Towards optimizing outpatient waiting time through e-governance: Exploring digital registration barriers in first-level hospitals, Lusaka, Zambia

Authors

DOI:

https://doi.org/10.51867/ajernet.6.4.73

Keywords:

Digitization, Health Systems Management, Hospital Efficiency, Lusaka, Patient Satisfaction, Waiting Time, Zambia

Abstract

The issue of long queues in outpatient departments in urban hospitals is a topical challenge given the context of health facilities operating in the sphere of the state that brings the issue of patient dissatisfaction, frustration and loss of confidence in the healthcare delivery system. Such a long waiting time does not only cause inconvenience to the patients but also exposes the healthcare staff to excessive work, thus overworking the service-delivering systems. Waiting time is a major indicator of the health system performance; in the event whereby the waiting time is longer than the acceptable mark, it may contribute to the incidence of adverse health outcomes and reduce adherence to the treatment process by the patients and the overall quality of care. The latter phenomenon, in its turn, requires the consideration of reducing the patient experience and improving the health service delivery. Queuing theory guided this research. This study employed a qualitative design, the target population being those in charge of hospital managerial and operational decisions. This research involved the purposive sampling of 12 healthcare managers to give information on barriers associated with digital registration in first-level hospitals. The selected first-level hospitals were Chilenje and Kanyama First Level Hospitals, based in Lusaka, Zambia. Collection of data was done using in-depth interviews, and analysis was done using themes that were produced during the study. This study has revealed that digital systems are associated with barriers which ultimately impact patient waiting time. According to healthcare providers, the constant system malfunctioning was a major disruption of the registration process, forcing them to revert to the manual methods. In conclusion, this research recommends modernising infrastructure to maximise capacity, integrating registration with other departments to maximise patient flow, and ensuring reliable, well-maintained systems. The study further suggests a thorough focus on comprehensive staff training, supporting patient digital literacy, promoting staff adoption through change management, and increasing administrative response.

Downloads

Download data is not yet available.

References

Abeni, D., Rotunno, R., Diociaiuti, A., Giancristoforo, S., Bonamonte, D., Filoni, A., Schepis, C., Siragusa, M., Neri, I., Virdi, A., Castiglia, D., Zambruno, G., Bodemer, C., & Hachem, M. (2021). The Burden of Autosomal Recessive Congenital Ichthyoses on Patients and their Families: An Italian Multicentre Study. Acta Dermato Venereologica, 101(6), adv00477. https://doi.org/10.2340/00015555-3822

Alodan, A., Alalshaikh, G., Alqasabi, H., Alomran, S., Abdelhadi, A., & Alkhayyal, B. (2020). Studying the Efficiency of Waiting Time in Outpatient Pharmacy. MethodsX, 7, 100913. https://doi.org/10.1016/j.mex.2020.100913

Beck, D., Veliz, P. T., Munro-Kramer, M., Boyd, C., Sakala, I., Chiboola, N., & Lori, J. (2021). Exploring change over time in community mobilization domains: Results from a maternity waiting home intervention in rural Zambia. International Journal for Equity in Health, 20(1), 228. https://doi.org/10.1186/s12939-021-01557-5

Bilandžić, J. (2022). A Prospective Observational Study to Assess Waiting Times to First Treatment in Patients Diagnosed with Brain Tumor. Acta Clinica Croatica, 61. https://doi.org/10.20471/acc.2022.61.01.15

Biya, M., Gezahagn, M., Birhanu, B., Yitbarek, K., Getachew, N., & Beyene, W. (2022). Waiting time and its associated factors in patients presenting to outpatient departments at Public Hospitals of Jimma Zone, Southwest Ethiopia. BMC Health Services Research, 22(1), 107.

https://doi.org/10.1186/s12913-022-07502-8

Bolton Moore, C., Pry, J. M., Mukumbwa-Mwenechanya, M., Eshun-Wilson, I., Topp, S., Mwamba, C., Roy, M., Sohn, H., Dowdy, D. W., Padian, N., Holmes, C. B., Geng, E. H., & Sikazwe, I. (2022). A controlled study to assess the effects of a Fast Track (FT) service delivery model among stable HIV patients in Lusaka Zambia. PLOS Global Public Health, 2(8), e0000108. https://doi.org/10.1371/journal.pgph.0000108

Bontia, Md, A. A. I., & Babsa-ay, Md, J. D. (2024). Factors Affecting Waiting Time of Patients Referred to Specialty Clinics from a Family Medicine Clinic in a Tertiary Government Hospital: A Retrospective Chart Review. Acta Medica Philippina, 58(13).

https://doi.org/10.47895/amp.v58i13.8098

Girmenia, C., Gentile, G., Micozzi, A., Petrucci, L., Malaspina, F., Di Prima, A., Baldacci, E., Bianchi, S., Pugliese, P., Turriziani, O., Antonelli, G., Tombolini, V., Foà, R., & Martelli, M. (2020). COVID-19 in Patients with Hematologic Disorders Undergoing Therapy: Perspective of a Large Referral Hematology Center in Rome. Acta Haematologica, 143(6), 574-582. https://doi.org/10.1159/000510769

Haleema Muhamed. (n.d.). Wainting time and Patients satisfaction. 2023.

