Written as a business novel about a struggling hospital, Pride and Joy
takes the reader through a journey of discovery into why good people with good intent struggle to achieve a breakthrough in performance. It offers a practical way to address the core problem of our health systems and achieve high-quality, patient-centered affordable care for all.
The first third focuses on answering the questions, \\\'Why is there a need for change?\\\' and \\\'What to change?\\\' The analysis is based upon the typical situation found at a local level.
The middle third of the book applies the Theory of Constraints (TOC) to the hospital\\\'s major streams of care and links in the healthcare chain. The Theory of Constraints was invented by Dr Eliyahu M. Goldratt and is best known through his book, The Goal. TOC is based on the belief of inherent simplicity—that in any goal-oriented system there are only ever a few places that have the power to affect the performance of the whole system: the weakest link(s)/constraint(s). In Pride and Joy the TOC principles have been adapted to fit the healthcare environment and through logical derivation the reader sees how the ideas are practical, common sense and can be implemented in a short timescale to achieve unprecedented results.
The final part of the book demonstrates how a nation can safely, and in an affordable envelope, achieve a breakthrough in performance at a national level and provides a working hypothesis for a global solution that involves a change in mindset of all stakeholders in the chain.
Health Systems Around the World are facing the Perfect Storm
Healthcare systems appear complex. Each patient requires the efforts of many different resources—both people and equipment—before they are clinically fit to go home or move to the next stage of their healthcare journey. The most common response to this seeming complexity is to divide the system into parts and manage and measure each part in an attempt to improve the whole. Such an approach may have an impact when the number of system variables are relatively small and the variability within each dimension is relatively small. However, our health systems are an example where almost the opposite extreme is true: we face the perfect storm.
Pride and Joy is an extraordinary book in the way it communicates actionable insights about the inherent simplicity in apparently complex human systems such as healthcare organisations. Taking the form of a very readable novel it describes how focusing on patient flow brings significant improvement in health outcomes without exhausting finite resources or compromising quality of care. As a customer and financier (through tax) of the UK healthcare system I sincerely hope the message in this book will be absorbed and acted upon by political, clinical and operational leaders.
Vice President of a major global industrial company
Pride and Joy has the potential of doing to healthcare what Goldratt’s The Goal did to manufacturing and supply chain. Alex describes the environment and crisis situations where they could take place in the US, UK, Australia, Canada, etc. The problems are universal. The situation is complex and impossible to many BUT as anyone in TOC knows, the more complex the situation the simpler the solution. Alex proves this to be correct. Once you read each solution; your response should be: That’s brilliant! You end up making this statement a number of times throughout the book. In my opinion, this book may provide the solution to implementing universal healthcare without bankrupting the country for the US.
James F. Cox III
Professor Emeritus, University of Georgia
This is a must read for politicians, policy makers, clinicians and managers. It tells the story of how healthcare systems can be managed in a sustainable way with the patient at the centre of decision making.
Dr Mike Williams
Patients should only stay in hospital as long as they need to. This is central to the quality of care. Read this book - it will change your view of how to manage patient flow in a hospital. It can transform the way we deliver care and steer us away from the downward spiral of poor quality, poor performance and inefficiency.
NHS Trust Development Authority
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