TABLE
OF CONTENTS
Page
Declaration – – – – – – – – – ii
Approval – – – – – – – – – iii
Dedication – – – – – – – – – iv
Acknowledgements – – – – – – v
Table of contents – – – – – – vi
List of Tables – – – – – – – – – x
List of Figures – – – – – – xi
Abstract – – – – – – – xii
CHAPTER ONE
- Background of the Study – – – – – 1
- Statement of Problem – – – – – 4
- Objectives of the Study – – – – 5
1.4 Research Questions – – – – – 6
1.5 Research Hypotheses – – – – – 6
1.6 Significance of the Study – – – – – 7
1.7 Scope of the Study – – – – – 7
1.8 Limitations of the Study – – – – – 8
1.9 Profile of the Selected Mission Hospitals under Study – 8
1.10 Operational Definition of Terms – – – 12
References
CHAPTER TWO
REVIEW OF THE RELATED LITERATURE
2.0 Introduction – – – – – 14
2.1 Conceptual Framework – – – – 14
2.1.1 The Purpose of Policies – – – – – 15
2.1.2 Characteristic of Business Policy – – – – 16
2.1.3 Element of Business Policy – – – – 16
2.1.4 Types of Policies – – – – – 17
2.1.6. Implementation of Business Policy – – – 19
2.1.7 Objectives of Business Policy – – – – 20
2.2 Theoretical Framework – – – – – 20
2.2.1 Introduction – – – – – 20
2.2.2 Open System Model – – – – – 20
2.2.3 Characteristics of Open Systems – – – 24
2.2.4 Open Systems Management – – – – 25
2.2.5 Closed-System Models: – – – – 25
2.2.6 Business Environment – – – – 27
2.2.7 Characteristics of Environment – – – – 29
2.2.8 Classification of Environment – – – – 30
2.2.9 External and Internal Environment of Business – 30
2.2.10 Classification Based on the Rate of Change – – – 31
2.2.11 Nigerian Business Environment. – – – 32
2.2.12 Environmental Effect of Businesses – – – 33
- Types of Environment faced by Business Organizations 33
2.2.14 Impact of Public Policies on Businesses – – 37
2.2.15 Open systems and Environments – – – 39
2.2.16 Nature and scope of hospital – – – 39
2.2.17 Functions of the Hospital – – – 40
2.2.18 Service Quality and Open Business Policy in Hospitals 41
2.2.19 Increasing Patient Satisfaction and Quality of Care – – 42
2.2.20 Challenges in the Administration of Mission Hospital – 43
2.2.21 Human Resource Management as a Profession in
Mission Hospitals 45
2.2.22 Role of Human Resource Management in Hospitals – – 46
2.2.23 Human Resource Requirements in Hospitals: – 49
2.2.24 Causes for Poor Human Resource Management – 49
2.2.25 Manpower Planning – – – 50
2.2.26 Benefits of Manpower Planning – – – 50
2.2.27 Objectives of Manpower Planning – – – 51
2.2.28 Teamwork – – – – – 51
2.2.29 Team-building among Health Care Professionals – 52
2.2.30 Association among Health Care Professionals – 53
2.3 Empirical Review – – – – 54
2.3 .1 Introduction – – – – – 54
2.4 Summary of the Related Literature Review – – 56
Reference
CHAPTER THREE
RESEARCH
METHODOLOGY
3.1 Introduction – – – – 61
3.2 Research Design – – – – – 61
3.3 Sources of Data – – – – – 61
- Instruments for Data Collection – – – 62
3.5 Population of the study – – – – 62
3.6 Sample Size Determination and Sample Technique – 64
3.7 Sampling Procedure – – – – 66
3.8 Validity and Reliability of Instrument – – 66
3.8.1 Validity of instrument – – – – – 66
3.8.2 Reliability of Instrument – – – – 66
3.9 Data Treatment Techniques – – – 66
References
CHAPTER FOUR
PRESENTATION AND ANALYSIS OF DATA
- Introduction – – – – – 69
4.1 Questionnaires Distribution and Response – – 69
- Hypotheses Testing – – – – – 91
4.3 Discussion of Results – – – – 103
CHAPTER FIVE
SUMMARY OF MAJOR FINDING, RECOMMENDATIONS
AND CONCLUSION
5.1 Summary of Major Finding – – – – 110
5.2 Recommendation – – – – – 111
5.3 Conclusion – – – – – 111
5.4 Contribution to Knowledge – – – – 111
5.5 Areas for Further Research- – – – – 113
Bibliography – – – – – 114
Questionnaire – – – – – 118
Appendix
1 – – – – – 123
Appendix
11 – – – – – 137
Appendix
111 – – – – – 138
Appendix
1V – – – – – 139
LIST OF TABLES
Table 1 Population of staff – – – – 63
Table 2 Sample size allocation – – – – 65
Table 4 Question distribution and response – – – 69
Table 5 Distribution of respondents by Gender – – 70
Table 6 Distribution of respondents by Age – – – 71
Table 7 Educational Qualification of Respondents – – 72
Table 8 Marital Status of Respondents – – – – 73
Table 9 Work Experience of the Respondents – – 74
Table 11
Objective One To what extent is the
quality of service to patients
in the
mission hospitals dependents on having a suitable open system
business policy model – – – 75
Table 12
Objective Two What is the relationship between open system
business
policy model and the management of human resource in
the
mission hospitals – – – – – 78
Table 13 Objective Three What are the reasons for failure in service delivery among mission hospitals – – 82
Table 14
Objective Four What is the utmost challenge of adopting business
policy
models in mission hospitals – – – – 85
Table 15
Objective Five What are the benefits from utilizing open system
business
policy among mission hospitals – – – 88
LIST OF FIGURES
Figure 1 Basic open system model – – – 22
Figure 2 Overview of the open system of an oganisation – 23
Figure 3 An organisations environment – – – 38
