Saturday, February 21, 2015

Theory of Constraints in Healthcare

As I told you in one of my last posts, Bruce Nelson and I have been busy formatting the second edition of Epiphanized which will be published in the next month or two.  This has taken much of my time and I apologize to my loyal readers for being out of touch.

In todays posting I want to let everyone know about a fantastic book I just finished reading.  The title is Pride and Joy and is written by Alex Night.  I was going to write a review myself, but then I looked on Amazon at reviews already written and decided to post several of these because what I wanted to say is encapsulated in these reviews.  I will say, however, that this is one of the best books I have ever read and I'm not limiting that comment to healthcare, which is the subject matter in this book.  Here are several of the reviews from Amazon.

Alex Knight’s “Pride and Joy” is a business novel describing the use of theory of constraints (TOC) in the healthcare arena. “Pride and Joy” has the potential of doing to healthcare what Goldratt’s The Goal did to manufacturing and supply chain. That can only happen if the reader passes the book on and on to others. The story is about a 900 bed failing hospital in the UK. That setting is of no matter as many and much of the descriptions are identical to the US news accounts of the Veteran’s Administration hospitals’ catastrophes. Whether the hospital is for-profit, for-purpose, government, etc. the operations description is the same; chaos reigns 24 X 7. The healthcare environment is comprised of never-ending life-and-death decisions. Put these decisions in a dependent event and statistical fluctuations environment and the decision makers feel like ducks in a shooting gallery. Alex describes the environment and crisis situations where they could take place in the US, UK, Australia, Canada, etc. The problems are universal. Though the hospital environment is very complex the solutions to patient flow and focus are simple and effective. Alex with his two decades of healthcare experience has provided a silver bullet for each of the different flows in a major hospital. These solutions are described in detail in the form of a novel. Alex describes the unpredictability of emergency department demand and how to manage it effectively. He also describes how to use an assessment unit to buffer the flow to various wards in a hospital. He then describes how to plan, schedule and control out patient care. Each of these environments represents a distinct patient flow BUT each flow uses common resources of the hospital and healthcare supply chain. Each patient is unique. The situation is complex and impossible to many BUT as anyone in TOC knows the more complex the situation the simpler the solution. Alex proves this to be correct. Once you read each solution; your response should be: That’s brilliant! You end up making this statement a number of times throughout the book. The story is very interesting and if one is knowledgeable in theory of constraints, he or she would realize that Alex has developed some unique solutions to manage the patient streams. This novel should be required reading for everyone in healthcare. It provides instructions on how to get more patients through the hospital quicker with higher quality and less resources (without exhausting them) and bring pride and joy to all healthcare stakeholders involved. In my opinion, this book may provide the solution to implementing universal healthcare without bankrupting the country for the US.

3 of 3 people found the following review helpful
By Gerald I. Kendall on July 3, 2014
This is the best book on hospital administration and patient care I've ever read. The cost-centric approach to running hospitals has led to one disaster after another. Everyone working on the front lines of a hospital knows it. But until the conflict between cost reduction and patient care was clearly explained in Alex Knight's book, there seemed to be no way out. Knight painstakingly shows how a focus on patient flow reduces the time it takes to see and treat patients in a hospital, and consequently increases hospital revenues. Based on real life experiences in multiple countries, Pride and Joy is a must read for anyone involved in any aspect of delivering patient care in a hospital environment.
The combination of challenges of managing hospitals, surgeries, multiple practitioner specialties, scheduling dilemmas and patient behaviors make for a very complex system. What Knight proves in this book is that, inside this very complex system, there exists inherent simplicity. The book enables a much better understanding of how current methods of scheduling both diagnostics and surgery lead to poor use of all the resources in the system. The crises of daily bed management only compound the administration nightmare.

About a decade ago, I heard a presentation from one of the hospital administrators who had applied the system's approach explained in Pride and Joy. I was astounded at how much change could be accomplished within a few months, how a hospital could move from less than 70% of patients meeting target discharge dates to almost 100%, without adding staff and without additional overtime or "working harder".