Hall, R., Harvey, M. R., & Patel, V. (2022). Diabetes care in the time of COVID ‐19: Video consultation as a means of diabetes management. Practical Diabetes, 39(2), 33. https://doi.org/10.1002/pdi.2387

Hamoonga, T. E., Mutale, W., Igumbor, J., Bosomprah, S., Arije, O., & Chi, B. H. (2024). Preferences for pre-exposure prophylaxis delivery among HIV-negative pregnant and breastfeeding women in Zambia: Evidence from a discrete choice experiment. Frontiers in Reproductive Health, 6, 1350661. https://doi.org/10.3389/frph.2024.1350661

Malécot, N., Chrusciel, J., Sanchez, S., Sellès, P., Goetz, C., Lévêque, H.-P., Parizel, E., Pradel, J., Almhana, M., Bouvier, E., Uyttenhove, F., Bonnefoy, E., Vazquez, G., Adib, O., Calvo, P., Antoine, C., Jullien, V., Cirille, S., Dumas, A., … Cavet, M. (2022). Chest CT Characteristics are Strongly Predictive of Mortality in Patients with COVID-19 Pneumonia: A Multicentric Cohort Study. Academic Radiology, 29(6), 851-860. https://doi.org/10.1016/j.acra.2022.01.010

Musonda, M., Lupo, R., Muro, M., Grilli, G., Ogorzalek, K., Rubbi, I., & Artioli, G. (2021). Nurse's knowledge and perceptions on communicative hypnosis: An observational study. Acta Biomedica Atenei Parmensis, 92(S2), e2021027. https://doi.org/10.23750/abm.v92iS2.11211

Naiker, U. (2017). Waiting Times: The Outpatient Referral Process, Variation, Performance and Structural Influences [Queensland University of Technology]. https://doi.org/10.5204/thesis.eprints.108004

Oeser, G., & Romano, P. (2021). Exploring risk pooling in hospitals to reduce demand and lead time uncertainty. Operations Management Research, 14(1-2), 78-94. https://doi.org/10.1007/s12063-020-00171-y

Parast, L., Burkhart, Q., Bardach, N. S., Thombley, R., Basco, W. T., Barabell, G., Williams, D. J., Mitchel, E., Machado, E., Raghavan, P., Tolpadi, A., & Mangione-Smith, R. (2022). Development and Testing of an Emergency Department Quality Measure for Pediatric Suicidal Ideation and Self-Harm. Academic Pediatrics, 22(3), S92-S99. https://doi.org/10.1016/j.acap.2021.03.005

Rapoport, C., Wells, C., Torres, G., Ortiz‐Maldonado, R., Venkatachalam, S., Stradford, L., Gavigan, K., Boyd‐Floering, B., Danila, M. I., Nowell, W. B., & Carandang, K. (2023). Balancing COVID ‐19 Risk With Physical and Mental Wellness: Perspectives of Patients With Autoimmune Rheumatic Diseases Throughout the Pandemic. ACR Open Rheumatology, 5(6), 310-317.

https://doi.org/10.1002/acr2.11551

Schmidt, S., Madsen, K. P., Pedersen-Bjergaard, U., Rytter, K., Hommel, E., Cleal, B., Willaing, I., Andersen, H. U., & Nørgaard, K. (2023). Associations between clinical and psychosocial factors and HbA1c in adult insulin pump users with type 1 diabetes. Acta Diabetologica, 60(8), 1089-1097. https://doi.org/10.1007/s00592-023-02081-4

Sialubanje, C., Kaiser, J. L., Ngoma, T., Mwananyanda, L., Fong, R. M., Hamer, D. H., & Scott, N. A. (2023). Postnatal care services in rural Zambia: A qualitative exploration of user, provider, and community perspectives on quality of care. BMC Pregnancy and Childbirth, 23(1), 39. https://doi.org/10.1186/s12884-023-05350-w

Tanabe, P., Ibemere, S., Pierce, A. E., Freiermuth, C. E., Bosworth, H. B., Yang, H., Osunkwo, I., Paxton, J. H., Strouse, J. J., Miller, J., Paice, J. A., Veeramreddy, P., Kavanagh, P. L., Wilkerson, R. G., Hughes, R., & Barnhart, H. X. (2023). A comparison of the effect of patient‐specific versus weight‐based protocols to treat vaso‐occlusive episodes in the emergency department. Academic Emergency Medicine, 30(12), 1210-1222. https://doi.org/10.1111/acem.14805

Villegas, A. C., Saylor, D., Kvalsund, M., Atadzhanov, M., Chiluba, C., Chishimba, L., Zimba, S., Chomba, M., & Siddiqi, O. K. (2021). Task-shifting to optimize outpatient neurological care in Zambia. Human Resources for Health, 19(1), 88. https://doi.org/10.1186/s12960-021-00619-7

Zhang, H., Ma, W., Zhou, S., Zhu, J., Wang, L., & Gong, K. (2023). Effect of waiting time on patient satisfaction in outpatient: An empirical investigation. Medicine, 102(40), e35184. https://doi.org/10.1097/MD.0000000000035184

Downloads

Published

2025-11-14

How to Cite

Nang’ama, F., Mutandi, M., Mukonka, P. S., & Mwape, L. (2025). Towards optimizing outpatient waiting time through e-governance: Exploring digital registration barriers in first-level hospitals, Lusaka, Zambia. African Journal of Empirical Research, 6(4), 822-829. https://doi.org/10.51867/ajernet.6.4.73