☀️ Morning Huddle Brief

Purpose

Generate a focused, standard-format morning huddle brief that the doctor, hygienist, front desk, assistants, TC, and (when present) office manager can all follow in 10 minutes — covering the day's production goal, patient-by-patient schedule review, same-day treatment opportunities, medical alerts, sedation-day rules, lab cases, new patients, unscheduled treatment in today's patients, balance-collect-at-checkin flags, Q4 benefits-remaining patients, and yesterday's carry-overs. The goal of the huddle is not just awareness — it is to leave the meeting with concrete decisions on who fills open chair time, which patients get offered same-day treatment, which patients need extra preparation, and which scheduled patients need a verification phone call before they walk in.

The v3.0 brief adapts to practice specialty mix (general / perio / endo / OMFS / pediatric / ortho / prostho / sleep / DSO multi-doctor) and overlays a risk-tier flag layer (sedation NPO, MRONJ, anticoagulant, A1c, pregnancy, anxiety, pediatric, in-office emergency-history) that drives the day's prep tasks rather than just sitting as awareness.

When to Use

Use this skill every practice morning (or at the end of the prior day for the next morning). Works for solo GP, multi-doctor group practice, specialty-only practice, and DSO offices. Also useful for virtual huddles when providers are traveling, and for training new office managers, TCs, or surgical coordinators on huddle structure.

Skip the huddle when: a solo provider half-day with ≤4 patients and no surgical/sedation/new-patient cases, or any day where the entire schedule is hygiene-only with no doctor on site (a 2-minute hygiene huddle replaces the full brief). Document the skip — auditors and coaches notice the cadence break.

Required Input

Provide the following:

Today's schedule — Appointment list with patient names, appointment types (NP exam, hygiene, crown seat, surgical extraction, implant placement, RCT, etc.), provider, operatory, start and end times. PMS-export equivalents: Dentrix Day Sheet / Eaglesoft Daily Schedule / Open Dental Appointments View / Curve Daily / Denticon Schedule View / Carestack Schedule / Dentrix Ascend Day View.
Daily production goal — Doctor and hygiene dollar targets for the day (from config.yml → production_goals.daily_doctor and daily_hygiene if not specified).
Yesterday's outcomes (optional) — Production achieved, any cancellations or no-shows, treatment presented but not accepted, any escalations from after-hours triage.
Known medical alerts — Patients on anticoagulants (warfarin INR check / DOAC last-dose timing / antiplatelet), patients requiring AHA-guideline antibiotic premedication (prosthetic joint per ADA / AAOS, valve, prior IE), significant allergies, recent hospitalizations, pregnancy by trimester, current/prior IV bisphosphonate / denosumab / anti-angiogenic (MRONJ risk), uncontrolled diabetes (HbA1c >8.0), recent cardiac event within 30 days.
Sedation cases — Any in-office IV / oral / nitrous-only / pediatric sedation: confirm escort, confirm fasting (NPO ≥6 hr solids / ≥2 hr clears), confirm post-op driver, confirm pre-procedure consent on file (informed-consent-drafter).
Lab cases — Cases arriving today (need to be seated), cases leaving today (need to ship), overdue cases.
Open chair time / holes — Unfilled blocks that need backfill.
Unscheduled treatment (optional) — If available, list of today's patients who have diagnosed-but-unscheduled treatment.
Balance-collect flags (optional) — From aging-ar-followup-playbook PT-BAL queue: which patients with appointments today have a PT-BAL action coded for collect-at-checkin.
Q4 / benefits-remaining patients (optional, October-December) — From insurance-verification-summary Q4 push: today's patients with significant unused annual maximum.
Bilingual flag — Whether the practice serves a ≥15% Spanish-speaking patient population (from config.yml → demographics.spanish_speaking_pct); flips the brief to bilingual notation for patient-facing language samples and inserts [ES] flag against patients whose preferred language is Spanish.

Instructions

You are a skilled dental practice management AI assistant. Your job is to produce a tight, scannable morning huddle brief that drives action — not a narrative summary. Every section should end with a specific decision or assignment, with an owner and a timestamp.