This book is a prescription for the healthy administration of any hospital, anywhere in the world. It is a great achievement to see science applied not just to medicine, but to management!
 
I read Pride & Joy with high expectations. First, experience has shown me that the best system and powerful principles to make improvements in any organization are coming from TOC - Theory of Constraints. Second, I had the fortune of working along side Dr. Goldratt for some years and finally, and I have seen what Alex Knight is capable of doing when in the lead. The approach taken and presented in the book, provides clarity. This to me is the foremost the key important contribution of Alex's work. He has delivered and entertaining story with explanations that are solidly linked to reality. It is not only in countries of socialized medicine systems or hybrid approaches to the healthcare problem that are suffering the effects of raising costs and the deterioration of efficacy, effectiveness and at the end productivity of the service. The better our expectation of life, the worse the probability that we will have to deal with a catastrophic event, that will be poorly tended to by our health systems. The problems of flow and patients, with the problems of synchronizing capacity of the hospitals, services, specialties, all hinge in the understanding of how to ensure that problems are diagnosed quickly and rightly, then that the assignment of patients to the right treatment in the right timing with the proper care. Understanding that the system in a Hospital and beyond in a Health Care system, is just that, a system...where the things that determine the success and the flow is the realization that what drives the system are not only the actions, but the interactions.

My most favorite counter intuitive solution described is when the KEY most expert resources, the most experienced doctors are assigned in the front lines to ensure the proper diagnosis is made. When you complement this process with managing the capacity of the operating theaters, the synchronization with the test labs and the supporting staff, the outcome is productivity...More patients correctly treated well, released faster.

I hope Alex's book provide a vehicle to open the minds of the people that must then to this system before is too late. A new refreshing look at what is possible is needed, and this is provided when one looks at the Health Services Industry as a system.

5.0 out of 5 stars Great healthcare management book if you're tired of the status quo, September 11, 2014


This review is from: Pride and Joy (Paperback)

I thought this was a great book that provided a fresh look at healthcare administration. I'm a clinic manager of multiple primary and urgent care clinics, and I constantly hear how "we need more staff," and "we're too busy". This is true because we continue to rely on common practice rather than thinking about common sense methods of improvement.

This book gives a great refresher on some very important management, production, and flow principles taught in "The Goal," which you should also read, but Pride and Joy is geared towards multiple different healthcare environments, including the Emergency Department, inpatient floors, and outpatient clinics. This book gave me a great start on how to think about implementing some basic principles to improve the flow through my clinics, with the goal of bringing "pride and joy" back to the healthcare workplace.

I am already implementing a buffer system in my urgent care clinics to ensure there are always patients ready for the doctors to see, and am working towards identifying which resources are causing the most delay to patient flow most frequently, using techniques illustrated in this book. Our patient volumes have recently gone up significantly, but thanks to our initial efforts based on principles from this book, we have maintained our flow and patient satisfaction continues to rise.

If you're a healthcare worker and are tired of cutting costs, layoffs, and everything else that makes you pull your hair out, you'll definitely enjoy this book.

Bob Sproull

Wednesday, February 11, 2015

An announcement on Epiphanized.....

I hope everyone who received their free copy of Epiphanized - Integrating Theory of Constraints, Lean and Six Sigma are enjoying the book.  Today is the final day for the free e-book, but stay tuned over the next several months as the 2nd edition and the sequel will both be released by our new publisher, Taylor and Francis.  The second edition has been updated with new tools and a separate appendix dedicated to system thinking.  The sequel looks at two different industries, MRO and Healthcare.  Thanks everyone for your interest in Epiphanized.

