Bacelar-Silva Gustavo M, Cox James F, Rodrigues Pedro
Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine (MEDCIDS-FMUP), University of Porto, Porto, Portugal.
Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.
Health Syst (Basingstoke). 2022 Aug 29;13(1):48-61. doi: 10.1080/20476965.2022.2115408. eCollection 2024.
Lack of timeliness and capacity are seen as fundamental problems that jeopardise healthcare delivery systems everywhere. Many believe the shortage of medical providers is causing this timeliness problem. This action research presents how one doctor implemented the theory of constraints (TOC) to improve the throughput (quantity of patients treated) of his ophthalmology imaging practice by 64% in a few weeks with little to no expense. The five focusing steps (5FS) guided the TOC implementation - which included the drum-buffer-rope scheduling and buffer management - and occurred in a matter of days. The implementation provided significant bottom-line results almost immediately. This article explains each step of the 5FS in general terms followed by specific applications to healthcare services, as well as the detailed use in this action research. Although TOC successfully addressed the practice problems, this implementation was not sustained after the TOC champion left the organisation. However, this drawback provided valuable knowledge. The article provides insightful knowledge to help readers implement TOC in their environments to provide immediate and significant results at little to no expense.
缺乏及时性和能力被视为危及各地医疗保健提供系统的根本问题。许多人认为医疗服务提供者短缺导致了这个及时性问题。这项行动研究展示了一位医生如何运用约束理论(TOC),在几乎没有成本的情况下,在几周内将他的眼科影像业务的吞吐量(治疗患者数量)提高了64%。五个聚焦步骤(5FS)指导了TOC的实施——其中包括鼓-缓冲-绳调度和缓冲管理——并且在几天内就完成了。实施几乎立即带来了显著的底线成果。本文首先从总体上解释了5FS的每个步骤,接着阐述了其在医疗服务中的具体应用,以及在这项行动研究中的详细运用。尽管TOC成功解决了实际问题,但在TOC倡导者离开该组织后,这种实施并没有持续下去。然而,这一缺点提供了宝贵的知识。本文提供了有深刻见解的知识,以帮助读者在他们的环境中实施TOC,从而在几乎没有成本的情况下立即取得显著成果。