Frameworks

The methods I keep returning to, and where each one is set out.

This page is a directory, not an explanation. Each entry names a method that already appears in the writing, says what it is for in a line or two, and points at the piece where I work through it properly.

01 / Why this page exists

A method is only worth naming if it survives a bad week.

Most of these started as a habit rather than a framework. A sorting rule I used on a Sunday evening, a set of questions I kept putting to vendors, four lines I wrote down because I did not trust my memory of a decision. They became named methods only after they had been used enough times to be worth defending.

Nothing new is explained here. If an entry interests you, the link takes you to the place where the reasoning, the limits and the failure modes are written out in full. The list grows as the writing does.

01

The five parts of an instruction

Every step of a written procedure answers the same five questions: trigger, owner, action, proof, escalation. When one of them is missing, people build a shortcut, and the shortcut is usually a fair verdict on the document.

Why clinical SOPs fail

02

The handoff as a controlled event

Ready, transferred, accepted, recovered. Most operating failures do not live inside a task, they live between roles, so a handoff needs an acceptance signal and a recovery path rather than only a sender.

Process and SOP design guide

03

Invariants and local choices

The split that tells a network what must never vary from what a local team is expected to decide for itself. Local freedom without a boundary produces drift, and central rules without a reason produce workarounds.

Franchise operations guide

04

The seven handoffs

The seven points between a first enquiry and a completed treatment where responsibility for a patient moves from one person to another. Each one named in order, with what fails there and what costs nothing to fix.

Lead to surgery: the seven handoffs

05

The context packet

The minimum context that must travel with a patient at every handoff, defined once and then audited the way calls are audited. A handoff that arrives without its packet did not really happen.

Contact centre and patient journey guide

06

Five kinds of gap

Knowledge, judgement, process, resource, documentation. Naming which kind a review finding belongs to decides who owns the fix, and stops every problem receiving the same instruction to be more careful.

Clinical quality systems guide

07

Observation, interpretation, action

Feedback written in three separate layers, in that order, with the confidence stated on the middle one. When someone pushes back you can find which layer the disagreement actually lives in.

Reviewing surgical quality when you cannot be in the room

08

Four kinds of training time

Instruction, observation, supervised application, review. A calendar that treats every hour as interchangeable hides the different work each of the four is doing.

What a doctor training calendar actually has to solve

09

The automation control ladder

Assist, recommend, execute, escalate. Four levels of authority for an automated step, chosen by describing the worst plausible wrong action, how fast it would be noticed, and whether it can be reversed.

Operations automation guide

10

Claim, fact, signal, inference

A label attached to every item in a research file. It stops confident language outrunning its source, which is the commonest failure in vendor reviews and competitor work.

Competitive intelligence guide

11

The one-page organisation map

Every domain a business runs on, listed on a single page and marked for how well it is actually held rather than how well it is described. Then the discipline of touching only the three weakest first.

How I map an organisation in one notebook page

12

The decision journal

Four lines written at the moment a decision is made: what was chosen, what is expected, what would show it was wrong, and when to look again. The third line does most of the work.

Stoic operating discipline for people who run clinics

13

The pre-mortem

Before a launch, assume it is six months later and the thing failed, then write down why. Nobody wants to run the meeting. Everybody who has run it has found something.

Stoic operating discipline for people who run clinics

14

Detect, evidence, prioritise

Brand protection run as a standing loop rather than an occasional emergency: detection on a schedule, evidence captured in the form a lawyer would need it, and cases ranked by patient harm before annoyance.

Brand protection is an operations job

15

The five commitments

What a cross-border care operator has to promise and then prove: the named doctor performing the work, accreditation that means something, one written price, records that travel home, and aftercare with a name attached.

The trust gap is the market

Continue

The methods make more sense inside the problems that produced them.

Read the field notes