Stop Hiring Your Way Out of a Process Problem
Why 'FTE Headcount' is a vanity metric that hides the real constraint: Nursing Minutes at the Bedside.
Tag
Theory of Constraints
8 posts
Why 'Agile' Fails in Hardware (And What Actually Works)
You cannot 'sprint' a circuit board design. A systems architect's view on why software methodologies break when applied to physics, and how Critical Chain solves the real constraint.
The 'Quality' Illusion: Why FDA Compliance Can Make Devices Less Safe
When Regulatory departments prioritize 'documentation stability' over 'engineering reality,' patient safety suffers. A systems view on the conflict between Compliance and Quality.
The Metrics Trap: Why Hospitals Drown in Data but Starve for Wisdom
Most dashboards measure local efficiency at the expense of global throughput. Here is how to define the minimum dataset that actually drives system performance.
The 'Perfect' Product That Killed the Company
Why 'Scope Creep' is usually a symptom of a deeper strategic failure—in software, in hardware, and in healthcare.
The Post-Acute Care Plan (PACP)
A proactive approach to discharge readiness that treats discharge delays as an input quality problem, not a process problem.
Structural Conflicts in WA State Nursing Agreements
Analysis of 134 structural conflicts across 10 Washington State nursing CBAs reveals why higher wages aren't fixing nurse burnout.
The Cath Lab Is Empty at 2 AM
Why smart, well-run organizations reliably get stuck on solvable problems, and what tribal dynamics and cognitive limits have to do with it.