Total Quality Management Practices and Service Delivery of Selected Public Hospitals in Machakos County, Kenya
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Date
2024-09
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Kenyatta University
Abstract
The fundamental right for all citizens is to be able to access health care needs in a timely manner that meets the quality standards recommended by World Health Organization. Machakos County has put in place infrastructural needs, resource allocation, and recruitment of competent staff, partnership and collaboration with relevant stakeholders to enhance service delivery within its public hospitals. However, there is inefficiencies and ineffectiveness evidenced in prolonged waiting time, absence of essential medical supplies, overcrowding and shortage of qualified personnel that have reduced service delivery. The study intended to establish total quality management practices and service delivery of selected public hospitals in Machakos County. Specific objectives were; to find out the effect of continuous improvement, to establish the effect of customer focus strategies, to determine the effect of top management support and to find out the effect of employee involvement on service delivery of selected public hospitals in Machakos County, Kenya. Deming theory of quality and SERVEQUAL model guided the study. Descriptive research design was used with a target population of 35 public hospitals and 800 healthcare workers in Machakos County. The sample was 267 healthcare professionals generated using Yamane sample size formula. Stratified random sampling was used to group respondents according to their similarities. Systematic random sampling aided the identification of respondents from their groups. Semi structured questionnaire enabled the generation of primary data. Pilot study was done in Athi River with all six public hospitals. Content validity, expert opinion and face validity enabled the determination of the instrument’s validity. Internal consistency was used to establish reliability of the instrument. Descriptive and inferential statistics were used in primary data analysis with the aid of SPSS version 23. Diagnostic tests such as normality, multicollinearity and autocorrelation were done. All approvals from relevant authorities, compliance to data protection laws, voluntary participation and respect to all research stakeholders guided the conduct of the research study. The findings showed that continuous improvement had a direct and positive relationship with service delivery. Continuous improvement had positive and significant effect on service delivery. The results demonstrated that customer focused strategy had positive relationship and had significant effect on service delivery. The study revealed that even though top management had a positive relationship, it did not have any significant effect on service delivery. The findings showed that employee involvement had positive relationship and had significant effect on service delivery in selected public hospitals of Machakos County. The study concluded that continuous improvement had effect on service delivery while customer focused strategy was effective in improving service delivery. It was concluded that top management support did not have any significant effect on delivery of services. The study concluded that the involvement of employees had significant effect on service delivery. It was recommended that public hospitals should regularly undertake service evaluation in line with total quality management practices, incorporation of customer satisfaction feedback in total quality management practices, commitment from top management on total quality management practices and inclusion of employee suggestions in decision making on total quality management practices to enhance service delivery. Future studies could be done in the county targeting private healthcare to benchmark the study findings and to incorporate moderating and mediating variables to establish any similarity in the findings.
Description
A Research Project Submitted to the School of Business, Economics and Tourism in Partial Fulfillment of the Requirement for the Award of Masters of Business Administration Degree (Strategic Management), Kenyatta University, September 2024