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Even before seeing a physician, patients must first gain access to the hospital system. At large hospitals with high patient volumes, access to specialty care can pose a particular challenge. This study examines the effects of specific initiatives to increase clinic capacity, appointment use, and ease of scheduling on both patient satisfaction and hospital revenue. In 2017, a task force at a large, multidisciplinary pediatric hospital instituted a number of initiatives to increase patient access to ambulatory specialty clinics. Clinic