Sciences for the survey data and manual thematic coding for the qualitative interview data. The findings revealed that HFMCs get information on the status of healthcare provision from the management, medical staff, subordinate staff, and the county government. In addition, the findings revealed that HFMCs are usually guided by formal and informal guidelines. Furthermore, the findings revealed that one on one community meetings are the most helpful participatory mechanism. One-on-one meetings allow HFMC members to engage directly with community members on a personal level. Finally, the findings revealed that among decisions that HFMCs are involved in are income-generating activities decisions and hiring and firing of facility support staff. Regarding sources of information used by HFMCs, the researcher concluded that the main source of information is from the member’s community. Concerning the existing guidelines on the functions of HFMCs, the study concluded that the majority of the guidelines used by the committee are informal. The study also concluded that one one-on-one community meetings are the most commonly used participatory mechanism. Regarding the decision making process the study concluded that HFMCs are involved in various decision making however they are mostly involved in advocating and mobilizing resources on behalf of the health facilities they represent. From the conclusion the study recommended that the County Government of Nyandarua should ensure that there is training of the committees and availing of guidelines for the HFMC on various issues including information gathering, community participation, and decision making.
The Effect of devolved governance on the delivery of health services in Wajir County, Kenya
(Strathmore University, 2024) Abukar, S. M.
One of the key components of the Kenyan constitution is the concept of devolution which emphasizes the bringing of crucial services closer to people at the grassroot level. Devolved governance has been endorsed as a means of reducing inefficiencies when delivering healthcare services besides enhancing responsiveness to community needs. Wajir County was among the counties ill equipped to provide quality health services under the devolved governance structure. Even though studies had demonstrated the connection between devolved governance systems and improved delivery of services including healthcare, county governments in Kenya still grappled with inadequate capacity and resources to effectively deliver. Fewer current studies had been undertaken to examine the impact of devolved governance on health services in resource-deprived Arid and Semi-Arid counties such as Wajir. This study sought to address this gap by assessing the effect of devolved governance on the delivery of health services in Wajir County. The study determined the effect of devolved health staffing, devolved health financing and devolved hospital leadership/management on delivery of health services in Wajir County. The study was anchored on the systems theory and the theory of fiscal federalism. A convergent parallel research design was applied. Target population consisted of county health officials namely 33 county health management team members and 126 public health facility managers. 5 county health management team members were purposively sampled while a census of the 126 public health facility managers was taken. The primary data used was collected using an interview guide and a questionnaire. To analyze the data, qualitative and quantitative techniques were used. Data from interviews was analyzed using content analysis while quantitative data was analyzed through descriptive and inferential. A multiple regression model was used to show the relationship between the study variables. Qualitative findings were presented using narratives and appropriate verbatim quotes while quantitative findings were presented using charts and tables. The study established that devolved health staffing, devolved health financing and devolved hospital leadership/management positively and significantly affected health services delivery in Wajir County. Devolved hospital leadership/management was found to have the largest effect on the delivery of these services. The study therefore, concluded that devolved governance had a positive significant effect on the delivery of health services in Wajir County. Improved devolved governance would boost the delivery of health services in this county. Several recommendations for improvement were proposed. The study recommended that the county government should progressively increase funding to public health facilities. Increased budgets for recruitment of additional staff and facilitating their capacity development were also recommended. Formation of independent hospital management boards, institution of diversified motivation incentives for staff and adoption of efficient funds disbursement mechanisms that incentivized public health facilities to deliver quality and efficient health services were also recommended. It was expected that study findings would serve as a foundation for future studies.
Relative influence of factors affecting physician prescribing decisions in Nairobi County
(Strathmore University, 2024) Kanda, C. O.
Over the past few decades, the overall healthcare expenditure and particularly towards medication has increased quickly in many countries. The consequence of this is reduced access to treatment especially for non-communicable diseases. To address the rising expenditure on medication, lower priced high quality generic medication have been considered. However, their use remains below expectation with previous literature attributing this to physician prescribing patterns. The current study used empirical methods to determine the comparative effect of these factors on generic prescribing of antihypertensives among physicians practicing in Nairobi County. The study applied the theory of planned behavior. It identified intention as a major factor in prediction of behavior occurring from subjective norms, attitudes, and perceived behavioral control. The correlational study design was applied to measure the relationship between the independent and dependent variables, with nonprobability sampling being used to recruit