COVID-19 outbreak: implications on healthcare operations

RNA Viromics of Southern California Wastewater and Detection of SARS-CoV-2 Single-Nucleotide Variants

Municipal wastewater provides an integrated sample of a diversity of human-associated microbes across a sewershed, including viruses. Wastewater-based epidemiology (WBE) is a promising strategy to detect pathogens and may serve as an early warning system for disease outbreaks. Notably, WBE has garnered substantial interest during the coronavirus disease 2019 (COVID-19) pandemic to track disease burden through analyses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Throughout the COVID-19 outbreak, tracking SARS-CoV-2 in wastewater has been an important tool for understanding the spread of the virus. Unlike traditional sequencing of SARS-CoV-2 isolated from clinical samples, which adds testing burden to the health care system, in this study, metatranscriptomics was used to sequence virus directly from wastewater. Here, we present a study in which we explored RNA viral diversity through sequencing 94 wastewater influent samples across seven wastewater treatment plants (WTPs), collected from August 2020 to January 2021, representing approximately 16 million people in Southern California. Enriched viral libraries identified a wide diversity of RNA viruses that differed between WTPs and over time, with detected viruses including coronaviruses, influenza A, and noroviruses. Furthermore, single-nucleotide variants (SNVs) of SARS-CoV-2 were identified in wastewater, and we measured proportions of overall virus and SNVs across several months. We detected several SNVs that are markers for clinically important SARS-CoV-2 variants along with SNVs of unknown function, prevalence, or epidemiological consequence. Our study shows the potential of WBE to detect viruses in wastewater and to track the diversity and spread of viral variants in urban and suburban locations, which may aid public health efforts to monitor disease outbreaks. IMPORTANCE Wastewater-based epidemiology (WBE) can detect pathogens across sewersheds, which represents the collective waste of human populations. As there is a wide diversity of RNA viruses in wastewater, monitoring the presence of these viruses is useful for public health, industry, and ecological studies. Specific to public health, WBE has proven valuable during the coronavirus disease 2019 (COVID-19) pandemic to track the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without adding burden to health care systems. In this study, we used metatranscriptomics and reverse transcription-droplet digital PCR (RT-ddPCR) to assay RNA viruses across Southern California wastewater from August 2020 to January 2021, representing approximately 16 million people from Los Angeles, Orange, and San Diego counties. We found that SARS-CoV-2 quantification in wastewater correlates well with county-wide COVID-19 case data, and that we can detect SARS-CoV-2 single-nucleotide variants through sequencing. Likewise, wastewater treatment plants (WTPs) harbored different viromes, and we detected other human pathogens, such as noroviruses and adenoviruses, furthering our understanding of wastewater viral ecology.

An Optimized System to Reduce Procurement Risks and Stock-Outs: A Simulation Case Study for a Component Manufacturer

In the current global system; supply chains are at risk due to increasing procurement shortages, supply disruptions, and the reliability of on-time deliveries with the original order quantities. As a result, an anticipated management model is of vital importance to provide companies with the productive flexibility necessary to adapt quickly to supply changes, in order to ensure the quality and delivery time through efficient management of stocks and supply costs. In this context, this research aims to develop a system to complement classical procurement planning based on inventory management methods and MRP (material requirements planning) systems by considering suppliers’ behavior regarding procurement risks. For this purpose, a system is developed that seeks to simulate the impacts of procurement shortages of different natures. Moreover, the research investigates the development of a system that performs procurement planning of a component manufacturer to determine the supply orders necessary to meet the master production schedule. The system is analyzed based on a set of indicators in the event that the supplier of a material needed for production does not supply on time or has short-term problems. Several scenarios are simulated, and the results are quantified by changing the procurement order quantities, which may or may not follow the economic order quantity (EOQ) model, and the potential procurement disruptions or shortages. The results show how the simulation and anticipation of potential suppliers’ procurement behavior concerning potential shortages and their probability are key for successful procurement within a joint strategy with classical procurement methods.

Supply chain recovery challenges in the wake of COVID-19 pandemic

The COVID-19 pandemic has revealed the fragility of global supply chains arising from raw material scarcity, production and transportation disruption, and social distancing. Firms need to carefully anticipate the difficulties during recovery and formulate appropriate strategies to ensure the survival of their businesses and supply chains. To enhance awareness of the issues, this research aims to identify and model recovery challenges in the context of the Bangladeshi ready-made garment industry. A Delphi-based grey decision-making trial and evaluation laboratory (DEMATEL) methodology was used to analyze the data. While the Delphi method helped identify the major supply chain recovery challenges from the impacts of the COVID-19 pandemic, the grey DEMATEL approach helped categorize the causal relationships among these challenges. Of the 23 recovery challenges finalized, 12 are causal challenges. The study's findings can assist decision-makers in developing strategic policies to overcome the recovery challenges in the post-COVID-19 era.

