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The purpose of this study is to assess the implementation of a Process Of OnGoing Improvement based on the Theory of Constraints in a Hospital. Which steps have been taken to achieve this objective and what has been done to sustain this process? Which steps or elements have been missing, what are the consequences for improvement and what could be done to overcome and maybe prevent this? A single-case case study was performed with one Dutch Hospital which already built up experience with this process for a number of years. All wards of one of the Hospital´s location were involved in the study. The research revealed a stagnating process of ongoing improvement. Less than 50% of the planned steps in the process have been taken, resulting in some wards still struggling with proper use of the supporting information system, some wards experiencing deteriorating results, but also some wards ready to take the next step. In order to break the dilemma a solution is developed which should support the hospital in mastering step 3 of the 5 focusing steps. The most important and also delicate one is the management demonstrating their commitment and being the Driver of Continuous Improvement.

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Andrea, Gijs
The Theory of Constraints (TOC) has been developed by Dr. Eli Goldratt (1947-2011) and applied in many industries. Gijs has been working with this material for more than 20 years, implemented it in Hospitals and followed an academic study about TOC in Nothingham. This is his thesis about improving the implementation process itself.

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