Causes of Long Waiting Time in General Outpatient Departments of a Federal and a State Teaching Hospital in Enugu State, Nigeria: A Mixed-Methods Comparative Study
1Peace Nkechi Ani; 2Chika Grace Ugochukwu; 3Peace Njideka Iheanacho; 1Adaora Ukamaka Okoli and 1,4Ebuoh Maryann Chiamaka
1Enugu State College of Nursing Sciences Parklane, Enugu, Nigeria.
2Department of Nursing Sciences, Godfery Okoye University, Enugu, Nigeria
3Department of Nursing Sciences, University of Nigeria, Enugu Campus
4Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, State University of Medical and Applied Sciences (SUMAS), Igbo-Eno, Enugu State, Nigeria.
Corresponding author: Ebuoh, Maryann Chiamaka (maryann.ebuoh@sumas.edu.ng +2348149560255)
ABSTRACT
Waiting time refers to the total time a patient spends in a health facility from arrival at registration to completion of the final service point, including time spent on registration, consultation, emergency care, diagnostic tests/procedures, and receiving results. Because prolonged waiting time is a key indicator of healthcare quality and a determinant of patient satisfaction, this study analysed the causes of long waiting time in the General Outpatient Departments (GOPDs) of a federal and a state teaching hospital in Enugu State, Nigeria. A mixed-methods comparative design was used in the GOPDs of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, and the Enugu State University of Science and Technology Teaching Hospital Parklane (ESUTTHP). The sample was drawn from 250 consenting adults (≥18 years), with sample size allocation guided by WHO national guidelines for health study sample size determination and based on facility attendance patterns. Quantitative data were obtained using a structured questionnaire and a patient time-tracking schedule developed from the study objectives and similar studies, while qualitative data were collected through semi-structured interviews with audio recording. Of the recruited participants, 188 were included in the analysis (UNTH n=108; ESUTTHP n=80), and six were purposively selected for in-depth interviews. The total mean time from arrival to the final service point was 227.21 minutes at ESUTTHP and 234.00 minutes at UNTH. Mean waiting times at key service points (ESUTTHP vs UNTH) were 31.13 vs 121.05 minutes for payment, 26.46 vs 51.00 for registration, 43.70 vs 29.79 for the waiting area, 41.20 vs 9.25 for the nurses’ station, and 58.29 vs 34.51 for the doctors’ room. Most participants attended for medical care related to a present illness (75.0%) and reported delays mainly at the records unit and waiting area, with reported drivers including network-related problems, long queues, overcrowding, and queue jumping. Commonly perceived causes of long waiting time included inadequate staffing, long queues at records/payment/registration, overcrowding, queue jumping, delays in triage/nursing assessment, inadequate direction/wayfinding, and inadequate work materials, and waiting time differed significantly between facilities (p < 0.0001). Overall, outpatient waiting time exceeded three hours in both hospitals, with facility-specific bottlenecks particularly prolonged payment time at UNTH suggesting that strengthening staffing at high-volume stations, improving queue governance, ensuring resilient records systems, optimizing triage, and improving wayfinding could reduce waiting time and improve patient flow and satisfaction.
Keywords: waiting time; outpatient department; patient flow; teaching hospitals; Enugu State; Nigeria.
CITE AS: Peace Nkechi Ani; Chika Grace Ugochukwu; Peace Njideka Iheanacho; Adaora Ukamaka Okoli and Ebuoh Maryann Chiamaka (2025). Causes of Long Waiting Time in General Outpatient Departments of a Federal and a State Teaching Hospital in Enugu State, Nigeria: A Mixed-Methods Comparative Study. NEWPORT INTERNATIONAL JOURNAL OF BIOLOGICAL AND APPLIED SCIENCES, 6(3):1-9. https://doi.org/10.59298/NIJBAS/2025/6.3.190000