Environmental-Adaptive Change Management Strategy and Performance of Selected Private Hospitals in Nairobi City County, Kenya
DOI:
https://doi.org/10.5281/zenodo.23311536Keywords:
Environmental-adaptive change management, Hospital performance, Private hospitals, Nairobi City CountyAbstract
Purpose of Study :
This study examined the influence of environmental-adaptive change management strategy on the performance of selected private hospitals in Nairobi City County, Kenya. Specifically, it assessed how adaptation to regulations, technological responsiveness, and market sensitivity influence operational efficiency, customer satisfaction, employee engagement, and financial performance within the dynamic healthcare environment.
Methodology:
The study adopted an analytical cross-sectional research design targeting 1,092 managerial staff from 26 private hospitals. A sample of 293 respondents was determined using Kothari’s formula. Primary data were collected through structured questionnaires and analysed using SPSS version 28. Descriptive statistics, Pearson correlation, and regression analysis were employed.
Findings:
The findings revealed that environmental-adaptive change management was highly rated, with an overall mean of 4.25 (SD = 0.72). Adaptation to regulations recorded the highest mean (4.32), followed by technological responsiveness (4.25) and market sensitivity (4.19). Hospital performance achieved an overall mean of 4.19 (SD = 0.72), with customer satisfaction scoring highest (4.31) and financial performance lowest (4.06). Environmental-adaptive change management demonstrated a strong, positive, and statistically significant relationship with hospital performance (r = 0.69, p < 0.01). Regression analysis confirmed a significant positive effect (β = 0.39, p < 0.001). Consequently, the null hypothesis was rejected.
Conclusion:
The study concludes that environmental-adaptive change management significantly contributes to the performance of private hospitals in Nairobi City County. Proactive adaptation to regulatory changes, technological developments, and market demands strengthens organisational performance. Hospital managers should institutionalise environmental scanning, invest in continuous staff training, adopt appropriate technologies, and establish flexible decision-making structures to sustain competitiveness.
Downloads
References
Arabi, Y. M., Al Ghamdi, A. A., Al-Moamary, M., Al Mutrafy, A., AlHazme, R. H., & Al Knawy, B. A. (2022). Electronic medical record implementation in a large healthcare system from a leadership perspective. BMC Medical Informatics and Decision Making, 22(1), 66. https://doi.org/10.1186/s12911-022-01801-0
Boyle, R. E., Jonker, L., Xirasagar, S., Okut, H., & Badgett, R. G. (2024). Hospital workforce engagement, satisfaction, burnout and effects on patient mortality: Findings from the English National Health Service staff surveys. Health Services Management Research, 37(2), 108–114. https://doi.org/10.1177/09514848231179175
Ellis, L. A., Tran, Y., Pomare, C., Long, J. C., Churruca, K., Saba, M., & Braithwaite, J. (2023). Hospital organizational change: The importance of teamwork culture, communication, and change readiness. Frontiers in Public Health, 11, 1089252. https://doi.org/10.3389/fpubh.2023.1089252
Gaspar, T., Gómez-Baya, D., Guedes, F. B., & Correia, M. F. (2023). Health management: Evaluating the relationship between organizational factors, psychosocial risks at work, performance management, and hospital outcomes. Healthcare, 11(20), 2744. https://doi.org/10.3390/healthcare11202744
Gifford, R., Fleuren, B., van de Baan, F., Ruwaard, D., Poesen, L., Zijlstra, F. R. H., & Westra, D. (2022). To uncertainty and beyond: Identifying the capabilities needed by hospitals to function in dynamic environments. Medical Care Research and Review, 79(4), 549–561. https://doi.org/10.1177/10775587211057416
Hussein, M., Pavlova, M., & Groot, W. (2022). The attitudes of hospital directors towards normalising accreditation standards: A qualitative descriptive study for Saudi Arabia. International Journal for Quality in Health Care, 34(3), mzac070. https://doi.org/10.1093/intqhc/mzac070
