Background: Given the increasing necessity to increase efficiency and decrease cost in outpatient cardiology, quality improvement efforts are necessary to enhance delivery of care. Our multidisciplinary clinic tailors care based on individual and family needs to include cardiac and genetic testing along with evaluation by multiple providers involved in the care of every patient. These individualized schedules can greatly impact clinic flow, wait times, and clinic resource utilization if they are not managed and executed appropriately. We see patients of all ages which necessitates dynamic resource utilization. There is a paucity of data evaluating quality improvement (QI) efforts in outpatient cardiology. We hypothesized that we could improve clinic flow via measured, planned interventions. Methods: All outpatients (children and adults) in the Cardiomyopathy/Heart Failure clinic at a single institution were assessed for anticipated and actual duration of clinic visits. Baseline assessments were made prior to QI efforts. A series of measured interventions were made as follows: designation of a flow coordinator for the clinic, implementation of a visual management system (VMS) showing patient status, and use of a clinic wide phone texting system to alert appropriate staff of status and next procedure/appointment. A time for Visit Length Expectation (VLE) was calculated based on the type of visit, complexity of patient, scheduled provider evaluations, and testing. Results: Baseline data revealed 20.6% of patients were meeting VLE. Over a third of patients (38.8%) had wait times > 20 minutes. Following our interventions, 75.6% were meeting their VLE with only 10% having wait times > 20 minutes. We are at 90% reliability in meeting expected VLE. Scheduling capacity has increased allowing for increased timely accessibility to clinic for patients and families. We have sustained these improvements for 6 months. Conclusions: Patient wait times and clinic resource utilization can be greatly improved with simple interventions such as identifying a clinic flow coordinator, utilization of a VMS, and enhanced communication internal and external to the clinic via a texting system. These interventions have increased available appointments and increased scheduling flexibility. Furthermore, we can now reliably predict VLE at the time of registration which better informs families of their anticipated total time in the clinic.