Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital. Key measures for improvement In the initial survey, outpatients waited a mean (±SD) of 52 ± 46 minutes for collection of outpatient cards, 152 ± 115 minutes to see the doctor, 9.6 ± 9.0 minutes with the doctor, and 34 ± 32 minutes to collect medication from the pharmacy. Mean total outpatient time was 248 minutes. Long waiting times were judged to result primarily from staff shortages, misfiling of cards, doctors' delay in starting consultations, and simultaneous break times. Strategies for change Corrective measures implemented included additional employment and reallocation of staff, training of medical records staff, recording times on outpatient cards, and scheduling follow-up visits for less busy times. Effects of change In a second survey5 years later, after corrective measures were implemented, the mean (range) outpatient time spent at the hospital was 184 (7 – 390) minutes, primarily due to reduction in waiting time to see the doctor of 48 (0 – 210) minutes. The card waiting time of 53 (2 – 165) minutes was unchanged. Lessons learned In-house training of records staff had little long-term impact on reducing the time patients waited to collect their cards. Increased staffing and coordinating staff strength to correspond to times of peak patient load had the greatest effect in reducing outpatient waiting time. Constructive use of patient waiting time may provide greater patient satisfaction. Monitoring patient waiting time can be feasibly implemented to measure performance of health systems and provides a basis for allocating resources.
Highland Medical Research Journal Vol. 3 (1) 2005: 36-42