This year’s medal is awarded to Victoria Mabin, Julie Yee, Sally Babington, Robyn Moore and Vanessa Caldwell of whom are based in New Zealand. This paper considers a major issue for healthcare; managing demand for services, within limited resources. The study is based on an approach (Theory of Constraints) with strong “real world” relevance that is relatively little used in the OR field and merits wider exposure and comparison with other approaches to investigating systems. The use of TOC methodology in the study, which focuses on problems with a hospital pharmacy and the relation of these to the wider hospital system, facilitates drilling down to the underlying issues and allows a "rich" analysis of problems and solutions. The account of the associated pilot project provides additional insights and shows commitment to involving stakeholders in the work, and shows clear evidence of implementation with a considerable and sustained impact on system performance. The paper is clearly written and presented.
