The team at First Settlement Orthopaedics (FSO) struggled with a manual scheduling process that involved updating multiple calendars and paperwork. The ASC (owned by the same group) were not always in the loop with scheduling, so the surgeons were often double-booked. And since tracking for surgeries was completed by hand, the hospital would regularly call the scheduling staff to ask for the precert status of surgeries scheduled the next day. As a result, many items were not completed in time, and cancellations ensued.