Theory of constraints for publicly funded health systems.
Originally developed in the context of publicly traded for-profit companies, theory of constraints (TOC) improves system performance through leveraging the constraint(s). While the theory seems to be a natural fit for resource-constrained publicly funded health systems, there is a lack of literature addressing the modifications required to adopt TOC and define the goal and performance measures. This paper develops a system dynamics representation of the classical TOC's system-wide goal and performance measures for publicly traded for-profit companies, which forms the basis for developing a similar model for publicly funded health systems. The model is then expanded to include some of the factors that affect system performance, providing a framework to apply TOC's process of ongoing improvement in publicly funded health systems. Future research is required to more accurately define the factors affecting system performance and populate the model with evidence-based estimates for various parameters in order to use the model to guide TOC's process of ongoing improvement.
Center for Research in Healthcare Engineering, Department of Mechanical and Industrial Engineering, University of Toronto, 5 King's College Road, Toronto, Ontario, Canada, M5S 3G8. Somayeh.Sadat@Alumni.Utoronto.Ca
Somayeh
S
Sadat
Michael W
MW
Carter
Brian
B
Golden
D006302:Health Services Research; D006801:Humans; D009937:Organizational Objectives; D011216:Practice Management, Medical / Q000458:organization & administration*; D017064:Process Assessment, Health Care; D017150:Public Sector; D019984:Quality Indicators, Health Care; D019057:Quality-Adjusted Life Years; D017749:Total Quality Management