About this Presentation
Hospital Central de San Isidro began its journey toward operational excellence by addressing long-standing emergency and inpatient care challenges. Faced with chaotic patient flow, frequent care interruptions, and extended hospital stays, the team applied the Theory of Constraints (TOC) to implement practical, high-impact changes. These included a color-coded streamlined triage system, dedicated care pathways based on urgency level, and new support roles to streamline physician tasks. In the inpatient unit, discharge planning tools and logistical coordination helped to release most patients on the planned discharge dates. These initial steps have led to reduced waiting times, improved patient satisfaction, and greater continuity of care. While progress is promising, this marks only the beginning—the hospital remains committed to deepening its improvement efforts and expanding the TOC approach across more care areas.
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.
The session reveals that financial constraints in organizations are often a symptom of flow breakdowns, not a lack of capital — and that unlocking throughput can free up performance without new funding.
It shows how rethinking priority, capacity protection, and work release can reduce the “need” for money by making existing resources more effective and aligned to true demand.
The presentation hints that when leaders learn to manage constraints first, money becomes a follower of performance — not the driver — leading to faster improvement and less waste.
Instructor(s)
Danilo Sirias, Ph. D.
Dr. Danilo Sirias holds a master’s degree in Industrial and Systems Engineering and a Ph.D. in Business Administration from The University of Memphis. He is recognized as a TOCFE trainer and TOCICO thinking process implementer. Currently serving as a Professor in the Department of Management and Marketing at Saginaw Valley State University, Dr. Sirias specializes in leveraging the Theory of Constraints to optimize patient flow across various medical settings such as Emergency Departments, Inpatient Units, Operating Rooms, and Outpatient Clinics. Notably, he co-authored the book
Dr. Josefina Greig
Dr. Josefina Greig, Associated Director of Inpatient and Outpatient Care, Hospital Central de San Isidro. Dr. Josefina Greig is an experienced General Surgery Specialist based in San Isidro, Argentina. She has extensive experience in emergency medicine, surgical care, and
medical auditing. She currently serves as the Associate Director of Inpatient and Outpatient Care at Hospital Central de San Isidro, bringing over a decade of clinical leadership. Dr. Greig has also served as Chief of Emergency Medicine and Deputy Chief of Surgery while continuing to advance her expertise with postgraduate training in medical auditing.
Dr María Ana Barra
Dr. María Ana Barra, Director, Hospital Central de San Isidro MARÍA ANA BARRA (M.D.) is an Internal Medicine Specialist who has led the ward at Hospital Central de San Isidro in Buenos Aires since 2018 and was appointed Director on April 18, 2024. With over 30 years of clinical, teaching, and research expertise, she coordinated the hospital’s Tuberculosis Program (1999–2001) and served as a Staff Physician in the Internal Medicine Department (2001–2018). Since 2002, she has directed postgraduate courses such as “Comprehensive Care for Surgical Patients” and “Ambulatory Medicine.” A published researcher on infectious and chronic diseases—including her 2022 study “COVID-19 in Hospitalized Patients, San Isidro, Argentina”—Dr. Barra earned her M.D. from UBA (1988), became Board-Certified in Internal Medicine in 1997, and holds a Postgraduate Diploma in Hospital Administration from ISALUD (2007). She recently began applying the Theory of Constraints across multiple hospital departments.