COVID-19 experience in Morocco: Modelling the agile capabilities of Moroccan Clinics

The COVID-19 pandemic posed multiple challenges to the healthcare sector. To be a leader under this crisis, healthcare organizations need to be agile in order to face the various challenges of the pandemic, as the treatment of COVID-19 patients, equipping hospitals with medical and protective equipment, strengthen epidemiological monitoring. Acknowledging the importance of this concept, many healthcare organizations have implemented agility on their health care system. In this context, this study uses total interpretive structural modeling (TISM) for two purposes. First, it models the agile capabilities of a Moroccan healthcare organization in a hierarchical form by differentiating between the driving capabilities and the dependent ones. Second, it interprets the interrelationship among them and ranks the capabilities based on their influence on agility. Through a literature review, different capabilities of organization agility have been identified followed by a questionnaire circulated among different healthcare professionals. Results indicate the most agile capabilities that bring agility in the healthcare organizations in order to address those challenges caused by the COVID-19 crisis.

Impact of COVID-19 on supply chains: lessons learned and future research directions

Purpose

This study aims to review and organize the research articles which focused on the impact of COVID-19 pandemic in the supply chain (SC) domain through a bibliometric and network analysis.

Design/methodology/approach

Initially, a total of 772 research articles with selected keywords were retrieved from the Scopus database for the year 2020 (with the commencement of COVID-19 outbreak). After the filtration and refinement, 484 research articles were found relevant and unique. Further, this study systematically reviews and evaluates the 484 research articles including influential authors, keys journals, influential research work, and collaboration among the countries and institutes with the help of bibliometric analysis tool. The emergent research clusters are identified and established.

Findings

The findings reveal that the total number of related publications are steadily growing with the United States leading the way. European countries have made notable accomplishments as well. In addition, both the most cited publications and the keyword distribution provide research guidance for future research.

Practical implications

This study focuses on the need and advancement of the literature on the impacts of the COVID-19 pandemic on SCs to frame a research agenda for researchers and practitioners.

Originality/value

The present study offers future research directions in the area of SC under the pandemic situation.

Key supply chain strategies for the post-COVID-19 era: implications for resilience and sustainability

Purpose

The impacts of the novel coronavirus (COVID-19) outbreak continue to devastate supply chain operations. To attain a competitive advantage in the post-COVID-19 era, decision-makers should explore key supply chain strategies to move forward and ready their policies to be implemented when the crisis sufficiently subsides. This is a significant and practical decision-making issue for any supply chain; hence, the purpose of this study is to explore and analyse key supply chain strategies to ensure robustness and resilience in the post-COVID-19 era.

Design/methodology/approach

This study conducted an expert survey targeting practitioners and academics to explore key supply chain strategies as means of moving forward in the post-COVID-19 era. Further, the key strategies were quantitatively analysed by applying the best-worst method (BWM) to determine their priority importance in the context of the manufacturing sector.

Findings

The results revealed that supply chain resilience and sustainability practices could play a dominant role in this period. The findings of the study can assist supply chain decision-makers in their formulations of key strategies.

Originality/value

This is the first study to investigate key supply chain strategies for the post-COVID-19 era. This study will help practitioners paying attention to resilience and sustainability practices for managing the impacts of future large-scale disruptions.

Rural Healthcare Enterprises in the Vortex of COVID-19: The Impact of Public Policies on the Internal and External Environment

The public policies implemented in order to contain the spread of COVID-19 in the community have created issues both in the internal and the external environments of the Greek rural healthcare enterprises. This study aimed to investigate the full extent of the issues (internal and external) caused by the public policies. Regarding the external factors, we examined the state, the local authorities, the financial institutions, the social stakeholders and the citizens. Regarding the internal factors, we focused on turnover, liquidity, working conditions, internal changes related to patient care and the implementation of protective measures. A qualitative research was conducted among twelve rural healthcare business owners in the form of semi-structured interviews. The research was conducted in the fall of 2020 during the second phase of COVID-19. The research showed that these enterprises were severely impacted by the government’s public policies. Local authorities were not involved due to lack of competence. The business owners were unwilling to support their enterprises via bank lending. During the first phase of COVID-19, citizens postponed nonessential medical examinations, causing a reduction in these enterprises’ turnover. As a result, in the following periods, these enterprises faced liquidity problems. However, they developed social objectives and implemented protective measures for their employees and patients. The present study contributes to the mapping of the factors affecting the internal and external environments of rural healthcare enterprises along with the public policies developed in times of prolonged crisis. These kinds of data are crucial to the business world and government officials voting on social policies. One cannot rule out the possibility of a new financial or health crisis; the findings of this study can prove to be a useful tool in the process of decision making.

