American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 234 | P a g e EFFECTS OF QUALITY MEDICAL LABORATORY SERVICES ON WORKERS PRODUCTIVITY IN STATE HOUSE CLINIC ASO ROCK, ABUJA Titus-Okpanachi Akuchinyere Onyinyechukwu and Prof. Ngozi Ejionueme Department of Business Administration, Faculty of Management Sciences, Enugu State University of Science and Technology DOI: https://doi.org/10.5281/zenodo.15296431 Abstract: The study explored the effect of quality medical laboratory services on workers’ productivity in the State House Clinic, Abuja. The study defined some research objectives, questions, and hypotheses. Data was collected through primary and secondary sources. The study used stratified random sampling as the study population was not homogeneous, as it consisted of 29 Doctors, 17 Nurses, 18 Clinical Officers, 14 Laboratory Scientists/Technicians, and 12 Pharmacists, making it the most appropriate sample to come up with the target sample. Data collected were analyzed using the normal frequencies, percentage, and chi-square test. Results showed that Employees’ capacity influences the provision of quality medical laboratory services in State House Clinic, Abuja (X2=60.6>x2 =9.488). The adoption of technology has a significant effect on quality medical laboratory service delivery in the State House Clinic Abuja (X2=57.3>x2 =9.488). The study concluded that quality medical laboratory services have a great effect on workers’ productivity. The study recommended government comprehensively address all the issues of concern in the public health sector. Quality indicators in laboratory medicine that can evaluate and improve the health care system should be initiated. Keywords: Laboratory, Medical, Productivity, Services, Workers 1.1 Introduction The health sector is one of the most dynamic sectors, which has changed dramatically in recent years due to changes in patient expectations, quality health services, social models, public policies, and technological progress (Sorescu et al., 2008). Success in modern healthcare delivery worldwide depends on the accuracy and efficiency of diagnostic services rendered by biomedical scientists. Patients’ lives and the treatment they receive depend on biomedical scientists' valuable skills and knowledge. They carry out a range of laboratory and scientific laboratory tests that play a pivotal role in diagnosing and treating diseases. Their helpful service is the key to the effective functioning of many https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 235 | P a g e clinical departments, including the accident and emergency (A&E) departments. They play a key role in the diagnosis of diseases such as anemia, diabetes, malignancies, emergency blood transfusion services, meningitis, hepatitis, chronic liver disease, chronic kidney disease, hematological malignancies, hemoglobinopathies, coagulation disorders, HIV and AIDS (Erhabor and Njemanze, 2014). They also use computer-based laboratory information management systems (LIMS) and other highly sophisticated automated equipment employing a wide range of complex modern scientific techniques to carry out varied, efficient, and analytical tests on blood, body fluids, and other biological materials, including tissue samples in a bid to ensuring an excellent laboratory service delivery. Areas of specialties in Biomedical Science include hematology, blood transfusion science, medical microbiology, virology, clinical biochemistry, immunology, histology, cytology, andrology, and reproductive science (Erhabor and Njemanze, 2014). Therefore, accurate and timely medical laboratory testing and diagnosing are essential to a high-quality medical laboratory system. Quality medical laboratory services are the epicenter of the healthcare sector (Chawla et al., 2010). Delivery of quality service has a significant relationship with customer satisfaction, retention, loyalty (Boshoff and Gray, 2004), costs, profitability (Irving and Dickson, 2004), service guarantees, and organization growth (Kandampully and Butler, 2001). However, the poor state of medical laboratory service in some hospitals in Nigeria has resulted in high turnover and weak morale among staff/workers, making it challenging to guarantee 24-hour coverage, resulting in problems with patient care, increased cost of operations due to inefficiencies (Owino and Korir, 1997) leading some patients to look for an alternative provider and to spread negative word of mouth which affects potential patients hence growth of the hospital (Tam, 2005). Increasing productivity is one of the fundamental challenges of life sciences research. The work is complex, lengthy, and costly, and the failure rate is high. However, successful research can lead to disease- beating medicines and significant financial rewards for the research organizations involved. In the past, companies have tried to improve productivity through extensive, top-down initiatives, such as reorganizing research or investing heavily in new technology platforms (Beards et al., 2009). No known study has investigated the factors affecting quality laboratory services in the health sector. Therefore, this study explores the factors affecting the quality of medical laboratory services and their effect on workers’ productivity in Nigeria. 