Quality improvement practices and creative governance success in public hospitals in Kenya

https://doi.org/10.59952/tuj.v4i1.158

Authors

  • Veronicah Kaluyu Chandaria School of Business, USIU-Africa
  • Paul Wachana Chandaria School of Business, USIU-Africa
  • Elizabeth Kalunda Chandaria School of Business, USIU-Africa

Keywords:

creative governance, data analysis, monitoring for change, quality improvement, quality models

Abstract

This study assessed the influence of quality improvement practices on creative governance success in Tier four public hospitals in Kenya. The study adopted a descriptive correlation research design. The target population was 200 composed of Administrative officers and Mid-level employees from each hospital. A census survey of 200 respondents was used. A Questionnaire yielding an acceptable reliability coefficient 0.7 and response rate of 157 respondents was attained during data collection. The background information was analyzed using descriptive statistics such as frequencies and percentages. The hypothesis testing was done using linear regression analysis. Quality Improvement (QI) practices assessed entailed: Establishment of dedicated quality improvement teams, holding of regular quality improvement meetings, establishing QI procedures/models, evidence of QI data collection and analysis and, monitoring to measure change. Overall, there is implementation of QI practices to some extent in the Tier four hospitals in Kenya. Correlation analysis between QI practices and creative governance indicated a strong positive significant relationship (r= 0.672 p= 0.00,). Creative governance was measured by innovative ideas/products, creative designs of processes, learning new skills, attainment of organization goals, motivated staff and satisfied clients. On testing the study hypothesis, results showed that quality improvement practices influenced creative governance (β= 0.55; p=0.000) but to mere 55% in the case of these selected public hospitals. The study results therefore inform hospital managers on the need to pay more attention to quality improvement practices so that the hospitals may reap the benefits of creative governance which then leads to superior delivery of services.

References

Ahire, S., Golhar, D., & Waller, M. (1996). Development and validation of TQM implementation

constructs. Decision Sciences,27(1), 23–56.

Anderson, J. C., Rungtusanatham, M., Schroeder, R. G., & Devaraj, S. (1995). A path analytic model

of a theory of quality management underlying the deming management method: Preliminary

empirical findings. Decision Sciences, 26(5), 637-658.

Anyango, D., Wanjau, K. & Mageto, J. N. (2012). Assessment of the relationship between quality

management practices and performance of manufacturing firms in Nairobi. African Journal

of Business and Management, 2, 63-70.

Anyango, J.A. & Kegoro, H.O. (2020). Continuous improvement on operational performance of

selected public universities in Kenya. The International Journal of Humanities & Social

Studies, 8 (2)31-34.

Azevedo M. J. (2017). The state of health system(s) in africa: Challenges and opportunities. historical

perspectives on the state of health and health systems in Africa. The Modern Era, 2(5),1–73.

Bac, M., Bergh, A., Etsane, M.E. & Hugo, J. (2015). Medical education and the quality improvement

spiral: A case study from Mpumalanga, South Africa. Afr J Prm Health Care Fam Med., 7(1),

Barasa, E.W., Maina, T., Ravishankar, N. (2017). Assessing the impoverishing effects, and factors

associated with the incidence of catastrophic health care payments in Kenya. Int J Equity

Health, 16(31). https://doi.org/10.1186/s12939-017-0526-x

Batalden, P.B., & Davidoff, F. (2007). What is “quality improvement” and how can it transform

healthcare? QualSaf Health Care, 16(1), 2–3.

Bell, M. & Omachonu, V. (2011). Quality system implementation process for business success.

International Journal of Quality & Reliability Management, 28(3), 723-734.

Boaden, R., Harvey, G., Moxham, C., & Proudlove, N. C. (2008). Quality improvement: Theory and

practice in healthcare. NHS Institute for Innovation and Improvement.

Boyer, K.K, Gardner, J.W. & Schweikhart, S. (2012). Process quality improvement: An examination

of general vs. outcome-specific climate and practices in hospitals. Journal of Operations

Management, 30(4), 1- 4.

Chen, I. & Kuo, M.C. (2011). Quality improvement: Perspectives on organizational learning from

hospital-based quality control circles in Taiwan. Human Resource Development

International, 14(1), 91-101.

Choi, T.Y. & Eboch, K. (1998). The TQM paradox: Relations among TQM practices, plant performance

and customer satisfaction. Journal of Operations Management, 17(1), 59-75.

