From Waitlist to Wellness: How ZSFG is Improving Access to Pediatric Care

Traditional scheduling with appointments far in advance often collides with the realities of daily life, leading to long waitlists and missed appointments for families seeking care.  

To break this cycle, the UCSF Department of Pediatrics at Zuckerberg San Francisco General Hospital (ZSFG) has flipped the traditional scheduling model on its head. This new Open Access system has transformed appointment access for the thousands of children who rely on the safety-net hospital, allowing them to get the care they need when they need it.  

Appointments in Two Days, Not Two Months 

The core principle of Open Access is simple yet powerful: instead of pre-booking appointments months in advance, a significant portion of the schedule is intentionally reserved for short-term bookings. Instead of booking appointments a month or two ahead of time, families now regularly book and visit in the same week. ZSFG also directly texts families with reminders that they’re due for a visit, offering open appointment times in the coming days.  

"We’re putting the scheduling power back into the hands of families," says Taylor Clark, MD, an associate professor of Pediatrics at UCSF. She serves as associate director of quality for the Children’s Health Center at ZSFG and led the implementation of Open Access scheduling at the clinic.   

"When parents can book an appointment for the same week, they know it fits into their immediate schedule and makes it vastly more likely that their child will get the consistent, preventative care they deserve,” says Clark. 

Early Results: Improvement in Access and Attendance 

The data reveals the powerful impact of this new approach. The new patient waitlist, which previously had dozens of children in need but without an appointment, saw a dramatic and immediate drop to near zero after the Open Access launch in January 2025.  

“Seeing the new patient waitlist drop to zero almost overnight was a powerful affirmation that we are on the right track,” says Clark. “It shows that for many families, the primary barrier wasn't a lack of desire for care, but a system that didn't align with busy lives. This model helps us remove that barrier.”

 

The success of Open Access was likely amplified by the team’s sustained efforts to reduce language barriers and boost patient enrollment in the online portal, MyChart. With nearly 70% of empaneled patients enrolled in MyChart and virtually no gap between language groups, more families than ever are scheduling appointments when it works best for them. 

A Commitment to Continuous Improvement 

Integrating Open Access scheduling reflects the core philosophy of the UCSF Department of Pediatrics at ZSFG to listen to families, understand their challenges, and redesign systems to meet their needs. The team continues to analyze data and partner with families to find and remove the next barrier to care, ensuring ZSFG is there for the children of San Francisco who rely on it.  

But having a child in the clinic is just the first step. Once at ZSFG, families can benefit from a system designed to support the health of not just the child, but the caregiver and the whole family. Improving access is a single change with a great ripple: any visit can become a life-saving vaccination, a connection to housing, or a foundation for a healthier future. 

To learn more about our team and our mission to ensure every child in San Francisco can thrive, visit the UCSF Division of Pediatrics at ZSFG webpage.