| dc.description.abstract | The long-term success of organizations in a rapidly changing global economy is dependent on
organizational systems that are pegged at improving quality services which in turn translate to
customer satisfaction, continuous improvement and competitive advantage. Total quality
management impacts the creation of systems in an organization to help in learning and
improving business performance and productivity. TQM as a management principle ensures that
quality practices are inculcated in all areas of a business through inclusion of all levels of staff to
achieve customer satisfaction. To improve efficiency, NHIF is implementing TQM which
include leadership practices, training interventions and teamwork activities that play an
important role in the improvement of the electronic claims system. NHIF adopted the electronic
claims systems to increase efficiencies in payments of claims to HCPs and approval of LOUs for
its members. However, some challenges are being experienced in the day-to-day workings of the
system hampering quality service to customers. The main objective of the study was to establish
the effect of TQM on performance of E-Claims Systems in medical insurance firms in Kenya; a
case of NHIF, Kenya. The specific objectives were to establish the effect of leadership on
performance of E-Claims systems in medical insurance firms in Kenya; to assess the effect of
training on performance of E-Claims system in medical insurance firms in Kenya and to examine
the effect of teamwork on performance of E-Claims Systems in medical insurance in Kenya. The
specific objectives of the study were guided by three variables: leadership practices, training
interventions and teamwork activities. The study was guided by Public Value Theory and
Stakeholders Theory which will inform the study variables. The study adopted descriptive
research design because the study was intended to gather quantitative and qualitative data, which
described the effect of TQM and performance of E-Claims System in medical insurance firms in
Kenya. The target population consisted of 300 employees drawn from NHIF. The study sample
size relied on primary data collection. Data was analyzed using quantitative technique,
descriptive statistics (mean and standard deviation), inferential statistics (Pearson correlation and
regression analysis) as well as statistical package of social sciences (SPSS version 21.0) to
develop regression model for the study. The study findings established that there is a significant
positive relationship between leadership practices, training interventions, teamwork activities
and performance of E-Claims Systems. The study recommended that government should help in
formulating policies and laws that govern public sector organizations whose main mandate is
service delivery to ensure quality of service to customers. The study further indicated that further
studies should be undertaken to determine the extent of how other total quality management
practices can influence performance of the e claims systems in medical insurance. Further studies
should also be done in the private insurance firms for comparative analysis. | en_US |