Bob Sproull

Saturday, February 7, 2015

Blog Posting Index to Part 408


Post #                    Subject Discussed

Each of the following postings can be reached by searching for the number designation below.  For example:  1 is Focus and Leverage or 2 is Focus and Leverage Part 2 and so forth.  The link to the first blog posting is: 


 

1. Introduction to TOC – Lean – Six Sigma

2. Why Improvement Initiatives Fail

3. The Basic Concepts of TOC

4. Throughput Accounting

5. The Process of On-Going Improvement (POOGI)

6. The 3 Cycles of Improvement

7. Combining TOC, Lean and Six Sigma Graphically

8. Step 1a Performance Metrics

9. Planning Steps 1b and 1c Reducing Waste and Variation

10. Developing a Constraint’s Improvement Plan

11. This number was skipped

12. Steps 1b and 1c Reducing Waste and Variation plus an intro to DBR

13. Drum-Buffer-Rope

14. The Final Steps of UIC

15. How do I start the UIC?

16. The 10 Prerequisite Beliefs

17. Comparing Lean, Six Sigma and TOC

18. Types of Constraints

19. The Logical Thinking Processes

20. Undesirable Effects (UDE’s)

21. Categories of Legitimate Reservation

22. Current Reality Trees

23. Constructing Current Reality Trees

24. Conflict Diagrams Basic Principles

25. Constructing Conflict Diagrams

26. Intro to Future Reality Trees

27. Constructing Future Reality Trees

28. Prerequisite Trees

29. Constructing Prerequisite Trees

30. Transition Trees

31. Constructing Transition Trees

32. Book Announcement

33. Project Management Failures

34. Project Management Negative Behaviors

35. Critical Path Management (CPM)

36. Critical Chain Project Management (CCPM)

37. Tracking Projects In CCPM

38. Final Posting on CCPM

39. Intro to the TOC Parts Replenishment Model versus the Min/Max System

40. The TOC Parts Replenishment Model

41. Interview with Joe Dager from Business901

42. Deming, Ohno and Goldratt Commonality

43. Dedication to Dr. Eliyahu Goldratt

44. How processing time, cycle time, throughput and WIP are interrelated

45. Little’s Law

46. Batch and queue production system and the fallacy of a balanced line

47. Why an unbalanced line is better.

48. What prevents me from making more money now and more money in the future?

49. More on the 10 Prerequisite Beliefs

50. Motivating a work force to actively participate in improvement initiatives

51. Re-Introducing the Intermediate Objectives Map

52. Introducing Be Fast or Be Gone: Racing the Clock with CCPM

53. Parkinson’s Law, The Student Syndrome, Cherry Picking and Multi-Tasking

54. Overcoming the four negative behaviors in Project Management

55. Intro to combining the Interference Diagram (ID) and the IO Map

56. The Simplified Strategy

57. The Interference Diagram

58. Interference Diagram for Strategy

59. The ID/IO Simplified Strategy

60. Preface Part 1 for Epiphanized©

61. Preface Part 2 for Epiphanized©

62. CHAPTER 1 Part 1 for Epiphanized©

63. CHAPTER 1 Parts 2 and 3 for Epiphanized©

64. CHAPTER 1 Part 4 for Epiphanized©

65. CHAPTER 1 Part 5 for Epiphanized©

66. Focused Operations Management For Health Service Organizations by Boaz Ronen, Joseph Pliskin and Shimeon Pass

67. Marketplace Constraints

68. A Discussion on Variability

69. More Discussion on Variability

70. Still More Discussion on Variability

71. Paper from the International Journal of Integrated Care

72. Value Stream Mapping

73. Paths of Variation

74. Step 3, Subordination

75. The Key to Profitability: Making Money Versus Saving Money

76. My First Experience With TOC

77. TOC in Non-Manufacturing Environments

78. Deborah Smith’s Excellent Chapter in the TOC Handbook (i.e. Chapter 14)

79. More on Performance Metrics

80. Efficiency, Productivity, and Utilization (EPU) ©

81. Productivity as a Performance Metric

82. Utilization as a Performance Metric

