Rationalisation within a healthcare context: Application of the concept Theory of Constraints within a minor healthcare department

Sammanfattning: The demand for healthcare services is currently growing worldwide with an ever increasing pace.Healthcare institutions need to adapt to the changing demographics in order to satisfy the demand. Meanwhile, many hospitals and care units have limited economic means to find appropriate solutions. A concept from the manufacturing industry that is considered to fulfill these criteria’s is called Theory of Constraints (ToC). This concept is focusing on streamlining processes by coordinating the activities and ensuring an efficient stream the production flow. This study has investigated the ability of the concept to support medical and administration staff in the department’s overall objective to decrease overall lead time.The investigation has been realized by conducting a case study at one of the largest emergency hospitals in Stockholm, Sweden. The hospital is one of the leading hospitals within Swedish medicine and receives and treats over 300000 patients annually. The case design consisted of three methods all linked to qualitative data collection, the three methods consisted of interviews, observations and shadowing.The results suggest that the application of ToC revealed little resistance to change among the participants. The concept was able to identify and resolve minor constraints in the case setting; the department of obstetrics and gynecology and also display promising characteristics in terms of solving more complex and intricate constraints. ToC as a concept were able to identify constraints in a healthcare department with a simple yet apparent cause and effect linkage. Finally, the findings indicate that ToC complements the concept of working with Continuous Improvements (CI) within the healthcare.The conclusions from this study have implications both in a theoretical perspective and a practical perspective. The findings provide additional empirical data to a field that is currently dominated by theories. In a practical aspect, the results of this study provides hospitals insights of ToC, a potentially valuable tool to improve efficiency and decrease lead times while working long-term towards an approach with CI.