The client is a multi-provider dental practice operating in the Caribbean, offering general dentistry, orthodontics, oral surgery, pediatric care, dental hygiene, and in-house laboratory services. The practice employs dental therapists, a hygienist, an orthodontist, an oral and maxillofacial surgeon, a laboratory technician, and administrative staff. At the time of engagement, the practice was managing patient workflows, membership plans, insurance billing, and communications largely through informal processes, with limited standardization across its operations.
Situation
Despite a capable clinical team and a loyal patient base, the practice was running on tribal knowledge. Processes for patient intake, appointment scheduling, recall management, insurance billing, and membership enrolment varied depending on which staff member was on duty. There were no formally documented standard operating procedures, no centralized operations manual, and no structured onboarding pathway for new hires. The practice management system and CRM were underutilized, with data entry inconsistencies and limited automation for patient follow-ups and recall cycles.
At the same time, the owners were exploring a franchise expansion model, which made the absence of standardized, transferable systems a pressing strategic concern. Without documented workflows and clear operational standards, scaling the business would replicate the same inconsistencies across new locations. The owners recognized they needed external expertise to build the operational backbone that the practice had outgrown.
Objective
The engagement aimed to transform the practice from an informally managed operation into one that runs on documented, repeatable systems. Specifically, the objectives were to map the critical client flow from patient attention through service delivery and retention, capture and standardize all key workflows into formal SOPs, build an operations manual and supporting management tools, and create brand and people management assets that would support both current operations and future growth.
These goals aligned with the owners’ broader ambition to establish a scalable operating model that could eventually support new locations or franchise arrangements with minimal disruption.
Approach
Phase 1: Strategy Alignment and Discovery. We began with biweekly strategy calls with the owners to confirm objectives, clarify priorities, and address immediate operational needs. During this phase, we mapped the high-level patient flow collaboratively with the clinical and administrative teams in a group workshop, walking through how patients move from initial awareness of the practice through to rebooking and recall. We assessed the current state of branding, management structures, and technology usage, and established a project charter documenting goals, timelines, roles, and responsibilities. The franchise concept was initially part of the scope but was deferred by the client to focus resources on the core operations.
Phase 2: Process Standardization and Documentation. This was the most intensive phase. We conducted detailed workflow discovery interviews with front desk staff, dental therapists, the hygienist, the orthodontist, the laboratory technician, and management. Each interview asked staff to walk through their processes as if training a new employee, capturing not only the steps but also common mistakes, workarounds, and improvement suggestions. From these interviews, we extracted and organized SOPs across four departments: front desk and reception (fourteen SOPs covering inquiries, bookings, referrals, membership management, and follow-ups), billing and finance (three SOPs for in-person payments, insurance billing, and online payments), marketing and patient engagement (four SOPs for community outreach and social media channels), and management and clinical operations (including Health Regulations Authority policies, orthodontic workflows, and laboratory procedures).
Phase 3: Brand Integration and Management Development. We developed a brand and business blueprint that provided the practice with a clear brand narrative, visual identity guidance, and marketing assets through a Canva kit with templates for social media, blog posts, and patient-facing communications. Concurrently, we built a people management kit addressing recruitment templates, onboarding workflows, performance management frameworks, and offboarding procedures. We reviewed existing management roles and provided guidance on the potential appointment of an office manager to serve as the operational point person for SOP implementation and ongoing oversight.
Phase 4: Systems Integration and Automation. We worked with the practice to address how their digital tools—primarily Open Dental and Zoho CRM—were being used and where gaps existed. A significant focus was placed on the recall system within Open Dental: we helped the team understand how procedure-based triggers, manual recall intervals, and appointment reminders work together, and we configured the system so that cleaning procedures (the practice’s primary revenue driver) would be properly tracked and recalled. We also addressed data synchronization between Open Dental and Zoho, set up email verification processes to reduce bounced communications, and designed an inventory management system with reorder points and master item lists. Three AI chatbots were developed: one for Open Dental procedural guidance, one for content writing aligned to the practice’s brand voice, and one for searching the Zoho CRM knowledge base.
Phase 5: Implementation Planning and Handoff. We compiled all deliverables into a structured Google Drive folder with a linked directory index, enabling the team to navigate SOPs, templates, and guides independently. An implementation plan was developed for phased rollout of the SOPs, starting with the highest-impact processes. We used Asana to organize tasks with daily, weekly, and monthly cadences, and assigned implementation responsibilities to the designated point person. An operating routines checklist and a management metrics checklist were delivered to support ongoing accountability. All materials were formally handed off, and the engagement was closed with recommended next steps.
