Systems, Standards, and a Culture of Care

On 22nd July 2025, the Master of Business Administration in Healthcare Management (MBA-HCM) students at Strathmore University Business School (SBS) were privileged to host Dr. Robert Nyarango, the CEO of Gertrude’s Children’s Hospital, for a Guest Lecture Session. His session covered the principles, systems, and global benchmarks that define quality healthcare delivery.

Dr. Nyarango started by demystifying the philosophy that underpins operations at Gertrude’s Children’s Hospital. Their model’s core is patient-centered care, driven by a culture of accountability, systems thinking, and technology-enabled solutions. He emphasized that healthcare that impacts should be sustainable, benchmarked against international standards, and underpinned by people-centered and process-oriented leadership.

Most of his session was devoted to organizational culture as a buzzword and a measurable, structured force. Gertrude’s approach begins recruitment and induction and ensures new employees learn about and integrate into the hospital’s values. Regular internal training, competence testing, practice audits, and culture of safety surveys are all integrated within the system so that every member of the team is attuned to the hospital’s commitment to excellence.

Dr. Nyarango made it clear that culture is everyone’s business, from governance and leadership to individual practitioners and frontline staff. With this collective involvement, cultural alignment is not hoped for but is institutionalized and continuously examined.

He then introduced the students to Gertrude’s systems approach, which aligns practice with policy. From disaster plans to standard operating procedures, the organization diligently ensures that even amid high-stress events such as disasters or emergent care scenarios, staff members act with precision and purpose. At the core of this preparation is the hospital’s use of predesigned, practiced actions and well-developed, well-advertised procedures.

Gertrude’s also applies the 5S methodology Sort, Set in Order, Shine, Standardize, and Sustain to enhance operational efficiency. According to Dr. Nyarango, this methodology is all about making it easy to do the right thing, not just once, but repeatedly.

The discourse later turned to quality assurance using international standards. Dr. Nyarango gave a practical explanation of ISO 9001:2015 and Joint Commission International (JCI), which Gertrude’s has adopted to drive institutional performance. He clarified that ISO 9001:2015 provides a clear model founded on three stages: Input, Process, and Output. By focusing on people as a major input, simplifying business processes, and measuring outputs, Gertrude can ensure continual improvement. The outcome is a responsive, effective, standardized healthcare environment supported by measurable information and shared institutional language.

On the other hand, JCI accreditation offers a healthcare-specific orientation. By focusing on delineated patient care processes, measurable elements, and an entire-systems view, JCI allows organizations like Gertrude’s to gain targeted excellence in patient safety and clinical results. Dr. Nyarango clarified that JCI expands on ISO by emphasizing what truly matters in healthcare: safe, accountable, and quantifiable outcomes.

As challenging as applying such systems can be, he sketched their ultimate payoff in developing internal capacity, discipline, and a sense of common purpose. “It’s not about getting a certificate,” he said. “It’s about feeling good because we know we’re doing the right thing consistently.”

The session concluded with an emphasis on leadership and empowerment. Dr. Nyarango challenged the MBA-HCM students to view healthcare not as a service, but as a system of systems whereby leadership, culture, data, and people all work like clockwork. “Most problems are not because we don’t know what to do,” he said to them, “but because we don’t do it. Systems and culture close that gap.”

His wisdom offered a stirring blueprint for future healthcare leaders: think systemically, lead with integrity, and always keep the patient at the center.

Learn more about the MBA Healthcare Programme here

Article by Miriam Wafula