Healthcare Management and Quality during the First COVID-19 Wave in a Sample of Spanish Healthcare Professionals

The aim of this study was to assess how the healthcare professionals in the Castellón Province (Spain) perceive healthcare quality and management during the first COVID-19 wave. A cross-sectional study was carried out. An online survey on healthcare quality and management during the first COVID-19 wave was sent to healthcare professionals. Almost half of the sample believed that healthcare quality worsened during the first COVID-19 wave (45.3%; n = 173). Heavier workload (m = 4.08 ± 1.011) and patients' complexity (m = 3.77 ± 1.086) were the factors that most negatively impacted healthcare quality. Health department 3, primary care center, and other doctors assessed human and material resources management as significantly worse (p < 0.05). Human and material resources management and the healthcare organization negatively affected healthcare quality during the first COVID-19 wave. Significant differences were observed according to departments, services, and professionals.

Covid-19 Impacts on Florida's Healthcare Professionals

This study described how COVID-19 impacted employment, telehealth usage, and interprofessional collaboration. A cross-sectional survey was deployed in June 2020 to healthcare professionals in Florida. Job status was uniquely separated by profession, with more nurses and medical doctors reported having no effect, and more mental health counselors transitioned to telehealth. Over a third of rehabilitation providers reported being furloughed. Over forty percent of providers had no training in telehealth, yet 33.1% reported an increase in usage. Interprofessional interactions are lower across professions during the pandemic, compared with before. This study shows the need for additional training on telehealth and interprofessional collaboration.

Process improvement approaches in emergency departments: a review of the current knowledge

Purpose

The healthcare system has been under pressure to provide timely and quality healthcare. The influx of patients in the emergency departments (EDs) is testing the capacity of the system to its limit. In order to increase EDs' capacity and performance, healthcare managers and practitioners are adopting process improvement (PI) approaches in their operations. Thus, this study aims to identify the main PI approaches implemented in EDs, as well as the benefits and barriers to implement these approaches.

Design/methodology/approach

The study is based on a rigorous systematic literature review of 115 papers. Furthermore, under the lens of thematic analysis, the authors present the descriptive and prescriptive findings.

Findings

The descriptive analysis found copious information related to PI approaches implemented in EDs, such as main PIs used in EDs, type of methodological procedures applied, as well as a set of barriers and benefits. Aiming to provide an in-depth analysis and prescriptive results, the authors carried out a thematic analysis that found underlying barriers (e.g. organisational, technical and behavioural) and benefits (e.g. for patients, the organisation and processes) of PI implementation in EDs.

Originality/value

The authors contribute to knowledge by providing a comprehensive review of the main PI methodologies applied in EDs, underscoring the most prominent ones. This study goes beyond descriptive studies that identify lists of barriers and benefits, and instead the authors categorize prescriptive elements that influence these barriers and benefits. Finally, this study raises discussions about the behavioural influence of patients and medical staff on the implementation of PI approaches.

Procurement 4.0 to the rescue: catalysing its adoption by modelling the challenges

Purpose

The pandemic crisis has resulted in global chaos that had caused massive disruption to the supply chain. The pharmaceutical industry, in particular, has been working tirelessly to ensure that they can cater to the people who need them. With restrictions being imposed to prevent the spread of the COVID-19 virus, the movement of raw materials required has been affected, thus creating the need for the procurement function to be innovative. This study proposes the application of Industry 4.0 concepts into the procurement activities of an organization to make it more resilient and efficient.

Design/methodology/approach

To study the intensity of the challenges, Total Interpretive Structural Modelling is used alongside the “Matrice des Impacts Croises Multiplication Appliquee a un Classement” (MICMAC) technique.

Findings

Resilience can be achieved through the collaboration between the organization and its network of suppliers. This is however easier said than done. High and unclear investments have been identified as the challenge that is taking a toll on all technological investments in the pandemic era. The study also shows that organizational inertia which is present in established and structured firms are a deterrent as well.

Originality/value

This study is based on the application of procurement 4.0 to ensure that pharmaceutical supply chains stay least affected since they are essentials. This study using a multi-criteria decision-making approach to prioritize the challenges. This will help practitioners make decisions faster.