Key Decisions
We decided to start with the cleaning patient flow rather than documenting all processes simultaneously. Cleanings are the heartbeat of the practice’s revenue, and the owners confirmed this was the single most critical workflow. Focusing here first allowed us to demonstrate the systemization methodology on the highest-value process, build team buy-in through early wins, and establish a template that made subsequent SOP development faster.
We decided to capture SOPs through guided interviews rather than written questionnaires. The team’s expertise lived in how they performed their work, not in how they described it on paper. By asking staff to explain each process as if training a new hire—and recording those sessions—we captured richer detail, identified common mistakes, and surfaced improvement opportunities that a form-based approach would have missed.
We decided to defer the franchise expansion component. Early in the engagement, it became clear that the practice needed a solid operational foundation before layering on the complexity of a franchise model. We recommended focusing all resources on building the core systems that would eventually make franchising viable, rather than splitting attention between both objectives.
We decided to configure recall management through manual interval settings rather than relying solely on procedure-based triggers. Open Dental’s recall system was not being fully utilized, and the existing procedure codes were outdated. Rather than a wholesale system overhaul, we guided the team to set manual recall intervals for each patient and sync procedure codes, which cleaned up the recall list and established a reliable foundation for automated patient reminders.
We decided to build AI chatbots as lightweight training and reference tools. Rather than investing in a full learning management system, we created targeted chatbots that staff could query for Open Dental procedures, brand-aligned content, and CRM workflows. This provided an accessible, low-friction way for the team to find answers independently, supporting the broader goal of reducing reliance on any single person’s knowledge.
Work Completed
The following deliverables were produced and handed off to the client:
HRA Standard Operating Procedures and HRA Policies
Orthodontics SOPs
Laboratory SOPs
Administrative Staff SOPs (14 front desk procedures, 3 billing procedures, 4 marketing procedures)
Management SOPs
Paradise Smiles Operations Manual (compiled SOP library)
Operating Routines Checklist (daily, weekly, monthly cadences)
Management Metrics Checklist
Brand Kit and Marketing Kit (brand and business blueprint, Canva kit, blog and social media templates)
People Management Kit (recruitment, onboarding, performance management, offboarding templates)
Inventory Management System Design
Dental Care Manual
Patient Communication Templates
AI Chatbot: Open Dental procedural guide
AI Chatbot: Brand-aligned content writer
AI Chatbot: Zoho CRM knowledge base assistant
Folder Index Guide for navigating the shared drive structure
Website updates
Recall list management automation and configuration
Outcome
The practice received formal commendation from the Health Regulatory Authority (HRA) on the quality of the documentation produced through this engagement. The HRA review validated that the SOPs and policies met the standards required for regulatory compliance, providing the practice with confidence that their documented processes would withstand external scrutiny.
During the workflow discovery interviews, staff engaged openly with the process and surfaced operational pain points and improvement ideas that had not previously been documented or discussed. This level of participation indicated growing trust in the process and a shift from informal problem-solving to structured feedback.
The brand and business blueprint gave the ownership team, for the first time, a clear articulation of their business narrative, service logic, and visual identity standards. This moved the practice from ad-hoc branding decisions to a coherent framework that could be applied consistently across patient communications, social media, and marketing materials.
The recall system reconfiguration resolved a long-standing issue where patients were either stuck on outdated recall lists or missing from the system entirely. After syncing procedure codes and setting manual recall intervals, the practice had a clean, functional recall list that could drive automated reminders—a critical step for their primary revenue stream.
The Asana-based task management structure and operating routines checklist provided the practice with its first formal mechanism for daily, weekly, and monthly operational accountability, replacing the previous reliance on verbal coordination and memory.
By the close of the engagement, the practice had moved from an operation held together by institutional memory and individual expertise to one supported by a documented, organized, and navigable system of standard operating procedures, management routines, and digital tools. Staff now have a single source of truth for how each process should be performed, new hires can be onboarded using structured materials rather than informal shadowing, and management has clear metrics and routines for maintaining oversight.
The ownership team has a brand identity and business blueprint that articulates who they are and how they operate, along with people management tools that formalize how they recruit, evaluate, and develop their team. The recall system is configured to track and re-engage patients systematically, and the inventory management design provides a framework for controlling supplies and costs.
These changes represent a shift from reactive, person-dependent operations to a proactive, system-dependent operating model—the foundational requirement for any future growth, whether through additional locations or franchise arrangements.
