toward integrating toc and deming

7/22/2019 Toward Integrating TOC and Deming

1/23

Toward Integrating Theory ofConstraints and Deming into the HCA

Curriculum

M. Scott Stegall, MHSA, Ph.D.Mary K. Madsen Ph.D., R.N., FAAMRUniversity of WisconsinMilwaukee

2006 AUPHA Undergraduate WorkshopChicago, IL

November 19, 2006


2/23

Toward Integrating Theory of Constraints and

Deming into the HCA Curriculum

Email for PDF of presentation slides:

[email protected]


3/23

Overview

Why should HCA programs be interested inDeming and Goldratt?

What are SoPK and TOC?

What are the key undergraduate educationand training goals for SoPK and TOC?

How were Deming and Goldratt integratedinto the UWM curriculum?

What market is there for students soeducated? What are the available resources?


4/23

My Backgroundnot an expert but Began introducing Deming and Goldratt

to HCA students back in the early 90s

Graduate work in SPC Attend Deming Four Day Seminar

Several presentations at Deming InstituteConference meetings

Academic Jonah

Deming Immersion Program


5/23

Why shou ld HCA pr og ram s beWhy shou ld HCA prog ram s be

in t e rest ed inin t erest ed inSoPKSoPKand TOC?and TOC?

TOC and SoPK are changing the British NationalHealth System (NHS).

Examples of Change

See overheads at: http://www.healthcare-toc.com/results_files/Page392.htm


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If the UK, why not the US?

Applies within a system

Do we have a healthcare system?

Who is trained to do it?

Theory of Constraints in Healthcare 11/06

USA


7/23

What a r eW hat a r eSoPKSoPK& TOC?& TOC?

Deming (SoPK) Transformation

System of Profound Knowledge

Four Parts

Goldratt (TOC)Throughput

Theory of Constraints

Focus on Bottleneck


8/23

Deming (SoPK) System of Profound

Knowledge SoPK as Design Principles

Psychology

Intrinsic vs. extrinsic motivation for coordination Theory of Knowledge

Perception of realitytruth or maps

Variation

Predetermined source vs. investigation of process

Systems

Independent vs. interdependent processes


9/23

Goldratt: Focus on the bottleneck!!! Explicit Questions

What to change?

To what to change? How to cause the change?

Implicit Question

Why change? System is producing undesirable effects UDEs


10/23

Integration of SoPK & TOC

TOC Provides Aim for SoPK

Work on weakest link of chain for bottom line

results

SoPK Provides Culture for TOC

TOC withers without an environment of trust

I tell my students they must know if aprocess is stable or not and whether it is thebottleneck or not before they are capable ofeffective management.

Handout: TOC within SoPK


11/23

Wha t a re t he k ey unde rg radua t eW ha t a re t he k ey unde rg radua t e

educa t ion and t ra in ing g oa ls fo reduca t ion and t ra in ing goa ls fo rSoPKSoPKan d TOC?and TOC?

SoPK

Psychology

Type and temperament

Theory of Knowledge

PDSA cycle, measurement, primer on philosophy of science,concept maps, and knowledge vees

Variation Control Charts

Systems

Process studies & general systems theory


12/23

Wha t a re t he k ey unde rg radua t eW ha t a re t he k ey unde rg radua t e

educa t ion and t ra in ing g oa ls fo reduca t ion and t ra in ing goa ls fo rSoPKSoPKan d TOC?and TOC?

TOC Bottlenecks: physical, policy, paradigm

Focusing Steps

Thinking Process

Logic Trees

Three Ps: Now and in future

profit, people, product/service

Five Focusing Steps

Drum-Buffer-Rope

Layers of Resistance to Change


13/23

How w ere Dem ing and Go ld r at t How w ere Dem ing and Go ld r a t t

i n t eg ra t ed in t o t he UWM cu r r i cu l um ?in t eg ra t ed in t o th e UWM cu r r icu l um ? Hired faculty member with background and training

Course changes: Add sophomore Leadership course

Convert junior Healthcare Process Measurement course to statisticalprocess control, process studies and philosophy of science as well asmeasurement

Convert junior Epidemiology to managerial epi with science focus

Add senior Advanced Systems Thinking

Integrate Deming and Goldratt (Senge for grads and doctoral students) Provides 12 credit hoursin addition we have quality course

Program Director & Department Chair support every step ofthe way!


