SkipTheQ: Impact of a digital appointment system on waiting times and patient satisfaction at a tertiary hospital pharmacy in Gauteng province, South Africa

Abstract

Background Long waiting times at outpatient pharmacies negatively affect patient satisfaction, medication adherence, and healthcare efficiency. In South Africa, tertiary hospital pharmacies face mounting pressure from high patient volumes, staffing shortages, and growing demand for chronic medication services. The SkipTheQ (STQ) mobile and web-based appointment system was implemented at a tertiary hospital in Gauteng, South Africa, to reduce waiting times and improve service delivery. This study evaluates the impact of STQ on patient waiting times, satisfaction levels, and implementation challenges. Methodology A descriptive, cross-sectional, quantitative study was conducted among 297 adult STQ users at a tertiary hospital outpatient pharmacy in Gauteng province. Data were collected over five weeks (April–May 2025) using structured questionnaires covering socio-demographics, digital connectivity, booking experiences, and satisfaction (12-item scale, 0–4 Likert). Waiting times were recorded manually and compared with pre-implementation hospital data. Statistical analysis included descriptive statistics, Mann-Whitney U and Kruskal-Wallis tests, and multiple linear regression ( p ≤ 0.05). Results Participants were predominantly female (68.4%), aged 51–65 years (34.3%), with secondary education (63.6%). Most owned smartphones (89.9%) had internet access (82.8%) and could afford mobile data (76.4%). Website access (94.3%), booking confirmation (98.7%), and preferred slot allocation (93.9%) were high. Satisfaction scores ranged from 3.05 to 3.38 (mean), with the highest ratings for packaging/labelling and likelihood to recommend. Affordability of data, employment status, successful booking confirmation, and preferred time slot significantly predicted satisfaction ( p < 0.05). Average waiting time decreased from 87 min (pre-STQ) to 29 min (post-STQ). However, 25% of users reported delays, with challenges including system downtime (21.8%), unprepared medication (18.8%), and full booking slots (12.5%). Conclusion STQ significantly reduced outpatient pharmacy waiting times and achieved high patient satisfaction. Digital connectivity, particularly data affordability and reliable booking confirmation, was a key driver of satisfaction. However, operational challenges (staffing, system reliability, and digital literacy) must be addressed to ensure scalability and equitable access. Future implementation should prioritise strengthening infrastructure and implementing digital inclusion strategies to maximise public health impact.