Organizational Innovations, Facility Size and Service Delivery of Public Health Institutions Among Selected Counties in North Rift Region, Kenya

Service delivery among health institutions is vital for a healthy nation, focusing on high-quality, affordable, and timely healthcare services. This study examined how organizational innovations impact service delivery in public health institutions across select counties in Kenya's North Rift Region. The study explored the effects of technological, process, learning and development, and cultural innovations on service delivery, with facility size as a moderating factor. The Diffusion of Innovation Theory guided the research, which utilized an explanatory research design. The target population comprised 336 hospitals classified as level 5, level 4, and level 3. A multistage sampling technique was used, and data were collected using a questionnaire, validated through expert reviews, and tested for internal consistency using Cronbach's Alpha. Data analysis involved descriptive statistics, including frequency, percentages, averages, and standard deviation, and inferential statistics like regression models and correlation. Hierarchical regression analysis examined the relationships between dependent, independent, and moderating variables. The findings revealed that technological innovation significantly and positively affected service delivery (β1=0.330, p<0.05). Process innovation (β2=0.243, p<0.05), learning and development innovations (β3=0.148, p<0.05), and cultural innovations (β4=0.178, p<0.05) all had positive and significant impacts on service delivery. Facility size moderated these relationships, with varying effects: technological (β=-.029; p<0.05), process (β=-.095; p<0.05), and learning and development (β=-0.058; p<0.05) innovations were negatively moderated, while cultural innovation was positively moderated (β=.034; p<0.05). The study concludes that innovations in healthcare service delivery significantly improved accessibility and patient satisfaction. The study recommends enhancing appointment scheduling systems for better integration with existing processes, investing in mobile health clinics and telemedicine. Keywords: Healthcare innovation, service delivery, patient satisfaction, telemedicine, cultural competence