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Pride and Joy: a healthcare novel

based on the application of the Theory of Constraints in health and social care presenting the Flowful approach in a fictive business novel format.

A must read for all politicians and government involved in managing and improving healthcare.”

Kristen Cox, Founder & CEO of Epiphany Associates, Former Executive Director of Utah Governor’s Office of Management and Budget

“What should the health system prepare for after this pandemic? What is necessary to do so? Whatever circumstances we are in, a management theory which that on patient flow to create more bed capacity, improve quality of care and the finances simultaneously, can greatly contribute to the system and bring pride and joy to all of us involved. “

Dr. Toru Nishi, Director, Sakura-jyuji Yatsushiro Rehabilitation Hospital

What is the Flowful approach and the Pride and Joy business novel about?

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 healthcare systems are an example where almost the opposite extreme is true.

Healthcare spend is rising and rising as a percentage of GDP. This leads to the fact the affordability of care comes into question, as we so often see played out in headlines across the globe.  Unless a breakthrough is realised, the only way to sustain the position is to ensure GDP grows faster than the growth in healthcare. The other, less palatable, option is for healthcare to be rationed.

Pride and Joy is a business novel about a struggling fictional hospital. It tells the story of how a management team resolves an unattainable situation where the hospital is facing growing queues of patients waiting for care, overstretched and demoralized staff, care quality and safety concerns, and dwindling financial viability. Although the book is written as a fast-paced fictional novel, it is based on real-life problems and experiences faced by hospitals around the world.

The first third focuses on answering the questions, ‘Why is there a need to change the way we operate our healthcare systems?’ 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. 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 affordably, 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.

The book has been written as a novel to address a major point: a paradigm shift in thinking needs to occur at all levels of the system – preferably simultaneously. As such, the audience for this book is anyone who is involved in, interested in and responsible for health care at a local, national, and global level. 

Flowful is a novel solution to creating breakthroughs in the timeliness, quality, safety, and affordability of healthcare. It operationalizes the TOC-based approach described in the book Pride and Joy. Flowful has been applied across hospitals in different environments globally, consistently demonstrating significant improvments in patient flow, rapidly reducing the length of stay to free up capacity. This has allowed hospitals to provide better access to care, while reducing the burden on staff, all without adding resources.

Interested in the Pride and Joy novel and Flowful approach?

Please download the Pride and Joy novel as eBook or get in touch!

Kindly nota that a paperback or Kindle version is also available available at Amazon (ORDERLINK).




More about the author Alex Knight

The author Alex Knight has extensive experience in supporting health and social care systems and government. He has worked around the world alongside many great leaders in for-profit and not-for-profit organisations. His consulting, lecturing and coaching work has shown him first hand, the joys and struggles people face in their endeavors to improve their businesses. The book Pride and Joy describes through an entertaining novel, how to apply the Theory of Constraints in healthcare.

Alex’s work is guided by the scientific approach and the principles underpinning the Theory of Constraints (TOC); a belief that inherent simplicity exists: in any goal-oriented system there are only a few places that have the power to affect the performance of the whole system – the system’s constraint(s).