Boston Children’s Hospital neurosurgery department was able to cut patient appointment wait times, increase volume by 12% and cut cancellations by 26% with three operational changes.
The department manages more than 7,000 outpatient encounters and approximately 1,000 surgeries each year, according to a May 19 news release. Over the last five-years, patient demand increased roughly 60%. In 2024, the appointment lag time for new patients was 40 to 47 days, far beyond the target of 14 days. In addition, about 30% of appointments had to be rescheduled due to missing imaging, incomplete documentation, provider schedule changes or urgent surgical cases.
Boston Children’s partnered with MIT Sloan Healthcare Lab to find the operational drivers behind the delays and find ways to improve. The team analyzed more than 25,000 appointment records from October 2023 through September 2024, and interviewed department staff.
The analysis found that the standardized 30-minute appointment slot did not align with actual clinical workflows. Routine follow-up appointments frequently needed about 20 minutes, while complex cases needed closer to 40 minutes. The team changed appointment windows to better align with patient needs.
The team also recommended standardizing clinic preparation workflow and created a diagnosis-specific checklist and centralized tracking system to ensure necessary records and notes were collected before appointments occurred. They also reserved dedicated blocks for urgent cases and directed more routine follow-up visits with advanced practice providers when appropriate.
These changes led to notable operational results:
- Patient visits increased 12%
- Patient satisfaction scores improved about 7%
- Daily cancellation rates were cut by 26%
- Departmentwide “ease of scheduling” score improved from 77% to 84%
- The revised scheduling template is projected to generate approximately $210,000 in additional annual net patient revenue
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