Facility Management Practices and Their Effect on Quality Healthcare Delivery in Public Hospitals in Oyo State, Nigeria

This study examined how facility management practices influence service delivery in government secondary hospitals in Oyo State, Nigeria. Guided by Donabedian’s Structure–Process–Outcome model, facility management was treated as the structural platform that enables reliable clinical and operational processes and, in turn, better outcomes. A convergent parallel mixed-methods design was applied across a stratified sample of hospitals, combining a researcher-administered facility audit, staff and patient surveys, and interviews and focus groups with managers, biomedical engineers, matrons and frontline clinicians. A composite Facility Management Practices Index captured energy reliability, WASH and environmental services, biomedical equipment lifecycle, space and amenities, and digital maintenance systems, while outcomes included outpatient waiting time, cancellations attributable to utilities or equipment, hygiene spot-check pass, and a patient-experience score. Higher index scores were independently associated with shorter waits, fewer cancellations, better hygiene compliance and higher patient experience; the strongest effects related to energy reliability and equipment lifecycle, while WASH and space quality were most closely linked to experience. Qualitative data traced mechanisms to clear accountability, funded operations and maintenance, enforceable vendor service levels, and the integration of cleaning within infection prevention teams. The study concludes that disciplined facility management is a central determinant of timeliness, continuity, safety and user experience. It recommends appointing facility-management focal persons, protecting operations and maintenance budgets, enforcing equipment service agreements, embedding WASH within infection prevention and control, adopting a simple maintenance management system, and prioritising solar-battery solutions in settings with unreliable grid supply.