Evaluation of SkipTheQ intervention implemented to reduce patient waiting times at an outpatient pharmarcy of a tertiary hospital in Gauteng Province, South Africa

Abstract

Background: Pharmaceutical systems face challenges such as inventory shortages, long waiting times, patient satisfaction, and understaffing, posing risks to medication adherence, illness worsening, potential income and employment loss. Long waiting times have a negative impact on patients, including loss of income, medication adherence, the risk of drug resistance, and deterioration of their health. Recently, an electronic innovative intervention “SkipTheQ” (STQ) was developed and implemented to reduce patient waiting times at an out-patient pharmacy of a tertiary hospital in the Gauteng province. Therefore, this study aimed to evaluate the STQ intervention implemented to reduce patient waiting times. Methods: This is a descriptive, quantitative and cross-sectional study that was conducted with 297 STQ patients, aged 18 or older, who provided written consent. Ethical clearance was obtained from the Turfloop Research Ethics Committee and permission to conduct research from Kalafong Hospital. The study collected data on socio-demographic, connectivity, and booking variables, satisfaction with STQ and challenges encountered with STQ, using structured questionnaires. The average waiting times of the patients registered on STQ were collected over a period of five (5) weeks from April 2025 to May 2025 and were compared with the average waiting times prior implementation of STQ. Differences in the mean scores and association between socio-demographic, connectivity, and booking variables and satisfaction with STQ, were identified using Mann-Whitney U-test and Kruskal-Wallis H-test (as the data was non-parametric). Multiple linear regression analysis was conducted to identify the predictors of satisfaction with STQ. The statistical significance threshold of p < 0.05 was set for this study. Results: More than half of the participants in this study were females (n=203; 68.4%) and had education between Grade 8-12 (n=189; 63.6%). More than three-quarters of the patients were able to afford mobile data (n=227, 76.4%), possess smartphones (n=267, 76.4%), and have an internet connection (n=246, 82.8%). Majority of the participants were able to access the STQ website (n=280, 94.3%) receive their booking reference numbers (n=289, 97.3%), and have their preferred slots confirmed (n=279, 93.9%). Gender, location, affordability of data, education, work, successful booking and booking the preferred slots showed a strong association (p<0.05) with the total STQ satisfaction scores. The linear regression analysis indicated that affordability of mobile data, employment status, successful booking confirmation, and receipt of a preferred time slot were significant predictors of overall satisfaction with the STQ programme. Patients who received slots they wanted and confirmation of successful booking, and could afford data, were happier, which goes to show that easy access to technology and reliable systems played a major role in the users experience towards the service. The average waiting time for participants to collect the medication through STQ was found to be 29 minutes compared to the average waiting time prior to the STQ implementation which was 87 minutes. Conclusion: Long waiting times in health institutions are influenced by socio-demographic, connectivity, and satisfaction factors. Addressing STQ booking issues is crucial for patient satisfaction and appointment adherence. The STQ programme has met the patient satisfaction, but prolonged waiting times are due to staff shortages, patient file unavailability, and the STQ slots being fully booked. Results are relatively positive and show that, on average, the STQ programme makes patients happier. However, for it to reach full potential, there is a great need for improvement regarding operational capacity and digital access.