An evolutionary approach to the architecture of effective healthcare delivery systems.

PURPOSE Aims to show that material flow concepts developed and successfully applied to commercial products and services can form equally well the architectural infrastructure of effective healthcare delivery systems. DESIGN/METHODOLOGY/APPROACH The methodology is based on the "power of analogy" which demonstrates that healthcare pipelines may be classified via the Time-Space Matrix. FINDINGS A small number (circa 4) of substantially different healthcare delivery pipelines will cover the vast majority of patient needs and simultaneously create adequate added value from their perspective. RESEARCH LIMITATIONS/IMPLICATIONS The emphasis is firmly placed on total process mapping and analysis via established identification techniques. Healthcare delivery pipelines must be properly engineered and matched to life cycle phase if the service is to be effective. PRACTICAL IMPLICATIONS This small family of healthcare delivery pipelines needs to be designed via adherence to very specific-to-purpose principles. These vary from "lean production" through to "agile delivery". ORIGINALITY/VALUE The proposition for a strategic approach to healthcare delivery pipeline design is novel and positions much currently isolated research into a comprehensive organisational framework. It therefore provides a synthesis of the needs of global healthcare.

[1]  T. Newman,et al.  The power of stories over statistics , 2003, BMJ : British Medical Journal.

[2]  Jonathan Shapiro,et al.  Lessons for the NHS from Kaiser Permanente , 2003, BMJ : British Medical Journal.

[3]  Nick York,et al.  Hospital bed utilisation in the NHS, Kaiser Permanente, and the US Medicare programme: analysis of routine data , 2003, BMJ : British Medical Journal.

[4]  J. Birkmeyer,et al.  Surgeon volume and operative mortality in the United States. , 2003, The New England journal of medicine.

[5]  Martin Christopher,et al.  Designing healthcare delivery systems , 2003 .

[6]  S. Moore,et al.  Capacity planning – modelling unplanned admissions in the UK NHS , 2003 .

[7]  Camilla Monefeldt,et al.  Client Involvement in Simulation Model Building: Hints and Insights from a Case Study in a London Hospital , 2003, Health care management science.

[8]  Shah Ebrahim,et al.  NHS waiting lists and evidence of national or local failure: analysis of health service data , 2003, BMJ : British Medical Journal.

[9]  Jordana M. K. Signer,et al.  Performance Improvement Capability: Keys to Accelerating Performance Improvement in Hospitals , 2003 .

[10]  D. Towill,et al.  Analysis and design of focused demand chains , 2002 .

[11]  Neelam Sekhri,et al.  Authors' reply to getting more for their dollar: Kaiser v the NHS , 2002, BMJ : British Medical Journal.

[12]  John Bowers,et al.  Concentration and the variability of orthopaedic demand , 2002, J. Oper. Res. Soc..

[13]  R. Feachem,et al.  Getting more for their dollar: a comparison of the NHS with California's Kaiser Permanente. , 2002, BMJ.

[14]  Luk N. Van Wassenhove,et al.  Learning across Lines. The Secret to More Efficient Factories. , 2002 .

[15]  M. Christopher,et al.  Developing Market Specific Supply Chain Strategies , 2002 .

[16]  Peter C Smith,et al.  A note on the integration of system dynamics and economic models , 2002 .

[17]  Gillian Mould,et al.  The deferrable elective patient: a means of reducing waiting-lists in orthopaedics. , 2002, Journal of management in medicine.

[18]  Atul A. Gawande,et al.  Complications: A Surgeon's Notes on an Imperfect Science , 2002 .

[19]  S. Shapiro,et al.  24/7 Innovation: A Blueprint for Surviving and Thriving in an Age of Change , 2001 .

[20]  Gary P. Pisano,et al.  Organizational Differences in Rates of Learning: Evidence from the Adoption of Minimally Invasive Cardiac Surgery , 2001, Manag. Sci..

[21]  M. Christopher,et al.  An Integrated Model for the Design of Agile Supply Chains. , 2001 .

[22]  E. El-Darzi,et al.  A simulation study of the winter bed crisis , 2001, Health care management science.

[23]  Henry Mintzberg,et al.  Managing the care of health and the cure of disease--Part I: Differentiation. , 2001, Health care management review.

[24]  Regina Herzlinger,et al.  Market‐Driven, Focused Healthcare: The Role of Managers , 2000 .

[25]  R. Coile.  Millennium Outlook: Focused Factories vs. a Global Perspective , 2000 .

[26]  L. Locock.  The changing nature of rationing in the UK national health service , 2000 .

[27]  Daniel Berry,et al.  The BPR SCOPE concept in leveraging improved supply chain performance , 1999, Bus. Process. Manag. J..

[28]  Denis Royston Towill,et al.  Using the Information Decoupling Point to Improve Supply Chain Performance , 1999 .

[29]  R. Ackoff.  Ackoff's Best: His Classic Writings on Management , 1999 .

[30]  Stephen Martin,et al.  Rationing by waiting lists: an empirical investigation , 1999 .

[31]  N. Tang,et al.  The introduction of patient process re-engineering in the Peterborough Hospitals NHS Trust. , 1999, Journal of management in medicine.

[32]  Richard Koch,et al.  The 80/20 Principle: The Secret of Achieving More With Less , 1998 .

[33]  John P. Shewchuk,et al.  Agile manufacturing: One size does not fit all , 1998, Strategic Management of the Manufacturing Value Chain.

[34]  D Pencheon,et al.  Economic evaluation in health: a thumb nail sketch , 1998, BMJ.

[35]  M. Christopher.  Logistics and Supply Chain Management: Strategies for Reducing Cost and Improving Service (Second Edition) , 1999 .

[36]  A. Werr,et al.  The functions of methods of change in management consulting , 1997 .

[37]  M. Fisher.  What is the Right Supply Chain for Your Product , 1997 .

[38]  D M Berwick,et al.  A primer on leading the improvement of systems , 1996, BMJ.

[39]  M. Tavakoli,et al.  An economic model of the market for hospital treatment for non-urgent conditions. , 1995, Health economics.

[40]  J. Fuller,et al.  Tailored logistics: the next advantage. , 1993, Harvard business review.

[41]  Denis Royston Towill,et al.  Supply Chain Dynamics—The Change Engineering Challenge of the Mid 1990s , 1992 .

[42]  A. Mulley,et al.  Developing shared decision-making programs to improve the quality of health care. , 1992, QRB. Quality review bulletin.

[43]  Denis Royston Towill,et al.  Engineering change; or is it change engineering? A personal perspective , 1991 .

[44]  P Horrocks,et al.  The components of a comprehensive district health service for elderly people--a personal view. , 1986, Age and ageing.

[45]  C. M. Lindsay,et al.  Rationing by waiting lists. , 1984, The American economic review.

[46]  Denis Royston Towill,et al.  Dynamic analysis of an inventory and order based production control system , 1982 .

[47]  Jay W. Forrester,et al.  Common foundations underlying engineering and management , 1964, IEEE Spectrum.