Outcome evaluation of effect of organizational strategies on reduction of patient waiting time at the outpatient department at Kilimanjaro Christian Medical Centre – Northern, Tanzania

Abstract

Background The Tanzanian healthcare system has long grappled with extended waiting times in outpatient departments (OPD). Studies at Kilimanjaro Christian Medical Centre (KCMC) revealed an average wait of six hours, marking KCMC with the longest waiting time among Tanzanian referral hospitals. Thus, this study was undertaken to assess the efficacy of the programme interventions and their effect on waiting time at KCMC, OPD. Methods An analytical cross-sectional approach quantitatively and qualitatively examined the subject. The study enrolled 412 patients who completed structured questionnaires, while 14 participants underwent in-depth interviews (ID) (8 healthcare providers, 6 patients) from 3rd to 14th, 2023. Documentary review supplemented data. Quantitative analysis included descriptive statistics, bivariable, and multivariable techniques. Qualitative data underwent thematic analysis. Significance tests were at a 5% level. Result The overall OPD waiting time significantly decreased to 3.30 hours IQR (2.51-4.08) in contrast to the previous 6 hours prior to the intervention, showing the effectiveness of the intervention achieving a reduction of waiting time by 55%. Improvements were particularly evident, waiting time for registration (9 minutes), payments (10 minutes), triage (14 minutes for patients with insurance) and pharmacy (4 minutes). The implementation of Ushers emerged as a significant predictor to patient waiting time (AOR = 2.08, 95% CI, 1.10-3.94, p-value=0.025). Based on the IDI, the findings indicate a favourable change in patients' attitudes towards waiting time at the OPD. However, there is skepticism regarding the expansion of hospital infrastructure and its effect on waiting time, as well as reliance on auxiliary support due to insufficient human resources. Conclusion Even though the established intervention strategies have managed to reduce waiting time, additional measures to attain the global standard of waiting time from 30 minutes to 2 hours are needed.