KNH’s five-year Strategic Plan 2018-23 Performances at a Glance

By Henry Karuti

Organizational past performance is an activity in which the success or failure of past planned activities, programs/projects in an organization is critically and analytically assessed. Assessing organizational past performance has been proven empirical in provision of effective insights and benchmarks in forging the organizational future aspirations. Kenyatta National Hospital (KNH) has been executing various plans, activities, strategies, programs and projects aimed at achieving its overall strategic objectives, mission and ultimately vision.

KNH has established an elaborate and tightly knit performance management system for effective and efficient management, monitoring evaluating performance. The performance management framework consists of various tools that are used interdependently in ensuring high and sustained performance levels are achieved within the organization.

HENRY KARUTI

PHOTO | COURTESY

These include; corporate strategic plan, business level strategies, operational strategies, scorecards, implementation matrices, performance contracts, annual work plans, employee performance appraisal and job descriptions. Others include; Individual target setting tool, employee productivity tool, rewards and sanctions policy, succession planning, staff retention strategy, performance reviews and peer reviews.

The Hospital’s main performance management tool is the Strategic Plan. The Hospital develops fiveyear strategic plans that provide a roadmap for the direction that the Hospital intends to take towards realizing her mandate. To help in the achievement of the Hospital performance objectives and goals, as espoused in the strategic plan, other anchoring strategies policies and guidelines have been developed. These are aimed at instilling a culture of performance while minimizing any threats that may affect performance. These include the Culture Change Strategy, Code of Conduct and Ethics, Anti-corruption Policy, Succession Plan, Whistle Blower Policy, Staff Retention Policy, Sexual and Gender Based Violence Policy, and Rewards and Sanctions.

Hospital performance at a glance

Over the last five years, the Hospital performance has increased tremendously owing to a raft of deliberate and targeted initiatives by the Hospital management aimed at performance improvement. Currently, the Hospital is implementing the final phase of the Fourth Strategic Plan 2018-2023.

The Hospital past performance assessment using different lenses and parameters is as elucidated below:

Specialized Diagnostic Services

The numbers of the various radiological services increased steadily in the first half of the strategic plan period followed by a small drop in the 4th year and a subsequent surge in the 5th year. Significant increase in CT scans, interventional radiology MRI and X-Rays were reported compared to the base year 2018/19. The Hospital has increased the number of laboratory tests conducted over the previous plan period as illustrated below:

The improvement in performance in these services is as a result of improvement in process flows through process mapping, business process re-engineering, automation of processes and acquisition of new diagnostic equipment including MRI, CT Scans and centralization of laboratory services.

Total Revenue and Expenditure Performance

During the strategic plan period under review, a significant increase in revenues was witnessed from the base to year 3 (53%) followed by a slight drop in FY 2021/22. The Hospital’s sources of income include recurrent grants from the government and internally generated revenue from fees charged for services rendered.

Organizational Performance

The Hospital, in furtherance to its endeavor for attainment of higher performance has developed a three tier performance management system that is closely interwoven and interlinked. The performance system is in line with the empirically proven principle of alignment in strategy execution.

Patient and employee satisfaction

The Hospital treasures and holds in high esteem the importance of satisfying its primary customers i.e. the patients and employees. The Hospital, being a public entity, is mandated to offer quality services to patients. A satisfied and motivated health workforce is critical to achieving desired healthcare outcomes. A well performing workforce is one that is responsive to the needs and expectations of people, is fair and efficient to achieve the best outcomes possible given available resources and circumstances. The Hospital monitors patient satisfaction with respect to the different services sought at the facility using various parameters. Employee satisfaction is tracked with respect to the promised value proposition as detailed in the work and employee satisfaction indices.

The employee and work environment indices rose from 64.30 and 61.60 in the base year FY 2018/19 to 74.70 and 71.60 in the first half of the strategic plan period. The respective indices reduced in FY 2020/21 before rising again in the next FY. The reduction in the two indices in the FY 2020/21 can mainly be attributed to the impacts of the COVID- 19 pandemic that caught the entire world unawares and the Hospital was struggling with ensuring that staff are safe and satisfied at work. A significant rise in customer satisfaction has been witnessed as indicated by the trend from the 65.30 in the base year to 76.90 in FY 2021/22.This can be mainly attributed to process improvement initiatives, automation of processes, creation of centres of excellence, expansion of existing services and culture change drives.

Is Past Performance important or muddling through can suffice?

“An analysis of past performance is a key ingredient in formulating a workable and effective strategy as it identifies challenges experienced in previous periods and lays downs deliberate foundations to alleviate possible pitfalls in implementation of the next strategy,” states Mr. Job Makanga, OGW Senior Director Corporate Services.

Mr. Vincent Chagara, Chief Manager Strategy and Performance Management acknowledges the pivotal role of this evaluation noting that the analysis of past performance helps an organization to delineate what worked from what didn’t work thus enabling it to leverage on the areas its best at, develop new strategies or refocus its strategy altogether.

Mr. Job Makanga OGW - Senior Director Corporate Services

PHOTO | COURTESY

“Past performance is essential for making evidencebased decisions on the various courses of action to be taken to achieve the desired goals. Data forms the backbone of decision making and authenticates various courses of action,” echoes Mr. Felix Kilumbi, MangerMonitoring & Evaluation.

Past performance and strategy

According to Mr. Chagara, past performance is related to intrinsic ability inside the organization and provides a criterion for organizations adapting to the external environment. It has a significant impact on organizational performance and thus strategic choices. “Strategy evaluation plays a critical role in charting the direction for the organization. KNH conducted the evaluation in line with best practice and used lessons learned, challenges experienced and opportunities available in formulating the 2023-2028 Strategic Plan,” concludes Mr. Makanga .

MAIN PHOTO | COURTESY KNH Board and Management Strategic Planning during a recent retreat