Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021

ISSN: 2746-878X (Print), 2746-8798 (Online)

THE IMPACT OF ORGANIZATIONAL STRUCTURE AND

ADMINISTRATIVE POLICES OF HOSPITALS ON DELIVERING
QUALITY OF SERVICE FOR PATIENTS SATISFACTION

Kenneth Amoah-Binfoh1*, Pradhyuman Singh Lakhawat2, Rita Agyapong3

1*
Hospital Management Study Program, All Nations University, Koforidua, Ghana
2
Joseph School of Business, India
3
University of Cape Coast, Ghana

ARTICLE INFORMATION ABSTRACT

Background: A well-organized hospital will determine the

Received : May 9th, 2021 kind of service it will render to its patients. This diverse mix
Revised : August 16th, 2021
of objectives determine the nature of the hospital, its
Available online : August 31st, 2021
organizational hierarchy, the scope and volume of activities,
the number and size of departments, staffing patterns, etc.
CORRESPONDENCE Objective: The study seeks to examine the health workers
and in-patient’s relationship building and to identify the
importance of organizational structure in delivering quality
Phone : - services to in-patients.
Email : [email protected]
Method: The researchers considered a total of 35
management, and 70 in-patients together in all 105 as the
KEYWORDS sample size. These consisting of both males and females
working in the various functional areas, and operations in
Organizational Structure; Administrative
the Hospital. This sample size was chosen because it formed
Policies; Hospitals a fair representation of the population. Simple random
sampling was the sampling technique used for the study..
Result: This output also shows that Patients satisfaction
have a high positive relationship with Environment &
physical ambience, Payment process & Discharge process
,Information flow to family about patient condition &
treatment, Janitorial (daily cleaning), and Doctors
information about treatment & concerns (administrative
polices).
Conclusion: It was also recommended that; Management
should reduce the number of health workers working under
a superior and should also reduce the number of superiors’
management reports to. It was further recommended that,
management should, improvement the clarity of
communication and information giving to patients’ relatives
on patients’ condition and Management should also paste
the vision and mission statement of the hospital on walls and
vantage points for reminder.

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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

INTRODUCTION extended to alleviate health problems of the

The healthcare organizations community, Teaching and Research. Further
worldwide are struggling to deal Deloitte the secondary objective of the hospital
However with increasing health costs while includes financial viability, staff satisfaction,
providing high quality services to consumers motivation, productivity and Quality service:
at lower costs, in comparison to other which has to do with efficiency, effectiveness,
industries, the healthcare industry is a very equity, safety, patients-centered. Depending
costly industry as the medical practice today on the emphasis that the management wishes
requires more usage of technology and to give to achievement of some or all of the
modern medical tests. Most of the hospitals objectives or activities enumerated above,
spend millions to purchase and to upgrade each hospital develops and proclaim its
their medical equipments (Shukria & mission statement or philosophy. The mission
Deloitte, 2015). statement serves as a guideline to the
During the last decade, hospitals management and the senior executives.
have tried to move from functional towards The mission and vision statements
process-oriented organizational forms. In a form part of the organizational and
process-oriented hospital, the focus is on the administrative polices. The hospital set long
process of care instead of on functional term goal with the hope of achieving it in the
departments such as radiology and internal short run. It gives meaning to the purpose of
medicine. In hospitals, patient care comes the hospital and tells an employee what
first. In larger hospitals, particularly those institution expects in terms of his
attached to medical colleges, there will be contribution. The hospital philosophy and the
emphasis on training. The more specialized mission statement should therefore, be
centers will additionally have elements of publicized widely and be internalized by staff
research. More and more hospitals are and all those intimately involved in the affairs
getting involved in community health and of the hospital for easy acquaintance.
outreach programmes. The principal The quality of health services
objectives of a hospital include central provision in Indonesia’s hospitals is low and
goals: these are cure, diagnostic, treatment the Indonesian Government is seeking to
procedures and rehabilitation. Medication as improve this situation through its legislative
a supportive goal: care which includes, and administrative capacity. This is because
nursing care, providing an atmosphere for the established practices of the public sector
rest, quietness, comfort and thereby in Indonesia is to follow regulations set out in
facilitates healing and reassuring patients’ umbrella laws or policies, and such laws or
rehabilitation. However, the goals are policies ensure public goods, such as health
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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

