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examples from health care", Managing Service Quality: An International Journal, Vol. 6 Iss 2 pp. 30-34 http://
dx.doi.org/10.1108/09604529610109738
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Abstract
What is TOC?
The general principles of TOC can be applied to improve
the performance of service organizations. A classified The Theory of Constraints (TOC) is largely
model is proposed for such applications based on the result of the work of Dr Eliyahu M.
Schmenner's classification of service organizations. The Goldratt. TOC is an overall management
flow of ``material'', inventory and throughput is identified philosophy that recognizes constraint on any
at various service organizations of the four quadrants of system restricts the maximum performance
the service matrix. The definition of these terms might be level that the system can obtain in relation to
dependent on the service. Since system constraint is at its goal. For most manufacturing and service
the heart of TOC, the recognition of the nature of organizations the goal of the organization is to
organization constraint is the first step towards contin- make a larger profit now and in the future.
uous improvement. Since the goal is to make a profit, constraints
on manufacturing and service organizations
Electronic access keep the organization from making a higher
The current issue and full text archive of this journal is level of profit.
available at The TOC philosophy could be applied to
http://www.emerald-library.com every day operations decisions as well as to
continuous improvement effort. The TOC
consists of two main branches; logistics (every
day operations) and continuous improvement.
Logistics branch
The logistics branch has three elements,
V-A-T analysis, scheduling process and
performance measures.
V-A-T analysis
Managing Service Quality
Volume 9 . Number 4 . 1999 . pp. 255±264 This is a method to classify plants based on
# MCB University Press . ISSN 0960-4529 the product and the process flow. The ``V''
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Samia Siha Volume 9 . Number 4 . 1999 . 255±264
plant has very few raw materials and many above may not be appropriate for all service
final products. The ``A'' plant has many raw businesses.
materials and a limited number of final The measures T, I, and OE are global
products. The ``T'' plant has many final indicators of system performance. Organiza-
products that are assembled in many different tions should work to increase overall system T
ways from a limited numbers of components while simultaneously reducing I and OE.
and subassemblies. This analysis is very Unfortunately these global measures cannot
important in recognizing the type of pro- be transferred verbatim to individual pro-
blems, issues and concerns associated with cesses for use as local measures of
each type. performance. For example, a non-constraint
work center that increases its output without
Scheduling process
regard to events at downstream work centers
The TOC has a unique method of scheduling
could increase the system's total inventory
process with constraints, called Drum-Buffer-
without increasing the system's output. We
Rope or DBR. To maintain a system at must be cautious that we select local perfor-
maximum performance we must design the mance measures that drive individual
system so that capacity constraints within the processes toward improved global perfor-
system are always operating at peak capacity. mance.
The Drum is the capacity constraint. The
capacity constraint sets the pace for the Continuous improvement branch
system as a drum sets the pace for marching The continuous improvement branch has two
soldiers. elements: effect-cause-effect (ECE) diagrams
Managing Service Quality 1999.9:255-264.
The Buffer isolates the capacity constraint and the five-step focusing process.
from negative effects of the rest of the system.
The Rope ties raw material release to the ECE diagrams
capacity constraint buffer to assure that The process of developing these diagrams
inventory is at the lowest level that will forces managers to think about the true causes
maintain capacity constraint performance at of problems. Utilizing critical thinking and
maximum. Socratic methods, the root cause of a problem
is identified. A plan is developed for elim-
Performance measures inating the root cause rather than treating
We must use measures of performance that symptoms of the problem.
accurately indicate the system's performance This approach answers three questions,
relative to its goal. For manufacturing, three what to change, what to change to, and how
to change.
global measures are suggested by Goldratt
and Cox (1992). The three measures are: Five-step focusing process
(1) Throughput (T): the rate at which the Considering the TOC philosophy, improve-
system generates money through sales. ments in performance can only be achieved by
(2) Inventory (I): all the money invested in focusing on system constraints. This focus is
purchasing things the system intends to achieved by a series of five steps suggested by
sell. Goldratt and Cox (1992). The steps are
(3) Operating Expense (OE): all the money generic in that they can be applied to any
the system spends in turning inventory system, including service businesses. The five
into throughput. steps are:
(1) Identify the system constraint(s). A sys-
Although these measures are different from
tem cannot be maintained at maximum
traditional measures they can be converted to
performance unless we know what con-
more traditional measures with simple math-
strains the system so we can design
ematical operations (Finch and Luebbe
control mechanisms appropriate to the
1995). For example:
constraints.