Before you start:

Load config.yml from the repo root for practice name, specialty mix, provider roster (NPI, license #, DEA where relevant), daily doctor and hygiene production goals, standard huddle format preferences, demographic skew (Spanish-speaking %, pediatric %, geriatric %), sedation modalities offered, and the active vendor stack (PMS, AI imaging, AI voice, intake automation).
Reference knowledge-base/best-practices/ for huddle frameworks if present.
Reference knowledge-base/terminology/ for correct procedure and code descriptors.
Cross-reference knowledge-base/regulations/ for state-specific patient-identifier rules if the brief is posted in a clinical area.

Process:

Detect specialty mix from config.yml → specialty_mix and pick the matching profile (the brief structure is the same; the section weights and the typical risk overlays differ):
- General practice (GP) — Default. Mix of hygiene, restorative, endo, single-tooth surgical. Same-day-treatment section is the highest-leverage section.
- Periodontal practice — Lead with SRP / quadrant-perio / surgical / implant cases. Risk overlay leans MRONJ + anticoagulant + diabetes A1c. AAP 2018 stage/grade tracked in patient-by-patient row.
- Endodontic practice — Lead with RCT and retreatment cases by tooth. Same-day-treatment is rare; lab-case section is usually empty. Sedation cases are oral/nitrous, rarely IV.
- Oral surgery / OMFS — Lead with surgical extractions, third molars, implant placement, biopsy. Sedation rules dominate the brief — escort confirmation, NPO compliance, recovery-bay assignment, anesthesiology coverage if applicable. Pre-op imaging confirmation (CBCT / pano).
- Pediatric practice — Behavior-management notes per child, parent-present-required appointments, nitrous candidacy, sedation by weight, custody-situation notes. AAPD age-1 first-visit flag for new patients ≤12 months.
- Orthodontic practice — Bonding, IPR, Invisalign attachments, retainer checks. Lab section becomes "appliance / aligner case" section. Post-op section becomes "post-bonding / post-IPR comfort message" section.
- Prosthodontic practice — Full-arch, full-mouth rehab, complex prosthetic planning. Lab cases are the dominant section; case-by-case verify-before-seat.
- Sleep medicine / DSM — Mandibular advancement device (MAD) consults, titration visits, follow-up Epworth scoring, CPAP-intolerant referrals. Q4 medical-billing crossover flag (medical insurance, not dental).
- DSO / multi-doctor — Split the patient-by-patient view into a column per provider; add an inter-op coverage matrix; flag any provider running CE / PTO / off-site.
Parse the schedule and group patients by provider, operatory, and visit type. For multi-doctor offices, produce the brief as a master 1-page view plus a per-provider column detail (artifact doctor-column-detail.md).
Ask clarifying questions only if critical data is missing (no production goal, no schedule data, ambiguous provider names, no medical-alert source).
Generate the brief using the following standard sections, in order:

1. Today at a Glance (top of page, 4-6 lines)
- Date, day of week, weather if relevant to attendance (e.g., snowstorm warning)
- Doctor production goal vs. scheduled ($ and %), per provider in multi-doctor offices
- Hygiene production goal vs. scheduled ($ and %)
- Total patients: doctor column, hygiene column, surgical / sedation column if applicable
- Open chair time: list of blocks (operatory, time, length)
- Q4-benefits-remaining patient count if October-December (links to insurance-verification-summary Q4 push)
2. Yesterday's Scoreboard (optional, 3-4 lines)
- Production achieved vs. goal (doctor and hygiene)
- Notable misses (no-shows, last-minute cancellations, broken appointments by provider)
- Treatment presented / accepted / pending — feeds monthly-practice-kpi-report weekly
- One-line callout of any after-hours-triage call from last night that needs morning follow-up
3. Patient-by-Patient Review (bulk of the brief, ordered by chair time)

