Assesment of the implementation of quality management processes within selected public health facilities in Bungoma county, Kenya

Abstract

Quality Healthcare is the kind of care that meets the expectations of patients, financiers, and all other stakeholders. Quality management process is a set of procedures to ensure that deliverables meet the expectations of the customers. This involves the interaction between healthcare personnel, customers, procedures, equipment, modern technology, and other resources to deliver expected quality health services to customers. The study assessed the implementation of Quality Management processes within selected public Health facilities in Bungoma County Kenya. The objectives of the study are to establish the patient’s perception on implementation of quality management processes, staff adherence to standard operating procedures and assess the level of the hospital management involvement in implementation of quality management process within selected public health facilities in Bungoma county. The significance of the study is to come up with findings that will be used by the county government of Bungoma to strengthen the Quality assurance department to ensure Quality health care. The study was conducted in Bungoma County within three sub-county hospitals that is Kanduyi, Bumula and Kabuchai. The facilities were selected based on the Volume of patients seen.364 respondents (324 patients, and 40 health workers, The response rate for patients was 95.1%. The study design used was descriptive cross-sectional survey. Data was collected using a structured questionnaire and an observation checklist for the health workers. Data was managed using SPSS V22, descriptive data was analyzed using means, frequencies, and percentages while chi-square was used to establish association between variables. Study findings indicate Most, 195(63.3%) patients perceived implementation of quality management processes to be below average. Waiting time for the services as per the service charter was long more than one hour (54.4%). The health services offered were not affordable, inadequate staff, inadequate medical supplies and equipment, delay in referral systems and attendance emergencies. Staff adherence to Sop’s in implementation of quality management processes shows all, 40(100.0%) indicated adherence to SoP’s, 28(70.0%) didn’t have hard/soft copies of Sop’s, 30 (77.5%) did not refer to the Sop’s when discharging their duties, all indicated presence a service charter, 32 (80.0%) did not refer to the service charter while engaging in their daily duties, only 16 (40.0%) had been trained on Sops. All 40 (100%) reported computerization of their hospital. All 40(100%) indicated their facility had a Quality Assurance Department (QAD) where 25 (62.5%) reported that their QAD conducted audits with 14 (35.0%) observing that their Quality assurance department offered feedback reports on the audits. On average about, 55.25% of health workers were in agreement/perceived that there was implementation of quality management processes in hospitals. On average, more than a half, 58.25% indicated that hospital management does not involve fully in implementation of quality management process. From the study findings, there was inadequate staff 31(77.5); p=0.001, inadequate financial resource allocation, 34(85%), p=0.000, inadequate medical supplies, 33(82.5%) p=0.000, inadequate staff involvement in change management,28 (70%), p=0.001, irregular customer surveys, 32(80%, p=0.335, irregular quality management staff teaching /training, 27(67.5%), p=0.001. Study will provide findings that will be crucial in improving implementation of quality management processes in Bungoma hospitals with a view of enhancing customer satisfaction.