Toward Integrating Theory of Constraints and Deming into the HCA Curriculum

M. Scott Stegall, MHSA, Ph.D. Mary K. Madsen Ph.D., R.N., FAAMR University of WisconsinMilwaukee
2006 AUPHA Undergraduate Workshop Chicago, IL November 19, 2006

Toward Integrating Theory of Constraints and Deming into the HCA Curriculum

Email for PDF of presentation slides: sstegall@uwm.edu

Overview
Why should HCA programs be interested in Deming and Goldratt? What are SoPK and TOC? What are the key undergraduate education and training goals for SoPK and TOC? How were Deming and Goldratt integrated into the UWM curriculum? What market is there for students so educated? What are the available resources?

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 Institute Conference meetings Academic Jonah Deming Immersion Program

Why should HCA programs be interested in SoPK and TOC?

TOC and SoPK are changing the British National Health System (NHS).
Examples of Change See overheads at:
http://www.healthcare-toc.com/results_files/Page392.htm

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

What are SoPK & TOC?

Deming (SoPK) Transformation
System of Profound Knowledge
Four Parts

Goldratt (TOC)Throughput
Theory of Constraints
Focus on Bottleneck

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

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

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 a process is stable or not and whether it is the bottleneck or not before they are capable of effective management. Handout: TOC within SoPK

What are the key undergraduate education and training goals for SoPK 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

What are the key undergraduate education and training goals for SoPK 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

How were Deming and Goldratt integrated into the UWM curriculum?
Hired faculty member with background and training Course changes:
Add sophomore Leadership course Convert junior Healthcare Process Measurement course to statistical process control, process studies and philosophy of science as well as measurement 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 of the way!

What market is there for students so educated?

GE Medical Direct Supply Graduate schools? Long-term care facilities ?

What are the available resources?

 Websites

Great Britain

Deming

National Health Service NHS Improvement Leaders Guides (see at site below) http://www.wise.nhs.uk/sites/toolandtechniques/ILG/pag es/The%20Guides.aspx www.deming.org http://deming.edu/demingcoop.html www.goldratt.com www.dbrmfg.co.nz

Goldratt

 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 and Managing 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, SPC Press, Knoxville, TN, 1993. Balestracci and Barlow. Quality Improvement: Practical Applications for Medical Group Practice, second edition, Center for Research in Ambulatory Health 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

 Goldratt Textbooks
Goldratt, Eliyahu M. and Jeff Cox. The Goal, third edition, North River Press, Great Barrington, MA, 2004. Goldratt, Eliyahu M. Its Not Luck, North River Press, 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's Theory of Constraints for Healthcare Systems, North River Press, 2006

Textbooks
Integration of Deming & Goldratt
Lepore C. & Cohen, O. Deming and Goldratt: The Theory of Constraints and the System of Profound Knowledge, North River Press, Great Barrington, MA, 1999.

 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 Systems Thinking, S.A. Carlton, Minneapolis, MN, 1980. Keirsey, D. The Sixteen Types (edited from Please Understand Me II), Prometheus Nemesis Book Co., Del Mar, CA, 1998. Myers, Isabel Briggs Introduction to Type: A Guide to Understanding Your Results on the Myers-Briggs Type Indicator, 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.

Faculty Preparation
Jonah Program (TOC)
Two week programcontact Goldratt Institute

Deming Institute Fall Conferences (SoPK)

Beginning four day conference Advanced four day conference

Tapes and Books

See both websites

Practice Important
Get into the field
Service learning Faculty service or consulting

Toward Integrating Theory of Constraints and Deming into the HCA Curriculum

Email for PDF of presentation slides: sstegall@uwm.edu

Toward Integrating Theory of Constraints and Deming into the HCA Curriculum
M. Scott Stegall, MHSA, Ph.D. Mary K. Madsen Ph.D., R.N., FAAMR University of WisconsinMilwaukee
2006 AUPHA Undergraduate Workshop Chicago, IL November 19, 2006