I contacted the QFI team one Sunday afternoon immediately after reading Pride and Joy and within an hour Alex himself replied direct to my email. We quickly teamed up and their initial analysis provided us with the focus and actions that enabled us, for the first time in eighteen months, to achieve the emergency four-hour access target. Their analysis helped us to gain consensus among clinical staff and take the few actions necessary to improve patient flow across the hospital and almost eliminate outliers, which had peaked at over ninety. Over subsequent months they took the refreshing approach of educating and embedding their expertise inside our own staff, paving the way for an internally led patient-centred approach. We are now embarking on our first implementation using the Pride and Joy software and analytical tool. Once successful we will be embedding this into the core of the way we do things. We always look forward to return visits from Alex and his senior team, with so many of our hospital staff genuinely inspired to learn more about the application of Theory of Constraints in a busy healthcare environment.

Neil Doverty, Chief Operating Officer, Peterborough & Stamford Hospitals NHS Foundation Trust, England

Never in our 68 year existence have we implemented a change more effectively to as large an audience as we did with our TOC implementation. In addition, the significance of changing the cultural and emotional ties we had to our previous processes speaks volumes to the quality of work and individuals that have chosen to make the Fike Corporation their employer of choice.

Brad Batz, Executive Vice President - Oil & Gas Strategic Business Unit, Fike Corporation

The positive impact on efficiency and quality of service has been significant: we are now able to create internal inpatient capacity every working day.

Oliver Treacy, Service Director, Barnet, Enfield and Haringey Mental Health Trust

We began working with QFI over 7 years ago and our relationship goes from strength to strength. From the start they took the time to understand our business; recognising what we had achieved and questioning where we wanted to go. QFI have a great balance of slowing you down and making you really consider as well as probing and pushing you to raise your ambitions. They make sure you take the time to devise your plan and help in monitoring the delivery without ever being intrusive into your business. Above all they are people you can trust and have some fun with on the way!

Miles Linney, Chief Executive, Linney Group

I am delighted we are at the forefront of productivity initiatives in the NHS Mental Health service. 

Maria Kane, Chief Executive, Barnet Enfield and Haringey Mental Health Trust

Our fees have gone up - we've changed our processes and embraced the whole approach.

Jackie Gillespie, Partner, Head of Personal Injury, Howlett Clark Solicitors

We wanted to create a breakthrough strategy and decided to use the Theory of Constraints as the basis of this work.  Writing a new strategy using a new method is a daunting prospect but QFI supported us through it to give us something that is right for us and that has been easily and quickly adopted by our thousands of workers and supporters.

Belinda Phipps, Chief Executive, National Childbirth Trust

With the start of the TOC-programme, hospitals in the UK, USA and Australia were able to see their results in healthcare improve.  This success was a reason why we worked with QFI, the developers of this simple Jonah approach.  Within a few months the results were visible: the average length of stay decreased.  A practical approach and not just a beautiful story in a book!

Mary Groenewould, Service Director, Amphia Ziekenhuis, The Netherlands

By working with QFI to apply their Theory of Constraints approach to our discharge processes across all our twelve community hospitals, we have been able to reduce our length of stay by a third within a matter of weeks and make big improvements to the quality of our patients' rehabilitation and discharge.  The process has developed staff's confidence in their ability to take control and make changes which improve quality and productivity and has significantly improved multi-agency working across health and social care in Derbyshire."

Tracy Allen, Managing Director, Derbyshire Community Health Services, England

We had a two-day meeting with Alex Knight and at some point in the second day I realised this must be the solution. It was quite a different view of how to manage an outpatient clinic. It was a paradigm shift because it is a completely different way of working."

Frank van den Hoogen, Lead Consultant Rheumatology, St Maartenskliniek, Nijmegen, The Netherlands

I have seen many methodologies but, putting it simply, the combination of the Theory of Constraints and QFI Consulting delivers results much faster than anything else around."

Averil Dongworth, Chief Executive, Barking, Havering & Redbridge University Hospitals NHS Trust

The nursing team, from the heads of nursing to ward managers and the individual nurses on each ward, play a leading role in the effective management of the patient's journey through the hospital.  Working together with other clinical and management colleagues including doctors, physiotherapists, occupational therapists and the divisional management teams, they have embraced new management practices through QFI-Jonah.  This helps us to ensure that our patients get the right treatment at the right time from the right people.  As a result of this great team working across many disciplines, supported by QFI-Jonah, the average length of stay for our patients has been considerably reduced, helping us to improve the quality of our patient care."

