Beyond the Queue: Your Whole Hospital Visit, Step by Step

Think back to your last hospital visit. Chances are the first thing you remember is the waiting: the bench outside the consultation room, the number you listened for, your phone battery dropping as the morning went by.

The queue is the part everyone talks about. But it is only one stop on a longer journey, one that starts before you leave home and often continues for weeks after you leave the facility. Seeing the whole journey explains why a visit can feel so draining, and shows where it can be made easier.

Why the queue exists

Queues are not a sign that nobody cares. Most often they reflect facilities serving more people than they were built for, and health workers doing their best with the time and staff they have. The World Health Organization has long highlighted that Africa carries close to a quarter of the global disease burden but has only about 3% of the world’s health workers.

Queues also form because many patients arrive at the same time, first thing in the morning, and because of triage: seeing the sickest people first. If someone who arrived after you is called in before you, they may simply need care more urgently. That same system protects you on the day you are the sickest person in the room.

Before the visit: three steps that happen at home

1. Deciding whether to go

The first hurdle is often “Is this serious enough?” Some people wait too long; others rush to hospital for things a pharmacist could handle. Reliable information and a quick professional opinion, from a pharmacist, a Community Health Promoter or an online consultation where appropriate, can help you decide.

2. Finding where to go

Kenya’s public system is organised in levels of care: community health services (Level 1), dispensaries (Level 2), health centres (Level 3), sub-county hospitals (Level 4), county referral hospitals (Level 5) and national referral hospitals such as Kenyatta National Hospital and Moi Teaching and Referral Hospital (Level 6). Private, faith-based, and NGO facilities also play a big role. For most everyday concerns, starting near you at a lower level and being referred up if needed saves time.

3. Getting there

Matatu fare, a boda boda to the stage, time off work, someone to watch the children. Booking ahead, or choosing a facility near your workplace rather than home, can cut the real cost of getting there.

During the visit: more than one queue

·         Waiting to be seen. Registration, then triage, where a nurse may check your temperature, blood pressure and weight, then the wait for the clinician.

·         The consultation. Often the shortest part of the day. Knowing what you want to say and ask makes those minutes count.

·         The lab. If tests are needed, there may be another queue, another payment and a wait. Ask when results will be ready and whether you must come back for them.

·         The pharmacy. Sometimes a separate counter, sometimes a chemist outside. Ask how to take each medicine and what to do about side effects.

·         Paying. Cash, M-Pesa, SHA or private insurance can each involve their own steps. Asking about costs early avoids surprises at the end.

After the visit: where journeys quietly stall

Results that arrive after you have gone home can go unread. Make sure you know who will explain them to you, and how.

Follow-up is where many journeys stall, because life gets busy: a review date missed, a repeat blood pressure reading never taken, a referral letter left in a drawer. Yet follow-up is often where the real improvement happens.

Where digital tools help, and where they don’t

Technology cannot replace the physical examination, the lab bench, the pharmacist’s counter or the nurse at triage. In-person care stays at the centre. What digital tools can do is remove friction around it:

·         Deciding and finding: reliable health information, and searching for professionals, labs and pharmacies by specialty and location.

·         Getting there and waiting: booking ahead instead of arriving at dawn and hoping to be seen.

·         Results and follow-up: an online consultation to go through results or review how treatment is going, where appropriate, instead of a second full-day trip.

·         Paying: mobile money such as M-Pesa has already made this step simpler for many.

The goal is not fewer hospital visits for their own sake. It is fewer wasted ones, so that when you do go in person, the visit counts.

Tips to make any visit smoother

·         Carry the essentials: your ID, SHA or insurance details, previous results, and your child’s Mother and Child Health booklet for a child’s visit.

·         List your medicines, including herbal remedies, or take photos of the packets.

·         Write down your main concern and questions before you leave home.

·         Ask ahead about fasting if you may need blood tests.

·         Ask about costs for the consultation, tests and medicines before you commit.

·         Bring a companion for an older relative, or if you are feeling very unwell.

·         Photograph prescriptions and results so they don’t get lost.

·         Leave knowing your next step: when to come back, who will explain results, and which signs mean returning sooner.

·         Be kind to the staff. Most are working very hard.

In an emergency, skip all the planning. Go straight to the nearest emergency department or call 999 or 112. Article 43(2) of the Constitution of Kenya states that a person shall not be denied emergency medical treatment.

Key takeaways

·         A healthcare visit is a journey of about ten steps; the queue is only the most visible one.

·         Queues usually reflect overstretched facilities, health workers doing their best and triage that sees the sickest first.

·         Knowing Kenya’s levels of care helps you start in the right place.

·         Digital tools can smooth finding, booking, results and follow-up, while in-person care stays central.

·         Preparation, from a medicines list to asking about costs, makes any visit smoother.

·         In an emergency, go straight to hospital or call 999 or 112.

Make your next visit a little easier

You can’t control the length of every queue, but you can shape much of the journey around it. On askremohealth.com, you can search for doctors, clinics, hospitals, labs, and pharmacies; view their profiles and book ahead; or consult online where your concern allows, for example, to review results or check whether you need to be seen in person.

If you run a clinic, lab or pharmacy, listing on AskRemoHealth helps patients arrive at the right place, prepared.