A standardization model for staffing among medical doctors at hospitals in Nairobi county, Kenya.
Kiura, Daniel Munyi
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Across the globe it has been a challenge for Hospital Administrators to accurately estimate the required workforce to cater for patient needs. Various methodologies have been used including Hospital bed capacity to doctor ratio, Population to doctor ratio and policy guidelines. None of these systems have adequately addressed the problem. Irad Ben-Gal et al (2010) proposed a model for determining the required number of doctors in any hospital department by taking into account factors such as average occupancy rates, staff leave, allowances, doctors' duties and patient service levels. This proposal aims to assess how adaptable the proposed model is through replication in a different setting. The study aims to confirm or disapprove the correlation between the time taken to perform direct and indirect patient care activities and the required physician staffing level at four hospitals in Nairobi County, Kenya namely Kenyatta National Hospital (KNH) ,Aga Khan University Hospital, Nairobi (AKUH,N), St. Mary's Mission Hospital(SMMH) and Mbagathi District Hospital (MDH) while taking into account patient occupancy rates. Arising from this study, recommendations will be made for any modifications to the model found necessary. A comparison will be made between the results established using the proposed model and those using the current method of staffing requirement in KNH, AKUH, N, SMMH and MDH A cross sectional survey will be done to establish the current method of determining the required number of doctors in the hospitals under study. The survey will employ use of an orally administered questionnaire to establish the different types of activities that physicians carry out in their daily work and the approximate length of time each activity takes .. The results of the survey will help design the work sampling study. The work sampling will be carried out using an Observation Schedule & Work Sampling Data Collection application tool. The tool will be downloaded onto a Samsung Galaxy 3 android handset or a handset of similar capability. In order to test the Standardization Model, work sampling studies will be carried out on the various factors and variables that affect the work load and required physician capacity. The data collected from the survey will be analyzed and factored into the model so as to derive the required physician staffing level. The data collected will be analyzed using Statistical Package for Social Sciences (SPSS) version 22. Linear regression analysis will be used to correlate the average occupancy rates and the required physician staffing level. Test for statistical significance will be carried out on each variable measured to determine the variable's importance in influencing physician staffing requirement. This study is expected to provide suggested ways of increasing staff utilization of permanent staff, reducing staff burnout and driving lowered cost of employing locum (temporary) doctors