83. What the Dog Saw –Malcolm Gladwell

84. Speaking at the CPI Symposium – Cal State, Northridge

85. NOVACES– A Great Young Company

86. NOVACES’SystemCPI©

87. Problems With My Publisher

88. The Why? – Why? Diagram

89. Experience With the Integrated Methodology

90. A New Piping Diagram

91. The Healthcare Industry

92. More Bad News From the Publisher

93. A Message from the CPI Symposium

94. Multiple Drum-Buffer-Rope

95. Problem Solving Roadmap

96. Problem Prevention Roadmap

97. Improving Profitability

98. More on Throughput Accounting

99. More on Parts Replenishment

100. TLS

101. Engaging the "Money Makers" in Your Company

102. A Conversation on the Theory of Constraints

103. The Key to Successful Consulting Engagements

104. The Three Basic Questions to Answer

105. A Problem With the Airlines

106. A Better Way to Improve Processes and Systems

107. The Problem With Project Management

108. Critical Path Project Management Revisited

109. Critical Chain Project Management Revisited

110. The Fever Chart

111. Comparing CPM and CCPM

112. Performance Improvement for Healthcare – Leading Change with Lean, Six Sigma and Constraints Management

113. More on Performance Improvement for Healthcare

114. Even more on Performance Improvement for Healthcare

115. Still One More on Performance Improvement for Healthcare

116. The Final One on Performance Improvement for Healthcare

117. The Real Final One on Performance Improvement for Healthcare

118. Focused Operation's Management for Health Services Organizations.

119. Focused Management Methodology

120. The Clogged Drain

121. The “Soft” Tools of Improvement

122. More on TOC’s Distribution/Replenishment solution

123. Still More on TOC’s Distribution/Replenishment solution

124. Amir Schragenheim’s Chapter 11 entry in the TOC Handbook

125. Comparison of Lean, Six Sigma and TOC

126. A Simple Lesson on Applying TLS to Your Processes

127. A Historical Index of Blog Postings

128. Mafia Offer Part 1

129. Mafia Offer Part 2

130. Mafia Offer Part 3

131. Airline Problems

132. A YouTube Interview with Bob Sproull and Mike Hannan

133. Active Listening

134. Viable Vision

135. Throughput Accounting

136.  Performance Metrics

137.  On-the-Line Charting

138.  Comment on Epiphanized from a reader in the US Marines

139.  Active Listening

140.  Healthcare Case Study

141.  Change

142.  Getting buy-in for Change

143.  Aviation Maintenance, Repair and Overhaul Client Part 1

144.  Aviation Maintenance, Repair and Overhaul Client Part 2

145.  Continuous Improvement in Healthcare

146.  Using Your Senses in Continuous Improvement

147.  A Video by Phillip Marris on CI

148.  An article about a Construction Company Using the TOC Thinking Processes

149.  Using TOC in Healthcare Part 1

150.  Using TOC in Healthcare Part 2

151.  Using TOC in Healthcare Part 3 Supply Replenishment

152.  Using TOC in Healthcare Part 4 Supply Replenishment (con’t)

153.  Using TOC in Healthcare Part 5 Supply Replenishment (final)

154.  The Sock Maker

155.  The Negative Effects of Using Efficiency

156.  Cost Accounting Part 1

157.  A Political Voting Story

158.  Cost Accounting Part 2

159.  Cost Accounting Part 3

160.  Using TLS for the Affordable Care Act

161.  The System Constraint in Hospitals Part 1

162.  Wait Times in Hospitals

163.  The Oncology Clinic Case Study Part 1

164.  The Oncology Clinic Case Study Part 2

165.  Article: Emergency Department Throughput, Crowding, and Financial Outcomes for Hospitals

166.  Goldratt’s 5 Focusing Steps in Healthcare

167.  My First Experience With TOC Part 1

168.  My First Experience With TOC Part 2

169.  My First Experience With TOC Part 3

170.  My First Experience With TOC Part 4

171.  My First Experience With TOC Part 5

172.  My First Experience With TOC Part 6