1.2 Statement of Problem Laboratory services are the cornerstone of health care programs, as laboratory test results directly influence 70% of clinical decision-making. Quality medical laboratory services are recognized globally; quality and reliability are essential for appropriate case management. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com http://labmed.ascpjournals.org/search?author1=Ranjna+Chawla&sortspec=date&submit=Submit American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 236 | P a g e Poor quality of laboratory services and unreliable test results can lead to inappropriate actions or inaction, such as over- or under-treatment, when healthcare providers act upon inaccurate laboratory results. In an era of potential and infectious disease epidemics or pandemics, laboratory facilities of poor quality or limited capacity may lead to a severe under-detection of disease cases, allowing epidemics to gain a critical mass and spread. Poor performance and productivity result from too few staff or staff not providing care according to standards and not being responsive to the needs of the community and patients. Most performance problems can be attributed to unclear expectations, skills deficits, resource or equipment shortages, or a lack of motivation (Hughes et al., 2002). These causes are rooted in a failing health system, low salaries, difficult working and living conditions, and inappropriate training. This situation is further worsened by the patient's or customer's perception of functional issues which they perceive and interact with during seeking treatment, such as physical facilities, internal process, interactions with doctors, nurses, and other support staff as poor and unresponsive (Boshoff and Gray, 2004; Algilanan and Connor, 2003). 1.3 Objectives of the Study The main objective of this study is to determine the effect of quality medical laboratory services on workers’ productivity at State House Clinic, Abuja. The specific objectives of this study are as follows:- i. To determine the influence of employees’ capacity on providing quality medical laboratory services. ii. To determine the effect of adopting technology on quality medical laboratory service delivery. 1.4 Hypotheses of the Study i. Employees’ capacity does not influence the provision of quality medical laboratory services. ii. Technology adoption does not affect the quality of medical laboratory service delivery. Literature Review 2.1 Conceptual Review Quality, as defined by the International Organization for Standardization, is a relative concept. If a service's inherent characteristics meet the customer's requirements, it can be rated high quality (Reinartz, 2004). In a service industry like healthcare, the patient's experience plays a crucial role in rating and assessing the quality of services. Quality in healthcare may comprise newer technology, newer and effective medication, higher staff-to-patient ratios, affordability, efficiency, and effectiveness of service delivery (Tam, 2005). The health sector comprises the public system with major players, including the Ministry of Health and parastatals organizations, and the private sector includes private for-profit, Non-Governmental Organizations, and Faith-Based Organizations facilities (Rok, 2010). In the healthcare industry, service quality has become imperative (Ennis and Harrington, 2001) in https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 237 | P a g e providing patient satisfaction because delivering quality service directly affects customer satisfaction, loyalty, and financial profitability of service businesses. In healthcare, service quality can be broken down into two quality dimensions: technical quality and functional quality (Dean and Lang, 2008). While technical quality in the health care sector is defined primarily based on the technical accuracy of the medical diagnoses and procedures or the conformance to professional specifications, functional quality refers to how the health care service is delivered to the patients. The Organization for European Economic Cooperation formally defined productivity as: “the quotient obtained by dividing output by one of the factors of production. In this way, it is possible to speak of capital productivity, investment, or raw materials according to whether output is being considered about capital, investment or raw materials, etc”. It must be noted that productivity is a relative concept with comparisons either being made across time or between different production units. Productivity is represented where unit of measurement of both outputs and inputs is given in dollar values (NZD$) or in any other relevant unit. A productivity index is defined as the ratio of an output index to an input index, that is: Where is a labour productivity index, is an output index and is a labour input index. Each index represents accumulated growth from period 0 to period t. Some of the most common index formulae (Laspeyres, Paasche, Fisher, and Tornqvist) are included here. Suppose information on