Radiographers' perspectives on triage systems: Exploring workflow impacts and enhancement opportunities in resource-constrained radiology departments.

Introduction: Efficient radiology triage systems are crucial for healthcare quality in resource-constrained settings, yet Zimbabwe's quaternary hospitals face significant challenges, including staff shortages, outdated equipment, and inconsistent protocols. While existing literature addresses workflow optimization in high-resource settings, few studies examine triage systems in African referral hospitals. This study aimed to explore radiographers' experiences of triage-related inefficiencies and their recommendations for improvement in Zimbabwe's radiology departments.

Methods: A qualitative exploratory design was employed, using semi-structured interviews with 12 radiographers from two quaternary hospitals in Harare. Participants were purposively sampled based on experience and direct triage involvement. Thematic analysis was conducted using NVivo 12 to identify key challenges and solutions. Trustworthiness was ensured through member checking, thick description, and reflexivity.

Findings: Four major themes were created 1) patient safety concerns, including preventable deaths due to delay;s 2) staff well-being, with burnout linked to high workloads and emotional strain 3) workflow disruption from unclear protocols and conflicts; and 4) institutional credibility risks from poor service quality. Radiographers proposed three key solutions 1) staffing enhancements; 2) equipment upgrades; and 3) standardized protocols for mass casualty events.

Conclusions: This study highlights the systemic impact of triage inefficiencies on patient care and radiographer well-being in Zimbabwe's resource-limited settings. The proposed solutions-staffing improvements, equipment investments, and protocol standardization-offer actionable pathways for strengthening radiology services. These findings underscore triage reform as both an operational and strategic priority for LMIC healthcare systems, with implications for policymakers, administrators, and global health practitioners.