MIT Sloan Healthcare Lab Project Improves Patient Access at Boston Children’s Hospital

Executive Summary

As patient demand increased in the Department of Neurosurgery at Boston Children’s Hospital, appointment lag times for new patients grew to as long as 40-47 days, substantially exceeding the department’s target of 14 days. Frequent appointment rescheduling further disrupted physician schedules, delayed care, and increased administrative burden. 

Boston Children’s partnered with a Healthcare Lab team to analyze the operational drivers behind these delays and identify opportunities to improve scheduling efficiency and patient access. Using quantitative analysis of more than 25,000 appointment records, along with interviews with physicians, administrative staff, and scheduling personnel, the team developed recommendations focused on scheduling flexibility, documentation workflows, communication standardization, and provider utilization.

Boston Children’s subsequently piloted several recommendations, including redesigned 20/40-minute scheduling templates and standardized clinic preparation workflows. One year later, participating providers experienced a 12% increase in patient volume without additional clinic hours, while cancellations declined by 26%. Patient satisfaction scores related to scheduling also improved.

This project illustrates how Healthcare Lab student teams can apply operational analysis to real-world healthcare challenges and produce measurable organizational impact.

Rising Demand Strains Scheduling and Patient Access

The Department of Neurosurgery at Boston Children’s Hospital manages more than 7,000 outpatient encounters and approximately 1,000 surgeries annually. Over a five-year period, patient demand increased by roughly 60%, placing growing pressure on the department’s outpatient scheduling system. 

By 2024, appointment lag times for new patients had reached 40-47 days despite an internal target of approximately two weeks. Roughly 30% of appointments required rescheduling, often because of missing imaging, incomplete documentation, provider schedule changes, or urgent surgical cases that displaced routine visits. 

The delays were especially concerning because many pediatric neurosurgical conditions require timely evaluation and intervention. At the same time, the operational causes of delay were difficult to isolate. Physicians, administrators, and scheduling staff all experienced the problem differently. Schedules were frequently disrupted by urgent cases, and outside medical records often arrived late. Multiple disconnected communication methods, including EPIC, email, spreadsheets, phone calls, and handwritten tracking systems, led to communication difficulties.  

As one administrative staff member explained:

“When one morning patient is late, the whole day’s schedule falls apart.” 

Healthcare Lab Students Analyze Scheduling Challenges

To better understand the operational drivers behind the department’s access challenges, Boston Children’s partnered with students participating in the MIT Sloan Healthcare Lab. The project team included Kimberly Dutta (MIT undergraduate), Joseph Pipia (MIT Sloan Fellows MBA), and Yuetong Xu (MIT ORC PhD student)

The team conducted both quantitative and qualitative analyses of the department’s outpatient scheduling process. Using a dataset containing more than 25,000 appointment records from October 2023 through September 2024, the students analyzed appointment lag times, cancellation patterns, billing codes, and scheduling comments. 

The analysis revealed that the department’s standard scheduling templates did not align well with actual clinical workflows. Routine follow-up appointments frequently required less than the standard 30-minute slot, while new or medically complex consultations often required significantly more time. Only 48% of new patient appointments occurred within the department’s 14-day target window, and nearly 1 in 5 rescheduled appointments were delayed by more than 30 days. 

The team also used natural language processing and clustering techniques to analyze scheduling comments associated with rescheduled appointments. The findings showed that emergency surgeries, provider schedule changes, missing documentation, and movement into earlier appointment openings were major drivers of scheduling disruption. 

Alongside the quantitative work, the students interviewed physicians, administrative assistants, and Patient Shared Access Center staff to better understand how scheduling decisions were made in practice.

The interviews revealed a system that depended heavily on workarounds and informal coordination. Administrative staff described relying on spreadsheets, handwritten notes, Outlook reminders, and repeated phone calls to track outside imaging and referral records. Providers described clinic schedules that were frequently destabilized by urgent surgical cases or by appointment templates that failed to reflect the actual complexity of patient visits.

One provider summarized the challenge directly:

“On days with a lot of complex cases, I often run behind schedule because I can’t finish in 30 minutes. But for quick follow-ups, the extra time is wasted.” 

Student Recommendations Focus on Flexibility and Throughput

Based on the findings, the MIT Sloan Healthcare Lab team proposed a series of operational recommendations intended to improve throughput, reduce rescheduling, and better align physician time with patient needs.

The most significant recommendation was to redesign appointment templates. Rather than relying primarily on standardized 30-minute appointment slots, the team recommended introducing 20-minute appointments for routine follow-up visits and 40-minute appointments for more complex consultations. 

The team also recommended standardizing clinic preparation workflows. Administrative staff would use diagnosis-specific checklists and centralized tracking systems to ensure that imaging, referral notes, and outside medical records were collected before appointments occurred. Providers would review documentation further in advance of clinic sessions to identify any missing materials earlier. 

Additional recommendations included reserving dedicated blocks for urgent cases, clustering telemedicine appointments to reduce physician movement between spaces, improving communication standardization across scheduling teams, and directing more routine follow-up visits to Advanced Practice Providers when clinically appropriate. 

The recommendations focused on improving utilization of existing clinical capacity rather than expanding staffing or infrastructure.

One Year Later, the Pilot Shows Measurable Results

Boston Children’s subsequently piloted several of the recommendations during 2025. Three providers adopted the revised 20/40-minute scheduling templates, while a fourth provider maintained the original scheduling structure and served as a control comparison. The department also implemented a more standardized clinic preparation process for participating providers. 

One year later, the pilot demonstrated measurable operational improvements.

The three providers using the revised scheduling templates experienced an average 12% increase in patient volume without adding clinic hours. Provider-specific gains included:

• Dr. A: from 6.8 to 7.6 average daily appointments 
• Dr. B: from 7.9 to 8.8 
• Dr. C: from 7.3 to 8.3 

The control provider, Dr. D, whose templates remained unchanged, showed no increase during the same period. 

The standardized clinic preparation process also reduced operational disruption. Daily cancellation rates declined by 26% across participating providers despite increased patient volume. Department-wide “Ease of Scheduling” scores improved from 77% to 84%. 

The operational improvements also carried financial implications. Based on outpatient reimbursement estimates and clinic volume, department leadership projected that broader adoption of the revised scheduling templates could generate approximately $210,000 in additional annual net patient revenue, with no additional personnel or infrastructure costs. 

Reflecting on the project, host Dr. Edward Smith, MIT Sloan MBA ’23, wrote:

“After working here, they gave a series of recommendations, which we trialed with A/B testing using several attendings here as both experimental and control clinics.” 

He further noted:

“This led to a ~12% increase in visits, a 26% reduction in cancellations, and a ~7% increase in patient satisfaction survey scores.” 

A student project producing measurable operational improvements one year later is not a common outcome in healthcare operations work. Many recommendations remain theoretical or are never implemented beyond the presentation stage. In this case, Boston Children’s Hospital translated the Healthcare Lab team’s recommendations into operational pilots that improved scheduling efficiency, reduced cancellations, and expanded patient access.

The project’s success reflected a combination of factors: a clearly defined operational challenge, engaged project hosts, strong collaboration between hospital staff and students, and a willingness within the department to test new approaches and measure their impact. Together, these elements allowed the project to move beyond analysis and produce meaningful operational change for both patients and providers.