services, are appropriate and delivered METHODS

effectively (Wulan, 2017). Hospitals are The researchers considered a total of
health facilities that provide in-patient, out- 35 management, and 70 in-patients together in
patient, and emergency care with all its all 105 as the sample size. These consisting of
supporting facilities. To be able to perform both males and females working in the
their activities, each hospital must establish various functional areas, and operations in the
rules that regulates how healthcare is Hospital. This sample size was chosen
provided, this is regulated into the hospital because it formed a fair representation of the
by-laws. population. Simple random sampling was the
sampling technique used for the study. This
probability sampling method was adopted
because it gives every member of the
population an equal chance of being selecte.
RESULTS
Table 1

Items Description N=70 100%

Age a. 20-30 24 34.3
b. 30-40 42 60.0
c. 40-50 4 5.7
Gender a. Male 46 65.7
b. Female 24 34.3
Occupation a. Private employee 25 35.7
b. Government 15 21.4
c. Professional 30 42.9
Monthly income a. 15000-19000 33 47.1
b. 20000 and above 37 52.9
Re-visit and recommend this hospital a. Yes 70 100
Management N=35 100%
The structure of this organization a. Functional 18 51.4
b. Matrix 7 20.0
c. Divisional 10 28.6
Number of superiors you report to a. 1 15 42.9
b. 2 18 51.4
c. 3 2 5.7
Number of health workers under you a. 1-5 15 42.9
b. 6-10 11 31.4
c.11-15 5 14.3
d.16-20 4 11.4
State the mission and vision of this hospital a. Yes 15 42.9
b. No 20 57.1
The number of times you report to your superior a. Everyday 27 77.1
b. Twice in a week 6 17.1
c. Sometimes 2 5.7
Patients’ inability to pay bills a. Management decision
(Field survey 2015)

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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

From the above table, the age services given by the hospital. The
composition of the patients ranges from 30- management of the hospital agreed that their
40 which shows 60% of the distribution. structure is functional which represents
65.7% of the patients were males with 51.4%. The majority of the management
differing health issues. Majority of the report to 2 superiors which show 51.4% of
respondents were professionals 42.9% who the distribution. Most of the management
owned their business or work else. Monthly members could not state the vision and
income of the majority of the patients ranges mission state of the hospital which represents
from 20000 rupees and above representing 57.1%. Management members report to their
52.9%. Patients were asked if they will superiors every day for update and prompt
recommend and re-visit the hospital, they decision which shows 77.1%. When patients
happily responded yes representing 100%, are unable to pay their bills, management
this means patients were satisfied with decide on what to do.

Table 2

Model Summary

Std. Error Change Statistics

R Adjusted R of the R Square F Sig. F
Model R Square Square Estimate Change Change df1 df2 Change
1 .968a .938 .927 .88571 .938 87.408 5 29 .000
a. Predictors: (Constant), Clarity of communication, Ability to solve problem promptly,
Organizational productivity, Timeliness in completing the work, Focus on organizational objectives

This output shows quality of service variance in quality of service is accounted by

have a high positive relationship with Clarity organizational structure (i.e. Clarity of
of communication, Ability to solve problem communication, Ability to solve problem
promptly, Organizational productivity, promptly, Organizational productivity,
Timeliness in completing the work, and Timeliness in completing the work, Focus on
Focus on organizational objectives as that R- organizational objectives) which shows how
value (.968) indicates a very strong closely knit they.
relationship between the two variables and
R2 value of .938 indicates that 93.8% of the

