Engagement and Perceptions of Middle Managers in PhilHealth Benchbook IIAccreditation: Evidence from a Tertiary Hospital Case Study
DOI:
https://doi.org/10.65166/jev58v44Keywords:
PhilHealth Benchbook II, hospital accreditation, middle managers, work engagement, implementation climate, resource constraints, quality improvement, PhilippinesAbstract
This study examined middle managers’ engagement and perceptions regarding the implementation of PhilHealth Benchbook II accreditation in a tertiary hospital in Metro Manila, Philippines, and assessed whether engagement is associated with more favorable accreditation perceptions. Using a quantitative cross-sectional descriptive–correlational single-site case study design, a structured survey was administered to 30 middle managers from nursing and non-nursing departments. Descriptive statistics summarized respondent profile, engagement, and perceptions; Pearson correlation tested the association between engagement and perceptions; and group comparisons examined differences by demographic and departmental categories. Results indicated that middle managers were generally engaged in Benchbook II implementation (M = 3.96, SD = 0.75) and expressed positive perceptions of accreditation (M = 4.09, SD = 0.54). Resource constraints (staffing, budget, equipment) emerged as the most frequently reported challenge (63.3%), while anticipated benefits were framed primarily in terms of improved patient care (53.3%) and enhanced institutional credibility (33.3%). Engagement was significantly and positively correlated with perceptions (r = .588, p = .001), suggesting a reinforcing relationship between participation and accreditation appraisal. Engagement differed significantly by department affiliation (p = .035), while perceptions did not significantly vary across most demographic groupings. Overall, findings suggest that accreditation buy-in among middle managers is strong, but implementation reliability is moderated by capacity constraints and documentation/process burden. Institutional strategies should prioritize resourcing, documentation governance, and department-sensitive support structures to sustain accreditation readiness and quality improvement outcomes.
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Agang-Ang, G., Quinto, L., Kim, Y., Eustaquio, J. C., De Vera, R. K., Crisologo, J., & Lavalle, D. K. (2025). Gender differences in nutrition, lifestyle, and distress among dormitory medical students: A cross-sectional study. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/xngg1k50
Albaroudi, H., Altuwaijri, A., Albagieh, M., & Iqbal, S. (2025). Unlocking university performance: The role of staff commitment and accreditation effectiveness in Saudi universities. Humanities and Social Sciences Communications, 12. https://doi.org/10.1057/s41599-025-05533-0
Alhawajreh, M., Jackson, W., & Paterson, A. (2025). Healthcare professionals’ perceptions about implementing accreditation as a strategy to improve healthcare quality and organisational performance: A cross-sectional survey study. PLOS ONE, 20. https://doi.org/10.1371/journal.pone.0320664
Alhawajreh, M., Paterson, A., & Jackson, W. (2023). Impact of hospital accreditation on quality improvement in healthcare: A systematic review. PLOS ONE, 18. https://doi.org/10.1371/journal.pone.0294180
Al-Muttairi, W. (2025). The effect of quality assurance on university performance through quality culture: Evidence from accredited Iraqi universities. Dibon Journal of Business. https://doi.org/10.64169/djb.104
Alturbag, M., & Alyahya, A. (2025). An overview of Central Board for the
Accreditation of Healthcare Institutions in Saudi Arabia: A narrative review. Cureus, 17. https://doi.org/10.7759/cureus.95137
Al Ansari, A. (2022). Competencies for Successful Middle Managers in Healthcare and Medical Education (Doctoral dissertation, Antioch University).