14/23

Wha t m ar k et is t her e f o r W ha t m ar k et is t her e f o r st u den t s so edu ca t ed?st u den t s so edu ca t ed?

GE Medical

Direct Supply

Graduate schools?

Long-term care facilities ?


15/23

What are t h e avai lab leW hat are t h e avai lab le

resources?resources?


16/23

Websites Great Britain

National Health Service NHS Improvement LeadersGuides (see at site below)

http://www.wise.nhs.uk/sites/toolandtechniques/ILG/pages/The%20Guides.aspx

Deming www.deming.org http://deming.edu/demingcoop.html

Goldratt www.goldratt.com www.dbrmfg.co.nz


17/23

Deming Textbooks Deming, W.E. The New Economics: For Industry, Government, Education,

2nd ed., MIT Press, Cambridge, MA, 1994. Deming, W.E. Out of the Crisis, MIT Press, Cambridge, MA, 1986.

Neave, Henry R. The Deming Dimension, SPC Press, Knoxville, TN, 1990.

Scholtes, P.R. The Leaders Handbook: A Guide to Inspiring Your People andManaging the Daily Workflow, McGraw-Hill, New York, NY, 1998.

Brassard and Ritter. The Memory Jogger II, GOAL/QPC, Methuen, MA, 1994. Melton, Kim. Introduction to Statistics for Process Studies, second edition,

McGraw-Hill, New York, NY, 1993.

Wheeler, D. Understanding Variation: The Key to Managing Chaos, SPCPress, Knoxville, TN, 1993.

Balestracci and Barlow. Quality Improvement: Practical Applications forMedical Group Practice, second edition, Center for Research in AmbulatoryHealth Care Administration, Englewood, CO, 1996.

Wheeler, D. and Chambers, D., Understanding Statistical Process Control,Second Edition, SPC Press, Knoxville, TN

Wheeler, D.,Advanced Topics in Statistical Process Control, SPC Press,

Knoxville, TN


18/23

Goldratt Textbooks Goldratt, Eliyahu M. and Jeff Cox. The Goal,

third edition, North River Press, GreatBarrington, MA, 2004.

Goldratt, Eliyahu M. Its Not Luck, North RiverPress, Great Barrington, MA, 1994.

Scheinkopf, Thinking for a Change: Putting the

TOC Thinking Processes to Use, St. Lucie Press,1999.

Right and King We All Fall Down: Goldratt'sTheory of Constraints for Healthcare Systems,

North River Press, 2006


19/23

Textbooks Integration of Deming & Goldratt

Lepore C. & Cohen, O. Deming and Goldratt: TheTheory of Constraints and the System of ProfoundKnowledge, North River Press, Great Barrington,MA, 1999.


20/23

Misc Textbooks Berens, Linda V. Understanding Yourself and Others: An

Introduction to Temperament, 2nd edition, Telos Publications,Huntington Beach, CA, 2000.

Covey, Stephen R. The 7 Habits of Highly Effective People:Restoring the Character Ethic, Fireside, New York, NY, 1990.

Kauffman, Jr., Draper L. Systems 1: An Introduction to SystemsThinking, S.A. Carlton, Minneapolis, MN, 1980.

Keirsey, D. The Sixteen Types (edited from Please UnderstandMe II), Prometheus Nemesis Book Co., Del Mar, CA, 1998.

Myers, Isabel Briggs Introduction to Type: A Guide toUnderstanding Your Results on the Myers-Briggs TypeIndicator, 6th edition, Consulting Psychologists Press, Palo Alto,

CA, 1998. Senge, P. The Fifth Discipline: The Art and Practice of the

Learning Organization, second edition, Doubleday, New York,NY, 1994.


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Faculty Preparation

Jonah Program (TOC) Two week programcontact Goldratt Institute

Deming Institute Fall Conferences (SoPK)

Beginning four day conferenceAdvanced four day conference

Tapes and Books See both websites

Practice Important Get into the field

Service learning

Faculty service or consulting


22/23

Toward Integrating Theory of Constraints and

Deming into the HCA Curriculum

Email for PDF of presentation slides:

[email protected]


23/23

Toward Integrating Theory ofConstraints and Deming into the

HCA Curriculum

M. Scott Stegall, MHSA, Ph.D.Mary K. Madsen Ph.D., R.N., FAAMRUniversity of WisconsinMilwaukee

2006 AUPHA Undergraduate WorkshopChicago, IL

November 19, 2006

toward integrating toc and deming

Documents