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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

Table 3

ANOVAb
Model Sum of Squares Df Mean Square F Sig.
1 Regression 342.850 5 68.570 87.408 .000a
Residual 22.750 29 .784
Total 365.600 34
a. Predictors: (Constant), Clarity of communication, Ability to solve problem promptly, Organizational
productivity, Timeliness in completing the work, Focus on organizational objectives
b. Dependent Variable: Quality of Service (QOS)

The ANOVA table above, the F-ratio regression model was good and was fit for
where F (5, 29) = 87.408, p < .0005 (i.e., the the data significantly)

Tabel 4

Coefficientsa
Standardized
Unstandardized Coefficients Coefficients
Model B Std. Error Beta T Sig.
1 (Constant) .750 .693 1.083 .288
Organizational productivity 3.000 .545 .459 5.508 .000
Ability to solve problem
-2.000 .617 -.280 -3.244 .003
promptly
Timeliness in completing
2.500 .476 .566 5.255 .000
the work
Focus on organizational
.500 .723 .076 .691 .495
objectives
Clarity of communication 1.250 .747 .184 1.673 .105
a. Dependent Variable: Quality of Service
(QOS)

It can be observed that, organizational service whilst focus on organizational

productivity (.000), ability to solve a problem objectives (.495) and clarity of
(.003) and timeliness in completing the work communication (.105) have no impact on
(.000) have a positive impact on quality of quality of service.

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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

Tabel 5

Model Summary

Change Statistics
Mode Adjusted R Std. Error of R Square Sig. F
l R R Square Square the Estimate Change F Change df1 df2 Change
1 .898a .806 .791 .79035 .806 53.088 5 64 .000
a. Predictors: (Constant), Environment & physical ambience, Payment process & Discharge process,
Information given to your family about patient condition & treatment, Janitorial (daily cleaning), Doctors
information about treatment & concerns

Tabel 6

ANOVAb

Model Sum of Squares Df Mean Square F Sig.

1 Regression 165.808 5 33.162 53.088 .000a
Residual 39.978 64 .625
Total 205.786 69
a. Predictors: (Constant), Environment & physical ambience, Payment process & Discharge process,
Information given to your family about patient condition & treatment, Janitorial (daily cleaning), Doctors
information about treatment & concerns
b. Dependent Variable: Patients satisfaction

The ANOVA table above, the F-ratio where regression model was good and was fit for
F (5, 64) = 53.088, p < .0005 (i.e., the the data significantly)

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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

Tabel 7

Coefficientsa
Standardized
Unstandardized Coefficients Coefficients
Model B Std. Error Beta t Sig.
1 (Constant) 3.362 .511 6.574 .000
Doctors information about
.764 .409 .257 1.867 .067
treatment & concerns
Janitorial (daily cleaning) -.396 .313 -.160 -1.263 .211
Payment process &
1.963 .227 .747 8.649 .000
Discharge process
Information given to your
family about patient .071 .344 .025 .206 .837
condition & treatment
Environment & physical
.913 .226 .250 4.043 .000
ambience
a. Dependent Variable: Patients satisfaction

It can be observed that, Doctors information satisfaction whilst payment & discharge
(.067), Janitorial (.211) and information (.000) and environment and physical
given to relatives on patients’ condition ambience (.000) have a positive influence on
(.837) have no influence on Patients the Patients satisfaction.

Estimated model coefficients

The common structure of the Y= Patients Satisfaction
equation to predict patients’ satisfaction, X1= Environment & physical ambience
from Environment & physical ambience,
X2= Payment & Discharge processes
Payment process & Discharge process,
X3= Information given to your family
Information given to your family about about patient condition & treatment,
patient condition & treatment, Janitorial X4= Janitorial (daily cleaning)
(daily cleaning), Doctors information about
X5= Doctors information about treatment
treatment & concerns. & concerns.

