Total Quality Management Practices and Performance of Level Four Hospitals in Kilifi County, Kenya

Abstract

The performance of the public hospitals in Kenya has not been optimal. It is estimated that more than 74,000 children in Kenya die every year before reaching five years due to the poor service quality of the hospitals. In Kilifi County, the performance of some public hospitals has been dismal, leading to loss of life. The infant mortality rate in the county was 51.13 in 2015, 50.06 in 2016, 49.83 in 2017, 49.62 in 2018 and 49.59 in 2019. Thus, the study sought to examine the relationship between total quality management practices and the performance of Level four Hospitals in Kilifi County. The study was based on five theories: kaizen theory, coordination theory, empowerment theory, Crosby theory and balanced score model. The explanatory research design was utilised in this study. The targeted population was 303. The unit of analysis included Kilifi level four hospital, Mariakani level four hospital, Malindi level four hospital and Tawfiq level four hospital. The study used the stratified random technique to select the respondents. The sample size was 172 respondents, obtained using the Yamane formula. Content analysis was used to examine the qualitative data and the results were presented in writing. Quantitative results included both descriptive and inferential statistics. The study found the health care continuous improvement, customer focus, employee empowerment and top management commitment had a positive and significant relationship with the performance of level 4 hospitals in Kilifi County. The study concluded that the hospitals the employees are motivated through benchmarking which enable a mindset and culture of continuous improvement and the hospital management encourages engagement of employees in decision making. The hospitals offer prices that are affordable to their which has enabled it to increase their client base and hence better performance. The hospital has empowered their employees by laying trust on them and motivates them for better performance. The management of the hospitals are committed towards seeing better performance of the level four hospitals within the County. The study recommended that the hospitals should guarantee that there is effective communication which is a key element for the continuous culture through conveyance of the right message on the right time to enable the employees align with the corporate culture. The hospital management should first identify customer needs and expectations. Seek and promote customer feedback by allowing the customers to share their views of the hospitals on an individual basis. The hospital management should carry out delegation of duties to employees with and intention to grow and develop the capabilities and responsibilities of its employees. The hospital management should build better employee-employer relationships by indispensably motivate its workforce, give due credit and recognize a job well done and ensure that the employees are regularly and steadily consulted about critical decisions.