System performance analysis and process improvement: a perspective on healthcare

Several management approaches focus on processes and system performance analysis in order to achieve ‘continuous’ (or more accurately continual) improvement in organisations. The main focus of the present research has been on applying Business Process Management (BPM), Theory of Constraints (TOC) and Discrete-Event Simulation (DES) to healthcare processes. BPM is a discipline dealing with the management of business processes; on the other hand, TOC promotes improvement by focusing on the system constraint(s), which limits the system performance. DES helps to visualise process behaviour, measure process operational performance and also evaluate different scenarios for improvement. In particular, this research employs the Business Process Model and Notation (BPMN) modelling standard as a process/conceptual mapping tool and as a gateway to TOC and DES modelling in an effort to overcome barriers to stakeholder engagement. The main contributions of the work in this thesis are demonstration of the effectiveness of BPMN in these roles (in particular to achieve fully-facilitated DES in healthcare and, where this remains not practicable, to describe the further barriers), the potential value of extending the BPMN 2.0 toolset, and demonstration of the adaptation of TOC’s Drum-Buffer-Rope (DBR) tool to healthcare.