dc.description.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. | en_US |