prices and quantity of I outputs is available for period t = 0…T. Denote the price and quantity vectors as respectively; the Laspeyres , Paasche , Fisher , and Tornqvist quantity indices are defined as follows: https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 238 | P a g e For and and where Of these, the Tornqvist and Fisher index formulae are the most widely used by statistics officials around the world. Health Sector in Nigeria The health sector in any country has been recognized as the primary engine of growth and development. But despite the laudable contributions of the health sector to economic development, the Nigerian health sector has witnessed various turbulence that has negatively reversed the progress recorded at different times. Nearly 15 percent of Nigerian children do not survive to their fifth birthday. Two leading causes of child mortality are malaria (30 percent) and diarrhea (20 percent). Malnutrition contributes to 52 percent of deaths of children under five. A household survey conducted by the government in 2003-2004 showed that 54.4 percent of the population is poor, with a higher poverty rate in rural area of 63.3 percent (HERFON, 2006). The incidence of poverty in Nigeria is widespread and increasing with some of the worst poverty linked health indicators in Africa. There has been a sharp increase in poverty from 1992 to 1996, with an estimated third of the population living below $1 per day and nearly two thirds below $2 per day (FMoH, 2005). Some of the factors that affect the overall performance of the health system include; inadequate health facilities/structure, poor human resources and management, poor remuneration and motivation, lack of fair and sustainable health care financing, unequal economic and political relations, the neo-liberal economic policies of the Nigerian state, corruption, illiteracy, very low government spending on health, high out-of-pocket expenditure in health and absence of integrated system for disease prevention, surveillance and treatment, inadequate mechanisms for families to access health care, shortage of https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 239 | P a g e essential drugs and supplies and inadequate supervision of health care providers are among some of the persistent problems of the health system in Nigeria. Health Workers’ Behaviour Health workers’ behaviour is a critical area of study within healthcare, as it significantly impacts patient outcomes, team dynamics, and overall healthcare delivery. This literature review synthesizes findings from recent studies focusing on the personality traits, behaviour styles, and emotional intelligence of health professionals, which are essential components influencing their behaviour in clinical settings (Clark et al. 2020). The determinants of health workers’ behaviour (in the workplace) are rooted in factors relating to: a) Macro level, or the overall health system, such as resource allocation, planning and deployment of health workers, current regulatory framework, communication and decision-making processes, and accountability mechanisms. These can be influenced by policy-makers and planners in the health sector, as well as other stakeholders at national level, such as the ministry of finance, ministry of education, professional associations, civil society groups and funding agencies (health systems level). b) Micro level, or the workplace itself (district or facility, etc.), such as availability of equipment, drugs and supplies, teamwork and human resources management activities. In principle, these can be influenced by local managers, colleagues, patients, and other local partners (health facility level). c) Individual characteristics and living circumstances, such as living in conflict areas or being a woman or a newly graduated professional. These require specific group strategies and can be developed locally by managers or nationally by policy-makers and planners together with other stakeholders (individual level). Interventions are designed based on an analysis of the determinants that influence health workers’ performance. Implementation of these interventions (inputs and process) provides outputs (expected results) in terms of improved working conditions, improved motivation, improved staff retention, etc. Employees’ Capacity Highly skilled physicians, nurses, administrators, and ancillary staff are critical to producing high- quality outcomes and effective quality improvement hence hospital growth (Argote, 2000). There is need for selective hiring of qualified staff. Successful recruitment and retention of staff is tied to empowerment of staff that must be treated as full partners in the hospital operation and given opportunities for advancement (Brown and Duguid, 2003). The hospitals need to place great emphasis on recruiting and retaining top-level physicians and nurses, accompanied by an effort to encourage these professionals to form working teams, including case managers, pharmacists, social workers, and others, to promote quality (Brown and Duguid, 2003). https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 240 | P a g e To facilitate service quality and