The Effect Of Hospital Accreditation On The Job Satisfaction Of Nurses: A Case Study Of Aga Khan University Hospital-Nairobi

ABSTRACT

Accreditation is an externally administered instrument to promote continuous quality improvement. In July 2013, Aga Khan University Hospital (AKUH)-Nairobi was accredited by the Joint Commission International (JCI). It became the first hospital in East Africa to receive this accreditation. The JCI accreditation process is both time consuming and resource intensive. It brings about various organisational and job-related changes, which ultimately affect the workload and quality of work life of staff. This study sought to assess the effect that accreditation has had on the job satisfaction of nurses working at AKUH. This was a crosssectional mixed methods study, combining quantitative and qualitative approaches. It was a case study of nurses working in the maternity department of AKUH. Quantitative data was collected through a questionnaire survey. Two focus group discussions were also conducted for the qualitative component. Thematic content analysis was used to analyse qualitative data, while descriptive statistics was used for quantitative data. This study established that hospital accreditation brings about both positive and negative changes to the work environment. 76% of participants agreed that the department became better equipped after accreditation. Teamwork was also seen to have improved since accreditation. However, staffing levels were seen to be inadequate which resulted in heavier workloads and overtime work as accreditation came with extra demands for staff including compulsory documentation. Another important aspect of accreditation was JCI surveys which are mandatory. These were seen to cause high levels of stress. The nurses also noted that they are not really involved in decisions affecting their work since accreditation. Accreditation resulted in feelings of pride and achievement. However nurses lacked recognition and advancement opportunities. Overall, most nurses were proud to work in an accredited hospital but job satisfaction was low with 74% of respondents saying that they were not satisfied with their jobs.