Influence of Strategic Leadership on Medical Employees’ Performance in County Referral Hospitals of Central Region Economic Bloc, Kenya

Abstract

Performance of medical employees became a major concern all over the world during the emergence of Covid-19 pandemic among others. Thus, it is paramount to assess performance of medical employees and its determinants to improve on quality of service offered and achieve organizational goals. Most referral hospitals in central region economic bloc (CEREB) of Kenya are perceived to be suffering from low medical employee performance which might be attributed to lack of strategic leadership abilities. There is scarce literature on how strategic leadership is employed in hospitals and its influence on performance of employees. This research aimed at establishing the influence of strategic leadership (strategic communication, strategic agility, strategic alignment and strategic direction) on medical employees’ performance in county referral hospitals in CEREB, Kenya. Positivism paradigm was the guiding philosophy while convergent parallel mixed methods design was employed in the study. The target population comprised of 1804 medical employees from the 10-referral hospitals in central regional economic bloc, Kenya. Stratified sampling and simple random sampling from the probability sampling approach was used in getting 327 employees. This study used both closed-ended and open-ended questionnaires. Validity and reliability of the research instruments was tested using appropriate methods like piloting and expert knowledge for validity while Cranbach’s Alpha coefficient was determined for reliability. Data was analysed using descriptive statistics such as frequencies and percentages, means and standard deviation. kurtosis, skewness and normality tests were carried out to ensure data was amenable to analysis. Results showed that all the four components of strategic leadership (strategic communication (β = 0.274, t =4.180, ρ = 0.000), strategic direction (β = 0.232, t=3.258, ρ = 0.001), strategic agility (β = 0.201, t = 2.797, ρ = 0.001), strategic alignment (β = 0.162, t= 2.470, ρ = 0.001) had significant and positive effect on medical employees’ performance in county referral hospitals. Results also revealed that innovative work behaviour significantly mediated the relationship between strategic leadership aspects (strategic direction (β = 0.444, BootLLCI = 0.307, BootULCI = 0.598), strategic alignment (β = 0.0432, BootLLCI = 0.003, BootULCI = 0.102) and strategic communication (β = 0.0415, BootLLCI = 0.006, BootULCI = 0.088) and medical employees’ performance in county referral hospitals. However, innovative work behaviour had insignificant mediating influence on relationship between strategic agility (β = 0.414, BootLLCI = 0.075, BootULCI = 0.598) and medical employees’ performance. Therefore, hospital leaders should provide timely feedback, foster effective vertical communication channels, ensure clarity of ideas and strategies, and utilize various communication channels and technology for improvement of employee performance. The hospitals should prioritize strategic agility by fostering flexibility in decision-making. They should also foster a culture of innovation. Future studies could consider replicating the study in different economic blocs in Kenya.