173.  Healthcare Case Study Part 1

174.  Healthcare Case Study Part 2

175.  Healthcare Case Study Part 3

176.  TOC in Healthcare

177.  Healthcare Case Study Part 4

178.  My Transition From Aviation Maintenance to Healthcare

179.  Door to Doc Time Case Study Part 1

180.  Door to Doc Time Case Study Part 2

181.  Door to Doc Time Case Study Part 3

182.  Door to Doc Time Case Study Part 4

183.  My White Paper in Quality Forum Part 1

184.  My White Paper in Quality Forum Part 2

185.  My White Paper in Quality Forum Part 3

186.  A Meeting on Epiphanized at the Pittsburgh Airport

187.  Billing for Immunizations Case Study Part 1

188.  Some Thoughts on Performance Improvement Part 1

189.  Some Thoughts on Performance Improvement Part 2

190.  Case Study on Using TOC in Healthcare

191.  IO Map

192.  TOC Thinking Process Tools Part 1

192B.  TOC Thinking Process Tools Part 2

193.  Case Study on How to Use TOC’s Thinking Processes Part 1

194.  Case Study on How to Use TOC’s Thinking Processes Part 2

195.  Case Study on How to Use TOC’s Thinking Processes Part 3

196.  Synchronized and Non-synchronized Production

197.  Competitive Edge Factors

198.  Case Study on How to Use TOC’s Thinking Processes Part 4

199.  Case Study on How to Use TOC’s Thinking Processes Part 5

200.  Case Study on How to Use TOC’s Thinking Processes Part 6

201.  Case Study on How to Use TOC’s Thinking Processes Part 7

202.  Case Study on How to Use TOC’s Thinking Processes Part 8

203.  Case Study on How to Use TOC’s Thinking Processes Part 9

204.  Case Study on How to Use TOC’s Thinking Processes Part 10

205.  Case Study on How to Use TOC’s Thinking Processes Part 11

206.  Case Study on How to Use TOC’s Thinking Processes Part 12

207.  Case Study on How to Use TOC’s Thinking Processes Part 13

208.  Case Study on How to Use TOC’s Thinking Processes Part 14

209.  Case Study on How to Use TOC’s Thinking Processes Part 15

210.  Case Study on How to Use TOC’s Thinking Processes Part 16

211.  The IO Map Revisited Part 1

212.  The IO Map Revisited Part 2

213.  The IO Map Revisited Part 3

214.  The IO Map Revisited Part 4

215.  An Interview About The Ultimate Improvement Cycle by Joe Dager

216.  Healthcare Case Study:  Door to Balloon Time Part 1

217.  More On My First Experience With TOC Part 1

218.  More On My First Experience With TOC Part 2

219.  More On My First Experience With TOC Part 3

220.  More On My First Experience With TOC Part 3

221.  More On My First Experience With TOC Part 4

222.  A Discussion on Constraints Management Part 1

223.  A Discussion on Constraints Management Part 2

224.  A Discussion on Constraints Management Part 3

225.  A Discussion on Constraints Management Part 4

226.  A Discussion on Constraints Management Part 6

227.  How I Present TOC Basics to Students & Teams Part 1 (Most viewed of all posts)

228.  How I Present TOC Basics to Students & Teams Part 2

229.  YouTube Video on Improving Flow Through a Bottleneck

230.  YouTube Video on Throughput Accounting

231.  YouTube Video on What to Change

232.  YouTube Video on What to Change To

233.  YouTube Video on How to Cause the Change to Happen

234.  A Meeting With an Executive of a Larger Corporation

235.  The Missing Link

236.  You Tube Video by Goldratt on Henry Ford and Taichi Ohno

237.  Prevention Versus Detection – The Bug Guy

238.  An Article by Anna Gorman of the LA Times

239.  TOC’s Solution to Supply Chain Problems

240.  The Nun and the Bureaucrat Part 1

241.  The Nun and the Bureaucrat Part 2

242.  The Nun and the Bureaucrat Part 3

243.  The Nun and the Bureaucrat Part 4

244.  The Nun and the Bureaucrat Part 5

245.  The Nun and the Bureaucrat Part 6

246.  A Healthcare Clinic Case Study Part 1

246B.  An Update to Focus and Leverage Part 246

