In hospitals of Addis Ababa, there is a high turnover of leaders while patient and health
workers’ satisfaction is low, and safety and quality are in dire situations. The purpose of
this study was to explore and propose strategies to improve effectiveness of hospital
leadership in order to enhance the quality of health care provided in hospitals through
improving health workers’ empowerment, job satisfaction and patient safety culture.
Thus, a sequential explanatory mixed method research design was used. The research
had three phases, in which the first phase used five structured questionnaires explored
leadership styles, the health workers’ satisfaction and empowerment, patient safety
culture, and the patient experience of quality of health care; while the second involved a
qualitative study (content analysis); and third phase focused on the preparation of a
strategy document.
Data in the form of interview responses was gathered from 75 leaders, 542 health
workers, 532 patients and 11 key informants. The analysis shows that, overall, hospital
leaders considered themselves more transformational (M=2.98, SD=0.41) than
transactional (M=2.85, SD=0.46). Job satisfaction of private and public hospital health
workers were 70.8 % and 57.1 % respectively (P-value<0.001). In addition, private
hospital workers had a higher score in structural and psychological empowerment than their pubic hospital counterparts; the difference was statistically significant in all
dimensions (P-value <=0.03). The analysis reveals that public and private hospitals’
mean total patient safety scores were 3.58 and 3.77 respectively (P-value=0.02). Finally,
the “overall rating of hospital” was better for private hospitals: 84.8% and 88.4 %
respectively (P-value=0.03).
The study makes a number of observations. It notes that, firstly, transformational
leadership has direct and strong correlation with structural and psychological
empowerment (r=0.70, P-value=0.04 and r=0.83, P-value=0.01 respectively). Secondly, structural empowerment has a direct and significant effect on psychological
empowerment (β=0.28, P-value=<0.01); and minimal indirect effect on patient safety
culture through psychological empowerment (β=0.05, P-value=<0.05). Thirdly, health
worker job satisfaction also has had a direct effect on patient safety culture (β=0.44, Pvalue=<
0.01. The fourth and final observation is that psychological empowerment has
had a direct and statistically significant effect on patient safety culture (β=0.19, Pvalue=<
0.01). These observations indicate that, although private hospitals are better in
every dimension of this study, the current hospitals situation in Addis Ababa needs urgent
attention. Hence, the identification and recommendation for the preparation of eight
strategic priority areas along with key interventions seeking to improve the hospital
leaders’ effectiveness. / Health Studies / D. Litt. et Phil. (Health Studies)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:unisa/oai:uir.unisa.ac.za:10500/26566 |
| Date | 07 1900 |
| Creators | Yeneneh Getachew Haile |
| Contributors | Nkosi, Z. Z. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 1 online resource (xv, 294 leaves) : illustrations (chiefly color), graphs (chiefly color), application/pdf |
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