The Challenge
The High-Risk Infant Follow-Up clinic was failing its most vulnerable patients. Forty-six percent of HRIF patients were not receiving their specialty appointments within 30 days of referral, the clinical standard for this population.
The root cause was operational: schedulers had no reliable way to identify HRIF patients within the general scheduling queue. Without a clear flag, these patients blended in with the broader caseload and were routinely deprioritized through a system that gave no visible signal of their elevated clinical need.
The Approach
A focused improvement initiative addressed the visibility and process gaps that were causing delays:
- A clear HRIF indicator was introduced directly within the scheduling system, making it immediately apparent which patients required expedited action
- The process was redesigned so schedulers could independently triage and book HRIF referrals without requiring physician intervention for each case
- Standardized workflows were introduced to support consistent prioritization across all schedulers
- Clearer communication protocols with families were established regarding upcoming referrals and expected timelines
- Performance was monitored regularly to track adoption and enable rapid course correction
The Outcome
Delayed appointments dropped from 46 percent to 15 percent, a 31 percentage point improvement in timely access for one of the most clinically vulnerable patient groups.
Families gained greater clarity about their referral pathway. Coordination across specialties improved. The new system established a sustainable, data-informed approach to prioritization that ensures high-risk infants are seen when they need to be.