Four Pillars: Everything Is Connected

For those who practice the Theory of Constraints (TOC), there are Four Pillars which represent a set of mindsets. Each pillar is representative of an attitude which helps individuals overcome challenges and reach breakthroughs. This is the third instalment of a four-part series, although each article provides its own value and can be read as a standalone piece. Click here to read about the first two pillars ‘Every Conflict Can Be Removed’ and ‘Never Say I Know’.

Everything in any system is connected. Whilst a system may be very complicated to describe, if you take the time to consider how everything relates to each other then you will learn that there are only ever a few key areas you need to focus on at any one time. A complicated system is likely to be very simple at its heart.

Take the UK COVID-19 vaccination programme as an example of a very complex system. Churches, mosques, schools… even racecourses, stadiums and museums have all been reappropriated to become spaces where people can receive their vaccination. This is in addition to traditional spaces such as hospitals, pharmacies, and health centres. Then, there are the nurses and administrators who need to be trained and organised. Vaccinations are administered per borough primarily in age order, although some people are fast tracked if they are considered high risk or a key worker. There are now three vaccines available in the UK (Pfizer/BioNTech, Oxford AstraZeneca and Moderna) however there is now the added complexity that not everybody is eligible for the Oxford AstraZeneca vaccine. Add to that, the logistics of making, transporting, and storing all the vials of the vaccine (at different temperatures!). This is also a two-dose system so all of this must happen twice for many patients. Recently there have emerged hot beds for the new variant of coronavirus (Bedford, Leicester, etc) which have called for an even faster distribution of the vaccine to prevent further spread.

This all sounds very complicated… but everything is related. If you can understand the relationships, you can simplify it down somewhat and make it easier to understand and manage. This pillar of the Theory of Constraints dictates that even complex systems are actually inherently simple. The UK vaccination programme appears very complex when you list the many people and operations that make it up. If you interviewed every person involved in this chain of events – from the pharmaceutical companies producing the vaccine all the way through to the patient receiving it – and asked them to write up their contribution to the process, what, why and how they do it, you would end up with a huge document which would be far too large for people to hold, let alone read. If we view complexity as how to describe the system, it is hugely complex. If we view the system in terms of aims and objectives, it all becomes much less complicated. There is one very simple aim: to vaccinate as many people as possible, as quickly as possible.

So, how do you look for the inherent simplicity? You must look for the cause and effect which governs the performance of the system. The performance of this system would be more people being dosed sooner. So, while there are many activities, people, processes, procedures, transportations, injections etc. that must occur, at its heart there are only a few key things that will speed up or slow down the delivery of vaccinations to people.

There are three potential situations. First, there are not enough people saying yes to wanting a vaccine on a given day, willing or able to make the appointments (demand). Alternatively, there isn’t enough vaccine to give to all the people who are available of a given day (supply). Or there are not enough centres, or nurses/administrators at those centres, to house and vaccinate all the people (capacity). If every vaccination centre was manned by enough trained administrators and had enough doses available to as many people as could be scheduled – then the UK would be vaccinating people at the maximum rate. So, this vastly complex system can be boiled down to three major control points: the capacity to deliver the vaccines, the availability of the vaccines themselves and the people to deliver them to. If we zoom out, at any one time only one of these will systematically determine the performance of the vaccination roll out – this gives you somewhere to focus. If we tackle the key thing that is systematically preventing us from vaccinating more people, we will have pared down a very complex system to just one key improvement – and the number of patients vaccinated each day would increase.

So, while on the surface this whole organisation seems very complicated (and it is!) if you are looking to improve the system, you need to be able to zoom in on the few key points that affect performance – and find the inherent simplicity.

If you think about it this way, how complicated would it be to try and describe what your organisation does? Where are the few key areas in your organisation that determine how well it systematically performs? At the heart of any system, all things are connected and once you can understand the connections you can find the right places to make improvements.

If you are interested in learning more about the Theory of Constraints, we share articles and videos on our LinkedIn. We also share educational videos to our YouTube channel. If you would like some advice on where you should focus your improvement initiatives, get in touch at [email protected].

By Phil Snelgrove, Lauren Wiles.