Access Optimization: Seattle Children’s Comprehensive Approach to Ambulatory Scheduling and Referral Management

Seattle Children’s strives to provide patients and families with timely access to specialized care and is dedicated to continually improving to meet the needs of the community. To support this work, our teams have worked with each other, families, and referring providers to understand current pain points and develop a multiyear plan to optimize patient access, with the ultimate goal of shortening the time between when a patient is referred and when the appointment is scheduled.

What We’ve Accomplished So Far

Seattle Children’s has been working on scheduling optimization since 2022, including the implementation of two new initiatives: fast-pass features that allow patients and families to add themselves to a waitlist for a faster appointment date and self-scheduling options in MyChart.

Building on these improvements, the Access Optimization project focuses on enhancing the efficiency and consistency of the triage process across more than 30 service lines. Each team requires flexibility to meet the needs of their unique patient populations while maintaining as much consistency as possible for patients, families, and referring providers. To support this, Seattle Children’s introduced a new policy this summer outlining baseline criteria for developing ambulatory referral guidelines and establishing a standardized process for exceptions and ongoing maintenance. As each service line moves through Access Optimization, they will assess their referral and scheduling practices against this policy. Any requested exceptions will be reviewed by a governing committee, and all approved changes will be communicated to key stakeholders, including community providers.

Examples of new system-wide standards include:

• Age: Referrals are accepted for patients under 18 years old at the time of referral, unless the service line has an approved exception.
  • Note: Exceptions will be in place for service lines with significant wait times, including the Autism Center, Genetics, and Pain Medicine.
• Scheduling Attempts: Once a referral is ready to schedule, at least three outreach attempts will be made within 10 business days, using outbound calls, MyChart messages, text messages, or other approved communication methods.
• Referral Expiration Timeframe: Referrals will expire after 12 months, instead of 18 months. We anticipate this change will take effect mid-December and will confirm in next month’s issue of Provider News.
  • Note: Exceptions remain in place for the Autism Center, Genetics, Pain Medicine, Acupuncture, and Neuropsychology, which expire after three years.

What to Expect Next

Access Optimization is a multiyear initiative. Each service line will move through a standardized 16-week process to review current practices, assess patient needs and provider capacity, and align referral guidelines or request necessary exceptions. Service lines are being prioritized based on patient demand and current access challenges.

Service lines we anticipate going live through the end of 2026 include Urology, Neurology, Gastroenterology, Dermatology, Adolescent Medicine, Endocrinology, Pulmonology, Otolaryngology, Rheumatology, and the Heart Center.

As service lines go through the Access Optimization process and go live, updates will be communicated via Provider News and by working with your dedicated physician liaison. Updates you may hear from us include:

• Encouragement to more fully utilize EpicCare Link, which supports data collection — helping us to see your patients sooner.
• Additional algorithms and care guidelines to help support management of common conditions in the primary care setting, avoiding additional time and costs for families.
• Stronger recommendations around the use of eConsults to help triage patients that likely do not need to see a specialist for service lines with limited capacity, allowing providers to prioritize patients who truly need a specialist.
• A potential narrowing of accepted diagnoses for some specialties, accompanied by resources to support primary care management.

In addition to external-facing changes, we are automating systems for our triage and scheduling teams that will enhance the patient and provider experience and ultimately result in faster scheduling. The eventual goal is to automate the referral process as much as possible, especially for cases that do not require complex triaging. In these instances, referrals will be sent directly to the patient’s MyChart account, allowing them to schedule appointments more quickly.

By removing manual processes and automating workflows where possible, patients will benefit from reduced wait times, while providers will gain efficiencies that improve their ability to deliver timely care.

For more information: Additional Provider News articles and announcements will be shared throughout the phased implementation of Access Optimization improvements.