growth, hospitals must implement effective human resource strategies involving selective hiring, and retention of physicians and nurses (Cohen and Levinthal, 2001); monitoring of doctors on staff (or with privileges) and ensuring that they must continue to meet certain performance and practice standards to retain credentials (Crewson, 2004). To improve efficiency in service delivery, public sector hospitals must build the capacity to o attract and employ an adequate number of high-quality nurses (Argote and Ingram, 2000) suggests that the key to service delivery is to adapt to circumstances that are constantly changing and that the long-term winners are the best adapters, but are not necessarily the winners of today’s race for market share. Hospitals quality of service often fails because of the sum total of seemingly inconsequential events arising from employees lack of capacity as in itself service delivery requires specific skill levels and experience which must be continuously learned (Cohen and Levinthal, 2001). Technology Technology for harnessing of Information and data play a critical role in the quality service delivery in hospitals (Allen, 2001). Investments in Technology that facilitate service assessment and improvement process is essential (Dutton and Starbuck, 2002). The hospital must show four main commitments: a willingness to invest in Information Technology; investments in Information Technology and in Quality Insurance departments with qualified staff that abstract medical records, analyze data, and facilitate the Quality Insurance process (Cibulskis and Hiawalyer, 2002). According to the Government of Kenya (2001) report, successful Technology strategy that needs to be employed by hospitals and this must involve four main commitments: a willingness to invest in Information Technology, Working with physicians and others to customize an information system to meet specific needs and culture of the institution; nurturing and encouraging buy-in so new systems will be utilized and their benefits will be realized and devising information technology systems that provide real-time feedback to providers as they are caring for patients. 3. Methodology The study adopted descriptive survey approach in collecting data from the respondents. The descriptive survey method was preferred because it ensures complete description of the situation, making sure that there was minimum bias in the collection of data and finding out the what, where and how of a phenomenon (Kothari, 2008). Data was gathered by use of closed and open ended questionnaires, which were self administered. The information required for the study is obtained directly from the target population. Data from questionnaires was analyzed using the descriptive statistics and chi- square statistical method which offers extensive data handling capabilities and numerous statistical analysis routines that can analyze small to very large data statistics. 4 Analysis of Questionnaire Return https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 241 | P a g e A total of ninety (90) questionnaires were distributed out of which ninety (90) were returned in usable form as shown in table 4.1 below. The result demonstrates that one hundred copies of the completed questionnaire were found useable giving a response rate of approximately 100 per cent. Table 4.1: Questionnaire Return Source: Field Survey, 2014 4.2 Demographic and Data Analysis The results in table 4.2 below showed that 69 out of 90 respondents are male and this gives 76.7% of the whole respondents while 21 out of 90 respondents are female and this constitutes 23.3% of the total respondent. We can then conclude that there were more male than female respondents in the research study. 21 out of 90 respondents were single and it gives 23.3% of the total respondents, 51 out of 90 respondents were married and this gives 56.7% of the whole respondents while 18 out of 90 respondents were divorced/separated and this represent 20.0% of the total respondents. Therefore we can then conclude from the analysis that there are more married than single respondents in the research study. The result above revealed that 11 out of 90 respondents were below the age 25 and this represent 12.2% of the whole respondents, 57out of 90 respondents were between the age 25-35 years and this constitutes 63.3% of the total respondents, 20 out of 90 respondents are between the age 36-45 years and this represent 22.2% of the total respondents while only two respondent were 46 years and above (2.2%). Therefore, we can then conclude that there are more respondents between the ages 25-35 years in the research study followed by 36 to 45. The populations were made up of 29 (32.2%) doctors, 17 (18.9%) nurses, 18 (20.0%) clinical officers, 14 (15.6%) laboratory scientists/technicians and 12 (13.3%) pharmacists. Variables Frequency Percentage % Questionnaires returned 90 100.0 Questionnaire not returned 0 0 Total 90 100.0 https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 242 | P a g e Table 4.2: Characteristics of Respondents VARIABLES FREQUENCY PERCENTAGE (%) Sex Male Female Total Marital Status Single Married Divorced/Separated