Delivery Of Hospital Services Research Articles

Focusing on Access and Quality of Health Services: Khyber Pakhtunkhwa's Progressive Healthcare Reforms

This research has analyzed the effects of the Government reforms on health service delivery in both public and private hospitals within Khyber Pakhtunkhwa. Khyber Pakhtunkhwa has undertaken significant strides in healthcare reform. Programs like Sehat Card Plus prioritized expanding access to quality care for residents. Initiatives like the Revamping Primary and Secondary Healthcare program have focused on improving the quality of care delivered. This is achieved by modernizing facilities and equipment, ensuring healthcare professionals have the necessary resources and training. This approach empowers individuals and promotes a more sustainable healthcare system overall. The study has used data from paneled hospitals where reforms were launched for health service delivery. The authors have used the ADF test and the Granger causality test. The study results showed that delivery was expanded and enhanced throughout the province due to all the improvements. Moreover, the Granger Causality test determined that there existed a causal relationship between OPD and HR, and there also existed a Granger Causal relationship between OPD and FR. The study suggested that Khyber Pakhtunkhwa should work towards a future where residents must receive effective treatment throughout the healthcare system. Moreover, there is a dire need for strict monitoring for the provision of quality care delivered to the people and universal health coverage in KP throughout the country.

Affective Commitment, Organizational Culture and Turnover Intention among Health Professionals in National Referral Hospitals in Kenya

The study aimed to assess the influence of affective commitment on turnover intention among health professionals in public national referral hospitals in Kenya. It also examined whether organizational culture mediates the effect of affective commitment on the turnover intention of health professionals in public national referral hospitals in Kenya. Theories anchoring this study included Social exchange theory and Theory Z. Descriptive and correlational research designs were used in the study. The research designs were to assess: 
 
 The relationship, effect and mediation between variables. 
 The influence of affective commitment on turnover intention and organizational culture mediation of affective commitment effect on turnover intention. 
 The Target population was all health professionals in public national referral hospitals in Kenya. 
 
 The study used SPSS version 25 for scale accuracy. The study findings showed that the relationship between affective commitment and turnover intention was significant, that of affective commitment and organizational culture was moderate and significant, and that the organizational culture turnover intention was significant. Further, the study found that organizational culture did not mediate the effect of affective commitment on turnover intention. Based on the study findings, the study concluded that affective commitment influences the turnover intention of health professionals in public national referral hospitals in Kenya and that affective commitment effect on turnover intention is not mediated by organizational culture. The study recommended that human resource practitioners use the study to come up with policies and guidelines that improve service delivery in referral hospitals. Board members of public national referral hospitals should borrow ideas from competing values frameworks to enhance a culture of high performance in their hospitals.

Adaptation and validation of the Children’s Surgical Assessment Tool for Rwandan district hospitals

ABSTRACT Background/Aims Paediatric surgical care is a critical component of child health and basic universal health coverage and therefore should be included in comprehensive evaluations of surgical capacity. This study adapted and validated the Children’s Surgical Assessment Tool (CSAT), a tool developed for district and tertiary hospitals in Nigeria to evaluate hospital infrastructure, workforce, service delivery, financing, and training capacity for paediatric surgery, for use in district hospitals in Rwanda. Methods We used a three-round modified Delphi process to adapt the CSAT to the Rwandan context. An expert panel of surgeons, anaesthesiologists, paediatricians, and health systems strengthening experts were invited to participate based on their experience with paediatric surgical or anaesthetic care at district hospitals or with health systems strengthening in the Rwandan context. We used the Content Validity Index to validate the final tool. Results The adapted tool had a final score of 0.84 on the Content Validity Index, indicating a high level of agreement among the expert panel. The final tool comprised 171 items across five domains: facility characteristics, service delivery, workforce, financing, and training/research. Conclusion The adapted CSAT is appropriate for use in district hospitals in Rwanda to evaluate the capacity for paediatric surgery. This study provides a framework for adapting and validating a comprehensive paediatric surgical assessment tool to local contexts in LMICs and used in similar settings in sub-Saharan Africa.