Strategic issues of big data analytics applications for managing health-care sector: a systematic literature review and future research agenda

Purpose

The proposed article is aimed at exploring the opportunities, challenges and possible outcomes of incorporating big data analytics (BDA) into health-care sector. The purpose of this study is to find the research gaps in the literature and to investigate the scope of incorporating new strategies in the health-care sector for increasing the efficiency of the system.

Design/methodology/approach

Fora state-of-the-art literature review, a systematic literature review has been carried out to find out research gaps in the field of healthcare using big data (BD) applications. A detailed research methodology including material collection, descriptive analysis and categorization is utilized to carry out the literature review.

Findings

BD analysis is rapidly being adopted in health-care sector for utilizing precious information available in terms of BD. However, it puts forth certain challenges that need to be focused upon. The article identifies and explains the challenges thoroughly.

Research limitations/implications

The proposed study will provide useful guidance to the health-care sector professionals for managing health-care system. It will help academicians and physicians for evaluating, improving and benchmarking the health-care strategies through BDA in the health-care sector. One of the limitations of the study is that it is based on literature review and more in-depth studies may be carried out for the generalization of results.

Originality/value

There are certain effective tools available in the market today that are currently being used by both small and large businesses and corporations. One of them is BD, which may be very useful for health-care sector. A comprehensive literature review is carried out for research papers published between 1974 and 2021.

COVID-19 pandemic related supply chain studies: A systematic review

The global spread of the novel coronavirus, also known as the COVID-19 pandemic, has had a devastating impact on supply chains. Since the pandemic started, scholars have been researching and publishing their studies on the various supply-chain-related issues raised by COVID-19. However, while the number of articles on this subject has been steadily increasing, due to the absence of any systematic literature reviews, it remains unclear what aspects of this disruption have already been studied and what aspects still need to be investigated. The present study systematically reviews existing research on the COVID-19 pandemic in supply chain disciplines. Through a rigorous and systematic search, we identify 74 relevant articles published on or before 28 September 2020. The synthesis of the findings reveals that four broad themes recur in the published work: namely, impacts of the COVID-19 pandemic, resilience strategies for managing impacts and recovery, the role of technology in implementing resilience strategies, and supply chain sustainability in the light of the pandemic. Alongside the synthesis of the findings, this study describes the methodologies, context, and theories used in each piece of research. Our analysis reveals that there is a lack of empirically designed and theoretically grounded studies in this area; hence, the generalizability of the findings, thus far, is limited. Moreover, the analysis reveals that most studies have focused on supply chains for high-demand essential goods and healthcare products, while low-demand items and SMEs have been largely ignored. We also review the literature on prior epidemic outbreaks and other disruptions in supply chain disciplines. By considering the findings of these articles alongside research on the COVID-19 pandemic, this study offers research questions and directions for further investigation. These directions can guide scholars in designing and conducting impactful research in the field.

Six Sigma to distinguish patterns in COVID-19 approaches

Purpose

COVID-19 has changed life as we know. Data are scarce and necessary for making decisions on fighting COVID-19. The purpose of this paper is to apply Six Sigma techniques on the current COVID-19 pandemic to distinguish between special cause and common cause variation. In the DMAIC structure, different approaches applied in three countries are compared.

Design/methodology/approach

For three countries the mortality is compared to the population to distinguish between special cause variation and common cause variation. This variation and the patterns in it are assessed to the countries' different approaches to COVID-19.

Findings

In the DMAIC problem-solving approach, patterns in the data are distinguished. The special cause variation is assessed to the special causes and approaches. The moment on which measures were taken has been essential, as well as policies on testing and distancing.

Research limitations/implications

Cross-national data comparisons are a challenge as countries have different moments on which they register data on their population. Furthermore, different intervals are taken, varying from registering weekly to registering yearly. For the research, three countries with similar data registration and different approaches in fighting COVID-19 were taken.

Originality/value

This is the first study with Master Black Belts from different countries on the application of Six Sigma techniques and the DMAIC from the viewpoint of special cause variation on COVID-19.

Measuring operational efficiency of isolation hospitals during COVID-19 pandemic using data envelopment analysis: a case of Egypt

Purpose

This study used Data Envelopment Analysis (DEA) to measure and evaluate the operational efficiency of 26 isolation hospitals in Egypt during the COVID-19 pandemic, as well as identifying the most important inputs affecting their efficiency.

Design/methodology/approach

To measure the operational efficiency of isolation hospitals, this paper combined three interrelated methodologies including DEA, sensitivity analysis and Tobit regression, as well as three inputs (number of physicians, number of nurses and number of beds) and three outputs (number of infections, number of recoveries and number of deaths). Available data were analyzed through R v.4.0.1 software to achieve the study purpose.

