Discharge waits on other services. The constraint often sits outside the ward that suffers from it.
Lean in the NHS
Lean for the NHS: fix the pathway, not the people
Your staff are already working flat out. The waiting list still grows. Most of the time a patient spends on a pathway is spent waiting between steps, not being treated. Lean finds those waits and removes them, with the clinicians and staff who run the pathway, not around them.
Chapter 1
Does this sound familiar?
Three systems disagree about when a patient arrived. Reconciling them is the first job.
Improvement done to a team does not survive. Done with them, it does.
Near full capacity, waiting does not rise gently. It climbs fast. Spare capacity is what lets work flow.
Chapter 2
What you get
Not more pressure on staff. Fewer waits for patients.
Not a programme from outside. A pathway your team owns.
Not averages. The long waits, where the risk is.
The change is built into how the pathway runs, measured against where it started, and owned by the team.
The people who run the pathway help find the cause, so they trust the fix.
Pathway time as a spread, not an average. Discharge delay with its reason recorded every time.
Vincent Chido King has designed and implemented evidence based improvements across clinical and operational pathways, and is studying adult nursing.
Chapter 3
How it works: the Chido method
Every engagement runs through the same five chapters. Each one ends with something you can see before the next one starts.
01
Dream It
Walk the process as it really runs, find the pain people have stopped mentioning, and agree the problem and the future you want.
02 Evaluate ItMeasure the gaps, put a cost on the delay and the rework, and rank what to fix by impact, not by who is loudest.
03 Learn ItDesign the fix with the people who will run it, and test it small before you commit money and reputation.
04 Build ItPut it in: processes, systems and people lined up from day one. Technology only where it serves the work.
05 Scale ItMake the new way the standard, measure it against where you started, and leave your people able to keep improving.
Chapter 4
See it worked through
A worked example I published
Meridian Hospital Group
A constructed hospital group, set out problem by problem, with every solution graded rather than sold.
The teaching page Lean Six Sigma in healthcareWhat breaks in a pathway, the numbers worth having, and what a project looks like.
Play it The Bed GameTen beds, two wards. Find out whether the shortage is real, or the flow.
Chapter 5
Where to start
Start with one pathway and one group of patients. A clear question can be finished; "outpatients are slow" cannot.
Free, thirty minutes
Book a discovery call
Tell me about one process that is costing you. I read every enquiry myself and reply within one working day.
A fixed price first step The Process CheckA two week check on one process: mapped, measured, and a clear verdict, with a stop at day five if it is not the process.
One pathway, one conversation
A free 30 minute discovery call about the pathway that worries you most. No patient details needed, only how the work flows.
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