Net profit = throughput ± operating expense
(2) Exploit the system constraint(s). We
Inventory turns = throughput /inventory
must make the best possible use of the
Productivity = throughput /operating expense
constraints. For example, physical con-
For most service businesses throughput (T) straints within the system must be
and operating expense (OE) are appropriate scheduled to produce the most profitable
measures. However, inventory (I) as defined products.
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Samia Siha Volume 9 . Number 4 . 1999 . 255±264
(3) Subordinate the non-constraint(s). Non- ``pure service'' and at the low contact end is
constraints, by definition; do not limit the ``quasi-manufacturing''.
maximum performance of the system. Silvestro et al. (1992) used information
Decisions affecting constraints must take from their empirical study to develop a
priority over those affecting non-con- service-process matrix (Figure 1). This form
straints. of service-process matrix has the volume of
(4) Elevate the constraint(s). After complet- customers processed on the horizontal axis
ing the above steps, further improvements and the service classification on the vertical
in performance of the system require axis.
changing a constraint. Increasing the Another approach involves translation of a
capacity of a machine that constrains successful classification scheme from manu-
profit is an example of this step. facturing to service. In manufacturing, a
(5) Return to step 1. After a constraint is method for classification is the product-
changed, new system constraints may process matrix (Hayes and Wheelwright,
surface. Return to step 1 to identify new 1984). Analogous to the product-process
matrix in manufacturing is the service process
constraints.
matrix developed by Schmenner (1986)
To apply the full range of TOC principles to (Figure 2). Two key elements are used to
any organization we must apply the five steps classify service delivery processes, labor in-
focusing process, develop proper local and tensity, and customer interaction and service
global performance measures, and design a customization. A two-by-two matrix can be
system for logistical control. TOC principles generated from these two classification cate-
Managing Service Quality 1999.9:255-264.
mance from a system by driving the system of TOC to service. He describes the successful
against its constraints. We should be aware application of the principles of TOC to both
that we might not be able to drive a system the accounting and the production systems at
against all its constraints simultaneously. a donut shop. Goldratt's five-step focused
In the next section we will present the few process was applied to the order entry process
articles that were published on the application in a furniture manufacturing company
of TOC to the service industry. (Spencer and Wathen 1994), the result was a
substantial reduction of shipment time and
improvement in customer services. Green and
Literature review Larrow (1994) report similar ideas where they
applied TOC principles to an accounting firm.
Both academic researchers and practitioners Constraints in some service organizations
have been slow to consider moving TOC from are found to be policies and procedures rather
the factory floor to non-manufacturing en- than physical capacity constraints. Motwani
vironment. The author performs an extensive et al. (1996b) examined the contribution of
literature review, which covers both refereed the TOC to non-profit service organization.
and non-refereed journals. The objective is to They presented a hypothetical implementa-
study and analyze the various applications of tion of the drum-buffer-rope control
TOC techniques to service organizations, and technique to the Red Cross operation in
to develop a classified model for these Florida, USA, following hurricane Andrew.
applications. Few publications were found They also reported actual application in two
(total of 12) and they are summarized below. initiatives at the University of Michigan
Adelman (1991), Green and Larrow Hospital, USA.
(1994), Spencer and Wathen (1994), Motwani and Vogelsang (1996) reported
Motwani, et al. (1996a, b) and Bramorski, et another successful application of the TOC
al. (1997) and Olson (1998) reported some of Principles. A US engineering firm used the
the few attempts in this direction. Adelman five-step focusing process to eliminate bot-
(1991) reported one of the early applications tleneck and to improve the overall
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A model for applying the theory of constraints to service organizations Managing Service Quality
Samia Siha Volume 9 . Number 4 . 1999 . 255±264
dollars. However, time, capacity and budget- neck. The installation process was re-
ary constraints, prevented the company from designed to allow technicians to work in
recovering all their money. teams and perform multi-task in parallel. The
A solution was devised to identify the ticket productivity of the technicians increased, the
errors that allowed the most recovery, given throughput increased and the demand was
that different ticketing errors take various met.
