Strategy implementation at Kenyatta National Hospital, Kenya

Abstract

Public institutions in Kenya, including Kenyatta National Hospital, have been involved in strategic planning as a requirement of performance contracting. These organisations are characterised by management failure and poor customer satisfaction. Performance contracts requires that all public institutions are involved in strategy drafting and implementation. Drafting a superior strategy does not always result into superior outcomes if the strategy is not well implemented. This study, therefore, sought to establish how strategy is implemented at Kenyatta National Hospital and the challenges facing strategy implementation at the country's largest teaching and referral hospital. The study employed a case study design employing qualitative data. Data was collected through personal interviews among four middle level managers at the hospital. Analysis was then done using content analysis and data presented in a descriptive format. The study found out that strategy at the hospital is implemented using the Balanced Score Card approach with the four perspectives: Internal business process, customer perspective, financial perspective and learning and growth perspective. Strategy implemented has been cascade from the top management (tier 1) to the individual level (tier 4) for effective implementation. There is continuous training for all the stakeholders to fully understand and implement the Balanced Score Card for optimal outcomes. The challenges facing strategy implementation at the hospital included the hospital culture that results into resistance to change, inadequate government support, lack of finances, inadequate skill sets for specialised services and inadequate infrastructure. Lack of management support to the strategy implementation was also a major challenge to strategy implementation. Thus, there exist pertinent challenges facing strategy implementation at Kenyatta National Hospital. The informants in this study view management training, outsourcing and an incentive system as likely to play a major role in overcoming these challenges. It may therefore be necessary to institute such measures in the hospital.