Walk into the Clinical Blood Sciences lab at Croydon University Hospital and you can’t miss them: a pillar covered in laminated wall charts, each one a grid of red and green marker strokes climbing towards a 95% goal line. They track urgent turnaround times for tests like troponin, U&Es and CRP, day by day, month by month. They’re simple. They’re visible. And according to the team behind them, they’re changing how the lab works.
I visited Croydon’s Pathology department to see the charts for myself and to speak with Fred Mpambire, Lead Biomedical Scientist and Spoke Manager, about Performance Partnership, the initiative driving this shift towards visual, staff-led improvement.
Alba Casadesus, Senior Biomedical Scientist and Quality Lead for Croydon, joined the conversation and provided much of the background on how the trackers and the wider partnership actually work day to day.
From monitoring to sharing
Croydon has been tracking urgent turnaround times for years. What’s changed, Fred explained, isn’t the measuring, it’s the sharing. Rather than performance data sitting in a spreadsheet somewhere, it’s now on the wall, updated daily, and visible to everyone who walks past. That visibility has turned performance from something managed from above into something the whole team can see, discuss and take ownership of.
It also opened the door to identifying “bottlenecks”, the small friction points in a process, and working through them collaboratively rather than dictating changes from outside. As Fred put it, staff know their own processes better than anyone. The role of Performance Partnership isn’t to walk in and tell people what to change; it’s to work alongside the team to find where the bottlenecks are and test solutions together.
Small changes, real impact
Some of the improvements sound almost too simple to matter, until you see the effect at scale. One example: reception staff used to rotate hourly between workstations, meaning urgent samples were sometimes booked in from whichever computer happened to be free, wherever that was in the room. The team tried a few alternatives, including a standing terminal by the sample track, before settling on keeping one computer nearest the track reserved specifically for urgent bookings. The saving per sample is only a matter of seconds, but multiplied across every sample booked in a day, it adds up.
A bigger example came from a review of bank staff hours. The team needed to reduce bank hours while keeping the same volume of work covered. Rather than simply asking people to do more, they looked systematically at where time was being lost, identifying different types of waste in the process, and redistributed tasks across the tools and rota already in place. Two months on, the reduction (3 hours per day, 15 per week) has held, and, importantly, it has also freed up time for training that the team previously struggled to fit in.
Standard work has been a recurring theme too. When there is DXA5000 track or IT downtime , everyone now follows the same documented procedure rather than relying on whatever the person on shift happens to know. It sounds like a small administrative fix, but it removes a layer of uncertainty exactly when the lab can least afford it.
A weekly habit, not a one-off fix
Underpinning all of this is a small, dedicated weekly work group, bringing together quality, chemistry, Haematology & BT and reception perspectives, whose job is to keep asking why. Why are samples booked in at one time but not reaching analytical areas until hours later? Where exactly is the delay? The group breaks problems down together until the root cause is agreed, then tests a change and watches what the tracker does next.
Fred was candid that not every change works. Some get reversed. Some get modified. What matters, he said, is that the team can see the impact quickly and adjust, and that they’re doing so with people who understand the work, rather than being told what “should” happen by those who’ve never done the job.
Leading from the floor
Talking to Fred, it was clear his approach to leadership is deliberately hands-on. He described the value of being visibly present with the team, especially during pressured moments like IT downtime, not necessarily to fix the problem directly, but to be seen supporting the people who are under strain. He also pointed to team size as a factor: As workforce size has increased over the years, structuring staff into smaller, well defined teams improved management effectiveness, communication, accountability and team cohesion, making it easier to align staff around common objectives.
It’s early days for some of the changes we have made, but the wall charts tell their own story, steadier green stretches where red once dominated, and a team that can point to exactly why. Performance Partnership at Croydon isn’t a single fix; it’s a habit of noticing, testing and sharing that the team plans to keep building on.
With thanks to Fred Mpambire and Alba Casadesus for their time and insight.