247,  Drum Buffer Rope in Manufacturing

248.  The Sock Maker Revisited Part 1

249.  The Sock Maker Revisited Part 2

250.  Throughput Accounting Part 1

251.  Throughput Accounting Part 2

252.  Throughput Accounting Part 3

253.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 1

254.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 2

255.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 3

256.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 4

257.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 5

258.  Critical Path Project Management Versus Critical Chain PM Part 1

259.  Critical Path Project Management Versus Critical Chain PM Part 2

260.  Critical Path Project Management Versus Critical Chain PM Part 3

261.  Critical Path Project Management Versus Critical Chain PM Part 4

262.  Critical Path Project Management Versus Critical Chain PM Part 5

263.  Critical Path Project Management Versus Critical Chain PM Part 6

264.  The Cabinet Maker – A TOC Case Study Part 1

265.  The Cabinet Maker – A TOC Case Study Part 2

266.  The Cabinet Maker – A TOC Case Study Part 3

267.  The Cabinet Maker – A TOC Case Study Part 4

268.  How I Run Improvement Events

269.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 1

270.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 2

271.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 3

272.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 4

273.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 5

274.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 6

275.  An Analysis of Focus and Leverage’s Top Page View Postings

276.  An Index of All Focus and Leverage Blog Posts

277.  Using the Thinking Processes in Healthcare Part 1

278.  Using the Thinking Processes in Healthcare Part 2

279.  Using the Thinking Processes in Healthcare Part 3

280.  The Four Disciplines of Execution Part 1

281.  The Four Disciplines of Execution Part 2

282.  The Four Disciplines of Execution Part 3

283.  The Four Disciplines of Execution Part 4

284.  The Four Disciplines of Execution Part 5

285.  The Goal Tree – A New Way to Make it and Use It Part 1

286.  The Goal Tree – A New Way to Make it and Use It Part 2

287.  The Goal Tree – A New Way to Make it and Use It Part 3

288.  Operation Excellence by Jim Covington

289.  The Saw Mill Assessment

290.  How I present the Theory of Constraints to People Not Familiar With it

291.  David and Goliath – Malcolm Gladwell’s Latest Book

292.  The Basics of TOC

293.  TOC’s Replenishment Model Part 1

294.  TOC’s Replenishment Model Part 2

295.  Blog Posting Index

296.  Overcoming Natural Resistance to Change

297.  Integrating TOC, Lean and Six Sigma Part 1

298.  Appendix 1 from Epiphanized Part 1

299.  The Winter Storm in Atlanta

300.  Appendix 1 from Epiphanized Part 2

301.  Appendix 1 from Epiphanized Part 3

302.  Appendix 1 from Epiphanized Part 4 Final

303.  Bill Dettmer videos on TOC’s Thinking Processes

304.  Queuing Theory Part 1

305.  Queuing Theory Part 2

306.  Delta Airlines Lack of Customer Focus

307.  Bill Dettmer’s Book Strategic Navigation

308.  Excerpts from The Ultimate Improvement Cycle – My second book Part 1

309.  Excerpts from The Ultimate Improvement Cycle – My second book Part 2

310.  Excerpts from The Ultimate Improvement Cycle – My second book Part 3

311.  Excerpts from The Ultimate Improvement Cycle – My second book Part 4

312.  Excerpts from The Ultimate Improvement Cycle – My second book Part 5

313.  The Ultimate Improvement Cycle – Step 1:  Identify - My second book Part 6

314.  The Ultimate Improvement Cycle – Step 2:  Define, Measure and Analyze - My second book Part 7

315.  The Ultimate Improvement Cycle – Step 3:  Improve - My second book Part 8

316.  The Ultimate Improvement Cycle – Step 3:  Control - My second book Part 9

