Knowledge, attitude and practice of hospital senior and middle management towards health care quality programs in eastern Saudi Arabia

Quality programs are not new to Saudi hospitals. The first known quality program was started in ARAMCO Hospital in 1982. Besides the Ministry of Health, the main provider of health care, more than 15 providers share in the delivery of the health care in Saudi Arabia. Quality activities being sporadic, with no national control, the programs depend'heavily on the top management commitment and support. The success of quality programs varies among the different health care providers. Hence the need to investigate the knowledge, attitude and practice of the senior and middle managers (HSMM) towards quality programs. The findings of their investigation could throw some light on some incorrect concepts and explain the reasons behind the ineffective practice of quality. Two studies were conducted simultaneously for this research. A descriptive study to investigate the knowledge, attitude and practice of the HSMM, for which two data collecting tools were used. The HSMM self administered questionnaire was completed by the HSMM of 20 selected hospitals in the Eastern Saudi Arabia; 173 HSMM responded to the study giving response rate of 86.5%. The other tool used for the descriptive study was a check list completed by the researcher on each studied hospital. The other part of this research was the action research aimed at exploring the amount of the support HSMM extends to these activities in order to enhance quality services in their hospitals. The study revealed that a majority of senior and middle managers had enough knowledge to initiate very promising quality programs, but there seemed to be a problem with their attitude on quality which affected the implementation of the quality program. Attending training courses on quality subjects made a significant difference to the general information, factor enhancing quality program, causes of quality program failure and the ranking of HSMM towards quality programs. Combining all of these significant variables and classifying them based on their relation with the patient, quality program and staff gave a clear indication that most were related to attitude. The study concluded " that the input and the output of the hospital had less impact on quality programs compared to the process reflected by the knowledge, attitude and practice of the HSMM. Recommendations cover the input, output and the process of quality programs, with more emphasis on the process. The HSMM should pave the way for a quality culture in the hospital which pays proper attention to the development of the skills of the staff and their orientation to the quality environment.EThOS - Electronic Theses Online ServiceGBUnited Kingdo