South African district hospitals face challenges in maintaining reliable systems due to resource constraints. A quasi-experimental design was employed, including pre- and post-intervention assessments of hospital operations across multiple districts. Data analysis revealed that the implementation of standardised protocols led to a 20% reduction in patient wait times (mean reduction = -15 minutes). Quasi-experimental design proved effective for assessing system reliability and identifying actionable improvements. District hospitals should prioritise training staff on standardised protocols and further streamline administrative processes. district hospitals, South Africa, quasi-experimental design, system reliability, resource constraints