Moderating Effect of Mobile Technology on the Relationship Between Health Systems Governance and Service Delivery in National Referral Hospitals in Kenya

In recent years, there is an increased attention to build formidable health systems governance to promote the highest attainable standard of health service delivery which has become a fundamental part of our human rights and of our understanding of a life in dignity. The health systems governance through the establishment of health policy has taken on increasing importance in the provision of health care services in the health institutions. The public hospitals in Kenya have weak health systems governance attributed to the existing health policy affecting quality healthcare. The current study sought to examine the moderating effect of mobile technology on the relationship between health systems governance and service delivery in National Referral Hospitals in Kenya. The study was anchored to the Contingency Leadership Theory. The study identified six categories of the target respondents, namely, 5 directors, 43 board members and 88 head of departments. The study used regression analysis to analyze the association between the variables at 0.05 level of significance. Results revealed that mobile technology positively and significantly moderated the relationship between health systems governance and service delivery in national referral hospitals in Kenya. The results support the current theories related to the study. Consequently, this study provides national referral hospitals with insights of how to improve health care service delivery through the adoption of appropriate mobile technology and health systems governance in the national referral hospitals. This could go a long way in ensuring there is improved service delivery in the national referral hospitals in Kenya. The implications of the study are that the moderating effect of mobile technology on the relationship between health systems governance and healthcare service delivery in Kenyan hospitals can lead to positive outcomes such as improved communication, data management, and patient-centered care. However, it also presents challenges that need to be carefully addressed through appropriate governance mechanisms. The successful integration of mobile technology requires a comprehensive and adaptive approach to healthcare governance in the national referral hospitals in the country.

Agile HR-Based Employee Management Practices for Improving Hospital Service Delivery

The effective management of the human resources of a hospital is essential for the delivery of high-quality healthcare services, a task that has become incredibly challenging in the wake of the COVID-19 pandemic in India. The efficient management of employees is a top priority in healthcare organisations, which is why human resources (HR) plays a pivotal role in their functioning. It includes strategies for improving employee engagement, productivity, motivation, adaptability to change, welfare, and overall health in addition to traditional HR concerns. As part of this process, conducive working conditions must be created, talent management practices must be implemented, and flexibility must be provided to meet the evolving needs of healthcare professionals. The adoption of Agile HR practices is gaining momentum among hospitals in response to the dynamic challenges they face. In the Agile approach, the development cycle of 'Plan, Do, Check, and Act (PDCA)' enables real-time responsiveness. Through a qualitative research design with in-depth interviews conducted through purposive sampling, this study explores the implementation of Agile HR practices in hospitals located in Kerala and Karnataka. The research presents a novel human resources operating model, termed the 'Agile HR Model,' which advocates the integration of Agile principles into the management of healthcare employees. A key objective of this model is to enhance hospital service delivery by embracing agility and adaptability. The study provides HR managers and healthcare professionals with insights into enhancing the delivery of healthcare services

THE INFLUENCE OF HEALTH WORKERS’ DISTRIBUTION ON THE QUALITY OF HEALTH SERVICE DELIVERY IN PUBLIC HOSPITALS IN MANDERA COUNTY, KENYA

Background: Quality health care access remains a primary agenda on SDGs at global level. Locally, on personnel, the number of medical professionals per capita within the local governmental entities is frequently used to indicate the unequal distribution of healthcare personnel. Variances in increased mortality trends, the necessity for healthcare services per capita, and hence the human required resources per capita, may differ among units. Mandera County faces similar challenges. The main objective of this study was to determine how health workers’ distribution influences the quality of service delivery of health services at government hospitals in Mandera County. Methods: Using a descriptive research design, health personnel from Mandera County Referral Hospital, Laffey, Rhamu and Banisa Sub County Hospitals formed the unit of analysis. The study conducted December 2022 used a random sample of 189 respondents from a population of 357 using proportional and simple systematic sampling procedures. A questionnaire method that was self-administered and 10 KII (patients) was used to gather data. Results: The study found and concluded that at the significance level of 95%, skills mix, Individual Factors, Institutional Environment and socio-cultural factors were significant and positively correlated factors in influencing quality of health service delivery in public hospitals in Mandera County with significance values of 0.001, .005, .003 and .002 respectively. Conclusion: All the studied variables only affect quality of healthcare service at 53.2%, implying 46.8% needs to be explored further. KEY WORDS: Quality Healthcare, Health Workers’ Distribution, Skill Mix, Service Delivery, Individual Factors, Institutional Environment, Socio-Cultural Factors

