Case Study: How a Pediatric Clinic in Hawaii Went From Scattered Processes to a Complete Operations Manual — and Set Itself Up to Scale to a Second Location
A fully booked doctor still being pulled into questions her team should be able to answer themselves
This client is a doctor and the owner of a pediatric clinic with a team of 15 to 20 people.
Her calendar is booked out four months in advance. Despite that, staff were regularly coming to her with questions — questions she had answered before, and would have to answer again.
There was no central place for the team to find information, so every time someone needed guidance, they went to her.
She came to us with three specific problems.
First, hiring, training, and onboarding new staff was taking far too long — and this applied to both clinical hires (doctors, nurse practitioners) and admin staff (medical assistants, receptionists, and others).
Second, there was no knowledge hub for the team. SOPs existed, but they were split between Notion and Google Drive, inconsistently maintained, and hard to navigate. Staff couldn't self-serve answers, so the owner absorbed all that friction.
Third, she had a clear goal of opening a second clinic location — but she knew she couldn't replicate what wasn't yet documented. Before she could expand, she needed the current location's operations fully built out.
One thing she said that stuck with us: everything lived in her head, and she needed to get it out.
A 15-section operations manual, built role by role
We started our knowledge extraction sessions by mapping the patient journey from the very first touchpoint to the last — step by step, with the responsible person, location, and method documented at each stage.
From there we extracted and built role-specific SOPs for every team in the clinic:
The operations manual has 13 sections in total. Most are team-specific SOPs hubs.
One section — the All-Employees SOPs Hub — is accessible to the entire team and covers the guidelines, policies, and procedures that apply across all departments regardless of role.
The final deliverable was presented to the owner and two members of her management team — three resources, one platform, one source of truth.
A full operating system for the entire clinic — built in Notion
After the operations manual was complete, the client wanted to continue with an operating system build.
This became the central hub where the whole team manages day-to-day work — all in one place.
It includes:
We also built a private CEO's hub for the owner including: business contingency plan, CEO master checklist, business KPIs, strategic planning, logs, and project-specific information she needed kept separate from the rest of the team.
She came to us for an operations manual. She stayed for the operating system and CEO's hub — because once she saw what was possible, she wanted all of it.
Onboarding is easier, the team is self-sufficient, and the second location now has a blueprint to work from
At the project close, the management team reported that before working with us, their processes had been scattered across platforms with no single source of truth.
Now, every team member has their SOPs documented and accessible. Onboarding new hires — clinical or admin — is significantly faster.
Rather than going to the owner with questions, staff go to the operations manual.
Something that wasn't planned but happened throughout the project: the team started developing systems thinking. Whenever a question came up that didn't have an SOP, the instinct shifted from "ask the owner" to "let's create an SOP for this and put it in the manual." That culture shift is what makes the system self-sustaining.
And the second location goal? The clinic now has a documented, replicable set of operations. The blueprint exists. What was once locked in one person's head is now a knowledge base the whole organization can build on.
Ready to get everything out of your head and into a system?
We'll build the operations manual and operating system your team can actually work from.