Figure 4 Environmental factors surrounding a
hospital employee and
industrial
employee – – – – – 48
Figure 5 Pie chart Representing respondents Gender – 70
Figure 6 Bar chart Representing respondents Age – – 71
Figure
7 Bar chart of Educational Qualification of Respondents – 72
Figure 8 Pie chart of Marital Status of Respondents – 73
Figure 9 Bar chart of Work Experience of Respondents – 74
ABSTRACT
The purpose of this research is
to analyse the appraisal of open system business policy model in the management
of mission hospitals in the South South Nigeria, the study was motivated by the
need to give possible strategies and solution through the use of open system
business policy model in the management of mission hospitals in the South South
Nigeria. The population of the study was 732 staff of the 10 selected mission
hospitals in Edo State, Delta State, River State and Cross River State in
south- south Nigeria. A sample size of 502 was determined from the population
using Taro Yamane’s formula in conjunction with two-tail test. The hypotheses
were tested using non parametric statistical technique which included: Friedman
Chi-square and Z-test. The findings reveal that the reasons for failure in
service delivery among mission hospitals in South South Nigeria are due to
abortive business policies, increasing rate of changes in technology, unhealthy
work environment and high bureaucratic difficulties (x2c =
496.660 > x2t= 7.815,
df =3 p<0.05).There is a significant
relationship between open system business policy model and the management of
mission hospital in South South Nigeria (Zc= 372.422 > Zt= 1.96, a<0.05).
That Open system model to large extents has assisted the mission hospitals in South
South Nigeria to benefit from its environment through exchange of information,
procurement of both input and economic resources, ability to adapt to changes
in the environment and effective quality service to patients (Zc= 4.179 >Zt= 1.96, a<0.05). The appropriate means for improving
quality of service to patient among mission hospitals in South South Nigeria
are adaptation of suitable open system business policy model, enabling work
environment, implementation of constant training programs and the presence of
foreign professionals (expatriate) (x2c = 372.422 > x2t= 7.815, df =3
p<0.05). Environmental effect on quality
service delivery to patients among mission hospitals in South South Nigeria are
unstable Government policy, increasing rate of changes in technology, environmental conflict and poor
innovation (Zc= 4.186 >Zt= 1.96, a<0.05) Based on the result of the study, the
following recommendations were made: Hospital Organizations should adopt a
suitable open system business policy model that will enable them interact
properly with their environment for exchange of information and procurement of
both input and economic resources. Hospital Management should continually
implementing constant staff training programme to improve synergy and
cooperation in work place Hospital Management should acquire the model
equipment and foreign professionals (expatriate) which will be advantageous in
the production of quality of service to patients. The study concludes that with
appropriate implementation of suitable open system business policy models and
proper environmental consideration there will be effective and improved service
quality for patients among mission hospitals in South South Nigeria,
environmental prediction and adaptation, effective and improved synergy, team
spirit and cooperation in work place
CHAPTER ONE
- Background
of the Study
A policy is
considered the general guideline for decision making. Kalejaye, (1998) defines
policy as the objectives, the mode of thought and the body of principle
underlying the activities of an organization Business policy is a guide and
roadmap to create awareness and direction to the management of any
organization. It publicizes the rights and obligations of different rung of the
ladder- horizontal and vertical-of the different capital human resource
engagement, finance utilization etc. It ensures that organizations deliver
better end product within a framework. It encourages, promotes and improves
performance attainment in an organization. Policy provides the bedrock for vision
and mission statement of the business organization along the corporate
objectives and goal. Policy enables the business to be assessed and given an
image by the way they carry out their responsibility along with their
relationship with their clients/customers. It is the ‘barometer’ of playing by
the rule and gives purpose to the strategy thrust of the organization. Business
Policy defines the scope or spheres within which decisions can be taken by the
subordinates in an organization (Wikipedia, 2012). It permits the lower level
management to deal with the problems and issues without consulting top level
management every time for decisions. It is the study of the roles and
responsibilities of top level management, the significant issues affecting organizational
success and the decisions affecting organization in long-run.