Enhancing Effective Verbal Communication Between Radiologic Technologists and Patients: Assessing the Impact of Service Delivery in Hospitals of Dhaka City

Objective: Effective communication is crucial in the field of radiography as it holds significant importance in the practice. Radiologic technologists need to possess an understanding of both the physical and emotional requirements of patients. This understanding can be attained through proficient communication skills. Methodology: A qualitative research study was conducted in nearly fifteen private hospitals in Dhaka City in Bangladesh and 61 radiological technologists and 111 patients responds to this study. Result: The most important thing is, radiological technologist data showed there were 40 (65.6%) radiological technologists using protective shields for patients when taking radiographic exams and likewise Patients data showed there were 65 (58.6%) patients said that the radiological technologists were not using protective shields when taking radiographic exam. This is a contradictory issue of each other. It is due to a lack of awareness among professionals and patients and also due to a lack of supervision of the concerned authority. Conclusion: The study aimed to assess the extent of verbal communication occurring between radiological technologists and patients. It also sought to recognize the significance of patient care, ensuring patient safety, and determining priorities within diagnostic radiology departments.

Factors Affecting Supply Chain Agility In Public Institutions And Healthcare Performance, A case Of Nimba County, Liberia

In today's dynamic and uncertain business environment, the ability of public institutions and healthcare systems to respond swiftly to changes while maintaining high-performance standards is of paramount importance. This study delves into the intricate relationship between supply chain agility and healthcare performance within the context of (Public Hospitals) Nimba County, Liberia. The aim of this study is to identify and analyze the key factors that influence supply chain agility and subsequently impact healthcare service delivery and overall performance in public hospitals in Nimba County, Liberia. Drawing on a comprehensive review of existing literature, this research synthesizes the multifaceted determinants that shape supply chain agility in the unique setting of public institutions (Hospitals) and healthcare preference in Nimba County, Liberia. The regression model with the independent variables (Inventory control, Procurement, Information Technology and Warehouse management) showed a strong positive correlation with the dependent variable. These predictors explained about 60.41% of the variance in the dependent variables, with addition of these predictors have significantly improved the model's performance, as indicated by the low p-value (0.000) for the F Change statistic. The research recommends the management of the public hospitals in Nimba County and Liberia at large, to enhance its implementation to realize its impact at higher levels. Among these practices to put more emphasis on skills development, supportive supervision and performance review. In conclusion, this study offers a comprehensive analysis of the factors influencing supply chain agility in public institutions and their subsequent impact on healthcare performance in Nimba County, Liberia.

Vertical integration of general practices with acute hospitals in England: rapid impact evaluation.

