An Investigation of Theory of Constraints (TOC) and Related Techniques in Health Care Operations

Purpose: Many management concepts, including Total Quality Management (TQM), Six Sigma, Lean and Theory of Constraints (TOC), have been developed over the years. They have been applied by many different organizations in various industries. The most common area of application of the concepts is manufacturing. There has also been an increase usage of the concepts in the service industry, including education, retail, banking and health care services. TOC has been successfully implemented in manufacturing and in many service oriented companies; however, its application in health care is not as common. This paper will discuss the similarities and differences between TOC, TQM, Six Sigma, and Lean, if any, and also investigate the potential reasons to why TOC is not used as much in health care compare to the other concepts. Design/methodology/approach: Case studies from published literatures provide examples of how each of the management concepts has been utilized in the manufacturing, service industries as well as health care services. From the case studies the paper will look at how TOC is similar to and different from the other management concepts. Face-to-face interviews were also conducted to understand how TOC has been used in health care and to comprehend why TOC has not been used extensively in health care relatively to the other concepts. Findings: From the case studies it was found that the application of each of the management concepts in a manufacturing oriented and a service oriented environment is the same; however, the problems that each of the concepts want to tackle are very different largely due to the nature of the business. TQM, Six Sigma, Lean and TOC share some similarities in that they focus on continuous improvement, customer satisfaction and employee empowerment. What makes TOC slightly different is TOC also focus on the systems capabilities and interdependencies between different processes in the entire system. Possible reasons that TOC is not used extensively are because the health care services are very complex with many variables to consider, especially the demand of services. The complexity of the system makes the implementation of TOC intricate and time consuming which could discourage health care professionals to implement TOC. Originality/value: The paper compares TQM, Six Sigma, Lean and TOC and examines whether TOC is qualitatively different from the other management concepts. It also suggests the reasons why TOC has not been as widely used in health care relatively to the other management concepts despite how simple and useful the concept seems to be