A LEAN SIX SIGMA MAP OF THE PATIENT JOURNEY
Every patient who hears the words "your kidneys are failing" enters a process — a real one, with suppliers, inputs, defects, and control limits, whether anyone ever draws it out for them or not. This is that process, drawn out: eleven stages, from the moment dialysis first enters the conversation to a lifetime of guarding a transplanted organ, mapped the way an engineer would map any system where failure costs a life.
Fig. 1 — the renal process, end to end
Lean Six Sigma treats every process the same way, whether it builds a car door or carries a patient toward a transplant: define what the process is supposed to do, measure what actually happens, analyze where it fails, improve the failure points, and hold the gains under control. Applied to transplant, the five phases aren't abstractions — they map onto eleven concrete, dated stages a real patient walks through below.
The disease is named and the future modality question is put on the table.
Baseline function, education, and referral timing are captured.
The multidisciplinary workup finds every root-cause reason a body might reject an organ.
Listing, donor-matching, and the wait itself — where the process is actively pushed forward.
Surgery succeeds only if the gain — a working graft — is held for life.
Before drilling into any one stage, a Six Sigma analyst first frames the whole system in a single table. Read left to right: who feeds the process, what they feed it, what the process itself does, what comes out the other end, and who that output actually serves.
A process is only as sound as its weakest handoff. National figures on the American transplant system are widely published and sobering on their own — they need no embellishment.
Each stage below states what is supposed to happen, in plain clinical terms — then names the failure mode the system allows anyway. The colored ring on the left names its DMAIC phase; the dashed note names the Six Sigma tool an analyst would reach for at that exact point.
A patient who can see the whole line — not just the exam room they're standing in — can ask sharper questions, push back on silence, and refuse to disappear between handoffs. That is the entire purpose of drawing this map: not to comfort, but to arm.