Enterprise Resource Planning Implementation Practices and Service Delivery in National Referral Hospitals in Kenya

Effective service delivery in National Referral Hospitals is critical for improving healthcare performance and patient outcomes in Kenya. However, inefficiencies, delays, poor coordination, and ineffective information management continue to affect healthcare service provision despite the adoption of Enterprise Resource Planning (ERP) systems. This study examined the effect of ERP implementation practices on service delivery in National Referral Hospitals in Kenya. Specifically, the study sought to determine the effect of technological factors and change management practices on service delivery. The study was anchored on the Technology Acceptance Model, with Institutional Theory, Organisational Learning Theory, and Change Management Theory serving as supporting frameworks. The study adopted a parallel mixed-methods research design. A total of 391 respondents were sampled from a population of 17,300 staff members from four National Referral Hospitals in Kenya: Kenyatta National Hospital, Moi Teaching and Referral Hospital, Kenyatta University Teaching, Referral and Research Hospital, and the National Spinal Injury Referral Hospital. Data were collected using structured questionnaires and semi-structured interviews. Quantitative data were analysed using multiple linear regression analysis, while qualitative data were analysed thematically. The findings revealed that all ERP implementation factors had significant positive effects on service delivery. The regression model showed a strong relationship between the study variables and service delivery (R = 0.781), with the independent variables jointly explaining 61.0% of the variation in service delivery (R² = 0.610; F = 115.62; p < 0.001). The study recommends that hospital administrators strengthen ERP integration across all hospital operations, invest in reliable technological infrastructure and technical support, and adopt integrated implementation approaches that address both technological and change-management dimensions. The findings provide evidence for policymakers to develop national guidelines for ERP implementation, establish dedicated funding for healthcare digital transformation, and integrate ERP indicators into hospital performance contracts.