Background: The purpose of this study was to develop the Hospital-Stakeholder Collaboration (HSC) Tool and Hospital Performance Factor (HPF) Tool to explore stakeholder perception and value for hospital service improvement. Methods: This exploratory mixed-method study involved three steps: initial tool development (Step 1), validity testing (Step 2), and module development (Step 3). In Step 1, qualitative data collection through literature reviews, focus group discussions, and interviews with hospital management experts led to the creation of the preliminary tools. Step 2 involved qualitative analysis by α 5-member expert panel, followed by quantitative analysis with 36 respondents for validity (Pearson correlation, α = 0.05) and reliability (Cronbach's Alpha, α = 0.6) tests. Step 3 encompassed the final module development. Results: The HSC tool contains 6 domains and the HPF tool contains 4 perspectives. The 6 HSC domains were: 1) stakeholder identification, 2) interactive dialogue, 3) commitment, 4) planning, 5) implementation, 6) change in action and behavior. The 4 HPF perspectives were: 1) stakeholder perspective, 2) financial perspective, 3) internal business process, and 4) staff and organizational capacity. The values of the HSC tool validity and reliability tests were around 0,0046 and around 0,995, respectively. Additionally, the values of the HPF tool validity and reliability tests were around 0,0062 and around 0,995, respectively. Conclusion: This study offers a practical tool for needs assessment for the improvement of service by analyzing direct feedback from hospital stakeholders and measuring hospital performance factors.

Original languageEnglish
Pages (from-to)1075-1086
Number of pages12
JournalEthiopian journal of health sciences
Issue number6
Publication statusPublished - 1 Nov 2023


  • Coverage
  • Hospital-stakeholder
  • Patient Experience
  • Patient Feedback
  • Service Improvement


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