Strategies for reducing outpatient waiting times in urban public hospitals in Lusaka, Zambia: A Cross-Sectional Study

Abstract

Delays in outpatient waiting times are one of the major barriers to health system performance and patient satisfaction in the low- and middle-income countries. In Lusaka, Zambia, there is still endemic congestion and inefficiencies within the functioning of the first-level hospitals in the country. In order to research these phenomena, a cross-sectional study was conducted at Kanyama and Chilenje First-Level Hospitals, where 410 adult outpatients were selected through the simple random sampling method. Queuing theory guided the study. These quantitative findings are just a portion of a large mixed study that aimed at developing an operational framework for optimizing outpatient waiting time in public health facilities in Zambia. A designed questionnaire was used to gather the information on demographics, service-point waiting time, patient perceptions, and factors with regard to management. Descriptive and inferential statistical analyses were implemented in SPSS v26 and responses given in open-ended format to thematic coding, respectively. Almost half (46.13%) of the respondents have waited between 3 and 6 hours, with the longest waiting time at the reception, triage, and pharmacy. The shortage in human resources, especially when the restaurant is facing peak times, as well as insufficient infrastructure, has turned out to be the effective predictor of long waiting times. Even though 82 percent of the facilities stated the use of an appointment system, most visits (72 percent) were walk-ins, meaning little use of scheduling tools. The measures that were confidently supported by patients included additional staffing during the busy hours, the task-shifting towards nurses in case of routine consultations (90.7%), and the introduction of the triage and appointment systems (more than 80). A willingness to repeat the same facilities was mentioned by only 31% of patients, and their reasons were long queues, bad coordination, and slow service delivery. Generally, the systemic inefficiencies, low capacity of the staff, and lack of infrastructure are the major causes of outpatient delays in the public hospitals of Lusaka. To effectively reduce outpatient waiting times, strategic efforts should prioritize workforce optimization, improvement of triage and appointment mechanisms, digitalization of patient registration through SmartCare, and expansion of healthcare infrastructure. Embedding these initiatives within Zambia’s broader health systems management and e-health frameworks is likely to yield substantial improvements in service delivery efficiency, patient satisfaction, and overall trust in the public health system.