Tracing the
history of business policy, Kazmi (2006) states that it can be traced back to
1911, when the Harvard Business School introduced an integrative course in
management in view of providing general management capability. This course was
based on case studies which had been in use at the School for instructional
purposes since 1908 (Christensen, et. al., 1982 cited in Kazmi, 2006). However,
the real impetus for introducing business policy in the curriculum of business
schools (as management institutes or departments are known in the United
States) came with the publication of two reports in 1959. In 1969, the
American Assembly of Collegiate Schools of Business), a regulatory body for
business schools, made the course of business policy a mandatory requirement
for the purpose of recognition. In the last two decades, business policy has
become an integral part of management education curriculum. The practice of
including business policy in the management curriculum has spread from the
United States to other parts of the world. The contents of the course, teaching
methodology and so on vary from institution to institution. But basically,
business policy is considered a capstone integrative course offered to students
who have already been through a set of core functional area courses. The term
“business policy” has been used traditionally though new titles such as
strategic management, corporate strategy and policy and so on are now used
extensively for the course. Business policy in term of hospital management
provides the guideline for deploying resources and mobilizing for the efficient
provision of effective health service which involves planning, organizing,
controlling, directing and leading (Olumide 1997)
Open system is a
system that regularly exchanges feedback with its external environment. Open
systems are systems, of course, so inputs, processes, outputs, goals,
assessment and evaluation, and learning are all important. Aspects that are
critically important to open systems include the boundaries and external
environment. Healthy open systems continuously exchange feedback with their
environments, analyze that feedback, adjust internal systems as needed to
achieve the system’s goals, and then transmit necessary information back out to
the environment. Hospital management open business policy provides guideline
that governs the hospitals interaction with its environment. A hospital cannot
operate independently without the presence of its suppliers, political cum
cultural, competitors, patients and religions environment. Some of the
subsystems within the hospital are the Nursing department, Laboratory department, pharmaceutics
department, emergency department etc need to be highly controlled and
predicted, possessing a considerable degree of self-regulation. A true open
system needs to be able to cope with controllable and unexpected inputs and
deal with these in predictable and contingent way (Katz 2004). (www.managementhelp.org/orgs).
Directory of
Hospitals in Nigeria, 1988, states that a hospital is an institution which is
operated for the medical, surgical and/or obstetrical care of in-patients and
which is treated as a hospital by the Central/state/government/local
body/private and licensed by the appropriate authority. Steadman’s Medical
Dictionary defined hospital as an institution for the care, cure and treatment
of the sick and wounded, for the study of diseases, training of doctors and
nurses. Open business policy provides guideline that governs the hospitals
interaction with its environment.
The product of a
hospital is service to people provided by its personnel with a variety of
skills. The nature of the demand for hospital services is also distinctive to
the hospital-as admission to the hospital for services is rarely voluntary. The
decision is made for the patient that is ill and requires services which cannot
be provided at home. The patient leaves home, family, friends, his work-place
and his way of life for a new environment i.e. the hospital. In this new
environment, he becomes one of the many. In his home, he has a definite role.
In the hospital, his role is similar to thirty or fourty others in the ward or
unit in which he is a patient. If he is a patient in a multiple-bed unit and
confined to bed, he is housed with strangers and carries out several intimate
functions in the presence of these strangers. He is subjected to a new set of
values and a new way of life. In his environment, he meets many new people, and
he is expected to relate and communicate with them. On occasions, patients
encounter more than thirty different hospital personnel in the room in one day,
each performing different functions. A hospital deals daily with the life,
suffering, recovery and death of human beings. For the direction and running of
such an institution, its administrative personnel need a particular combination
of knowledge, understanding, traits, abilities and skills.
www.nou.edu.ng/pdf/pdf2/mpa%207)
Nigeria has made
progress in the last two decades in reducing maternal deaths, but the number of
women who die in pregnancy or from complications associated with child-birth
remains appallingly high. Nigeria is Africa’s most populous country and,
despite being one of its wealthiest, continues to experience high rates of
maternal deaths. The country has the 10th-highest maternal mortality ratio
(MMR) in the world with 630 women dying per 100,000 births a higher proportion
than in Afghanistan or Haiti, and only slightly lower than in Liberia or Sudan.
An estimated 40,000 Nigerian women die in pregnancy or childbirth each year,
and another 1 million to 1.6 million suffer from serious disabilities from
pregnancy- and birth-related causes annually. Nigerian women have an average total
of 5.7 births in their life, with each pregnancy exposing them to the risk of
maternal complications. Over her lifetime, a Nigerian woman’s risk of dying
from pregnancy or childbirth is 1
in 29, compare