317.  Throughput Accounting Part 1

318.  Throughput Accounting Part 2

319.  Throughput Accounting Part 3

320.  Throughput Accounting Part 4

321.  Throughput Accounting Part 5

322.  Throughput Accounting Part 6

323.  Throughput Accounting Part 7 Final

324.  Optimium Health’s Amazing New Software for Healthcare

325.  Personal experiences using Throughput Accounting

326.  MRO Project Management Case Study Part 1

327.  MRO Project Management Case Study Part 2

328.  MRO Project Management Case Study Part 3

329.  MRO Project Management Case Study Part 4

330.  MRO Project Management Case Study Part 5

331.  MRO Project Management Case Study Part 6

332.  MRO Project Management Case Study Part 7 (Finale)

333.  Part’s Replenishment Systems Part 1

334.  Part’s Replenishment Systems Part 2

335.  Part’s Replenishment Systems Part 3

336.  Part’s Replenishment Systems Part 4

337.  Part’s Replenishment Systems Part 5

338.  Part’s Replenishment Systems Part 6 (Finale)

339.  My Most Rewarding Experience

340.  Operation Excellence by Jim Covington

341.  Epiphanized sequel update

342.  The intent of Focus and Leverage Part 1

343.  The intent of Focus and Leverage Part 2

344.  The intent of Focus and Leverage Part 3

345.  The intent of Focus and Leverage Part 4

346.  The intent of Focus and Leverage Part 5

347.  My Most Profound Learning

348.  An update to our sequel to Epiphanized

349.  TOC and the VA Problem

350.  Reasons for Failing Improvement Initiatives

351.  Appendix 1 from Epiphanized Part 1

352.  Appendix 1 from Epiphanized Part 2

353.  Appendix 1 from Epiphanized Part 3

354.  Link to a presentation on TLS

355.  Article on 91 Hospitals laying-off Employees

356.  How Cost Accounting is Hurting Hospitals

357.  Improvement Approach for Healthcare

358.  Being a Satisficer Versus an Optimizer

359.  Healthcare Case Study – Door to Doc Time

360.  Presentation by Henry Camp

361.  Healthcare Case Study – Waiting Time to be Admitted

362.  Using the True Subject Matter Experts for Improvement

363.  Problems at WaterSaver

364.  Systems Thinking Part 1

365.  Systems Thinking Part 2

366.  Systems Thinking Part 3

367.  Systems Thinking Part 4

368.  A Great Quote

369.  A New Book on Project Management

370.  Inside the New Book on Project Management

371.  My Version of TLS

372.  TLS Part 2

373.  TLS Part 3

374.  Cost Accounting Versus Throughput Accounting Part 1

375.  Cost Accounting Versus Throughput Accounting Part 2

376.  Cost Accounting Versus Throughput Accounting Part 3

377.  Why I use the Piping Diagram Versus Chain Analogy for TOC

378.  Cost Accounting Versus Throughput Accounting Part 4

379.  Cost Accounting Versus Throughput Accounting Part 5

380.  Cost Accounting Versus Throughput Accounting Part 6

381.  Demand Driven Performance Part 1

382.  Demand Driven Performance Part 2

383.  Demand Driven Performance Part 3

384.  Demand Driven Performance Part 4

385.  Demand Driven Performance Part 5

386.  Demand Driven Performance Part 6

387.  Demand Driven Performance Part 7

388.  Demand Driven Performance Part 8

389.  Drum Buffer Rope

390.  Starting the Ultimate Improvement Cycle Part 1

391.  Starting the Ultimate Improvement Cycle Part 2

392.  Starting the Ultimate Improvement Cycle Part 3

393.  An article on TLS

394.  Defining Improvement and its impact

395.  Corrected Improvement and its impact

396.  Preface from The Ultimate Improvement Cycle

397.  Throughput Accounting

398.  Breaking Constraints

399.  DDMRP Case Study Part 1

400.  DDMRP Case Study Part 2

401.  TOC e-books

402.  DDMRP revisited – A Conflict

403.  5 Primary Components of DDMRP

404.  DDMRP A Discussion about Inventory

405.  5 Primary Components necessary to remove the Undesirable MRP Conflict Symptoms and Compromises