Kim, E. J., Moretti, M. E., Kimathi, A. M., Chan, S. Y., & Wootton, R. (2022). Use of provider-to-provider telemedicine in Kenya during the COVID-19 pandemic. Frontiers in Public Health, 10, 1028999. https://doi.org/10.3389/fpubh.2022.1028999
Kruse, C., & Heinemann, K. (2022). Facilitators and barriers to the adoption of telemedicine during the first year of COVID-19: Systematic review. Journal of Medical Internet Research, 24(1), e31752. https://doi.org/10.2196/31752
Kruszyńska-Fischbach, A., Sysko-Romańczuk, S., Napiórkowski, T. M., Napiórkowska, A., & Kozakiewicz, D. (2022). Organizational e-health readiness: How to prepare the primary healthcare providers’ services for digital transformation. International Journal of Environmental Research and Public Health, 19(7), 3973. https://doi.org/10.3390/ijerph19073973
Loureiro, R., Ferreira, J. J., & Simões, J. (2023). Understanding healthcare sector organizations from a dynamic capabilities perspective. European Journal of Innovation Management, 26(2), 588–614. https://doi.org/10.1108/EJIM-02-2021-0085
McDonnell, R., Chauhan, A., Adams, C., Cardenas, A., Moscova, M., Walsan, R., Sina, M., Munro, A., Manias, E., Mitchell, R., Gust, A., Sabesan, S., & Harrison, R. (2026). Applying change models and methods during a period of vast digital transformation: A systematic review of practice in healthcare. The International Journal of Health Planning and Management, 41(5), 1032–1053. https://doi.org/10.1002/hpm.70092
Moturi, A. K., Suiyanka, L., Mumo, E., Snow, R. W., Okiro, E. A., & Macharia, P. M. (2022). Geographic accessibility to public and private health facilities in Kenya in 2021: An updated geocoded inventory and spatial analysis. Frontiers in Public Health, 10, 1002975. https://doi.org/10.3389/fpubh.2022.1002975
Ngugi, S. N., & Makhamara, H. F. (2025). Environmental scanning and strategy formulation on performance of Mama Lucy Kibaki Hospital, Nairobi City County. Journal of Strategic Management, 5(2), 25–35. https://ir-library.ku.ac.ke/handle/123456789/30106
Njau, M. J., & Abdul, F. (2022). Revenue cycle management strategies and financial performance of profit making private hospitals in Nairobi City County, Kenya. International Academic Journal of Economics and Finance, 3(7), 296–316. https://ir-library.ku.ac.ke/handle/123456789/26441
PATH. (2024). Overview of new health reforms launched in Kenya in 2023. https://www.path.org/our-impact/resources/overview-of-new-health-reforms-in-kenya/
Republic of Kenya. (2023). Digital Health Act, 2023. Government Printer. https://new.kenyalaw.org/akn/ke/act/2023/15/eng%402023-11-24
Republic of Kenya. (2023). Social Health Insurance Act, 2023. Government Printer. https://new.kenyalaw.org/akn/ke/act/2023/16/eng@2023-11-24
Rosenbäck, R., & Eriksson, K. M. (2024). COVID-19 healthcare success or failure? Crisis management explained by dynamic capabilities. BMC Health Services Research, 24, 759. https://doi.org/10.1186/s12913-024-11201-x
Shaik, S. A., Batta, A., & Parayitam, S. (2023). Knowledge management and resistance to change as moderators in the relationship between change management and job satisfaction. Journal of Organizational Change Management, 36(6), 1050–1076. https://doi.org/10.1108/JOCM-04-2023-0103
Shaik, S. A., Batta, A., & Parayitam, S. (2025). Unfolding the relationship between change management, employee engagement and productivity: Resistance to change and emotional intelligence as moderators. Journal of Advances in Management Research, 22(2), 153–182. https://doi.org/10.1108/JAMR-07-2023-0184
Tortorella, G. L., Fogliatto, F. S., Tlapa Mendoza, D., Pepper, M., & Capurro, D. (2023). Digital transformation of health services: A value stream-oriented approach. International Journal of Production Research, 61(6), 1814–1828. https://doi.org/10.1080/00207543.2022.2048115
Woldemariam, M. T., & Jimma, W. (2023). Adoption of electronic health record systems to enhance the quality of healthcare in low-income countries: A systematic review. BMJ Health & Care Informatics, 30(1), e100704. https://doi.org/10.1136/bmjhci-2022-100704
Downloads
Published
Issue
Section
License
Copyright (c) 2026 International Academic Journal of Economic and Financial Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). This permits others to share and adapt the work for non-commercial purposes, provided appropriate credit is given to the original author(s) and source.
