Abstract
Background
Ghana’s healthcare sector came under criticism regarding the quality of healthcare delivery, with issues relating to high-profile healthcare controversies, civil suits, and unfavorable patient outcomes due to medical incompetence. Despite the implementation of quality health programs, quality culture is yet to be institutionalized, leading to poor ties between clinical care and public health at the district level, and unclear monitoring and governance mechanisms. These have resulted in quality approaches that have had no effect on patient satisfaction and health outcomes. Even though nurses devote more hours to patients than most healthcare staff and offer care to patients on a regular basis, the daily assessment of the care they provide to patients is conducted without a thorough understanding of what quality healthcare entails. This study aims at assessing the quality of healthcare service delivery from the nurses’ perspective in a healthcare facility.
Materials and Methods
This was a cross-sectional quantitative study carried out among 104 systematically selected nurses. A standard questionnaire designed in accordance with the Donabedian Model of Quality Care was administered, and a reliability analysis (α) was conducted to ensure internal validity and reliability of the items used to measure the constructs. The structure subscale consisted of 12 items (α = 0.51), process subscale, 12 items (α = 0.62), and service quality (outcome) also consisted of 12 items (α = 0.58). Mardia’s Skewness and Kurtosis, Henze–Zirkler, and Doornik–Hansen multivariate normality tests were conducted at p values of .006, .102, .034, and .048, respectively, to ensure the independence of each construct as well as to satisfy the normality criteria. Descriptive analysis was also run to determine the extent to which the items reflect the current state of healthcare delivery. Finally, correlation, linear regression, and multivariate analysis of variance (MANOVA) analyses were carried out at a significant level of ≤0.05 to determine relationships and effects on healthcare delivery outcomes.
Results
Findings indicated a generally neutral opinion of the quality measures in relation to structures, processes, and outcomes of care at the study facility. Nurses faced limitations in providing needed care due to inadequate policy framework and enforcement, insufficient human resources, and lack of motivational packages. A Pearson r correlation matrix of the Donabedian constructs showed significant positive relationships between Structure and Process as well as Outcome and Process categories. A weak positive association outcome and structure constructs was, however, deemed insignificant. A MANOVA determined a significant effect of respondents’ gender and educational levels on their perception of quality healthcare.
Conclusion
Supervision in the hospital company and staff-management relationship must be strengthened to ensure a holistic quality of nursing care delivery.
Keywords
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