Y=β0 + β1X1+ β2X2+ β3X3+ε Y = 3.362+ 0.764X1 - 0.396X2+ 1.963X3 +

0.71X4+ 0.913X5

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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

DISCUSSION additional argument in support of innovation

This output also shows that Patients (Fiorio, 2018).
satisfaction have a high positive relationship Findings depict that private healthcare
with Environment & physical ambienc, service providers are attempting to deliver
Payment process & Discharge process, well improved healthcare services to their
Information flow to family about patient customers. Results confirmed that better
condition & treatment, Janitorial (daily quality of healthcare services inclines to build
cleaning), and Doctors information about satisfaction and loyalty among patients. The
treatment & concerns(administrative polices) healthcare service quality aspects are
as R-value (.898) indicates a very strong positively related with patient loyalty which is
relationship between the two variables that’s mediated through patient satisfaction (Fatima,
administrative polices and patients 2018).
satisfaction and the R2 value of .806 indicates Patient satisfaction in health care
that 80.6% of the variance in Patients constitutes an important component of
satisfaction is accounted by administrative organizational performance in the hospital
policies (i.e. Environment & physical setting. Satisfaction measures have been
ambience, Payment process & Discharge developed and used to evaluate and improve
process, Information given to your family hospital performance, quality of care and
about patient condition & treatment, Janitorial physician practice. In order to direct
(daily cleaning), Doctors information about improvement strategies, it is necessary to
treatment & concerns) which shows how evaluate both individual and organizational
closely knit they. factors that can impact patients’ perception of
An increasing number of hospitals care. The study aims were to determine the
react to recent demographic, epidemiological dimensions of patient satisfaction, and to
and managerial challenges moving from a analyze the individual and organizational
traditional organizational model to a Patient- determinants of satisfaction dimensions in
Centered (PC) hospital model. Although the hospitals (Kone Pefoyo, 2013).
theoretical managerial literature on the PC
hospital model is vast, quantitative CONCLUSION
evaluations of the performance of hospitals The growth of private healthcare
that moved from the traditional to the PC institutions has become numerous, and
organizational structure is scarce. However, therefore there is a need for quality services to
quantitative analysis of effects of managerial be addressed. The syndrome that the sick
changes is important and can provide needs the doctor has changed. It was explicit
that, patients were satisfied with the services
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 Hospital Management Studies Journal (Homes Journal) Volume 1 No 4, August 2021
ISSN: 2746-878X (Print), 2746-8798 (Online)

provided by the hospital and will however should also reduce the number of superiors’
refer others to the hospital. It was explained managements’ reports to.
that, there was a perfect positive relationship
RECOMMENDATIONS
between the organizational structure (i.e.
It is recommended that, there should
Clarity of communication, Ability to solve
be an improvement in the clarity of
problem promptly, Organizational productivity,
communication and information giving to
Timeliness in completing the work, Focus on
organizational objectives) and quality of patients’ relatives. Management should also

service. Organizational productivity, ability to paste the vision and mission statement of the

solve problems promptly and timeliness were hospital on walls and vantage points; thus,

effectively executed through the most health professionals did not know the

organizational functional structure. The vision and mission of the hospital used for the

management should improve on focusing on study. In hospital setting, human life is very

objectives and clarity of communication. It delicate and there’s therefore a need for

was also concluded that, there was a strong professional and adequate skills to handle life

positive relationship between administrative issues. Right from the front office to

policies and patients’ satisfaction. It was admission, IP and OP, diagnostics and all the

observed that the uniqueness of payment and other therapeutic services till cure, duty of

discharge process and the physical ambience care and reasonable service must be rendered

were awesome administrative policies. When to patients. A well-organized hospital will

patients are not able to pay their bills, determine the kind of service it will render to

management decide on what to do. its patients. Matrix organizational structure

Management should reduce the number of was however recommended.

health workers working under a superior and

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