Thesis:

Effects of strategy implementation on performance of item County referral hospital, Elgeyo Marakwet county, Kenya

Strategy implementation was recognized as a crucial element of the strategic management process, involving the enthusiastic execution of well-developed systems and coordinated activities utilizing various resources to achieve organizational objectives. Many institutions encountered significant challenges in policy implementation, with most strategies failing to improve performance due to poor execution. The study aimed to assess the effects of organizational structure, resource allocation, organizational culture, and rewards on the performance of Iten County Referral Hospital in Kenya, serving as a valuable resource for future researchers, policymakers, and hospital management by providing insights into how these factors influenced strategic success. Guided by resource-based view, agency, and upper echelon theories, the research employed a quantitative descriptive design, targeting a population of 214 staff members, with a sample size of 139 selected through simple random sampling. Data collection involved structured questionnaires, with reliability and validity ensured through correlation and content validity ratio, and analysis conducted using descriptive and inferential statistics, including multiple linear regression. Throughout the study, confidentiality, privacy, informed consent, and anonymity were upheld. The findings indicated that the hospital could overcome some implementation challenges by adopting strategies such as staff training, motivation, improved resource allocation, and fostering a positive organizational culture, which were expected to facilitate the successful execution of its strategic plans.The study, which achieved a response rate of 91.36%, found that organizational structure was the most significant predictor of performance, with a standardized beta coefficient of 0.478, indicating a strong positive impact. Enhancing structural elements such as clear hierarchies, efficient reporting systems, and streamlined decision-making processes was associated with notable improvements, with a one-unit increase in organizational structure linked to a 0.459 increase in performance. Organizational culture (β = 0.393) and resource allocation (β = 0.384) also significantly influenced performance outcomes; a positive culture and strategic resource distribution aligned with institutional goals contributed to increased productivity and operational efficiency. Reward systems, with a β of 0.357, played a critical role in motivating staff and improving organizational results. The findings concluded that equitable resource distribution and a strong organizational culture were fundamental to enhancing healthcare performance. Based on these results, it was recommended that healthcare organizations prioritize establishing transparent hierarchies, effective communication channels, role clarity, and a balanced approach to centralization and decentralization to foster staff motivation, teamwork, and operational effectiveness.