Eight p.m. in the "war room" of Johnson & Johnson Health Care Systems: 150 people from all over the world are on a conference call. The topic is a supply outage of trocars, a medical device used in microscopic surgery. Someone on the line, clearly untroubled by the crisis, speaks up. "It's just a trocar," he says.

If you were associated with manufacturing and distribution operations a few decades ago, you may have heard of Dr. Eli Goldratt, the theory of constraints and his book titled "The Goal."