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Sustainability: Moving from Common Sense to Common Practice
2016 International Conference
Leesburg, VA - National Conference Center

September 18th - 21st

Toward A TOC Approach to Worker Safety and Sociotechnical Health

David Anthony - Boeing Company

Science and innovation are processes of finding or creating relationships between concepts that previously appeared to be unrelated. The evolution of scientific or technological domains, as documented partially by Thomas Kuhn and others, proceeds via highly contingent, unpredictable local coevolution between individual populations and their existing observations, assumptions, technologies, etc. Separate fields of inquiry and development create isolated ivory towers which do reasonably well making predictions within their applicable bounds. The SOTSOG process advocated by Dr. Eli Goldratt is based on a fundamental assumption that the universe is whole – not fractured – and governed by an underlying consistent set of interlinked causality. The same causal chains giving rise to the predictive powers of one scientific domain also give rise to all the others – it is the limitations of human understanding and the contingencies of localized knowledge development that leads us to assume separate domains and therefore develop differing and inconsistent explanations for worldly phenomena.

Epidemiology is the study of patterns, cause, and effects of health and disease conditions in defined populations. Epidemiology has been extremely useful in helping policy and decision makers to understand the causes and contributing factors of wellness and lack thereof. One area of study within epidemiology is job-related stress and its associated health effects. Anecdotally, it was long established that job stress at least partially contributes to physical health and emotional well-being. More recently, epidemiology has established that workplace stress is an important contributor to physical, mental, and social health. Epidemiologists have moved beyond classification and correlation to toward clear causality. The concept of job strain – a measure of workload demands and worker autonomy – and was shown to be predictive of cardiovascular disease, and other negative health problems. The primary causal contributors at the chemical level are the release of cortisol and adrenaline, which readies humans for fight-or-flight. Chronic, prolonged exposure to these conditions can lead to long-term health effects. Epidemiology essentially stops there. It proposes the Demand/Control model of workplace strain, and suggests that managers consider lowering workload demands on workers, or increasing their control over tasks.

Such advice is extremely difficult to accept for most traditional (non-TOC) paradigms of management. Traditional management often advocates central tenants of management which include: assigning and controlling work, and ensuring workers and resources are highly efficient. Theory X management creates environments where micromanagement – a low level of worker autonomy – is the norm. It also regularly strives for "high productivity”, which calls for resources to be nearly 100% loaded. It's easy to see why the rules of traditional management would simply cast aside the recommendations of epidemiology as fundamentally incompatible with "the needs of the workplace”.

The general conflict cloud is given below:

Healthy Profits ← Managers in Control of Very Busy Workers A Healthy Workplace

Healthy Workers ← Autonomous Workers With Significant Downtime

The flawed assumptions have been exposed and a solution given by TOC. In most systems with inter-dependencies, it isn't possible to have a highly effective system and highly efficient ("high productivity”) resources. One must choose. Additionally, managerial attention is such a critical resource that managers must focus on what matters – this means ending micromanagement and instead delegating authority to workers.

The two recommendations from epidemiology – workload demand limits, and improved worker autonomy – are consistent with those of TOC:

1. Establish WIP Limits, End Bad Multi-Tasking
2. Increase Worker Autonomy (e.g., Lieutenant’s Cloud)

The predicted effect (FRT) of such an implementation would likely be twofold:

1. Improved systemic performance – higher throughput, lower inventory and OE, happier customers (well established)
2. A healthier and happier workplace (anecdotal)

The workplace health improvements should be measurable over time through lower health-related expenditures, fewer sick days, and higher happiness and commitment to work. These effects may also generate or open the opportunity for another positive cycle of benefits. Furthermore, anecdotal evidence should well-precede the numerical evidence of reduced health expenditures; probably not coincidentally, anecdotal evidence does suggest that there is an improvement in the workplace environment in companies who have implemented TOC. Further study is warranted to substantiate and measure the relative magnitude of these effects.

What to change?

We've known this for a long while. The flawed assumption of high-productivity through 100% resource loading, and the corresponding assumption of "good results through close managerial control” yield countless UDEs. They're at the core of a CRT which not only results in low systemic effectiveness. What is new is the epidemiology work that shows that traditional management causes high-strain environments, which increases worker health problems such as cardiovascular disease. This means there should be additional predicted effects we should be able to observe and measure.

What to change to?

We've also known this. We need to implement TOC. A very effective strategy would be to implement TOC and Mission Command. Both not only address and improve systemic effectiveness, they also directly address the Demand-Control strain model used in epidemiology. They should be expected to yield a win-win result for both systemic effectiveness and systemic health. We should begin trying to quantify the social health benefits of successful TOC implementations.

How to cause the change?

It may help people embrace TOC implementations if they were aware of the health benefit suggested by epidemiology. Successful TOC implementations should not only improve direct T, I, and OE associated with operations, but also probably reduce OE associated with medical expenses, as well as improve worker morale. Similarly, forging a bridge may help epidemiology and public health workers to understand how TOC can significantly improve the financial case for implementing their existing recommendations, which may – in the absence of a TOC perspective – appear to be unrealistic and economically intolerable.

Why was there a need for change?

A bridge is necessary between epidemiology and TOC to improve the former’s business case. Previously, public health advice based on epidemiology was providing useful recommendations which could lower workplace stress levels and improve worker health and morale. However, the epidemiology alone could not provide a compelling business case – without a TOC perspective, cutting WIP and increasing autonomy sounds like an economic risk. Additionally, health care costs are growing and quality of care is declining in many places. TOC is doing a great job to improve health care throughout the world. However, preventing the cause of disease and contributing to positive health must be part of the solution. Workers spend much, if not most, of their waking days in the workplace. It's clear that the work environment contributes greatly to worker health and happiness. TOC offers a win-win-win solution for worker health, employee development, and economic profits. The full magnitude of the win should be understood.

How do you measure, refocus, sustain and grow the change?

It would be beneficial to further spread TOC within the public health field. I hope this presentation provides a spark for other inquisitive minds find the relevant connections and ensure sound public health advice can be supported with a comprehensive TOC business case. I also hope we begin to clearly quantify the psychosocial health impacts of successful TOC initiatives, to continually improve our managerial approaches on all levels. To do this, it would be very beneficial to have a joint TOC/epidemiology research partnership begin a longitudinal study within firms that have implemented TOC to better quantify the health results; both the subjective quality of life results, as well as the objective measures of disease prevalence and total expenditures used in treatment. A good track record of solid psychosocial and economic evidence should be useful to help spread TOC to any company committed to improving worker safety. Alternatively, we might find health UDEs we can use to refine our implementations.

David Anthony has studied theory of constraints since 2005 and has attended several TOCICO international and regional conferences. His main focus within TOC is an exploration of the inherent simplicity in the nexus between patterns of belief, policy, and sociotechnical health; specifically, how shared narrative at the social-systemic level constrains the patterns of policy and health the social system can support. Core elements of this exploration include the science of complexity, epidemiology, evolutionary and developmental psychology, behavioral economics, linguistic anthropology, maneuver warfare, philosophy, myth, and motivation.

David has a Bachelor’s Degree in Mechanical Engineering from the University of Washington and a Master’s Degree in Engineering and Technology Management from Washington State University. David works at the Boeing Company doing project management and integration for new commercial airplane test programs and has supported the 787-8, 787-9, and 777X programs.

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