amounts of time to process and have discrete
amount of recovery worth. A Current Reality
Tree was done for the finance department. Service shop
The constraints were identified and the
contribution in dollars per constraint minute The ``Service Shop'' quadrant includes hos-
for each error type was determined. Delta was pitals, auto repair shops, and other repair
able to increase the amount of money services. High degree of interaction and
recovered by applying a solution based on customization and a low degree of labor
dealing with these constraints. intensity characterize the organizations in this
The applications of TOC to airline pro- quadrant. These organizations consider a
blems are endless. Consider, for example, a high mix and variety of services offered as
flight route Chicago-Atlanta-Miami. Bad their competitive advantage. However, these
weather in Atlanta causes delays into and out make the service shop difficult to control.
of Atlanta. If the flight from Chicago is In a medical environment, for example, the
allowed to take off it will increase the length of time it takes to heal a patient is
congestion at Atlanta. Using buffer manage- highly stochastic. Symptoms of a problem
Managing Service Quality 1999.9:255-264.
ment, when the ``inventory'' of flights on the may not lead directly to the actual cause of the
ground at Atlanta increases, the release of problem. A specific symptom may have
``raw material'' is stopped, this would reduce several causes. Several plans for care may
the congestion and the delay that would occur have to be followed until a successful result is
if the flight is allowed to take off as originally obtained. Highly specialized surgery may be
scheduled. required, but a surgeon with the proper skills
may not be immediately available. A heart
` ... In a medical environment, the length of transplant candidate may have to wait a
time it takes to heal a patient is highly significant amount of time for a compatible
stochastic. Symptoms of a problem may heart to become available. The failure of one
not lead directly to the actual cause of body function may cause damage to another
the problem.... ' otherwise good part of the body.
Dependent events where an event A must
be accomplished before an event B can begin
Another example from hospitality industry are common to theses service organizations.
shows how TOC can improve capacity and Patient records and medical history are
resource allocation: A hotel begins to fill to obtained before diagnosis. The nature of a
capacity, management enforces the check-in medical problem is diagnosed before treat-
and checkout times that otherwise are not ment is started.
enforced. Delaying check-in slows raw mate- A specific diagnosis does not necessarily
rial release increasing the buffer of unfilled lead to a specific plan of care. Plans of care are
rooms and expediting checkout also increases probabilistic in that some plans of care are
the buffer. This allows time to clean rooms more probable than others. Patient diagnosis
and replenish room supplies making the room and patient history can lead to different plans
ready for occupancy. of care. An older patient may not be able to
Olson (1998) presented the case of a tolerate an aggressive plan of treatment that
security-system company, which is a typical might be prescribed for a younger patient. A
service factory firm. The company is the young patient may not be able to tolerate
American Security and Alarm Co. and is aggressive treatment because of allergic reac-
located in Lubbock, Texas. They were unable tions to specific medications. Before diagnosis
to satisfy the market demand. The manage- preparation for care can only be probabilistic.
ment revised the installation process as a The interaction of stochastic cure times,
whole, rather than several smaller processes, dependent events and probabilistic care plans
and found the technicians to be the bottle- create a highly volatile and unpredictable
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Samia Siha Volume 9 . Number 4 . 1999 . 255±264
for engine components is likewise highly production labor is part of operating ex-
variable and uncertain. Demand for engine penses. So, moving wages from the cost of
assembly varies from less than five to as many sales to the operating expenses allows the
as nine engines per week. In-house developed company to recognize its true marginal cost,
production and inventory control methods which leads to competitive pricing. This in
similar to Material Requirements Planning
turn could help the company in acquiring
(MRP) systems were used before the appli-
more contracts using competitive bids that
cation of TOC.
NAD applied several features of TOC. reflect actual costs rather than inflated ac-
Goldratt's five focusing steps were used to counting cost. The challenge of properly
identify bottlenecks in flow of materials scheduling workforce, so that capacity and
through the facility. A modified version of production may be increased without adding
Drum-Buffer-Rope (DBR) was used to sche- operating expenses or compromising quality
dule production. A buffer was established can be met by applying the five-step process
prior to the bottleneck to ensure the con- and drum-buffer-rope techniques. Identifying
strained resource was not idle. Buffer
the system constraint, which is typically a
management was used to control the release of
physical one in mass services, is the first step.
