Flexible Work Arrangements and Employee Productivity in Murang'a Level 5 Hospital

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.