About this Presentation
Timeliness and capacity constraints are among the biggest challenges facing healthcare delivery systems worldwide. Many assume that the only solution is hiring more staff and acquiring additional equipment, but what if the key to solving this issue lies elsewhere? This presentation explores a groundbreaking action research study where an ophthalmologist increased patient throughput by 64% in just a few weeks—all without extra costs. The secret? Implementing the Theory of Constraints (TOC), a proven methodology for identifying and resolving bottlenecks. Using the Five Focusing Steps (5FS) of TOC, the doctor streamlined operations through drum-buffer-rope scheduling and buffer management, leading to immediate, measurable improvements. The presentation will break down these concepts in simple terms, demonstrating how they can be applied not only in ophthalmology but across various healthcare settings. However, this success story also reveals a critical lesson: while TOC can drive significant efficiency gains, sustaining these improvements requires ongoing commitment. After the TOC champion left the organization, the changes were not maintained—highlighting the importance of leadership and long-term implementation strategies.
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 identifying and managing the true system bottleneck — not just adding capacity — enabled a physician to dramatically increase throughput and quality in a clinical setting without additional cost.
The session reveals how applying TOC’s Five Focusing Steps and buffer logic creates predictable patient flow and reduces firefighting, allowing care teams to spend more time on meaningful clinical work.
It hints at why rapid improvement can occur in weeks — not years — when constrained resources are exploited and subordinated properly, turning chronic delays into sustainable performance gains.
Instructor(s)
Gustavo Bacelar PhD
GUSTAVO BACELAR (PhD) helps healthcare organizations achieve major performance improvements from existing resources. Introduced to Theory of Constraints (TOC) in 2005, he has been using this management methodology for business and life ever since. In Brazil, he implemented TOC in his ophthalmology practice (in a hospital and in his private practice) and was able to attend 64% more patients (without overtime, at no extra cost) providing better care. In Portugal, Gustavo has been working with TOC since 2012 in several areas of health (e.g. pharmacy, obstetrics) and taught a course on TOC in Healthcare (theme of his PhD) at the Faculty of Medicine of the University of Porto (FMUP). He has 2 MD degrees – from Brazil (EBMSP) and Portugal (FMUP) –, holds an MBA (FGV), a Master of Medical Informatics degree from FMUP and is a PhD (FMUP). Additionally, he is a proud member of TOCICO (Theory of Constraints International Certification Organization).