The World of the Theory of Constraints

Mabin, Victoria J.; Balderstone, Steven J.

doi:10.4324/9780429273056

Cited by 18 publications

(21 citation statements)

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“…Moreover, this change will significantly reduce the uncertainty (lower standard deviation) and improve the resource’s mean processing capacity. Although it may seem to be a huge improvement without adding new resources, it is perfectly reasonable for a TOC’s implementation as reported by Mabin and Balderstone [ 14 , 32 ], who reported a mean reduction in lead time of 70%, and by Bacelar-Silva et al [ 13 ], who reported a mean improvement of 61% in the percentage of the patients seen and released within the 4 h target at Accident and Emergency Departments and a mean reduction of 38% in the LOS (in a rich collection of environments, e.g., whole hospitals, specific wards, and emergency departments).…”

Section: Results (Playing the Game)mentioning

confidence: 81%

“…A literature review conducted by Mabin and Balderstone [ 32 ] assessed the results of the TOC’s implementations from 77 different companies. These companies had various distinctive purposes (government, not-for-profit, and for-profit) and differed in industries and sizes.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, non-constraint resources must prioritize, synchronize, and execute tasks to support the increasing constraint utilization and patient flow. When any investment is necessary, it is after a thorough analysis, and the return is expected to occur in a relatively short time [ 13 , 14 , 32 , 38 ]. That means the TOC allows organizations to achieve a much better system performance using the existing resources.…”

Section: Discussionmentioning

confidence: 99%

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Identifying and Addressing the Underlying Core Problems in Healthcare Environments: An Illustration Using an Emergency Department Game

Bacelar-Silva

Cox

Baptista³

et al. 2021

IJERPH

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The emergency department (ED) crowding is a critical healthcare issue worldwide that leads to long waits and poorer healthcare outcomes. Goldratt’s theory of constraints (TOC) has been used effectively to improve such problematic environments for more than three decades. While most TOC solutions are simple, with many viewing them as purely common sense, they represent paradigm shifts in how to manage complex, uncertain, and silo environments. Goldratt used a simple dice game with a straight flow (I-shape) to illustrate the impact of dependent resources and statistical fluctuations in managing resources. Additionally, games help to overcome resistance to change and gain ownership by having participants develop their solutions. This new cooperative game illustrates an ED environment where patients may follow different care pathways according to their clinical needs, timeliness of care is measured in minutes, the demand is highly uncertain, and treatment must frequently start almost immediately. A Monte Carlo simulation validated the TOC solution to this ED game, achieving results similar to the real TOC’s implementations. Moreover, this article provides a thorough process to Socratically introduce TOC to healthcare professionals and others to recognize that the EDs’ (like other healthcare systems’) core problem is the traditional approach to managing them.

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Section: Results (Playing the Game)mentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Identifying and Addressing the Underlying Core Problems in Healthcare Environments: An Illustration Using an Emergency Department Game

Bacelar-Silva

Cox

Baptista³

et al. 2021

IJERPH

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“…Numerous successful applications of this methodology have shown that it is indeed possible to implement a change management process which is both systematic and repeatable. Rahman (1998), Mabin and Balderstone (1999) and Blackstone (2001) present an in-depth literature review of the methodology and discuss its successful applications. Mabin and Balderstone (2003), Noreen et al (1995), Umble et al (2006) and Pegels and Watrous (2005) describe successful implementations of this methodology in the context of manufacturing firms.…”

Section: Systems Thinkingmentioning

confidence: 99%

Communicating for change: a systems thinking approach

Banerjee

Lowalekar

2021

JOCM

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PurposeThis study describes in detail an application of the Theory of Constraints (TOC)-based systems thinking approach towards clear and effective communication in a change management exercise. The same is achieved through the example of a large defence organization that is struggling with a multitude of problems in its stores and purchase departments.Design/methodology/approachIt is demonstrated through the case study how five systems thinking tools – Current Reality Tree (CRT), Evaporating Cloud (EC), Future Reality Tree (FRT), Negative Branch Reservation (NBR) and Prerequisite Tree (PRT) – can be applied in overcoming different layers of resistance and for getting the necessary agreement from the stakeholders for a successful change initiative.FindingsThe five logical thinking tools helped answer the three questions – “what to change”, “what to change to” and “how to cause the change” (Goldratt, 1990) – satisfactorily and overcome various layers of resistance to get the desired buy-in from the stakeholders for a successful change management exercise.Originality/valueThe cause-and-effect based method presented in this work is generic enough and can be adopted for getting a buy-in in a variety of change management contexts.

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“…These significant results support the investigation of TOC as a potentially effective solution for the chronic healthcare problem. However, the application of TOC still has few case studies published in refereed academic journals (Mabin & Mirzaei, 2016;Ronen, 2005), particularly in healthcare. Since academic papers do not entirely reflect the adoption of TOC in healthcare yet, answers to this subject may be covered in grey literature.…”

Section: Toc Overviewmentioning

confidence: 99%

Outcomes of managing healthcare services using the Theory of Constraints: A systematic review

2020

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Despite ever-increasing resources devoted to healthcare, lack of capacity and timeliness are still chronic problems worldwide. This systematic review aims to present an overview of the Theory of Constraints (TOC) implementations in healthcare services and their outcomes. We analysed 42 TOC implementations (15 full-text articles, 12 video proceedings, and 2 theses/ disserations) from major scientific electronic databases and TOC International Certification Organization Conferences. All implementations reported positive outcomes, both tangible and intangible. The two main improvements reported by authors were in productivity (98%; n = 41) -more patients treated -and in the timeliness of care (83%; n = 35). Furthermore, the selected studies reported dramatic improvements: 50% mean reductions in patient waiting time; 38% reduction in patient length of stay; 43% mean increase in operating room productivity and 34% mean increase in throughput. TOC implementations attained positive results in all levels of the health and social care chain. Most TOC recommendations and changes showed almost immediate results and required little or no additional cost to implement. Evidence supports TOC as a promising solution for the chronic healthcare problem, improving quality and timeliness, both necessary conditions for providing effective healthcare.

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The World of the Theory of Constraints

Cited by 18 publications

References 0 publications

Identifying and Addressing the Underlying Core Problems in Healthcare Environments: An Illustration Using an Emergency Department Game

Identifying and Addressing the Underlying Core Problems in Healthcare Environments: An Illustration Using an Emergency Department Game

Communicating for change: a systems thinking approach

Outcomes of managing healthcare services using the Theory of Constraints: A systematic review

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