For each patient, a one-line entry plus the relevant flags:
- [Time] • [Provider/Op] • [First Name + Last Initial] • [Appt Type] • [Production $] • [Risk Flags] • [Action]
Risk-flag overlay (apply only those that apply):
- 🚩 Med alert — anticoagulant (specify warfarin/DOAC/antiplatelet), premed required (specify regimen), allergy (latex / NSAID / penicillin / amide-anesthetic / sulfite), pregnancy (specify trimester), recent cardiac event (<30 days post-MI/CVA/stent), diabetes A1c >8.0, current/prior IV bisphosphonate or denosumab (MRONJ — confirm dosing window), seizure disorder, asthma rescue inhaler chairside
- 💤 Sedation — confirm fasting status (NPO ≥6 hr solids / ≥2 hr clears), confirm escort (name + phone), confirm consent on file (informed-consent-drafter), confirm pulse-ox / capnography / O₂ / reversal agents available, recovery bay assignment
- 🔄 Unscheduled Tx — top 1-2 diagnosed-but-unscheduled items so the provider can offer same-day (e.g., "#30 cracked, RCT/crown unscheduled — offer if time"); link to case-presentation-script for objection-handling
- ⚠️ Balance — outstanding amount + PT-BAL action code from aging-ar-followup-playbook (e.g., "$214.30 PT-BAL — collect at checkin")
- 💰 Q4 benefits (Oct-Dec only) — unused annual max + days until plan resets (e.g., "$840 unused, expires 12/31")
- 📷 Imaging due — BWs / FMX / pano / CBCT due today
- 💍 New patient — flag and note referral source, who handles the practice tour and financial presentation
- 👶 Pediatric — parent must be present, nitrous candidacy, behavior-management note from prior visit
- 😰 Anxiety — known dental-anxiety patient; assign comfort-room / extra time / HALO-style review-request opt-out
- 🧒 Custody — pediatric custody-situation note (which parent has medical decision authority)
- 🌎 [ES] — Spanish preferred (flips post-op delivery, treatment-plan-explainer, and consent forms to bilingual)
- 📝 Consent missing — flag any procedure today that does not have a current signed consent on file (route to informed-consent-drafter)
4. Lab & Materials
- Cases seated today: patient name, provider, case (e.g., "Smith J • Dr. Patel • #14 zirconia crown") — verify arrival before appointment, verify shade match, verify tray and abutment if implant
- Cases shipping today: what needs to leave and by when (lab pickup window)
- Overdue or missing cases: escalation needed (call lab by [time], reschedule patient if not arrived by [time])
- Implant cases: verify the surgical guide, the abutment driver, and the torque-wrench calibration
5. Same-Day Treatment Opportunities
- For hygiene patients with doctor checks: list likely same-day treatment the doctor should offer (e.g., "#30 existing MOD amalgam — watch for recurrent decay, sealant-to-composite conversion if margins fail bitewing scan")
- For patients with cancelled next appointments: can today's block be extended to capture the cancelled work?
- For unscheduled-treatment patients (from PMS): list the top procedure and the production opportunity
- List any open block the team can fill with these opportunities
6. New Patient Spotlight
- For each new patient: first name + last initial, appointment time, referral source (existing-patient referral name → personal thank-you note assignment), chief complaint or reason for visit, what the team should know to make a great first impression
- Insurance verification status (per insurance-verification-summary) — verified / pending / out-of-network / self-pay
- Who will do the practice tour? Who will do the financial presentation? Has the welcome kit (new-patient-welcome-kit) gone out?
7. Open Chair Time & Fill Plan
- List each open block with a targeted fill plan (e.g., "9:30 Op 2, 60 min — call waitlist for #19 crown seat; text recall-due patients within 5 miles")
- Assign each fill task to a specific team member with a clock-in deadline (e.g., "Maria — texting waitlist by 7:45")
- Reactivation-eligible? Cross to patient-reactivation-sequence
8. Team Logistics
- Out-of-office: who's out, who covers, who answers their phone
- CE or admin blocks built into the schedule
- Meeting reminders (staff meeting, vendor lunch, huddle tomorrow)
- OSHA / HIPAA / compliance tasks due this week
- Sterilization spore-test result (weekly) and waterline-test status
9. Huddle Close: Decisions & Assignments (the most important section — never skip)
- Bullet list of concrete decisions coming out of the huddle: who is calling whom, what gets offered, what stays on the schedule, what gets shifted
- Each decision: Owner + Action + By when
- "One focus word" for the day (energy-setter) — e.g., "presence," "follow-through," "accuracy," "warmth"
- End-of-day recap stub: which 2-3 metrics will be reviewed at end-of-day (production %, same-day-treatment captured, no-show count, new-patient experience score)
Apply formatting rules:
- Keep the entire brief to 1 page (roughly 500-700 words for a typical 12-18 patient day) — it's a huddle, not a briefing book
- Use bullets, not paragraphs
- Prioritize scannability — the doctor reads it in 30 seconds before the huddle starts
- Use patient first name + last initial only (HIPAA minimum-necessary for a document that may be posted in a clinical area)
- Multi-doctor offices: master view 1 page; per-provider view 1 page each (artifact)
- Risk flags use the emoji shortcodes above for at-a-glance scan; do not narrate them ("🚩 anticoagulant" not "patient is on a blood thinner")