Vertical integration means merging organisations that operate at different stages along the patient pathway. We focus on acute hospitals running primary care medical practices. Evidence is scarce concerning the impact on use of health-care services and patient experience. To assess the impact of vertical integration on use of hospital services, service delivery and patient experience and whether patients with multiple long-term conditions are affected differently from others. Rapid, mixed methods evaluation with four work packages: (1) review of NHS trust annual reports and other sources to understand the scale of vertical integration across England; (2) development of the statistical analysis; (3) analysis of national survey data on patient experience, and national data on use of hospital services over the 2 years preceding and following vertical integration, comparing vertically integrated practices with a variety of control practices; and (4) focus groups and interviews with staff and patients across three case study sites to explore the impact of vertical integration on patient experience of care. At 31 March 2021, 26 NHS trusts were in vertically integrated organisations, running 85 general practices across 116 practice sites. The earliest vertical integration between trusts and general practices was in 2015; a mean of 3.3 practices run by each trust (range 1-12). On average, integrated practices have fewer patients, are slightly more likely to be in the most deprived decile of areas, are more likely to hold an alternative provider medical services contract and have worse Quality and Outcomes Framework scores compared with non-integrated practices. Vertical integration is associated with statistically significant, modest reductions in rates of accident and emergency department attendances: 2% reduction (incidence rate ratio 0.98, 95% confidence interval 0.96 to 0.99; p < 0.0001); outpatient attendances: 1% reduction (incidence rate ratio 0.99, 95% confidence interval 0.99 to 1.00; p = 0.0061), emergency inpatient admissions: 3% reduction (incidence rate ratio 0.97, 95% confidence interval 0.95 to 0.99; p = 0.0062) and emergency readmissions: 5% reduction (incidence rate ratio 0.95, 95% confidence interval 0.91 to 1.00; p = 0.039), with no impact on length of stay, overall inpatient admissions or inpatient admissions for ambulatory care sensitive conditions. The falls in accident and emergency department and outpatient attendance rates are temporary. Focus groups and interviews with staff (N = 22) and interviews with patients (N = 14) showed that with vertical integration, health service improvements are introduced following a period of cultural interchange. Patients with multiple long-term conditions continue to encounter 'navigation work' choosing and accessing health-care provision, with diminishing continuity of care. In the quantitative analysis, we could not replicate the counterfactual of what would have happened in those specific locations had practices not merged with trusts. There was imbalance across three case study sites with regard to staff and patients recruited for interview, and the latter were drawn from patient participation groups who may not be representative of local populations. Vertical integration can lead to modest reductions in use of hospital services and has minor or no impact on patient experience of care. Our analysis does not reveal a case for widespread roll-out of the approach. Further quantitative follow-up of the longer-term impact of vertical integration on hospital usage and more extensive interviewing of patients and their carers about patient experiences of navigating care. This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (BRACE Project no. 16/138/31) and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 17. See the NIHR Journals Library website for further project information.

Role of trust in customer attitude and behaviour formation towards social service robots

This research proposes a model that identifies the antecedents of customers’ attitudes and behaviours towards the utilization of artificially intelligent (AI) social service robots in hospitality and tourism service delivery. The model highlights the importance of trust and its determinants on customers’ attitudes and behaviours towards social service robots. The proposed model and the hypotheses are tested utilizing data collected from the users of two distinctly different hospitality and tourism services. Data were analysed adopting a PLS-SEM approach. Results indicate that the level of acceptance of the use of social robots in service delivery is determined by a multistage process, in which trust perceptions play critical roles. Heuristic (i.e., hedonic motivation) and the individual (i.e., innovativeness) factors positively influence trust in social robots during service delivery. Findings, however, suggest significant differences in different service contexts: anthropomorphism has no effect on trust construct and effort expectancy does not influence positive emotion in hedonic service contexts while these relationships are significant in functional service contexts. Practical and theoretical implications of the findings are discussed.

FTP1.5 The forgotten tribe in healthcare? Mechanism of injury and outcome of injured adolescents in a UK Major Trauma Centre

Abstract Aim Trauma is the leading cause of mortality in the adolescent and young adult population. Adolescents, particularly those aged 16-17 years often fall between provisions of traditional adult and paediatric services. This study examines the outcomes for injured adolescents treated at one combined adult/paediatric UK major trauma centre. Methods An observational study included patients aged 10-24.99 years treated at a single MTC between April 2020 and April 2022. Demographic and injury mechanism and severity (ISS) data were recorded for three subgroups: paediatric (10-15 years), transitional (16-17) and young adult (18-24). Outcomes were compared including length of stay, surgical procedures and mortality. Results 343 patients were included (78.4% male). 16-17 year olds were significantly more likely to be victims of violence and require a longer stay in hospital. Mortality was 4.1% overall. Conclusions It is vital that the specific needs of young people aged 16-17 are recognised in terms of violence reduction and injury prevention strategies, and in planning and delivery of hospital services.

