Editor's Desk

By Michael Hughes

Unchain your physicians

If it’s not one thing holding back performance, it’s the other. And optimizing a system involves picking out the right one thing or another to target.

That’s where our old friend the theory of constraints can help. The late Eliyahu M. Goldratt based his philosophy on the belief that even complex systems could be controlled by managing the right leverage point.

In this month’s cover story, “Unconstraining a Doctor’s Office,” James F. Cox III, Dr. Timothy M. Robinson and Wendy Maxwell take us through a case where practitioners applied Goldratt’s philosophy to a small family practice clinic.

Observation revealed that various things stifled the productivity of the clinic’s most profitable assets, its physicians. Sometimes the doctor was ready to see a patient but no patient was ready. In other cases, interruptions took the doctors’ attention away from their patients.

The intervention team tackled the issue in classic TOC style with a series of buffers – the scheduling buffer, the constraint buffer and the physician interruption buffer. The buffers provided the practitioners with information, often visual cues, to improve the system continually and keep patients ready for the physicians. As a result, the clinic’s doctors were able to see more patients in a given time.

Cases like this are why healthcare is becoming more open to collaboration with industrial and systems engineers, and this month’s issue provides a glimpse of that world.

Besides the cover story on Page 28, The Front Line features an interview with a co-author of an Institute of Medicine report that touts systems thinking, along with detailing a new book about the emerging field of health systems engineering. Columnist William “Ike” Eisenhauer discusses how to turn knowledge hoarders into curators. Tools & Technologies examines data analysis software that works well in medical systems, and The Institute previews the Health Systems Process Improvement Conference 2016.

So turn the pages and learn how to unchain your healthcare operations. Your system’s patients will thank you.

Michael Hughes is managing editor of IIE. Reach him at mhughes@iienet.org or (770) 349-1110.