Influences on Compliance Behaviour towards ISO 9001:2015 QMS Implementation by Workers at Kenyatta National Hospital, Kenya

Abstract

The Introduction of ISO certification at KNH and in the public sector in general was aimed at improving service delivery to the citizenry. However, anecdotal evidence suggests that this has not been achieved. One of the reasons for this failure is the inability of the workers to fully comply with the requirements of the ISO Quality Management System (QMS) requirements. The study sought to examine the factors that influence compliance behaviour towards ISO 9001:2015 Quality Management System at Kenyatta National Hospital. Guided by the Theory of Planned Behaviour, the study sought to assess 1) compliance behavior towards ISO 9001:2015 QMS at KNH; 2) the effects of workers’ attitudes on compliance towards ISO 9001:2015 QMS procedures at KNH; 3) the influence of organization norms on compliance with ISO 9001:2015 QMS procedures at KNH; and; 4) the extent workers’ behaviour control affects compliance with ISO 9001:2015 QMS procedures at KNH. The study employed a cross sectional survey design. Primary data was quantitative and was collected from 291 staff of KNH selected through a multistage sampling procedure, by use of a questionnaire. Augmentative qualitative data was collected from purposively selected key informants and Focused Group Discussions. Statistical data was analysed and presented using tables and figures. Tests conducted included cross tabulations, correlation analysis, factor analysis as well as multiple regression analysis. Qualitative data was analysed thematically and presented using narratives and direct quotes. Findings revealed strong intentions to compliance with ISO 9001:2015 QMS procedures by workers at KNH with a mean score of 82%. However, this fell short of the required threshold of 100% compliance. Awareness levels were also high but also fell short of the required threshold. Tests for the hypotheses revealed that attitudes, norms and behaviour control are positively correlated with compliance with ISO 9001:2015 QMS procedures with Pearson’s r values of 0.522, 0.477 and 0.305 respectively. (p=0.00). Prediction tests on the other hand revealed that behaviour control had the least predictor value of compliance followed by attitude while norms had the highest predictor value. However, attitudes, norms and behaviour control only accounted for 37.8% of the effect on compliance with ISO procedures. The study concluded that positive workers’ attitudes have a positive effect on compliance with ISO 9001:2015 QMS at KNH; positive organization norms have a positive influence on Compliance with ISO 9001:2015 QMS at Kenyatta National Hospital and strong behaviour control affects compliance with ISO 9001:2015 QMS positively. The study recommends that to enhance compliance with reforms, there is need to improve on the attitudes and normative beliefs of staff. This can be achieved by improvements on policy development and communication, providing incentives linked with reforms, providing equipment and infrastructure, and enhancing employee involvement in order to improve adoption of reforms.