Mary Dunne, Director of Quality, Nursing and Patient Services, Frimley Park Hospitals NHS Foundation Trust, England

When we started to apply QFI-Discharge-Jonah we felt that suddenly we had a tool that we had not had the likes of before, a way of actually achieving what we had aspired to do for a long time. It is wonderfully simple but it is quite revolutionary.  Not only has it changed the process and the outcome in terms of reducing the lengths of stay and increasing the throughput but it is also helping to change the culture."

Tim Broadley, Associate Director of Service Delivery, Derbyshire Community Hospitals, England

In order to maintain Frimley Park's clinical excellence whilst at the same time living within our budget, the Trust Management Board decided that achieving a significant reduction in length of stay of our patients should be a strategic imperative.

We decided to invest in QFI-Jonah as part of our broad ranging strategy to reduce length of stay.  I am pleased to say that this overall strategy has produced very positive results with a reduction of more than 20% on those wards where QFI-Jonah is used.

Andrew Morris, Chief Executive, Frimley Park Hospital NHS Foundation Trust, England

Staff could actually see some changes starting to happen relatively early on.

Staff who were doing the Productive Ward series who didn't have Jonah were saying 'when do we get QFI-Jonah because it makes absolute sense!"

Lynn Walshaw, Head of Urgent Care and In-patient Services, Derbyshire Community Hospitals

During the implementation of discharge Jonah at B&CFH I was introduced to a new language and way of thinking called the Theory of Constraints.

I discovered a logical way of thinking and analysing problems that suited my pragmatic and practical approach to leadership within the Therapies team at B&CFH. With the support and guidance of the QFI team I embarked upon the MSc programme at NTU and found myself on an inspired journey of learning and development.

Eighteen months later I am a Master of TOC and yet feel like this is just the beginning. The MSc has provided me with new levels of confidence and way of tackling the issues created by health and social care - or indeed any complex system of dependent events. Whatever the future brings I feel equipped to meet the challenge head on and give it a go."

Vikki Butler, Head of Therapies, Barnet and Chase Farm Hospitals, London

Following a review of Intermediate Care by Derby City PCT Commissioners, we were challenged to reduce the average length of stay in our Community Hospital from 40 days to 30 days within the next six months.  I knew this would require a swift, sustainable major change in the way we delivered our service.

My confidence in QFI-Discharge-Jonah was rewarded by an average length of stay of 20 days which is maintained and is likely to reduce further, thus benefiting patients and delivering Best Value.

In addition, it has been a joy to watch the development of the ward teams, the increase in individual staff confidence, plus the improved interdisciplinary and multi-organisational working."

Glenys Crooks, Associate Director, Rehabilitation and Cancer Directorate, England

Throughput up, inventory down, expenses down; isn't that amazing! But, Rheumatologists expect to be able to deliver good work and to be able to be in contact with their patients. For them the benefit will be to be able to come in and not be bothered by administration. That is always one of the clinicians' complaints: that they have to do a lot of administration, which keeps them away from patients."

Inge Vogels, Rheumatology Centre Manager, St Maartenskliniek, The Netherlands

I don't think anybody could have anticipated the difference it actually made to our length of stay. It's been profound. Within two months we had halved our average length of stay. It has been a really positive initiative and I wouldn't like to let go of it now."

Lesley Dobson, Senior Sister, Derbyshire Community Hospitals, England

Implementing QFI-Discharge-Jonah within the Trust has made a significant improvement to the Trust's discharge performance and available bed capacity.  Our delayed discharges have improved year on year, with all staff focusing on the patient discharge from admission, and synchronising resources across the patient pathway.  Key to this improvement was the project and change management process delivered by QFI to ensure this was embedded into everyday practice and sustainable over the years."

Sarah Perry, Director of Operations, Emergency Care, Barnet & Chase Farm Hospitals NHS Trust

It might seem that we had too many patients for the respective months but that was one of the basic things that QFI said: it is not that you have too many patients or too little capacity; you just don't have the right capacity at the right moment."

Arjen de Boer, Information Analyst, St Maartenskliniek, The Netherlands

Jonah has transformed our ability to manage the priorities in our system and, for the first time, we have an instant picture of the overall situation and the areas on which to focus our immediate efforts.  For teams like the therapists team who safari the wards, it offers a system to prioritise workloads and focus on the most urgent cases first, thus increasing our productivity.

The Therapies team have taken the opportunity to link the leadership development programme delivered by QFI and TOC theory which has been of enormous benefit to the team and enables them to get a better understanding of the Trust's business and strategic direction.  This has led to many innovative improvements in our delivery of services.  The QFI team has been very supportive and the training is exciting and engaging."

Jude Monteath, Head of Therapies, Barnet & Chase Farm Hospitals NHS Trust