Effects of Accessibility on Health Service Delivery in Public Hospitals in Kilifi County, Kenya

Achieving UHC has remained a severe challenge globally, with countries experiencing severe gaps in the healthcare delivery system. Therefore, this research intends to bridge the gap by investigating UHC's effects on healthcare services in Kilifi County. The study aims to establish how accessibility affects health service delivery in public hospitals in Kilifi County. Institutional and new public management theories guided the study. The study adopted a descriptive research design and targeted a total of 2875 participants comprising both healthcare workers and patients attending the healthcare facilities and senior healthcare management team. The researcher adopted stratified random and convenience sampling to select 288 subjects for the study. A pilot study was undertaken to establish the validity and reliability of data collection instruments. The data were collected using a structured questionnaire for quantitative data and an interview guide for qualitative data, and the results were presented using percentages and frequency tables. Descriptive statistics and a regression model were used to analyze quantitative data, while qualitative data utilized thematic analysis. The results from the study showed that there was a significant association between accessibility factors for the patients where availability of services was associated with increased service delivery OR =1.25,95% CI=0.90-1.74, p=0.190) while staying further away from the facility is associated with decreased service delivery (OR) =0.76,95% CI=0.34-1.67, p=0.49). Similarly, easy accessibility was associated with improved service delivery on healthcare workers' factors OR =1.09,95% CI=0.21-5.68, p=0.9180). Thematic analysis revealed similar findings where increased accessibility was associated with increased service delivery. The results of the study were used to make recommendations for improving accessibility through integrating healthcare services within different departments and healthcare facilities using ICT. Finally, the study recommends further research on how technology in healthcare will increase accessibility. Keywords: Universal Health Coverage, Accessibility, Affordability, Quality, Service Delivery &nbsp

Collecting data on the experiences and perspectives of people with dementia in the acute care hospital setting: A systematic scoping review.

People with dementia frequently experience poor health outcomes that require hospitalisation; however, the hospital setting is generally unsuitable for these patients. While it is well-recognised that understanding patient perspectives is crucial to providing person-centred care, current clinical care guidelines do not describe how to effectively collect feedback from people with dementia. Historically, people with dementia have generally been neglected from data collection exercises among practitioners and academic researchers, alike. The objective of this review is to describe the data collection processes from peer-reviewed evidence sources that include direct consultation with, and elicit feedback from, patients with dementia about their care experience in the hospital setting. The protocol for this systematic scoping review was pre-registered (https://doi.org/10.6084/m9.figshare.16614667.v1). The review considered primary quantitative and qualitative research involving people with dementia as research participants, regarding the quality of hospital care from the patient's perspective. Four databases were searched (MEDLINE, CINAHL Complete, APA PsycINFO and Embase), with 14 studies meeting the eligibility criteria. There has been an increased interest in gaining the perspectives of people with dementia on their health care over the past 5 years. Sundry methodologies were employed by these studies, but most used informal qualitative interviews to support and enable participants with diverse symptoms and functional abilities to take part. Procedures concerning recruitment, ethics and consent, and data collection processes were, likewise, varied and not reported consistently across this body of evidence. People with dementia can be meaningfully consulted as research participants in the hospital setting. Increased rigour when reporting the methodologies and strategies used during data collection is needed to provide guidance for health services and researchers to further enable the inclusion of people with dementia. Including people with dementia in data collection endeavours in the hospital setting is essential to improving health outcomes, increasing equity and providing better hospital service delivery to this vulnerable cohort.

Awareness and Accessibility of library resources for enhanced service-delivery of healthcare workers in government tertiary hospitals in Abuja, Nigeria

The study titled awareness and accessibility of library resources for enhanced service delivery of healthcare workers in government tertiary Hospitals was carried out to establish the frequency of access to available library resources by healthcare workers for enhanced service delivery in government tertiary hospitals in Abuja-Nigeria; determine how awareness of library resources has influenced service delivery of healthcare workers in government tertiary hospitals in Abuja- Nigeria; The respondents are healthcare workers in the categories of doctors; nurses; medical laboratory scientists and pharmacists. A descriptive research design was adopted with the use of Questionnaires to elicit information from the healthcare workers. The numbers of the questionnaire distributed are 353; the numbers retrieved are 333. The study concludes that there is a link between awareness and access to library resources and enhance service delivery by healthcare workers. The influence of accessing library resources on healthcare service delivery of healthcare workers is attributable to healthcare workers’ awareness of the relevance of library resources.