Total Age Group Below 25 years Between 25-35 years Between 36-45 years 46 and above Total Job Category Doctors Nurses Clinical officers Lab. Scientists/technicians Pharmacist Total 69 21 90 21 51 18 90 11 57 20 2 100 29 17 18 14 12 90 76.7 23.3 100.0 23.3 56.7 20.0 100.0 12.2 63.3 22.2 2.2 100.0 32.2 18.9 20.0 15.6 13.3 100.0 Source: Field Survey, 2014 4.3 Analysis of Research Questions (SA- Strongly Agree, A -Agree, SD- Strongly Disagree, D- Disagree) Table 4.3: Results of the Respondents Views on the Research Questions https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 243 | P a g e Propositions Responses Frequency Percentage (%) State house clinic Abuja offers quality medical laboratory services Employee’s incompetence affects service quality in the public health sector Staff are usually sent for training programme. There is high level of technology investment State house clinic Abuja The communication channel used at State house clinic Abuja is very effective The working conditions in State house clinic Abuja are adequate enough for workers to be able to give their best SA A SD D SA A SD D SA A SD D SA A SD D SA A SD D SA A SD D SA A SD 75 15 - - 90 - - - 70 5 15 - 49 17 20 4 54 15 - 21 55 20 5 10 55 35 - 83.3 16.7 - - 100.0 - - - 77.8 5.5 16.7 - 54.4 18.9 22.2 4.4 60.0 16.7 - 23.3 61.1 22.2 5.6 11.1 61.1 38.9 - https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 244 | P a g e The type of communication channel used at State house clinic Abuja lead to patient’s satisfaction Medical tests and nature of treatment were clearly explained in the hospital There is a high level of financial resource allocation for the clinic There is high quality level of health services provided in the clinic Quality medical laboratory services has a positive effect on workers’ productivity D SA A SD D SA A SD D SA A SD D SA A SD D - 90 - - - 33 57 - - 63 6 21 - 90 - - - - 50.0 - - - 36.7 63.3 - - 70.0 6.7 23.3 - 100.0 - - - Source: Field survey, 2014 All (100%) of the respondents indicated that State house clinic Abuja offers quality medical laboratory services; Employee’s incompetence affects service quality in the public health sector; Quality medical laboratory services has a positive effect on workers’ productivity; The type of communication channel used at State house clinic Abuja lead to patient’s satisfaction; There is a high level of financial resource allocation for the clinic. They also agreed that medical tests and nature of treatment were clearly explained in the hospital. This is concurred with Rust and Tuck (2006) who stated that designing services to be user friendly will simultaneously facilitate consumer use and external communication as to what the service delivery system is actually able to provide the customers. Majority (83.3%) of the https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 245 | P a g e respondents indicated that the workers are usually sent for training programmes and workshops while a few (16.7%) of the respondents were of contrary opinion. On the level of technology in the State house clinic, majority (73.3%) of the respondents indicated that there was high level of technology investment while a few (26.6%) of the respondents indicated that there was low level of technology investment. Majority (76.7%) of the respondents agreed that the communication channel used at State house clinic Abuja was very effective while (23.3%) of the respondents disagreed. This concurred with Payne (2006) who indicated that through communication patients’ access to treatment, participation in preventive measures, ability to obtain consent, improve health professionals abilities to meet their ethical obligations, quality of care, including, hospital admissions, diagnostic testing, medical errors, patient follow-up, quality of mental health care and patient safety. 83.3% of the respondents agreed that the working conditions in State house clinic Abuja are adequate enough for workers to be able to give their best while 16.7% of the respondents were of contrary opinion. 4.4 Test of Hypotheses Chi – square is given as: X² = Σ (o – e)² e Where X² = Chi – square o = Observed frequency e = Expected frequency Σ = Summation of the frequency. DECISION RULE: Reject Null Hypothesis if calculated value of (X²) is greater than the critical value and accept Null Hypothesis if calculated value of (X²) is less than the critical value. The Degree of Freedom = (n - 1) (k - 1) Where Df = Degree of freedom n = Number of Rows k = Number of Column. 4.4.1 Hypothesis One H01: Employees’ capacity has no influence on the provision of quality medical laboratory quality services. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 246 | P a g e Table 4.4: Chi-square Table on the Influence of Employees’ Capacity on the Provision of Quality Medical Laboratory Services Options 0i Ei 0i-Ei (0i-Ei)2 (0i-Ei)2 Ei Strongly Agree 41 18 23 529 29.40 Agree 30 18 12 144 8.00 Undecided 5 18 -13 169 9.39 Disagree 9 18 -9 81 4.50 Strongly Disagree 5 18 -13 169 9.39 Total 90 90 0 1092 60.68 Source: Computed from Data, 2014 Calculated (x2) = ∑ (O – E)2 = 1092 = 60.6 E 18 Degree of freedom “d.o.f” = n – 1 Where n = number of rows Therefore, d.o.f = 5 – 1 = 4. Tabulated (x2) = At 0.05% level of significance, the tabulated value of x2 for 4 degrees of freedom is 9.488 Decision: Since the calculated X2 (60.6) is greater than the tabulated x2 (9.488), we reject the null hypotheses (H0) and accept the alternative hypotheses (HA). This indicated employees’ capacity has an influence on the provision of quality medical laboratory services. This concurred with Argote, (2000) who stated that highly skilled physicians, nurses, administrators, and ancillary staff are critical to producing high-quality outcomes and effective quality improvement hence hospital growth. 4.4.2 Hypothesis Two H02: Adoption of technology has no effect on quality medical laboratory service delivery. Table 4.5: Chi-square Table on the Effect of Adoption of Technology on Quality Medical Laboratory Service Delivery Options 0i Ei 0i-Ei (0i-Ei)2 (0i-Ei)2 Ei Strongly Agree 36 18 18 324 18.00 Agree 35 18 17 289 16.06 Undecided 9 18 -9 81 4.50 Disagree 5 18 -13 169 9.39 Strongly Disagree 5 18 -13 169 9.39 Total 90 90 0 1032 57.34 https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 247 | P a g e Source: Computed from Data, 2014 a. 0 cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 18. Decision rule: Reject H0, where X2 calculated is greater than x2 tabulated, otherwise, accept HA. Calculated (x2) = ∑ (O – E)2 = 1032 = 57.3 E 18 Degree of freedom “d.o.f” = n – 1 Where n = number of rows Therefore, d.o.f = 5 – 1 = 4. Tabulated (x2) = At 0.05% level of significance, the tabulated value of x2 for 4 degrees of freedom is 9.488 Decision: Since the calculated X2 (57.3) is greater than the tabulated x2 (9.488), we reject the null hypotheses (H0) and accept the alternative hypotheses (HA). This indicated that the adoption of technology in state house clinic Abuja has a significant effect on quality medical laboratory service delivery. The findings concurred with Mills (2001) who found that devising information technology systems provided real-time feedback to providers as they were caring for patients, through technology, the hospital would be in a position of offering bar-coded medications and automatic dispensing; coordinating patient admissions with bed capacity, immediate tracking of filled beds and daily changes in nursing needs. Adoption of technology enable the workers to employ a wide range of complex modern scientific techniques to carry out a varied, highly practical and analytical test on blood, body fluids and other biological materials including tissue samples leading to prompt diseases diagnosis and treatment of patients as well improve the capability and productivity of the workers. 5. Conclusion From the findings, the study concluded that organization must enhance employee’s capacity in order to improve provision of quality service which in turn increases workers productivity. Adequate number of high skilled and experienced employees must be employed continuously, ineffective recruitment must be discouraged, monitoring of doctors and other staff must be encouraged to ensure that performance and practice standards are met to enhance quality service provision. This would lead to proper medication services, patient satisfaction, good relationship between medical providers and patients, enable the participation in multi-disciplinary and attracts more patient hence effective improvement of hospital growth. From the findings, the study concluded that the health sector should improve the level of adoption of technology and willingness to invest and advance in modern technology in order to facilitate service assessment, improve process and communication which are essential for effective and efficient quality service in public health sector in Nigeria. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 248 | P a g e Recommendations The Nigerian government in an attempt to improve its public healthcare system has been in the processes of drafting various health policies. From the findings of this study, it is recommended that: i. It is imperative that the government comprehensively addresses all the issues of concern in the public health sector. ii. Efforts should be initiated to develop quality indicators in laboratory medicine that can evaluate and subsequently improve the health care system in an effective manner. References Allen, T. J. (2001). Managing the flow of technology: Technology transfer and the dissemination of technological information within the R&D organization. Elsevier. Algilanan, D. L., & Connor, R. (2003). Attitudes to service quality: The expectation gap. Nutrition and Food Science, 33, 165–173. Aregbeyen, J. B. O. (2001). Health sector reforms in Nigeria. Nigeria Institute of Social and Economic Research (NISER), Ibadan. NISER Monograph Series, No. 1, 22–27, 32–39. Argote, L. (2000). Organizational learning: Creating, retaining, and transferring knowledge. Springer. Argote, L., & Ingram, P. (2000). Knowledge transfer in organizations: A basis for competitive advantage in firms. Organizational Behavior and Human Decision Processes. Springer. Arhin-Tenkorang, D. (2000). Mobilizing resources for health: The case for user fees revisited. Commission on Macroeconomics and Health, World Health Organization. Geneva. Baldrige, C. (2003). Health care criteria for performance excellence. National Institute of Standards and Technology. Department of Commerce. Beards, M., Edwards, M., & Sheikh, M. (2009). What drives research productivity? An understanding of how the world’s most successful laboratories operate reveals some answers. McKinsey Solutions. http://solutions.mckinsey.com. (Date accessed: 21st April, 2014) Blas, E. M., & Limbambala, M. (2001). The challenge of hospitals in health sector reform: The case of Zambia. Health Policy and Planning, 16(2), 29–43. