In Indonesian hospitals, prolonged waiting times for outpatient services remain a critical challenge, particularly in facilities lacking integrated queue management technology. This study evaluates the variation in waiting time risks between hospitals utilizing traditional manual systems and those employing partially connected digital systems. Using a purposive sampling method, we assessed ten hospitals, comprising both public and private institutions. Crucially, we implemented the Risk Grading Matrix as a novel analytical framework to evaluate risk levels by quantifying the likelihood and clinical impact of service delays in every hospital. Our analysis revealed that all participating hospitals exceeded the national waiting time standard of 60 minutes. However, the risk assessment demonstrated distinct differences based on system integration. Hospitals with less advanced, partially connected digital systems exhibited significantly higher risk profiles compared to those relying on manual systems (total risk score: p=.008). Furthermore, both the likelihood of delays (p=.031) and the severity of impact on patient safety (p=.017) were statistically higher in facilities with inefficient digital integration. These findings indicate that the architecture of a queue management system is a primary determinant of waiting time risks, which directly undermines patient satisfaction and timely care delivery. Consequently, we advocate for the adoption of optimized digital queue management systems, as they provide a more robust approach to enhancing service quality, patient safety, and institutional risk governance.
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