Theoretical Review for Solution Recommendation on Waiting Time Issue at Malaysian Government Hospital

Abstract

Excessive patient waiting time remains a critical issue in Malaysian government hospitals, leading to reduced healthcare efficiency, overcrowding, and decreased patient satisfaction. This study presents a theoretical review of existing literature and frameworks addressing waiting time reduction through facility planning, service design, Lean principles, and resource optimization. The review highlights that long waiting times stem from systemic inefficiencies including poor spatial layouts, inadequate scheduling systems, outdated administrative procedures, and insufficient staffing. Using a systematic literature review method across Scopus, IEEE Xplore, and Web of Science databases, a total of 45 relevant studies were analyzed. Findings reveal that strategic service redesign, efficient facility layout, and the adoption of Lean methodologies significantly improve patient flow and operational performance. Concepts such as Patient Flow Engineering, Casemix Index (CMI) application, and integrated facilities planning emerged as effective approaches for addressing service bottlenecks without requiring major capital investment. The review also emphasizes the interdependence between facility layout, process design, and scheduling systems, suggesting that improvements in one area must align with the others to achieve sustainable outcomes. Moreover, digital integration—such as electronic health records and data-driven decision-making tools—further enhances coordination and reduces administrative delays. The study concludes that a multidisciplinary approach combining Lean thinking, facilities optimization, and technology adoption is essential to reduce waiting times and improve healthcare delivery efficiency. These findings contribute to a conceptual framework that can guide future empirical studies and policy reforms aimed at enhancing the operational performance of Malaysian government hospitals.