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Towards optimizing outpatient waiting time through e-governance: Exploring digital registration barriers in first-level hospitals, Lusaka, Zambia
Frank Nang'ama
Mwiya Mutandi
Priscar Sakala Mukonka
Lonia Mwape
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.