physicians. The population targeted were all physicians working in Kenya. Primary data was gathered using web-based questionnaires. The data that was collected and analyzed using quantitative methods, descriptive statistics, inferential statistics and SPSS. The factors affecting physician prescribing habits were assessed using spearman ranked correlation and logistic regression analysis. In addition, different percentages for each factor were compared using the Chi square test. The study findings established that physician, product, pharmaceutical, environmental and payer factors positively influenced prescribing behavior. The study also concluded that there was no relationship between patient factors and physician prescribing behavior of anti-hypertensive medication in Nairobi County. The main recommendation was to consider all factors as they affect prescribing behavior of anti-hypertensive drugs. Finally, the study recommended that physician knowledge enhances their experience, therefore hospitals should invest in providing opportunities for empowerment. The study had some limitations in that it was only done in Nairobi County and did not involve other Counties in Kenya. Moreover, only physicians were targeted mainly consultants, medical officers and interns and did not involve other non-physicians that provide clinical care especially in the primary healthcare setting.
Factors affecting the adoption of competitive strategies by private healthcare facilities in Nairobi, Kenya
(Strathmore University, 2024) Waitimu, F.
The healthcare industry is undergoing radical changes regarding applying new technologies and business models, complying with recent reforms and regulations, meeting the needs of the changing demographics, emerging diseases and social and economic trends. The democratization of healthcare has allowed various local and foreign players to enter this field, leading to the emergence of different private health organizations. To keep ahead, healthcare management has generated new competitive advantages to stay ahead. This study examined the characteristics that led Kenyan private healthcare facilities to adopt a certain competitive strategy. Resource Based theory inspired the research, while the Bowman's Strategy Clock was used to evaluate the competitive strategy adopted. The research examined how organizational and top management team variables impacted the competitive strategy adopted by the institutions. This descriptive quantitative research study employed survey questionnaires as the data collection tool. A stratified random sample was used to represent the population and minority groups. The data collected was then analysed using the SPSS model version 24. The study illustrated that the size of the organization, the financial capability and resource allocation, scope of operations, the top management teams’ decision-making process and entrepreneurial flair had a significant effect on the competitive strategies that were adopted by the private healthcare institutions within Nairobi County. With respect to strategy, results confirmed that the hybrid strategy on the Bowman’s Strategy Clock was the preferable strategy adopted by most private healthcare institutions in the region. Furthermore, the study recommended that private hospitals should optimize resource allocation, have corporate ownership or a board of directors to help with strategic decisions, improve their financial capabilities by seeking out new financing opportunities or foster strategic partnerships in order to stay ahead of their competitors. This research study added to the body of knowledge in strategic management and is beneficial to healthcare managers, entrepreneurs in the health sector, as well as policy makers. Keywords: Competition, strategy, health sector, private hospitals
Utilization of Health Management Information Systems at Vihiga County Referral Hospital
(Strathmore University, 2024) Matini, D. J.
Health Management Information Systems (HMIS) play a pivotal role in healthcare institutions. Previous evidence reveals that health information management systems are essential in facilitating the achievement of organizational objectives linked to patient care. However, despite HMIS utilization in some hospitals in Kenya, the country is yet to enjoy the full benefits of HMIS utilization. This study aimed to study the utilization of HMIS at Vihiga County Referral Hospital (VCRH), by considering the level of use and factors associated with its utilization. A mixed method cross-sectional study was in which all the 214 staff at VCRH were targeted for quantitative data collection using a questionnaire while qualitative data were collected from 10 purposively selected key informants. While quantitative data were analyzed using Stata 15, qualitative data were transcribed and analyzed thematically using Microsoft Word and NVIVO. 156 participants successfully completed questionnaires, of which only 135 were included in the analysis after removing incomplete questionnaires, while 10 key informants were interviewed. Individuals were aged between 30 to 39 (45.93%), with males comprising 47.41% and females 52.59%. The bivariate regression models demonstrated a significant effect of technological factors, managerial factors, operational factors, and organizational factors on HMIS utilization (p < 0.0001) while the multivariate regression model only showed significant relationship for technological factors (p<0.05). The qualitative results showed that persistent barriers included unstable infrastructure, personnel reluctance, and system functionality limitations. Strategic efforts focused on infrastructure, digitization of workflows, and end-user feedback mechanisms were advised by participants. The study concluded that technological factors, managerial factors, operational factors, and organizational factors were vital factors affecting the utilization of HMIS at VCRH while persistent barriers included unstable infrastructure, personnel reluctance, and system functionality limitations. There is a need to leverage on the identified factors to facilitate better transition to paperless record-keeping at VCRH.

Browse

Browsing MBA-HCM Theses and Dissertations (2024) by Issue Date

Results Per Page

Sort Options