From 3 to 6 Clinics in 14 Months Fractional COO in Healthcare
A fertility clinic network scaled from 3 to 6 locations through fractional COO leadership — establishing operational standardization, governance, and investor-grade reporting while maintaining clinical excellence.
Doubled clinic footprintClinical quality maintainedSeries B-ready governanceZero compliance violations
What they came to us with.
A fertility clinic network with three successful locations had attracted growth capital and planned to expand to six clinics within 14 months. Clinical operations were excellent — 65%+ success rates and strong patient satisfaction — but the organization ran in founder-led mode without professional operational infrastructure. The three clinics operated independently with inconsistent protocols, ad-hoc financial reporting, and no formal governance. Leadership couldn't articulate which clinics were profitable or why patient acquisition costs varied by location. The new investor capital came with accountability: quarterly reporting, governance expectations, and financial discipline. The founders needed experienced operational leadership to build systems in parallel with growth — not a permanent COO, but a fractional executive who could install the infrastructure and then transition cleanly to internal ownership.
Growth outpacing the operating model is a specific failure with a specific fix — standardise first, then scale onto it. That is the growth and turnaround pattern, delivered through a seated operator.
How the work actually ran.
- 01
Operational diagnostic
Conducted a comprehensive assessment across all three locations, documenting process inconsistencies, critical risk areas, and the gap between clinical excellence and operational maturity.
- 02
SOP standardization
Developed and implemented 60+ standard operating procedures covering clinical protocols, patient intake, financial processes, and compliance — with 98% staff adherence within 60 days.
- 03
Governance + compliance
Built a PIPEDA-compliant data privacy framework, clinical governance protocols, and risk management controls suitable for institutional investor scrutiny.
- 04
Financial visibility
Created clinic-level P&L accounting and a KPI dashboard tracking volume, success rates, acquisition cost, profitability, and NPS by location.
- 05
Scaled launch
Recruited a 4-member advisory board, established quarterly investor reporting, and managed a standardized launch process for three new clinics with operational consistency from day one.
The fractional COO was transformational. Within 14 months, the company went from operationally fragmented to a professionally managed network with governance discipline and proven ability to scale without losing clinical quality. That operational maturity was the prerequisite for Series B funding.
Selected. Closed.
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Where this becomes action.
Fractional Operating Leadership
Fractional operating leadership in Canada: an experienced COO or operating lead in the seat for a defined period, with clear decision rights and measures.
Strategy & Execution
Strategy and execution support for Canadian companies: a strategy that ships, with the operating plan, cadence, and accountability to deliver it.
Fractional HR
Fractional HR for Canadian employers: senior HR leadership for a defined period, from stabilizing employee relations to building the people function.
Tell us what you’re facing. We operate from there.
We reply to enquiries within one business day. Call timing, availability, and next steps are confirmed after the initial review.