How to Identify Operational Risk Before a Leadership Gap
Spotting vulnerabilities before they become crises
Why this matters
Every clinic, no matter how well run, has soft spots that only show under pressure. When a practice manager steps away - whether for leave, illness, or resignation - those weak points can surface overnight. Payroll delays, missing passwords, incomplete inventory logs, or unclear task ownership can all halt operations.
Identifying risk early isn’t pessimism; it’s leadership. It’s how you protect your team, your clients, and your reputation long before disruption begins.
Start with a systems audit
A systems audit isn’t a technical exercise - it’s a visibility check.
Review:
Access & permissions: Who holds administrative rights for HR, payroll, EMR, and vendor platforms? Is there a secondary login or documented process if that person is unavailable?
File organization: Are SOPs, forms, and templates stored centrally with version control?
Software dependencies: Which functions rely on single-user systems or personal email accounts?
Reporting cadence: Are financial and operational reports generated automatically or manually?
Flag anything that relies on one person’s memory or laptop.
Map critical workflows
Every clinic runs on a handful of essential cycles - payroll, scheduling, ordering, reporting, and client communication.
Ask:
What happens if this process stops for three days?
Who could step in, and would they know how?
Where is the written backup?
A simple flowchart or checklist library in Google Drive or SharePoint can prevent hundreds of small emergencies later.
Evaluate your communication chain
Leadership gaps often expose unclear communication lines.
Does every department know who to escalate issues to if the manager is absent?
Are staff group chats, emails, and calendars professional and centralized?
Are decisions logged (meeting notes, task trackers) or just verbal?
Even a well-meaning interim lead can’t function without context.
Review your staffing matrix
Look for single points of failure:
Who else can approve payroll or purchase orders?
Can a senior staff member or technician step into a light supervisory role if needed?
Is there cross-training or at least shadow documentation?
Cross-training doesn’t just build redundancy - it increases engagement. Staff who understand the bigger picture make better day-to-day decisions.
Assess leadership documentation
Leadership continuity depends on what’s written down:
Annual goals and budgets
HR calendars (reviews, renewals, compliance dates)
Vendor contacts and contracts
Emergency procedures
If those live only in one inbox, you already have operational risk.
Create a “Leadership Continuity Folder” with sub-sections for Admin, HR, Finance, and Operations. Update quarterly.
Check your culture indicators
Operational risk isn’t only procedural - it’s relational.
Pay attention to:
Morale dips during change or absence
Staff hesitancy to make decisions without direction
Dependence on a single “go-to” person for all solutions
Strong systems falter if the culture discourages initiative. Leaders should routinely delegate small decisions to test resilience.
Build a risk register
Document each risk, its potential impact, and mitigation plan.
Example:
Example: Simple Risk Register
Risk: Only one payroll admin
Impact: Payroll delay
Mitigation: Train backup admin; store written guide
Owner: Manager
Review Date: Quarterly
Risk: Staff scheduling only on paper
Impact: No continuation, lack of access
Mitigation: Digital, dynamic format; train additional lead
Owner: Ops
Review Date: Monthly
It’s simple, visible, and keeps accountability shared.
Conduct an annual continuity review
Once a year - ideally before budget season - review your risk register and update:
System changes
Staffing updates
New compliance requirements
Lessons learned from near-misses
Leadership stability is a living process, not a one-time project.
Key takeaways
Operational risk hides in routine. Review what feels “automatic.”
Redundancy is strength, not inefficiency.
Culture and documentation are equal partners in resilience.
The best time to test your systems is when everything’s still calm.
Further reading
This guide was prepared by Lalonde Strategies Inc., a North American management consulting firm specializing in operational stability and leadership support for healthcare, dental, and veterinary practices.