Chumba P; Sang H. W.; Kibett J. and Kirui J. K (2019) Relationship between ISO 9001 Certification

and the Number of Non- Conformities Identified during System Audits in Selected Public

Universities in Kenya. International Journal of Engineering and Management Research.

Volume- 9, Issue- 5.

Crosby, P. (1979). Quality is free. McGraw-Hill.

Csikszentmihalyi, M. (1996). Creativity: Flow and the psychology of discovery and invention.

HarperCollins Publishers

Dahlin, S., Eriksson, H., & Raharjo, H. (2019). Process mining for quality improvement: Propositions

for Practice and Research.Quality Management in Health Care, 28(1), 8-14.

Daily Nation. (2013, November 24). Public health crisis looms in Kenya as Doctors quit over

devolution. Retrieved from www.naton.co.ke.

Daniels B, Dolinger A, & Bedoya G. (2017). Use of standardised patients to assess quality of healthcare

in Nairobi, Kenya: a pilot, cross-sectional study with international comparisons. BMJ Global

Health, 2(1) 33.

Deming, E. W. (1982). Quality, productivity, and competitive position. Cambridge, MA: MIT Center

for Advanced Engineering Study.

Feigenbaum, A. V. (1991). Total quality control. McGraw-Hill.

Fiaz, M., Ikram, A., & Ilyas, A. (2018). Enterprise resource planning systems: Digitization of healthcare

service quality. Administrative Sciences, 8(3), 38.

Flodgren, G., Gonçalves-Bradley, D.C. & Pomey M.P. (2016). External inspection of compliance with

standards for improved healthcare outcomes. Cochrane Database of Systematic Reviews

, 12

Fønhus, M.S., Dalsbø, T.K, Johansen, M., Fretheim, A., Skirbekk, H., & Flottorp, S.A. (2018). Patientmediated

interventions to improve professional practice. Cochrane Database of Systematic

Reviews 2018(9). Art. No.: CD012472.

Fotso, J.C., Mukiira, C. (2011). Perceived quality of and access to care among poor urban women in

Kenya and their utilization of delivery care: harnessing the potential of private clinics? Health

Policy Plan, 27(6), 505–515.

Fredriksson, M., Halford, C. & Eldh, C. A., Tobias Dahlström1, T., Vengberg1, S. Wallin L., & Ulrika

Winblad, U. (2017). Are data from national quality registries used in quality improvement at

Swedish hospital clinics? International Journal for Quality in Health Care, 29(7), 909–915

Government of Kenya. (1994). Kenya's health policy framework. Ministry of Health.

Government of Kenya. (2007b). Kenya Vision 2030.Government of Kenya.

Government of Kenya. (2010). The Constitution of Kenya. Government of Kenya.

Government of Kenya. (2013). Millenium Development Goals: Status Report for Kenya. Nairobi:

Ministry of Devolution and Planning, Government of Kenya.

Government of Kenya. (2014a). Kenya Health Policy 2014-2030. Ministry of Health, Government of

Kenya.

Hysong, S., Best, R., Pugh, J., (2006). Audit and feedback and clinical practice guideline adherence:

making feedback actionable. Implement Sci,1(9), 1-9.

Juran, J. M. (2004). Architect of Quality. New York, NY: McGraw-Hill.

IOM (2000). World Migration Report, 2000. International Organization for Migration (IOM)

Kaoru, I. (1985). What is total quality control? Prentice-Hall.

KEMSA Taskforce Report, (2020). Strategic planning practices by Kenya medical supplies agency.

Leatherman, S., Ferris, T.G. & Berwick, D. (2010). The role of quality improvement in strengthening

health systems in developing countries. Int J Qual Heal Care, 22(1), 237–243.

Magutu, P. O., Aduda, J., & Nyaoga, R. B. (2015). Does supply chain technology moderate the

relationship between supply chain strategies and firm performance? Evidence from largescale

manufacturing firms in Kenya.International Strategic Management Review,3(1),4365.

McGivern, G., Nzinga, J., & English, M., (2017) 'Pastoral practices’ for quality improvement in a

Kenyan clinical network. Social Science & Medicine, 195(1),115-122.