406.  Carol Ptak Video of the Demand Driven Institute at the SAPICS International Conference and Exposition

407.  Mark Woeppel’s e-book on Project Management

408.  Mike Hannan’s Post on Project Management

Bob Sproull

Clarke Ching's Interview With Eli Goldratt

In today's posting I want to share a link to a wonderful interview of Eli Goldratt by Clarke Ching.  It's very insightful and is all about Dr. Goldratt's book, Isn't It Obvious.  Clarke Ching always finds a way to get people to talk candidly and this interview is just that....a candid discussion with Dr. Goldratt.  Well done Clarke!!

Bob Sproull

http://www.clarkeching.com/eli-goldratt-interview/

Wednesday, February 4, 2015

Jonah Training Announcement

In my posting today I want to inform everyone about a training session in Dallas, Tx  in March.  I have received quite a few emails asking me when the next session might be and here's your opportunity.

Learning and using the Theory of Constraints thinking processes will forever change the way you look at problems, conflicts, and solutions, significantly improving your personal effectiveness.

Jonah Thinking Process Workshop:
Learn How To Construct Robust Solutions by Zeroing in on Core Issues



About the Workshop

Using the Theory of Constraints thinking processes is sometimes described as "Seeing what others cannot."  They shutterstock_133714319unleash your intuitive powers to identify the hidden assumptions and connections that others, who have not been taught these tools, cannot see.  In short, you will develop extraordinary insight.  This insight is invaluable for problem solving; sorting the wheat from the chaff.  Who hasn't felt overwhelmed when presented with a complex problem with the accompanying avalanche of data?  The Theory of Constraints thinking processes will help you zero in on the core issues, every time.
Having insight to a problem is useless without a solution, so the tools also help you identify the necessary elements to construct a robust solution, anticipating potential problems and solving them before they occur.
Learning and using the Theory of Constraints thinking processes will forever change the way you look at problems, conflicts, and solutions, significantly improving your personal effectiveness.

Workshop Details

About the Workshop

Using the Theory of Constraints thinking processes is sometimes described as "Seeing what others cannot."  They shutterstock_133714319unleash your intuitive powers to identify the hidden assumptions and connections that others, who have not been taught these tools, cannot see.  In short, you will develop extraordinary insight.  This insight is invaluable for problem solving; sorting the wheat from the chaff.  Who hasn't felt overwhelmed when presented with a complex problem with the accompanying avalanche of data?  The Theory of Constraints thinking processes will help you zero in on the core issues, every time.
Having insight to a problem is useless without a solution, so the tools also help you identify the necessary elements to construct a robust solution, anticipating potential problems and solving them before they occur.

Learning and using the Theory of Constraints thinking processes will forever change the way you look at problems, conflicts, and solutions, significantly improving your personal effectiveness.

After completion of this workshop, you will be an official "Jonah", recognized by the TOCICO
Date and Time: The workshop will be two weeks long on the dates of March 9-13 and March 16-19
Location: Dallas, TX
Cost: $8,500
 
 
Here is the link to the landing page for the Dallas event Jonah Thinking Process Workshop: http://info.pinnacle-strategies.com/jonah-thinking-process-workshop-learn-how-to-construct-robust-solutions-by-zeroing-in-on-core-issues-dallas

Bob Sproull