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Improve Work Flow:
Find and Remove Bottlenecks

A bottleneck or constraint is anything that restricts the throughput of a system. A constraint within an organization would be any resource where the demand for that resource is greater than its available capacity. In order to increase the throughput in a system, the constraints must be identified, exploited if possible, and removed if necessary. Bottlenecks occur in many parts of our lives: the exit to a concert hall, rush-hour traffic, the telephone receptionist, or the cashier in a cafeteria line. You can usually find bottlenecks by looking where people are waiting or where work is piling up.




Examples of Tests of this Change

Often the absence of transfer orders delays moving patients out of the unit. There are several ways to remove this bottleneck, including writing transfer orders the evening before the expected transfer or developing a policy that authorizes Intensive Care Unit (ICU) nurses to create a set of temporary transfer orders.


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