Engagement and Perceptions of Middle Managers in PhilHealth Benchbook II Accreditation: Evidence from a Tertiary Hospital Case Study

This study examined middle managers’ engagement and perceptions regarding the implementation of PhilHealth Benchbook II accreditation in a tertiary hospital in Metro Manila, Philippines, and assessed whether engagement is associated with more favorable accreditation perceptions. Using a quantitative cross-sectional descriptive–correlational single-site case study design, a structured survey was administered to 30 middle managers from nursing and non-nursing departments. Descriptive statistics summarized respondent profile, engagement, and perceptions; Pearson correlation tested the association between engagement and perceptions; and group comparisons examined differences by demographic and departmental categories. Results indicated that middle managers were generally engaged in Benchbook II implementation (M = 3.96, SD = 0.75) and expressed positive perceptions of accreditation (M = 4.09, SD = 0.54). Resource constraints (staffing, budget, equipment) emerged as the most frequently reported challenge (63.3%), while anticipated benefits were framed primarily in terms of improved patient care (53.3%) and enhanced institutional credibility (33.3%). Engagement was significantly and positively correlated with perceptions (r = .588, p = .001), suggesting a reinforcing relationship between participation and accreditation appraisal. Engagement differed significantly by department affiliation (p = .035), while perceptions did not significantly vary across most demographic groupings. Overall, findings suggest that accreditation buy-in among middle managers is strong, but implementation reliability is moderated by capacity constraints and documentation/process burden. Institutional strategies should prioritize resourcing, documentation governance, and department-sensitive support structures to sustain accreditation readiness and quality improvement outcomes.