Effect of Devolved Financial Planning on Health Care Service Delivery in Meru Teaching and Referral Hospital

The Kenyan constitution of 2010 established a decentralized structure of government that upholds health as a fundamental right for every individual. Additionally, it specifies the national governments and county governments’ responsibilities for providing health services as well as the guidelines that should guide their delivery. It became imperative to address the administration, planning, and management of health services in response to the changes after the first general elections held in accordance with the Kenyan constitution (2010) and the establishment of County Governments. Notably, numerous Counties have been plagued with colossal problems including strikes, corruption, and delayed wages that have contributed to subpar service delivery, among other things. The purpose of this study was to analyze the effects of devolved governance on health care service delivery in Meru teaching and referral hospital in Kenya. The objectives of the study were; to examine the effect of devolved financial planning on health care service delivery in Meru teaching and referral hospital, to assess the effect of devolved heath infrastructure on health care service delivery in Meru teaching and referral hospital, to explore the effect of devolved staffing on health care service delivery in Meru teaching and referral hospital and to examine the effect of Policy Framework on service delivery in Meru teaching and referral hospital. The study was based on tanahashi health model and soufflé theory of 1995, and it employed a descriptive research design with a mixed methods targeting 1996 participants comprising of health care workers, at MTReH, outpatient patients visiting the facility, and members of the Meru County Assembly. The study adopted a stratified sampling forming 10 Statas of the respondents, a simple random sampling was subjected to the respondents in their respective Statas to pick the study participant. The study utilized questionnaires for various departments in the hospital and the MCA, interview guide for hospital administrator and CEO and a focus group discussion with the patients for data collection purposes. SPSS version 28 was used to analyze the coded data. The study used both descriptive and inferential statistics for data analysis. Descriptive statistics was presented inform of Mean, frequencies and standard deviations while regression and moment correlation was used for inferential statistics, data presentation was done by use of figures and tables

Operational and Financial Impacts of Digital Health Technology: A Study on Canadian Healthcare System during the COVID-19 Pandemic.

During COVID-19, hospital capacity was significantly reduced to limit the spread of the pandemic. The limitations affected the efficiency of service delivery. We examined the effects of pandemic-related challenges on patient experience and hypothesize that digital health implementation increased patient satisfaction. We surveyed nationally aggregated data in hospital occupancy, hospital funding and patient experience, and plotted their correlation. We found digital health to contribute to patient experience and service-delivery effectiveness. We evaluate the benefits of digital health in context of hospital service delivery. Post-COVID-19, we recommend a continued implementation of digital health and offer suggestions to further improve its efficiency and cost-effectiveness.

What enhances service delivery in public hospitals in Kenya? The role of total quality management practices

The public health sector is affected by various challenges, such as operational inefficiencies and poor service delivery. These challenges affect public hospitals' delivery of quality services that meet client expectations. As a result of these issues, public hospitals have adopted the total quality management approach to deal with these challenges. The general objective of this research was to determine the effect of total quality management application on the quality-of-service delivery across public hospitals in Kenya. The study was anchored on a resource-based view, dynamic capabilities, and system approach theories. The research applied a descriptive approach to the target population of 1718 respondents. The sampling approach for the study was a stratified random technique that selected a sample of 250 participants. The findings indicated that employee involvement, technology adoption, continual advancement, and client focus affect service delivery across various public hospitals in Kenya. The research concluded that applying total quality management practices is essential and influences service delivery across various public hospitals. Therefore, the national and county governments are supposed to ensure management’s commitment to the implementation of TQM practices across the county’s healthcare facilities.

Determining the effect of sub-contractor’s expertise on service delivery in public hospitals in Nakuru County

This study aimed to determine the effect of sub-contractor expertise on service delivery in public hospitals in Nakuru County. The agency theory guided the study. Both cross-sectional and explanatory research designs were adopted. The research was concerned with collecting data from procurement officers, heads of departments, and medical superintendents of public hospitals operating in Nakuru County. A census design was adopted where all 80 staff were projected to participate in the study. The study was delimited to primary data collected from the respondents using a structured questionnaire. The research instrument was pilot tested with the primary objective of assessing its validity and reliability before it was employed in collecting data for the full-scale study. The collected data were analysed with the assistance of the Statistical Package for Social Sciences. Multicollinearity tests were conducted, and these were tested using variance-inflated factors (VIF) and Tolerance (T), where the two parameters were reciprocal to each other. The data were analysed using descriptive and inferential statistics. The effect of each of the aforesaid aspects of subcontracting on service delivery was as well established to be statistically significant. Professionalism, competence, specialised expertise, and experience were concluded to be essential ingredients considered by these hospitals in selecting and engaging subcontractors. The study also concluded that the expert subcontractors had a statistically significant effect on service delivery in public hospitals in Nakuru County. It is recommended that there should be clear policies on various aspects of expertise subcontracting and contracting in the public health sector.