Atento, A. G., & Atento, R. G. (2025). A case study of Mercury Drug Corporation: Strategic adaptation to universal healthcare and digital disruption in the Philippines. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/zhw7dd39
Atento, R. G. (2025a). Exploring E-learning for sustainable development: Integrating SDGs in management education at Philippine higher education institutions. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/2qcjx561
Atento, R. G. (2025b). The credibility imperative 2025: Governance integrity, economic resilience, and strategic adaptability in Philippine diplomacy. International Journal of Health and Business Analytics, 1(2). https://doi.org/10.65166/6amaz997
Atento, R. G. (2025c). Valuation metrics, market efficiency, and investor sentiment: A descriptive analysis of Philippine Stock Exchange–listed firms. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/6kbeat87
Atento, R. G. O., Quinto, L. F., Espelita, C. A. M., & San Juan, F. M. (2025c). Narrative health analytics: Integrating empathy, data, and ethics in patient-centered healthcare. International Journal of Health and Business Analytics, 1(2). https://doi.org/10.65166/yxgx8e59
Atento, R. G., Quinto, L. F., & Espelita, C. A. M. H. (2025b). Bridging global health workforce gaps 2050: A multilevel analysis of global demand, Philippine supply fragilities, and competency alignment. International Journal of Health and Business Analytics, 1(2). https://doi.org/10.65166/kgbpey79
Atento, R. G., Quinto, L., Espelita, C. A. M., & Castaneda, C. (2025a). Integrating business and health analytics: A conceptual framework for dual outcomes in healthcare. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/04pdc866
Bermido, C. M., Quinto, L. F., & Atento, R. G. O. (2025). A qualitative thematic review of contemporary challenges affecting health professions education: Implications for higher education leadership. International Journal of Health and Business Analytics, 1(2). https://doi.org/10.65166/yfm5w791
Boutcher, F., Berta, W., Urquhart, R., & Gagliardi, A. (2022). The roles, activities and impacts of middle managers who function as knowledge brokers to improve care delivery and outcomes in healthcare organizations: A critical interpretive synthesis. BMC Health Services Research, 22. https://doi.org/10.1186/s12913-021-07387-z
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Dharmagunawardene, D., Bowman, P., Avery, M., Greenfield, D., & Hinchcliff, R. (2025). Factors influencing the establishment of hospital accreditation programs in low- and middle-income countries: A scoping review. Health Policy and Planning, 40, 496–517. https://doi.org/10.1093/heapol/czaf011
Elizalde, J., Lizarondo, L., & Corpuz, J. (2024). Barriers and facilitators to health professionals' engagement in quality improvement initiatives: A mixed-methods systematic review. International Journal for Quality in Health Care, 36(2), mzae041. https://doi.org/10.1093/intqhc/mzae041
Elsharif, S., Abdelraheem, E., Salih, H., Nasr, A., Elnour, M., Mohamedelmugadam, R., Omer, Z., Yousif, R., & Mohamed, A. (2025). Improving healthcare quality in Sudan: Situation and factors influencing healthcare professionals’ engagement. BMC Health Services Research, 25. https://doi.org/10.1186/s12913-025-13481-3
Espelita, C. A. M., & Atento, R. G. (2025). From Community Voice to Marketing Strategy: The Feeder-School Ecosystem as Basis for a Consumer-Centered Marketing Framework. International Journal of Health & Business Analytics, 1(2). https://doi.org/10.65166/mt4em434
Espelita, C. A. M., Atento, R. G., Rao, L. J., & Tian, Y. (2025). Understanding monetary policy: Student awareness, perceptions, and financial behaviors in the Philippine context. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/f7eayj47
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.
Giambartolomei, G., Forno, F., & Sage, C. (2021). How food policies emerge: The pivotal role of policy entrepreneurs as brokers and bridges of people and ideas. Food Policy, 105, 102038. https://doi.org/10.1016/j.foodpol.2021.102038
Hashish, E., Alnajjar, H., & Rawas, H. (2025). Voices on academic accreditation: Lived experiences of nurse educators, administrators, students, and alumni in nursing education. BMC Medical Education, 25. https://doi.org/10.1186/s12909-025-06657-2
Hezbiyan, Z., Aziz, A., Kadhim, A., Javadzadeh, A., Parizad, A., Chalan, P., Norouzadeh, R., Mehran, N., Babaii, A., Abbasinia, M., & Aghaie, B. (2025). Explaining the barriers and facilitators of the accreditation process in maternity departments. BMC Nursing, 24. https://doi.org/10.1186/s12912-025-02825-3
Hussein, M., Pavlova, M., Ghalwash, M., & Groot, W. (2021). The impact of hospital accreditation on the quality of healthcare: A systematic literature review. BMC Health Services Research, 21. https://doi.org/10.1186/s12913-021-07097-6
Iqbal, S., Taib, C., & Razalli, M. (2023). The effect of accreditation on higher education performance through quality culture mediation: The perceptions of administrative and quality managers. The TQM Journal. https://doi.org/10.1108/TQM-11-2022-0322
Issah, O., Brako, S., & Yeboah, H. (2025). Leadership, strategic quality management, and SMEs sustainability: The mediating effect of employee empowerment and engagement. International Journal of Social Sciences and English Literature, 9. https://doi.org/10.55220/2576683x.v9.412
Izak, M., Case, P., & Ybema, S. (2021). Monologue and organization studies. Organization Studies, 43(10), 1507–1522. https://doi.org/10.1177/01708406211069434
Joseph, L., Agarwal, V., Raju, U., Mavaji, A., & Rajkumar, P. (2021). Perception of hospital accreditation impact among quality management professionals in India: A survey-based multicenter study. Global Journal on Quality and Safety in Healthcare, 4(2), 58–64. https://doi.org/10.36401/JQSH-20-44
Kumar, N., Reddy, A., Ramya, T., & Rathod, P. (2025). Barriers to national accreditation board for hospitals and healthcare provider accreditation in public tertiary hospitals: A comprehensive review. Indian Journal of Medical Sciences. https://doi.org/10.25259/IJMS_258_2024
Lo, Y., Lu, C., Chang, Y., & Wu, S. (2024). Examining the influence of organizational commitment on service quality through the lens of job involvement as a mediator and emotional labor and organizational climate as moderators. Heliyon, 10(3), e24130. https://doi.org/10.1016/j.heliyon.2024.e24130
Mansoor, T., Puteh, S., Aizuddin, A., & Malak, M. (2024). Challenges and strategies in implementing hospital accreditation standards among healthcare professionals in healthcare systems in Yemen: A phenomenological study. Cureus, 16. https://doi.org/10.7759/cureus.59383
Mustafa, M., Hughes, M., & Ramos, H. (2022). Middle-managers’ innovative behavior: The roles of psychological empowerment and personal initiative. The International Journal of Human Resource Management, 34(18), 3464–3490. https://doi.org/10.1080/09585192.2022.2126946
Mutlu, H., & Mat, S. (2025). Accreditation through the eyes of nurse managers: An infinite staircase or a phenomenon that evaporates like water. Journal of Health Organization and Management. https://doi.org/10.1108/JHOM-01-2025-0029
Nasution, P., Ayuningtyas, D., Bachtiar, A., & Besral, B. (2025). The development and impact of hospitals accreditation in Southeast Asia: A scoping review. Journal of Health Research. https://doi.org/10.56808/2586-940x.1139
Quinto, L., & Atento, R. G. (2025). Economic growth and developmental equity in four ASEAN economies: Linking macroeconomic trends to employment and child nutrition (1999–2024). International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/nq75nv94
Rao, L., Tian, Y., & Atento, R. G. O. (2025). Adoption and perceived effectiveness of AI in education: Personalization, outcomes, and equity. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/qgq89291
Ren, W., & Li, J. (2023). Defining national translation capacity: A comprehensive framework for analyzing translation at country level. Perspectives, 31(6), 1092–1109. https://doi.org/10.1080/0907676X.2023.2194547
Schaufeli, W. B., Shimazu, A., Hakanen, J., Salanova, M., & De Witte, H. (2019). An ultra-short measure for work engagement: The UWES-3 validation across five countries. European Journal of Psychological Assessment, 35(4), 577–591.
Signo, C. (2025). Revisiting program accreditation and its implication to quality assurance management culture of a higher education institution. Diversitas Journal, 10(2). https://doi.org/10.48017/dj.v10i2.3232
Slootmans, S., Van Bogaert, P., Peremans, L., & Franck, E. (2025). Contextual factors and competencies influencing quality improvement: Perspectives from nurses and nurse managers. Journal of Health Organization and Management. https://doi.org/10.1108/JHOM-10-2024-0436
Srimulyani, V., & Hermanto, Y. (2022). Organizational culture as a mediator of credible leadership influence on work engagement: Empirical studies in private hospitals in East Java, Indonesia. Humanities and Social Sciences Communications, 9. https://doi.org/10.1057/s41599-022-01289-z
Temporada, K., Quinto, L., Tarraya, D. A., Sison, F. C., Marfil, J. F., Ramirez, C., & Ng, W. J. (2025). Awareness and preventive practices on leptospirosis in flood-prone communities of Marikina City, Philippines. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/x71zvx65
Teodosio, G. M., Atento, R. G., Boa, R. A., Malijan, A., Malolos, Q. A., Merciales, P. A., & Ricablanca, P. J. (2025). Creating a blue ocean for family-owned SMEs: Value innovation, digital transformation, and sustainability in the case of Ivan Color Paint Center. International Journal of Health & Business Analytics, 1(2). https://doi.org/10.65166/x4kqee91
Weiner, B. J., Lewis, C. C., Stanick, C., Powell, B. J., Dorsey, C. N., Clary, A. S., Boynton, M. H., & Halko, H. (2020). Psychometric assessment of three newly developed implementation outcome measures. Implementation Science, 15(1), 108.
Yin, R. K. (2018). Case study research and applications: Design and methods (6th ed.). Sage publications.
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