Theory of Constraints focuses on processes as they are rings of the same chain instead of thinking they are independent from each other. At the same time, theory focuses on the weakest points which are “bottlenecks” for the entire company and try to determine the relationship of these bottlenecks. (Şimşita, Günayb & Vayvayc, 2014). Bottleneck is any kind of situation that impedes the system to reach high performance level in terms of its purposes (Goldratt, 1990).
De-bottleneck is to remove what Goldratt calls an “impediment to the system”; this can be done by determining the bottleneck, exploiting it, making its resolution primary in next actions, evaluation of the impediment to confirm its removal and a high performance has been reached. If de-bottleneck has been successful, management can move on to the next bottleneck(s), if not then rinse and repeat the cycle.
De-bottlenecking is a essentially a process/system improvement method.
This method helps to unclog points in system(s) where delay affects output, that is Quality of service.
With 812 Walk-In Clinics and 471 Urgent care Centers in State of over 38million inhabitants (“California Urgent Care”, n.d.) it is clear California is under served and Care Professional to Individual/Potential Patient ratio is very wide, the gap keeps widening due to climate and other local attractions, still the competition is there amongst these relative few who are only able to serve a portion of the population anyways.
If i were the manager of any urgent care, my focus would be “highest quality” at the “fastest possible turn around time”. The A.F.C. has tried to recognize and tap into this, it reflects in their slogan of “The Right Care, Right Now” (“American Family Care”, n.d.): but if the experience in one of their 8 locations is anything to go by, they are yet to achieve that.
If I were the manager in one of their outlets I visited, my first point of call will be to decongest the reception area by employing two more people to man the desks and attend to patients who end up waiting for a while because the receptionist had to joggle between customers’ calls, walk-ins, nurses, handing out test results and so on. My friend and I spent 25 minutes in the lobby filling out forms and waiting just to find out afterwards that we could not be attended to for “not-acceptable insurance” reason. While we were waiting someone went up to receptionist to complain about the wait time, then left subsequently, so this apparently is a frequent issue. Bottomline is that the reception is not able to serve clients effectively and efficiently, this diminishes the number of potential clients that can be converted to real clients, if people walk away not only unattended to, but unsatisfied; the corollary of this is a bad repute.
As a manager, embracing how far technology has come and how much it can achieve has learnt speed to otherwise slow tasks. One other system that I would implement is the use of “online check-in” by new or returning clients on their route or within the reception. This check-in will cover basic symptoms, personal details, forms of payment and special requests. This check-in method has cut wait time down for air passengers, it can be useful in an Urgent Care facility, unlike Emergency Room (s) people that patronize Urgent Care are non-critical patients in no need of extreme life or death situations but who would still require immediate care as the name states. It is worthy to note that avoiding a cumbersome “check-in” page on the website maybe discouraging as one of the advantages of Urgent Care is to have access to healthcare professionals without the hurdles of scheduling and waiting for an appointment by clients.
In my time there I observed a particular care professional come out to ask the receptionist the same question twice, another way to de-bottleneck is to reduce the tasks on receptionist and give readily available information to care professionals, using a software application can resolve this, as patients’ data can be stored and accessed easily, can be shared among my associates in the facility care and support staff alike, ailments can be diagnosed and re-diagnosed by different eyes if required, human memory is more error-prone than an hence accuracy of data and this would also aid smooth transition in the case of a client that needs to be transferred to a hospital.
A level of motivation is required because no new system can be implemented without staff buy in. There will be incentives for the receptionist to create productive competition amongst the three based on thoroughness, quality and customer satisfaction.
Lastly I will ensure that, while i am de-bottlenecking the reception to allow for more clients, I do not ignore the fact that my back end operations have to run well and be capable of receiving and attending to the increased clientele.
Reference
The American Family Care (n.d.) Retrieved from https://www.afcurgentcare.com/locations/california/
California Urgent Care and Walk-in Clinics (n.d.) Retrieved from https://www.urgentcarelocations.com/ca/california-urgent-care
Goldratt, E.M. (1990). What Is This Thing Called The Theory Of Constraints?. North River Press, Croton-on-Hudson, New York.
Şimşita Z. T., Günayb N.S.,& Vayvayc Ö., (2014), Theory of Constraints: A Literature Review Retrieved from https://ac.els-cdn.com/S1877042814051532/1-s2.0-S1877042814051532-main.pdf?_tid=dd3febf4-4a42-48e3-a22c-7ddfaad9a69a&acdnat=1520883263_7d716f063fce2e1a8a40eb4117c2baa4
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