This field research in outpatient service operations examines original quantitative data on appointments
and analyzes a lean process improvement project that was conducted to increase capacity to admit
new patients into a healthcare service operation system. Analysis of 1726 intake appointments for the
year preceding and the full year following the lean project showed a 27% increase in service capacity
to intake new patients and a 12% reduction in the no-show rate as a result of the transformation of
service processes achieved by the lean project. This study’s action research methodology leverages the
researcher’s involvement in redesigning a service system that greatly improved performance and led
to reflection on traditional operations management (OM) approaches to appointment scheduling. The
study generates insights about effective alignment of resources, develops new strategies for service operations
to respond to no-shows, reveals time-related variables that have been overlooked in appointment
scheduling research, and challenges traditional OM scheduling performance measures. We provide recommendations
for effective and appropriate use of overbooking and identify avenues for future research
to continuously improve and increase the capacity of service operations.