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com http://solutions.mckinsey.com/ American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 249 | P a g e Boshoff, C., & Gray, B. (2004). The relationship between service quality, customer satisfaction, and buying intentions in the private hospital industry. South African Journal of Business Management, 35(4), 27–37. Brown, J. S., & Duguid, P. (2003). Organizational learning and communities-of-practice. Butterworth Heinemann. Buchan, J. (2005). Increasing the productivity of an existing “stock” of health workers: Review for DFID. Department for International Development. Chalker, J., Ratanawijitrasin, S., Chuc, N. T. K., Petzold, M., & Tomson, G. (2005). Effectiveness of a multi-component intervention on dispensing practices at private pharmacies in Vietnam and Thailand: A randomised controlled trial. Social Science and Medicine, 60, 131–141. Chawla, R., Goswami, B., Singh, B., Chawla, A., Gupta, V. K., & Mallika, V. (2010). Evaluating laboratory performance with quality indicators. Lab Medicine, 41, 297–300. Choi, K. S., Lee, H., Kim, C., & Lee, S. (2008). Service quality dimensions and patient satisfaction relationships in South Korea: Comparisons across gender, age, and types of service. Journal of Services Marketing, 19(3), 140–149. Cibulskis, R., & Hiawalyer, G. (2002). Information systems for health sector monitoring in Papua New Guinea. Bulletin of the World Health Organization, 80(9), 752–758. Cohen, W. M., & Levinthal, D. A. (2001). Absorptive capacity: A new perspective on learning and innovation. Administrative Science Quarterly, 34(4), 128–152. Coulthard, L. (2004). Measuring service quality: A review and critique of research using SERVQUAL. International Journal of Market Research, 46(4), 479–497. Crewson, P. E. (2004). Public-service motivation: Building empirical evidence of incidence and effect. Journal of Public Administration Research and Theory, 6(2), 499–518. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 250 | P a g e Davis, S. C., Schoenbaum, K. S., Collins, K., Tenney, D. L., Hughes, R. L., & Audet, A. J. (2002). Room for improvement: Patients report on the quality of their health care. The Commonwealth Fund, 45, 300–340. Dean, D. H., & Lang, J. M. (2008). Comparing three signals of service quality. Journal of Services Marketing, 23, 23–34. Dutton, J. M., Starbuck, W. H., & Krippendorff, K. (2002). Diffusion of intellectual technology. Communication and Control in Society, 45, 489–511. Gordon & Breach Science. Edvardsson, B. (2005). Guru’s view: Service quality: Beyond cognitive assessment. Passengers’ behavioral intentions. Journal of Travel Research, 42, 397–400. Ennis, K., & Harrington, D. (2001). Quality management in Irish healthcare. The Service Industries Journal, 21(1), 149–168. Erhabor, O., & Njemanze, C. (2014). Challenges of a negative workload and implications on morale, productivity, and quality of service delivered in NHS laboratories in England. Asian Pacific Journal of Tropical Biomedicine, 4(6), 421–429. Federal Republic of Nigeria. (2004). Health sector reform programme strategic thrusts with a logical framework and a plan of action 2004–2007 (Sept). FMoH. (2004). Achieving health-related millennium development goals in Nigeria – A report of the presidential committee on achieving millennium development goals in Nigeria (August 9) – Executive summary. FMoH. (2004). Health sector reform programme: Strategic thrust with logical framework and plan of action 2004–2007. Glied, S. (2000). Managed care. In Handbook of health economics (1st ed.). Kluwer Academic Publishers. Gonzalez, V., Padin-Lopez, A., & Romon-Garrid, E. (2005). Patient satisfaction with nursing care in a regional university hospital in Southern Spain. Journal of Nurses Care Quality, 20(1), 63–72. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 251 | P a g e Guilford, J. P., & Fruchter, B. (1973). Fundamental statistics in psychology and education. McGraw- Hill Kogakusha, Ltd. HERFON. (2006). Nigeria health review. Health Reform Foundation of Nigeria, Kenbim Press Ltd. Hongoro, C., & Normand, C. (2006). Health workers: Building and motivating the workforce. In D. T. Jamison et al. (Eds.), Disease control priorities in developing countries (2nd ed., pp. 1309– 1322). The World Bank Group. Hornby, P., & Forte, P. (2002). Guidelines for introducing human resource indicators to monitor health service performance. Keele University Centre for Health Planning and Management. Hughes, R. L., Ginnett, R. C., & Curphy, G. J. (2002). Leadership: Enhancing the lessons of experience. McGraw-Hill/Irwin. Irving, P., & Dickson, D. (2004). Empathy: Towards a conceptual framework for health professionals. International Journal of Health Care Quality Assurance, 17(4/5), 212–220. Janssen, J., & McLoughlin, S. (2008). New Zealand’s productivity performance. New Zealand Treasury. Kandampully, J., & Butler, L. (2001). Service guarantees: A strategic mechanism to minimize customers’ perceived risk in service organizations. Managing Service Quality, 11(1), 112–121. Karimi, J., Somers, T. M., & Gupta, Y. P. (2001). Impact of information technology management practices on customer service. Journal of Management Information Systems, 17(4), 125–158. Kothari, C. (2008). Research methodology: Methods and techniques (2nd ed.). New Age International Publishers. Lambo, E. (2006). Linkages between poverty, health, and sustainable development in Africa. Lowell, B., et al. (2010). Strengthening sub-Saharan Africa’s health systems. Businessday, 42–43. Lui, C. (2005). The multidimensional and hierarchical structure of perceived quality and customer satisfaction. International Journal of Management, 22(3), 426–435. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 252 | P a g e MacAuley, R. (2001). A modern paradigm for improving healthcare quality. Journal of Interactive Marketing, 15(2), 127–131. Olaniyan, R. O. (1995). Managing health development in Nigeria. Nigeria Journal of Health Planning and Management, 31–35. Oliveira-Cruz, V., Hanson, K., & Mills, A. (2001). Approaches to overcoming health system constraints at the peripheral level: A review of the evidence. Commission on Macroeconomics and Health, World Health Organization. Owino, W., & Korir, J. (2000). Public health sector efficiency in Kenya: Estimation and policy implications. Institute of Policy Analysis and Research. Parasuraman, A. (2002). Managing service quality: Integrating customer expectations: Implications for further research. Journal of Marketing, 58(2), 6–9. Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1990). A conceptual model of service quality and its implications for future research. Journal of Marketing, 49, 41–50. Payne, A. (2006). Handbook of CRM: Achieving excellence in customer management. Butterworth- Heinemann. Petrick, J. F. (2009). The role of quality, value, and satisfaction in predicting cruise passengers’ behavioral intentions. Journal of Travel Research, 42, 397–400. Reinartz, W. J. (2004). The customer management process: Its measurement and impact on performance. Journal of Marketing Research, 41(3), 293–305. Republic of Kenya. (2001). Health management information systems, report for the 1996 to 1999 period. Ministry of Health, Republic of Kenya. Rowe, A. R., De Savigny, D., Lanata, C. F., & Victora, C. (2005). How can we achieve and maintain high- quality performance of health workers in low-resource settings? The Lancet, 366, 1026–1035. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com American Research Journal of Economics, Finance and Management Volume 13 Issue 1, January -March 2025 ISSN: 2836-9416 Impact Factor: 6.41 Journal Homepage: https://americaserial.com/Journals/index.php/ARJEFM, Email: contact@americaserial.com Official Journal of America Serial Publication American Research Journal of Economics, Finance and Management https://americaserial.com/Journals/index.php/ ARJEFM, Email: contact@americaserial.com 253 | P a g e Rust, R. T., & Tuck, S. C. (2006). Marketing models of service and relationships marketing. Journal of Social Science, 25(6), 560–568. Singh, S., & Ranchod, A. (2004). Market orientation and customer satisfaction: Evidence from the British machine tool industry. Industrial Marketing Management, 33(2), 135–144. Sorescu, G., Popa, C., & Tuclea, F. (2008). Study on improving the quality of services provided by medical laboratories in Romania through the implementation of strategies for sustainable economic development. Retrieved from http://www.cedc.ro/media/MSD/Papers/Volume%204%20no%201%202012/MSD_4.pdf Sun, B., & Shibo, L. (2005). Learning and acting upon customer information: With an empirical application to the service allocations with offshore centers. Marketing Science, 24(3), 430–443. Tam, J. L. M. (2005). Examining the dynamics of consumer expectations in Chinese technologies. Journal of Marketing, 66(3), 98–111. Travis, P., et al. (2004). Overcoming the health systems constraints to achieve the Millennium Development Goals. The Lancet, 364, 900–906. UNICEF. (2007). Vitamin A supplementation: A decade of progress (pp. 24–31). WHO. (1995). United Nations country report (Sept. 1995). World Bank, CRS. (2005). Country status report for Nigeria. WHO. (2006). World health report 2006: Working together for health. World Health Organization. Retrieved from http://www.who.int/whr/2006/en/ World Bank/DMO. (2006). Country status report for Nigeria. Nigeria Debt Management Office report as quoted by World Bank. https://americaserial.com/Journals/index.php/ARJEFM mailto:contact@americaserial.com mailto:contact@americaserial.com http://www.cedc.ro/media/MSD/Papers/Volume%204%20no%201%202012/MSD_4.pdf http://www.who.int/whr/2006/en/