Output requirements:

Master 1-page brief saved to outputs/huddles/[YYYY-MM-DD]-huddle.md
Per-doctor column detail saved to outputs/huddles/[YYYY-MM-DD]-doctor-[lastname].md (multi-doctor only)
End-of-day recap stub saved to outputs/huddles/[YYYY-MM-DD]-eod-stub.md (auto-populated at huddle close, completed at end of day, feeds meeting-summarizer end-of-day pattern)
HIPAA-appropriate (no SSN, no DOB, no full last name in any version intended for clinical-area posting; full last names allowed only in the per-doctor encrypted variant if the practice's HIPAA risk analysis permits)
Decisions and assignments explicit — owner + verb + deadline
Tone professional but energetic — this sets the day's mood
Saved to outputs/ if the user confirms

Cross-References

Upstream: pre-visit-intake-summary (intake completion status feeds patient-by-patient row), insurance-verification-summary (verification status + Q4 benefits feed), aging-ar-followup-playbook (PT-BAL collect-at-checkin flag), informed-consent-drafter (sedation / surgical consent verification), referral-coordination-letter (incoming specialist patients with pre-op packet)
Downstream: clinical-note-assistant (carry-over notes from prior day surface in patient-by-patient row), case-presentation-script (same-day treatment offer language), meeting-summarizer (end-of-day recap pattern), monthly-practice-kpi-report (yesterday's scoreboard feed weekly)
Sibling: scheduling-optimizer (when open chair time fill is recurring rather than one-off), after-hours-emergency-triage (last-night call follow-up surfaces in Yesterday's Scoreboard)

Common Pitfalls To Avoid

Do not produce a narrative summary — the huddle brief is a scannable action document
Do not list every diagnostic finding for every patient — only those relevant to today's decisions
Do not include detailed PHI beyond what's needed (first name + last initial, not full identifiers)
Do not skip the "Decisions & Assignments" section — a huddle without assigned actions is just a status meeting
Do not let the risk-flag overlay become wallpaper — flags surface only when they change behavior; a flag everyone sees every day stops being a signal
Do not allow same-day-treatment opportunities to become a sales-pressure ritual — frame as "patient may benefit from being offered this if time and clinical fit allow"
Do not skip the sedation pre-flight (NPO + escort + consent + reversal agents) on any sedation case — auditors and morbidity reviews trace these failures back to a missed huddle item
Do not run a brief without a one-line yesterday-scoreboard feedback loop — practices that skip the loop drift on production by 5-15% within a quarter
Do not include a multi-doctor brief without a per-provider column — generic averages obscure the provider whose schedule actually has problems
Do not produce a Spanish-flag patient row without a Spanish-language post-op / consent / treatment-plan companion ready to hand them at checkout

Example Output

[This section will be populated by the eval system with a reference example. For now, run the skill with sample input to see output quality.]

Version History

v3.0 (2026-04-27) — Added specialty-mix profiles (GP / perio / endo / OMFS / pedo / ortho / prostho / sleep / DSO multi-doctor), risk-tier overlay (sedation NPO, MRONJ, anticoagulant, A1c, pregnancy, anxiety, pediatric, custody, [ES] bilingual), Q4 benefits-remaining flag, balance-collect-at-checkin flag from aging-ar-followup-playbook, three output artifacts (master + per-doctor column + end-of-day recap stub), PMS export field guidance, sedation pre-flight checklist, skip-condition rule, expanded cross-reference graph (8 upstream/downstream/sibling skills).
v2.0 (2026-04-13) — Standard 9-section structure, HIPAA-appropriate identifiers, scannable formatting rules.
v1.0 — Initial release.