Reducing OPD Waits at Rev John Chilembwe Hospital, Malawi – ACQUIRE QI Patient Safety Cohort 2 2026

Priscilla Maganga, stepping in to present for her team, shares how Reverend John Chilembwe Hospital in Malawi is reducing patient waiting time in its outpatient department (OPD) through coordinated care. Patients in the OPD were waiting an average of four hours and 30 minutes from consultation through investigations to treatment. The team set out to bring this down to two hours and 30 minutes, tracking waiting time on a run chart from the baseline. Their current-state analysis found that very sick patients were not being triaged, and that patients sent for radiology or laboratory tests were sent back into the waiting line instead of going straight to the consultation rooms. A fishbone analysis pointed to the lack of a standard patient flow pathway, departments working in isolation, too few staff for triage, no investigations on days with power outages, and equipment breakdowns. The team developed a standardised OPD patient flow pathway, set up communication between departments, trained more staff, lobbied for power backup and advocated for maintenance of faulty equipment. By giving patients returning from radiology and the laboratory their own queue, they cut time in the waiting area from one hour to 45 minutes. The OPD in-charge will own the standard pathway to sustain the change, which the team estimates delivers a 33.3% impact, and a key learning was to orient OPD support staff so they can help with triage when staff are short. Coach Grace Zakeyu thanked ACQUIRE for the opportunity, noting that the project has brought measurable change and that QI is not a destination but a start. Team leadership: Gerald Clement Mushani Sponsorship: Grace Zakeyu Mentorship: Grace Zakeyu Team: Christina Simila, Daniel Donni Nkhoma, Eddah Chunga, Felix Lucinio Kadzanja, Priscilla Maganga Chapters 0:00 Introduction 0:17 Problem statement 0:32 Target and baseline 0:43 Current state analysis 1:00 Root causes and key drivers 1:43 Results 2:07 Sustain plan 2:21 Impact and learning 2:47 Feedback and celebration This project is part of the 2026 ACQUIRE Quality Improvement-Patient Safety (QI-PS) Experiential Leadership Program, where frontline health workers across sub-Saharan Africa learn improvement science by leading real change in their own facilities. Quality takes a team! Learn more: https://acquirefrontline.org #QualityImprovement #PatientSafety #WaitingTime #OutpatientCare #Malawi #ACQUIRE