title: Viewing Kaiser Permanente via the logistician lens.
abstract: OBJECTIVE
  The aim of this paper is to undertake a holistic comparison between NHS and Kaiser Permanente (KP) healthcare delivery systems.
  
  
  METHODS
  The paper reviews in detail the many papers and communications published on KP via the "logistics lens" which is focussed on smooth patient flow from onset of problem to completion of treatment.
  
  
  RESULTS
  The paper finds that healthcare "best practice" is readily related to conventional supply chain performance metrics and engineering change model attributes. Much of the apparent success of KP is due to cultural and organisational factors. A noteworthy example deserving wide dissemination and application is in the effectiveness of interfaces between clinicians and managers.
  
  
  CONCLUSIONS
  This review exposes the need for the NHS to be driven by end-to-end processing times rather than the present salami principle of separating in-patient, out-patient and other queues into neat statistics, which can be meaningless to an individual patient.
  
  
  CONCLUSIONS
  Introduces clinicians and healthcare professionals to a range of tools and techniques for engineering "best practice". This method is well understood and proven in other areas of application. Particular aspects of the KP study are thus confirmatory of what is actually happening in small pockets of the NHS.
  
  
  CONCLUSIONS
  The paper provides a new perspective on the performance of healthcare supply chains. New knowledge and deeper understanding of the mechanisms of success emerge from a study adopting a different viewpoint.
authors.affiliation: Logistics Systems Dynamics Group, Cardiff Business School, Cardiff University, Cardiff, UK. scottd1@cardiff.ac.uk
authors.forename: Denis R
authors.initials: DR
authors.lastname: Towill
mesh_terms: D002140:California; D017598:Efficiency, Organizational; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom