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Healthcare management efficiency has become a golden goal in the operations of modern healthcare organisations across zones and cultures. This study aims to investigate five dimensions of Ouchi’s theory Z approach, mutual organisational trust, long-term employment/job security, employee participatory decision-making, employee well-being and generalised career path, concerning healthcare efficiency in government tertiary hospitals during COVID-19 period.

The probability sampling strategy was adopted among 300 participants of the hospitals in the healthcare workforce of the study population. The study adopted multiple scales on the identified variables of theory Z and employed principal component analysis to evaluate the components of Ouchi’s Theory Z in relation to healthcare efficiency among the workforce of tertiary hospitals in Lagos State, Nigeria.

The outcome of this study shows that all the dimensions were significantly related to healthcare efficiency in the study hospitals. It depicts that mutual trust among employees has a positive influence on the efficiency of healthcare management in government tertiary hospitals, and long-term employment opportunity has a significant impact on the efficiency of healthcare management in government tertiary hospitals. Employee participatory decision-making is essential to the efficiency of healthcare management in government tertiary hospitals. Employee well-being is fundamental to the efficiency of healthcare management in government tertiary hospitals. Generalised career path of healthcare personnel has a tremendous impact on the efficiency of healthcare management in government tertiary hospitals.

This study is limited to healthcare employees in Lagos State, Nigeria. The implication is that as old as Ouchi’s theory, its relevance remains green in the heart of contemporary organisations today even in healthcare facilities in Nigeria which aids the management of the global pandemic, COVID-19 outbreak.

The study shows that Ouchi’s theory Z approach that combines the Japanese and American patterns of organisational management is highly relevant in the operations and management of government hospitals in Nigeria to date even in the era of COVID-19, the global pandemic season.

Bureaucracy to a large extent entrenches orderliness and productive means of achieving goals in both public and private organisations across the world. However, bureaucracy is not suitable in the management of hospitals due to its peculiar nature of operations. This study investigates the conundrum of bureaucratic processes and health-care service delivery in government hospitals in Nigeria.

The study surveyed 600 outpatients and attendees visiting tertiary and government hospitals in Nigeria using descriptive design to obtained data from the respondents. A research instrument, questionnaire, was used to gather data. Out of the 600 outpatients visiting the 20 hospitals in government and tertiary hospitals, 494 responses were returned from the attendees. The study employed random sampling strategy to collect the information.

The findings of this study were that service delivery in government hospitals were in adverse position on all the four constructs of bureaucratic dimensions as against quality of service delivery in hospitals in Nigeria. It discovered that bureaucratic impersonality cannot impact on the quality of service delivery in government hospitals in Nigeria. Separation and division of labour among health workers have no significant effect on quality service delivery in government hospitals. Formal rules and regulations (administrative procedure, rules, and policies) prevent quality service delivery in government hospitals in Nigeria. Also, patient’s waiting time was not significant to the quality of service delivery in government hospitals.

The results are constrained with dimensions of bureaucratic processes. Thus, the implication of this study is that bureaucracy in the Nigerian public hospitals is an unnecessary marriage which should be carefully separated and de-emphasised for quality service delivery in the hospitals to thrive.

Largely, this study is practical essential as it unearths the irrelevant operations procedure that hinder progress in Nigerian hospitals.

The study accomplishes recognised importance to survey how bureaucracy impedes quality service delivery in government hospitals. This study has provided a vital clue to elements that will bring rapid attention to patients’outcome in Nigerian hospitals and health-care facilities which hitherto has not been emphasised. The study has contributed to the existing body of knowledge associated to healthcare service quality in developing country.