Theory of Constraints Handbook - James Cox Iii [612]
General Discussion
The health industry has to work at a systemic level and give up its focus on local efficiencies. Global metrics like Throughput, OE, Investment, due date, and on-time performance can align multiple physicians, hospitals, test facilities, etc. in value chains with the overall objective of satisfying the end customer—the patient. TOC provides excellent tools to understand these complex systems. The Lean and Six Sigma tools are tactics that help achieve the goals of the health care systems. The TOC tools provide the focus and measurements. The focus should be on the development of human knowledge and capability of the health care organization by hiring and training personnel, rather than cutting jobs. This strategy will lead to more health care Throughput (well patients at lower costs) and hence meet the goals of the organization.
The process to improve health care systems, however small or large, is the same. This improvement methodology can be applied to small clinics as well as to large hospitals or national health services. Five improvement processes exist in TOC that are useful in a medical practice: the 5FS, TA, the TP, BM, and Critical Chain.
The patient is the key beneficiary and thus dictates the health care system design. The TOC health care methodology also encourages all health care providers to coordinate their services with the one goal of providing fast, reliable services to the patients. This integrated methodology improves Throughput of the patients through the health care system, creating more capacity to treat larger numbers of patients. The doctor is the primary revenue-generating person and hence should be the constraint resource. All other resources should subordinate their actions to the constraint and to the flow of patients through the process. It is important to apply the 5FS to improve the Throughput and patient flow of the system. In hospitals, the radiology tools, operating rooms, etc. should not become a constraint if we want the doctors to maximize the Throughput. The TOC methodology recommends adequate support staff to protect the constraint resources and to absorb high levels of variation in health care systems. Lean and Six Sigma methodology help reduce variation and remove waste from the system, resulting in further improvements for the health system. The methodologies create high quality health care, jobs for workers, wealth for all stakeholders, and the whole value chain benefits.
References
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