Abstract:
This study examined the relationship between employee productivity and flexible work
arrangements (FWAs), such as compressed workweeks, flextime, and telecommuting at
Murang'a Level 5 Hospital, a Kenyan rural public healthcare facility dealing with a high
patient load and staff shortage challenges. Job Demands-Resources (JD-R) Model,
Herzberg's Two-Factor Theory, and Social Exchange Theory were used. A mixed-methods
approach was utilised, surveying 205 employees from a population of 421 selected through
stratified sampling. SPSS was used to perform analysis for both qualitative and quantitative
data, including thematic coding and multiple regression. Key findings from 186
respondents (90.7% response rate) showed that telecommuting (β = 0.176, p = 0.005),
flextime (β = 0.421, p < 0.001), and compressed workweeks (β = 0.269, p < 0.001) had
positive effects on employee productivity. The regression analysis yielded R² values of
0.046, 0.236, and 0.107, accounting for approximately 4.6%, 23.6% and 10.7% of the
employee productivity variance, respectively. In order to reduce social desirability biases,
productivity was assessed using a combination of self-declared Likert scale responses and
hospital data, for instance, patient load, attendance, and documentation processing rate. 24
semi-structured interviews were conducted under the qualitative phase, and were analysed
thematically by Braun and Clarke (2006) six-phase framework. Qualitative findings
explained how flextime helped employees become more productive as they could recover
from shifts better. The participants felt less exhausted, and their work-life balance
improved, especially those in the non-clinical and support roles. With longer off periods
that lowered fatigue, compressed workweeks allowed for more focus and efficiency.
Telecommuting did not help too much because there was not enough digital infrastructure
and remote-access policies for the clinical staff. Thematic analysis implies that the
mechanisms linking FWAs to higher productivity outcomes are employee autonomy,
managerial trust, and organisational support. The findings informed hospital management,
healthcare professionals, and policymakers on optimising hybrid FWAs to improve service
delivery, aligning with Kenya’s Vision 2030, Murang’a County 2022-2027 objectives, and
Sustainable Development Goal 3. The study extended existing literature by demonstrating
variations in FWA effectiveness across staff categories, with flextime showing stronger
impacts in non-clinical roles compared to clinical ones, where physical presence limited telecommuting. This addressed a gap in Kenyan public hospitals, where previous research
primarily focused on urban and non-healthcare settings, and highlighted the significance
of applying the findings to similar rural facilities while cautioning against direct
generalisation without considering local infrastructure.
