2012 has been an interesting
year for me. I have made the transition
from primarily serving the Aviation Maintenance industry to the healthcare
field and I must say I’m very happy I made the shift. That’s not to say that I didn’t enjoy the aviation
work because I totally did. In fact,
given the opportunity I would go back and help companies maintain military
vehicles especially those working within the Department of Defense. It’s clear to me that all governmental departments
in this country and many others need to change their focus to learn how to do
much more with much less. As the
politicians haggle over spending cuts and tax increases, most don’t understand
how to identify and focus on the right areas.
My blog is called focus and leverage for a reason. It doesn’t matter whether we’re talking about
a manufacturing company, a hospital or a governmental agency. There is a constraint that is limiting their overall performance and unless
and until it is identified improvement efforts will simply not be as good as it
could or should be. I’ve been fortunate
enough in my career to work in a variety of industries and they all share the
common need to identify the system constraint, exploit it and then subordinate
everything else to it. In a manufacturing
system or hospital or governmental agency or any other industry it’s all about
optimizing flow. Enhancing the flow or
throughput of products, patients or maintained military vehicles all boils down
to locating the constraint and ultimately breaking it.
If you’ve ever been in a
hospital emergency room or have had to wait for your turn to have a surgical
procedure or even received outpatient treatment, you have no doubt experienced an
inordinate amount of delays. In all
three cases, there is a single point in all of these processes that causes
these wait times. If the hospital wants
to reduce these delays, and they all will once the Affordable Care Act is
totally implemented, then the only way to do so is to identify that part of the
process that causes the delays (i.e. the constraint). Once it’s identified, it must be exploited by
eliminating (or reducing) the non-value-added waste that most certainly
exists. Attempting to eliminate waste in
a non-constraint is, in my opinion, wasted effort. Yes your efforts will reduce waste, but it
won’t reduce the flow time or improve the rate at which patients flow through the
hospital processes. In like manner, if
you’re trying to improve the number of say, aircraft through a maintenance
process, you must find the reason why you’re falling short of the number
required. And like hospital processes,
attempting to improve a non-constraint processing steps won’t help you improve
throughput.
In many, many cases (as high
as 90%) the constraint is not a physical process step at all that is causing
the process to be slower than it should be, but rather an existing policy or other
requirement in place. It might be
something as simple as an approval requirement that must be completed prior to
work being initiated. Sometimes in a
union environment it could be a job classification that prevents you from
performing a simple task. The key to
breaking a policy constraint is to use logic and common sense to eliminate the
impediment to improved flow. By that I
mean by simply understanding the policy in common sense terms an alternative
procedure can be put in place. There are
tools within the Theory of Constraints toolkit that are designed to break these
types of conflicts. The most popular of
these is the Conflict Resolution Diagram or Conflict Cloud or Evaporating Cloud
as it is known. The key to using these
tools is to clearly identify and define the conflict, surface the assumptions
behind the conflict and then develop injections that break the conflict.
In the coming weeks I’ll
report on the tools of TOC that will help everyone improve the flow of
processes. Since I have transitioned to healthcare,
much of what I’ll report on will be from the healthcare industry. Happy New Year everyone!!!
Bob Sproull
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