raw materials. Local performance measures
The constraint was identified when it was
were replaced with global performance mea-
sures. This was achieved by developing the noticed that another process had excess
causal relationship between individual actions capacity, and components to be processed by
and the common goal. the constraint process were continuously in a
Significant improvement in the perfor- queue. If these components had a shelf life,
mance of Alameda NAD are attributed to quality would also suffer. To exploit the
TOC. After one year of implementation turn constraint, the length of the buffer had to be
around time was reduced by 40 percent and determined and the arrival rate of compo-
WIP was reduced by 50 percent.
nents match the service rate. This required
tying the rope to the constraint process. To
subordinate everything to the constraint
Mass service
process, all duties performed by other pro-
Schmenner describes the service organiza- cesses had to be changed (workforce re-
tions in this quadrant as having relatively high scheduling). To elevate the constraint, it
labor intensity and low degree of customer might require adding an extra capacity.
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A model for applying the theory of constraints to service organizations Managing Service Quality
Samia Siha Volume 9 . Number 4 . 1999 . 255±264
` ... The general principles of TOC can be not exist in single person operations.
applied to improve the performance of
service organizations. Since system
constraint is at the heart of TOC, the Conclusions
recognition of the nature of
organization constraint is the first step The general principles of TOC can be applied
towards continuous improvement... ' to improve the performance of service orga-
nizations. It is important to identify the flow
of ``material'', inventory and throughput at
If an internal resource constraint exists it is various service organizations of the four
the professional, i.e. the doctor, lawyer or quadrants of the service matrix. The defini-
accountant. Therefore Goldratt's five focus- tion of these terms might be dependent on the
ing steps are reduced to exploiting the service. Since system constraint is at the heart
constraint, subordination of other activities to of TOC, the recognition of the nature of
activities of the constraint, elevating the organization constraint is the first step to-
constraint, and repeating the process. Ex- wards continuous improvement (See Table I).
ploiting the constraint might involve, for Constraints are sometimes found to be
example, using a receptionist to gather pa- policies and procedures rather than capacity
perwork and direct the patient to an or equipment. Although the drum-buffer-
examination room, using a nurse to check rope methodology was originated as a control
vital signs and record patient symptoms. technique for the shopfloor, it could be
When the doctor is ready to see the patient transferred to service organizations and used
the activities of the nurse are subordinated to exploit the system constraint and subordi-
and resumed after the doctor is finished. nate the resources to it. Table I summarizes
Several doctors sharing a practice elevate the the application of TOC to the four service
constraint. types in the service matrix. Table II sum-
DBR and buffer management are indeed marizes the TOC unique solutions to various
good tools to be used in this quadrant. The service organizations.
usual method for scheduling is to schedule Although the examples used in the paper
patients at equal time intervals without regard are from US companies, the author believes
to the actual time that might be required. To that the characteristics of the service organi-
keep the doctor working a buffer of patients is zations are universal. So, the TOC
built up in the waiting room. If too many applications could be utilized universally.
262
A model for applying the theory of constraints to service organizations Managing Service Quality
Samia Siha Volume 9 . Number 4 . 1999 . 255±264
. The synergy effect of applying TOC Green, G.C. and Larrow, R. (1994), ``Improving firm
along with TQM or any other quality productivity ± looking in the wrong places'', CPA
Chronical, Summer.
improvement technique.
Guide V., Daniel, R. Jr and Ghiselli, G.A. (1995),
. The various methods of initiating the ``Implementation of drum-buffer-rope at a military
change due to TOC applications. rework depot engine works,'' Production and
Inventory Management Journal, Vol 36 No. 3,
The results of such study should be of tremen-
pp. 79-83.
dous importance to both researchers and Hayes, R.H. and Wheelwright, S.C. (1984), Restoring our
managers. Managers should be able to use this Competitive Edge, John Wiley and Sons, New York.
knowledge to identify what prevents their firm Kingman, O. (1995), ``Applying a PQ type solution to
from achieving their highest objectives and apply problems in the finance department'', North Atlantic
Jonah Upgrade Workshop, September 18-21.
TOC principles to reach their goal. Managers
Motwani, J., Klein, D. and Harowitz, R. (1996a), ``Theory
need to have a new look at the problem and make of constraints in services: part 1 ± the basis''.
``common sense a common practice''. Managing Service Quality, Vol. 6 No. 1, pp. 53-6.
Motwani, J., Klein, D. and Harowitz, R. (1996b), ``Theory
of constraints in services: part 2 ± examples from
health care'', Managing Service Quality, Vol. 6 No. 2,
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