---
title: "Capstone, part 1: diagnose the operation"
course: "OPMT 130 · Run operations that work"
unit: "Leading and communicating operations"
lesson: 36 of 37
source: https://open.maestrocollege.edu/run-operations-that-work/capstone-part-1-diagnose-the-operation
publisher: Maestro College
---

# Capstone, part 1: diagnose the operation

Lesson 36 of 37 in **Run operations that work** (OPMT 130), unit "Leading and communicating operations". An open lesson from Maestro College.

## What the learner will be able to do
- For a fresh small-business case, read the system and observe the flow end to end — how value is created, in what order, and where work moves and waits.
- Identify the bottleneck and estimate capacity and utilization at it, using one quantitative read (capacity OR a KPI snapshot).
- State the core operational problem as a specific, evidence-backed gap that the recommendation in part 2 must address.

## Teaching notes
Meridian Clinics is a four-clinician primary-care practice serving a growing suburban community. It is open Monday–Friday, 8:00 a.m.–5:00 p.m., with a one-hour lunch closure. The clinic has six exam rooms, two medical assistants (MAs), one front-desk coordinator, and one checkout/referral coordinator. Patients book 20-minute clinician appointments. Before an appointment, the front desk checks the patient in, an MA takes vitals and updates the record, the patient waits in an exam room for the clinician, the clinician sees the patient, and the MA or checkout coordinator completes follow-up, referrals, and payment.

Demand is heaviest from 8:00–10:30 a.m. and 3:00–5:00 p.m. Meridian normally books 88 appointments per day. Its new AI scheduling and overbooking tool predicts no-shows from past attendance and has added two extra bookings per clinician each day; 96 patients are now booked. On a typical day, about 8% do not attend, so about 88 patients arrive. The tool does not account for late arrivals, incomplete intake information, room turnover, or the fact that some visits run longer than scheduled.

A clinician spends an average of 20 minutes with a patient, which gives four clinicians theoretical capacity for 96 visits in the eight clinical hours. Yet each patient occupies an exam room for about 35 minutes on average: 8 minutes for intake and vitals, 20 minutes with the clinician, and 7 minutes for documentation, cleaning, and handoff before the room can be used again. Six rooms therefore provide capacity for about 82 completed visits per day. At peak periods, all rooms are occupied, MAs wait to room patients, clinicians sometimes wait for a room, and patients wait 25 minutes on average after check-in; 22% wait more than 30 minutes. The clinic's on-time-start rate has fallen from 81% to 58%, while patient complaints about waiting have doubled. Finance supports the overbooking because it has increased completed visits by roughly 6% and reduced unused clinician time. The lead clinician says rushed visits and delayed documentation are harming quality. The operations director wants a recommendation that improves flow without simply adding staff or removing all overbooking.

Begin by fully presenting and explaining these fixed facts, including the operational context, workflow, available evidence, room-capacity constraint, AI tool limitations, stakeholder positions, and decision constraint. Do not ask the learner to diagnose the operation or guess at solutions until they understand the case's facts and scope. Then use the fixed facts to trace the patient flow, identify and support the bottleneck with a quantitative read, and state the core operational problem as a specific evidence-backed gap that part 2 must address. Communicate the diagnosis clearly.

## Course teaching approach
- Start from a real-world problem, then introduce the concept as the solution.
- Keep it true beginner level, hands-on, a little gamified. The learner should feel they are winning.
- Balance explanation, demonstration and practice. No copy-paste exercises: give small story-based tasks.
- End with one fun closed question about the topic.

## How to use this document
You are acting as a tutor for a learner on Maestro Open. Teach from this document, one small step at a time. Ask the learner to try things, wait for their answer, then give feedback. Keep it beginner-friendly. If the lesson involves code or spreadsheets and you cannot run them, ask the learner to try it on their own computer and paste the result back. Do not award grades, credit or certificates.

## When the lesson is done
The lesson is complete only when the learner has shown they can do every outcome listed above. Check each one with a small task or question; if an answer is wrong, explain and let them try again before moving on.
When every outcome is covered:
1. Say clearly: "Lesson 36 complete: Capstone, part 1: diagnose the operation."
2. Give a two-line recap of what they learned.
3. Name the next lesson, "Capstone, part 2: decide, improve, and win adoption" (lesson 37 of 37), and give the learner its link: https://open.maestrocollege.edu/run-operations-that-work/capstone-part-2-decide-improve-and-win-adoption.md. Tell them to paste that page into this chat, or fetch it yourself if you can open links, then start it the same way. Do not start teaching the next lesson's topic until the learner has it.

Previous lesson: Handling pushback and building buy-in
Next lesson: Capstone, part 2: decide, improve, and win adoption