About this Presentation
This case study showcases the implementation of the Theory of Constraints (TOC) in the surgical department of the largest private hospital in Cyprus, aiming to optimize operating room (OR) utilization and enhance surgical efficiency. TOC thinking process tools and Drum-Buffer-Rope (DBR) were employed to identify and address system constraints. The study revealed that ORs operated at only 56% utilization, with significant idle times between surgeries and during morning preparations. The DBR scheduling method was applied to manage workflow, ensuring that the constraint—the OR—was always prioritized, minimizing downtime and maximizing throughput. A cross-functional project team, including surgeons, nurses, and management, collaborated to implement solutions that improved operational efficiency while maintaining high standards of patient care. The results highlighted the potential of TOC and DBR in healthcare settings, offering a structured approach to reducing bottlenecks, enhancing financial performance, and delivering superior surgical services.
What Will You Learn
To help you get the most value from this session, we’ve highlighted a few key points. These takeaways capture the main ideas and practical insights from the presentation, making it easier for you to review, reflect, and apply what you’ve learned.
You’ll see how TOC’s Drum-Buffer-Rope and buffer management can turn a chaotic OR schedule into a predictable, high-throughput surgical flow that frees up capacity without adding resources.
The session reveals why focusing on the process constraint — not surgeon hours or rooms in isolation — unlocks hidden OR hours each week that can be used for additional procedures and less overtime.
It hints that by subordinating non-constraint work and aligning all perioperative steps to the bottleneck rhythm, hospitals can cut delays, cancellations, and wasted setup time — improving outcomes without costly new systems
Instructor(s)
Dr. Spyros Bonatsos
Dr. Spyridon Bonatsos is a seasoned executive and academic with a Ph.D. in Management Sciences from the University of Strasbourg, specializing in the Theory of Constraints (TOC)—a systemic methodology designed to identify and optimize organizational leverage points. As CEO of Atlas Panton Group, one of Cyprus's largest construction-centred business groups, Dr. Bonatsos brings a systems approach that he has consistently applied across his entire career, including roles as Commercial Director, Operations and Technical Director. His deep expertise in TOC and systems thinking has been pivotal in driving performance improvements, facilitating strategic market expansions, and enhancing manufacturing and supply chain efficiencies. Known for his capacity to streamline complex operations, Dr. Bonatsos combines a holistic perspective with rigorous analysis to manage high-stakes projects and advance international business growth. His unique blend of executive and academic experience positions him as a thought leader in applying systems thinking to complex organizational contexts, bridging the gap between theory and practice in today’s dynamic business landscape. Additionally, as an educator in Operations and Systems Engineering, he integrates theoretical knowledge with practical insights, empowering future leaders with a systemic and strategic mindset.