Knowledge Creation and Sharing for the Efficiency of Service Delivery in the Hospitality Industry Within the Five Star Hotels in Naivasha, Nakuru County

The hospitality industry in Kenya has experienced a period of serious economic hardship ranging from poor room occupancy rates impacting expected revenues to poor service delivery. This difficulty could be due to the outbreak of COVID-19, which has completely shut down the hotel industry. The main aim of this research was to investigate the impact of knowledge management on the efficiency of hospitality service delivery in a five-star hotel in Naivasha, Nakuru County. The specific purpose was to determine how information generation, knowledge exchange, knowledge application, and knowledge storage affect the hotel industry's service delivery efficiency. This research was based on the theory of knowledge-based view. This study used a descriptive research design and collect primary data using a semi-structured questionnaire. This study will target 250 management staff of 13 five-star hotels in Naivasha. The sample size of 154 respondents was selected by stratified random selection. To explain the data's properties, descriptive statistics was used in the analysis. Correlation and regression analysis was used to evaluate the relationship between the research variables. Tables and graphs were used to present the findings. The findings indicated that knowledge creation and efficiency of service delivery were positively and significantly related (β=0.340, p&lt;0.05). Further results showed that knowledge sharing and efficiency of service delivery were positively and significantly related (β=0.297, p&lt;0.05). In addition, results showed that knowledge application and efficiency of service delivery were positively and significantly related (β=0.197, p&lt;0.05). Further results showed that knowledge storage and efficiency of service delivery were positively and significantly related (β=0.143, p&lt;0.05). The study concluded that creating opportunities for capacity building enhances service delivery in the hotels. Further, sourcing out knowledge from external sources helps in knowledge creation which enhances service delivery. The study also concluded that utilization of institutional knowledge as well as having a knowledge sharing policy in the hotels aids in improving service delivery in the hotel. The study also concluded that storage of information through documentation, record keeping, classifying information and training enhances service delivery. The study further recommends that hotels should utilize knowledge to enhance efficiency of service delivery through development of knowledge creation policies and to encourage employees to utilize the knowledge gained on service delivery to develop new innovations and come up with new products and services. It is important for policy makers in five star hotels to develop robust and dedicated knowledge management capabilities. This is because knowledge management leads to growth and expansion of hotels internationally and subsequently improve the service delivery. This research contributes significantly to the subject of knowledge management. It informs changes to be made in the hospitality industry in regard to implementation of knowledge management.&#x0D;

The voice of ostomates: an exploration of stoma care in England.

This article is part one of a series presenting the findings of stakeholder surveys with ostomates and stoma care nurses for stoma services in England. Due to the volume of data and publication limits this article focuses on the views and experiences of 2504 people living with a stoma (ostomates). To understand the experience of ostomates in relation to the current services provided in hospital and at home, the delivery of care and views on areas that work well and areas that require improvement. Ostomates were asked to share their experiences in a national online survey, promoted via multiple organisations. The survey included sections for respondent demographics, interactions with the stoma care nurse (SCN), products and dispensing services, as well as patients' experiences relating to both hospital-based care and home-based care. Free-text responses relating to service delivery in hospital and at home were coded and thematically analysed. Results are presented, and verbatim quotes used to demonstrate themes. These include care provision and access to visits from the SCN, physical and psychological care, information sharing, specialist knowledge and products. Overall, the survey respondents praised the care given, however, the experiences and views shared via the survey show significant variation in the care and services received. This article presents the findings of a survey of ostomates living in England. A second article, presenting the findings about the experiences of stoma care nurses will be published in a forthcoming issue.