Mold, J. W., & Peterson, K. A. (2005). Primary care practice-based research networks: working at the

interface between research and quality improvement. Annals of family medicine, 3 Suppl

(Suppl 1), S12–S20. https://doi.org/10.1370/afm.303

Mugo, L. S., & Nzuki, T. (2019). Conceptualizing the integration of ehealth with egovernance in a

developing country. Information Resources Management Journal (IRMJ),34(3), 64-78.

Mukabana, B. Nancy Khayeli, N. & Adegu. W. (2018). Improving long acting and reversible

contraceptives uptake using quality improvement strategy at a sub-county hospital Kenya.

International Journal of advanced Research (IJAR) 6(8), 774-782

Murkomen, O. K. (2012, October 24). Devolution and the health system in Kenya. Retrieved

February15, 2017, from Health Policy Project:

https://www.healthpolicyproject.com/ns/docs/Kenya_Kipchumba_Presentation.pdf

Mutua, J. (2014). Quality management practices and financial performance of cement manufacturing

firms in Kenya. (Unpublished MBA Project), University of Nairobi.

Mwaambi, P.R. (2017). Universal health care coverage: Healthcare financing and access to health care

services in Kenya. Clinical Case Reports and Reviews, 3(10), 1-3.

Noël, G., Joy, J. & Dyck, C. (2017). Improving the quality of healthcare data through information

design. Information Design Journal,23(1), 104–122.

Oleribe, O. O., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T., Williams, R., &

Taylor-Robinson, S. D. (2019). Identifying key challenges facing healthcare systems in africa

and potential solutions. International Journal of General Medicine, 12(1), 395–403.

Omidvari, A.H., Vali, Y., Murray, S.M., Wonderling, D., Rashidian, A. (2016). Nutritional screening

for improving professional practice for patient outcomes in hospital and primary care settings.

Cochrane Database of Systematic Reviews 2013(6) doi: 10.1002/14651858.CD005539.pub2.

Opon, S. O. (2016). Provision of essential health package in public hospitals: A case of Homabay

Countyhospitals, Kenya. The Pan African Medical Journal:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992368/

Otieno, P.O., Wambiya, E.O.A., & Mohamed, S.M. (2020). Access to primary healthcare services and

associated factors in urban slums in Nairobi-Kenya. BMC Public Health,20(1), 981

https://doi.org/10.1186/s12889-020-09106-5.

Oyaya, C.O., & Rifkin, S. B. (2003). Health sector reforms in Kenya: An Examination of district level

planning. Elsevier Science Ireland Ltd: http://www.healthpolicyjrnl.com/article/S0168-8510

(02)00164-1/abstract

Shortell, S.M., Bennett, C.L., & Byck, G R. (1998). Assessing the impact of continuous quality

improvement on clinical practice: What it will take to accelerate progress. The Milbank

Quarterly, 76(4), 593-624.

Smyrnova, T. (2020). Healthcare industry challenges 2020.https://upplabs.com/ healthcare-industrychallenges-2020/.

Stasha, S. (2021). The state of healthcare industry – Statistics for 2021.Retrived on 7/12/2021from

https://policyadvice.net/insurance/insights/healthcare-statistics/ .

United Nations Development Programme. (2016, September 14). Kenya government gives road map to

implementation of SDGs. United Nations Development Programme

http://www.ke.undp.org/content/kenya/en/home/presscenter/pressreleases/2016/leave-noone-behind--

kenya-government-gives-road-map-to-implemen.html

Walsh, K., Helm, R., Aboshady, O.A. (2016). Quality improvement in health care: how to do it. Br J

Hosp Med (Lond),2(9), 536-538.

WHO, (2011). Abuja declaration 10 years on.

https://www.who.int/healthsystems/publications/Abuja10.pdf

WHO, (2017). Primary health care systems (PRIMASYS): Comprehensive case study from Kenya.

World Health Organization Report. Geneva.

WHO, (2018). The african regional health report: The health of the people. Bulletin, 96.

WHO, OECD & World Bank (2018). Delivering quality health services: A global imperative for

universal health coverage. Geneva.

Published

2023-03-27

How to Cite

Kaluyu, V., Wachana, P., & Kalunda, E. (2023). Quality improvement practices and creative governance success in public hospitals in Kenya . The University Journal, 4(1), XX-XX. https://doi.org/10.59952/tuj.v4i1.158

Most read articles by the same author(s)

1 2 > >>