How Nurses Cut Hospital Stays for People with Frailty (and what Agile teams can learn)

A five-nurse specialist team redesigned care for frail patients, slashing average hospital stay from ~18 days to ~2.4 days in six months. This is an ~86% reduction while improving experience and saving millions!

Here’s my Agile angle (real-world moves you can borrow):

  1. Treat assessment like fast triage: front-load expertise early to prevent long tail delays (NHS guidance ties early frailty teams to shorter LOS).

  2. Make a “same-day flow” lane: prioritize small, testable steps that discharge or decisively progress work within 24–48 hours (Frailty SDEC models show impact).

  3. Measure stability, not busyness: track time-to-first-decision and aging work; spotlight blockers daily.

  4. Run tiny service experiments: one hypothesis at a time (e.g., earlier specialist review) and keep what reduces average length of stay.

Coaching Moment: What’s our “early specialist” move that, if done within the first day, would prevent most downstream delays?

Predictability Before Velocity

Predictability isn’t about control—it’s about clarity. Before we chase faster, we need steadier. I look at three things every week:

1. Stability: % of planned scope actually delivered (keep it simple, team-level).

2. Flow health: aging WIP and average WIP vs. a sensible limit.

3. Surprises: unplanned work as a % of total.

If stability is jittery, velocity won’t save you—it’ll just hide the wobble. Start small: cap team WIP for one sprint, slice anything > 3 days of effort, and time-box a 15-min “assumption burn-down” review. Stability first. Speed later.

Want my Excel template and my one-slide PowerPoint exec view for free? Download them here