1180 Multi-Pronged Approach to Solve Fragmented Scheduling System in a Tertiary Sleep Center: Access Improvement Initiative

Abstract Introduction Administrative inefficiencies significantly delay patient access to healthcare, diagnosis of disease, and contribute to excessive provider time costs and poor patient satisfaction. Outdated, complex and manual fragmented scheduling practices remain a leading source of challenges with access. At the Cleveland Clinic’s Sleep Disorder Center, between 40-60% of pediatric sleep consult orders went unscheduled each month in 2020-2021. This study evaluates the impact of targeted initiatives between 2021-2025, aimed at improving access to sleep clinics by scheduling automation via unique informatics tools, increasing clinic capacity, and appointment utilization. Methods Several initiatives were introduced using an A3 project charter with continuous improvement methods: (a) electronic Health Record(EHR) based automated ticket scheduling and live dashboard, empowering patients to self-schedule consults, send reminders, and allows schedulers to focus on complex scheduling; (b) Cancellations requests only, where patients receive proactive phone calls for on-the-spot rescheduling and support to prevent loss to follow-up; (c) EHR FAST PASS, which lets patients on a waitlist reschedule earlier; (d) Live EHR Survey for no-shows, identifying addressable causes such as timing and transportation; and (e) Duplicate Appointment Cancellation Bot, which automatically identifies and hides duplicate appointments. Results These interventions improved the average proportion of scheduled appointments from 40-60% at baseline in 2020-2021 to 91% in 2022(1273/1401), 88% in 2023(1921/2184), 93% in 2024(1838/1974), and 83% from January-October 2025(1408/1698). Patient preference for the EHR Ticketing system grew steadily, with 49% of scheduled orders in 2022, 52% in 2023, 54% in 2024, and 59% in 2025(Jan-Oct) using this method. These interventions improved access by allowing 215(2022), 863(2023), 780(2024), 350(2025, Jan-Oct) more patients to schedule visits in respective year in comparison to years 2020-2021 leading to better disease detection and time savings for scheduling. Additionally, similar automation measures were generalizable to Home Sleep Apnea Test(HSAT) orders and Behavioral Sleep Consults, with up to 42% of orders processed through the automated system since its introduction in March 2025. Conclusion These continuous improvement interventions effectively benefited patients, providers, and administrative staff. The strategies are broadly applicable and can be adopted across healthcare disciplines, significantly improving patient access/disease detection, lowering scheduling time, and improving scheduling flexibility. Support (if any)