Multi-site healthcare services group · ~$88M net revenue · 11 clinics

Restoring throughput across an 11-site healthcare services group

One scheduling standard and a site-level operating review lifted clinician utilization from 61% to 79% and cut patient wait times by nineteen days.

Disciplines deployed: FOUNDATION → SIMPLIFY → LEAD
Measurement window: 14 months
Measures reported: 4

Condition 02 of eight

Complexity is consuming capacity

Busy everywhere, moving nowhere. The vital few are funded at the same rate as the trivial many.

All eight conditions

Present reality

Demand exceeded capacity while clinicians reported idle time. Each site scheduled its own way, referral backlogs sat unworked, and the executive team reviewed monthly financials long after the month could be influenced.

Constraint

Capacity was defined at the site level and nowhere else, so no one could see or move work across sites — the group ran as eleven separate practices sharing a balance sheet.

Intervention — architecture installed

Present-reality read of the patient value stream, one scheduling and referral standard across sites, group-level capacity view, weekly site operating review with named owners and leading measures.

FOUNDATION → SIMPLIFY → LEAD → GROW

Mapped to the operating system

What was architected inside each discipline, and the measured consequence. Disciplines held out of scope are shown with the reason — nothing is implied by omission.

1. FOUNDATION
Build
Loaded in this engagement
Present-reality read of the patient value stream and a group-level capacity view, replacing eleven site-level definitions of capacity.
Result: Unworked referral backlog fell from 3,400 to 410 (−88%).
FOUNDATION →
2. SIMPLIFY
Focus
Loaded in this engagement
One scheduling and referral standard across all eleven clinics.
Result: Days to third available appointment 27 → 8 (−19 days).
SIMPLIFY →
3. LEAD
Execute
Loaded in this engagement
Weekly site operating review with named owners and leading measures, replacing a monthly financial read taken after the month could be influenced.
Result: Clinician utilization 61% → 79% (+18 pts).
LEAD →
4. GROW
Scale
Held out of scope
No new sites or services were added during the engagement; growth without a group capacity view would have multiplied the constraint.
Result: Contribution margin per site rose 6.4 pts, which is the condition growth now proceeds on.
GROW →

ARC™ — the renewal loop around all four

Site leaders hold the weekly review and re-read capacity across sites each quarter, without the executive team present.

ARC™ →

Measured result — what moved, and by how much

Multi-site healthcare services group · ~$88M net revenue · 11 clinics — measured change over 14 months
Measure	Before	After (14 months)	Change
Clinician utilization	61%	79%	+18 pts
Average days to third available appointment	27 days	8 days	−19 days
Unworked referral backlog	3,400	410	−88%
Contribution margin per site	11.2%	17.6%	+6.4 pts

Before → after, measure by measure · 14 months

Clinician utilization
+18 pts
Before61%
After79%
Standardized against Billable / productive utilization — Scheduled available clinical hours as the denominator.
Average days to third available appointment
−19 days
Before27 days
After8 days
Standardized against Days to next available service — Third-available convention across all eleven clinics.
Unworked referral backlog
−88%
Before3400
After410
Standardized against Unworked backlog — Point-in-time count on the same day of the month.
Contribution margin per site
+6.4 pts
Before11.2%
After17.6%
Standardized against Contribution margin per unit of the business — Same allocation rules; unallocated overhead excluded.

The group now schedules as one enterprise; site leaders hold the weekly review whether or not the executive team attends.

Transfer — what the client now owns

Site leaders own the scheduling standard and the weekly operating review, and the group's own operations lead trains new site directors into both.

Compass leaves business architects, not dependency.

Client identities, brands, and locations are withheld under confidentiality. Metrics are client-reported and measured over the window shown; they describe those engagements and are not a projection of results for any other enterprise.

Start with your own present reality

Every engagement above began with an honest read of the architecture already producing the results. Score yours, or schedule a conversation.

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