Factors Influencing Delays Of Elective Surgical Cases At The Aga Khan Hospitals In Kenya

ABSTRACT

Countries face health systems challenges which in turn affect the quantity and quality of health services delivered to the people. This consequently results in poor service delivery, negative outcomes and client dissatisfaction. Globally, delays of elective surgical procedures are a major concern for all healthcare institutions and their resolution would be key in reducing waste and improving workflow efficiency. However, achieving efficiency in the performance of elective surgical cases has been marred by numerous factors especially in the developing world, and Kenya, in particular. This study sought to identify the factors influencing delays of elective surgical cases at the Aga Khan hospitals in Kisumu, Nairobi and Mombasa, Kenya. The study evaluated patient, staff, equipment and management support factors associated with delays of elective surgical cases. This research adopted a descriptive cross-sectional study design encompassing use of both quantitative and qualitative data. Quantitative data was collected through questionnaires administered to operating room staff while qualitative data was collected through Key Informant Interviews with operating room administrators. Stratified random sampling was applied to select 238 respondents from a target population of 494 operating room staff drawn from the Kisumu, Nairobi and Mombasa Aga Khan Hospitals. Two (2) Key informants from each targeted facility were purposively selected for inclusion in the study. The researcher obtained all required approvals from relevant authorities and obtained informed consent from research participants prior to conducting the study. Data was cleaned, entered into data base before commencement of analysis; Descriptive data was then analyzed using Statistical Package for Social Sciences version 23.0 to calculate the mean and standard deviation. Microsoft Excel program was used to generate percentages, frequency tables and pie-chart. Inferential statistics were calculated using Pearson’s Correlation and Multi-Linear regression methods to test the relationship between variables at 95% confidence interval where p-values of ≤ 0.05 were considered significant. Qualitative data was analyzed thematically and was guided by the study objectives, and then the results were triangulated with quantitative findings from questionnaires. The results indicate that out of the four factors studied, only Staff and Management factors (X2: β2 =.074, P< .007), (X4: β4 =.516, P < .000) had significant influence on the delays of elective surgical cases at the Aga Khan hospitals in Kenya, while Patient and Equipment factors (X1: β1 =.034, P>.267), (X3: β3 =.009, P >.841) were not found to have any significant influence on delays of elective surgical cases at the Aga Khan hospitals in Kenya. The study recommended that the hospital management of the three hospitals address Operating Room staffing, timely financial clearance for booked patients, staff coordination, timely replacement of old surgical equipment and adequacy of operating theatres.