Performance evaluation of tertiary care
British Journal of Health Care Management
Department of Radiography, College of Medicine, University of Lagos, Nigeria; Department of Medical Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Nigeria; Department of Radiography,
Aim: To evaluate the performance of tertiary healthcare institutions in Lagos State, Western Nigeria, with regard to their corporate goal of providing excellent tertiary healthcare services for the community. Methods: One hundred and ten structured questionnaires were distributed by stratified random sampling on healthcare workers in three tertiary healthcare institutions. The survey was first piloted on a separate hospital of equal status in Lagos State, which was not included in the study, after which minor changes were made with regard to presentation and wording. Surveys were completed and returned by 90 healthcare workers, giving a response rate of 82%. The questionnaires were analysed using percentages, frequencies and the chi-square (x2) test. Results: The hospitals studied did not translate their mission statements into specific performance objectives and goals; there appeared to be no framework to evaluate performance. Service delivery was generally hindered by poor staff training, poor funding (especially in government-run hospitals), lack of participative management, demotivation, work stoppages, and inadequate technology/obsolete equipment. Conclusions: Employee performance, and therefore productivity in the health sector, could improve if adequate attention is paid to the continuing professional development (CPD) of employees to match the trends in technology and meet the ever-changing needs of the patient. Public tertiary healthcare institutions have no system in place to improve performance. They seem not to bother about productivity as long as their funding is not dependent on performance. The risk is that these hospitals may not be self-sustaining should the government withdraw funding.