Findings

Based on DEA analysis, out of 26 isolation hospitals, only 4 were found efficient according to CCR model and 12 out of 26 hospitals achieved efficiency under the BCC model, Tobit regression results confirmed that the number of nurses and the number of beds are common factors impacted the operational efficiency of isolation hospitals, while the number of physicians had no significant effect on efficiency.

Research limitations/implications

The limits of this study related to measuring the operational efficiency of isolation hospitals in Egypt considering the available data for the period from February to August 2020. DEA analysis can also be an important benchmarking tool for measuring the operational efficiency of isolation hospitals, for identifying their ability to utilize and allocate their resources in an optimal manner (Demand vs Capacity Dilemma), which in turn, encountering this pandemic and protect citizens' health.

Originality/value

Despite the intensity of studies that dealt with measuring hospital efficiency, this study to the best of our knowledge is one of the first attempts to measure the efficiency of hospitals in Egypt in times of health' crisis, especially, during the COVID-19 pandemic, to identify the best allocation of resources to achieve the highest level of efficiency during this pandemic.

The Role of Coping in the Wellbeing and Work-Related Quality of Life of UK Health and Social Care Workers during COVID-19

The coronavirus disease 2019 (COVID-19) was declared a global pandemic in early 2020. Due to the rapid spread of the virus and limited availability of effective treatments, health and social care systems worldwide quickly became overwhelmed. Such stressful circumstances are likely to have negative impacts on health and social care workers' wellbeing. The current study examined the relationship between coping strategies and wellbeing and quality of working life in nurses, midwives, allied health professionals, social care workers and social workers who worked in health and social care in the UK during its first wave of COVID-19. Data were collected using an anonymous online survey (N = 3425), and regression analyses were used to examine the associations of coping strategies and demographic characteristics with staff wellbeing and quality of working life. The results showed that positive coping strategies, particularly active coping and help-seeking, were associated with higher wellbeing and better quality of working life. Negative coping strategies, such as avoidance, were risk factors for low wellbeing and worse quality of working life. The results point to the importance of organizational and management support during stressful times, which could include psycho-education and training about active coping and might take the form of workshops designed to equip staff with better coping skills.

Application of Lean 6s Methodology in an Engineering Education Environment during the SARS-CoV-2 Pandemic

In this work, the application of the Lean 6S methodology is exposed, which includes the Safety-Security activity in response to the demands caused by the epidemiological situation due to exposure to SARS-CoV-2, as well as its implementation through a standardized process in n higher education environment in the engineering field. The application of methodologies based on lean principles in the organizational system of an educational institution, causes an impact on the demands of organizational efficiency, where innovation and continuous improvement mark the path to success. The Lean 6S methodology, based on the development of six phases, guarantees, thanks to the impact of all its phases and especially of three of them: cleaning, standardize and safety, the control of the health risk against SARS-CoV-2. This guarantee is achieved through the permanent review of safety in the workplace. The areas of selected implementation to verify the effect have been the essential spaces for the development of the teaching activity: center accesses, learning rooms and practical laboratories. The laboratories are adapted to the security and organization conditions that are required in the regulations required by the Occupational Risk Prevention Services against exposure to SARS-CoV-2, since the appropriate protective equipment for the risk level is reviewed, the ordering of the workstations, the class attendance through the shifts organization and the rearrangement of the common places where the maintenance of a minimum interpersonal safety distance between the teaching staff, auxiliary services and students is guaranteed. The effort of the teaching staff in terms of following the established rules is notably increased. To balance this dedication, it is necessary to increase and rely on auxiliary personnel who guarantee rules compliance control in different spaces than the classroom and the laboratory.

Market-Oriented Procurement Planning Leading to a Higher Service Level and Cost Optimization

The current global market situation pursues high adaptability, but why? Complexity due to mass customization is greater than ever. Globalization is no longer a theory but a fact that makes disruptions in the globalized supply chain a major risk for operations. In this context, customers demand novelty and unique experiences. These are the main drivers for market success. Therefore, existing products are now in continuous states of change with shortened product lifecycles. The purpose of this article is to analyze the impact of new market entries and product changes along the lifecycle as well as supply chain disruptions in supplier inventory levels. The goal is to minimize costs by achieving a given service level with a market-oriented procurement planning model. The model pursues minimizing the time needed to align the system with the market and, therefore, the adaptability of the system. The research compares classical inventory management models with the new proposed approach by means of simulation with the system dynamics methodology. The results show how the proposed model increased the delivery service level, reduced inventory costs, and increased the utilization of resources due to lower demand uncertainty. Therefore, the developed model is able to plan the inventory supply with a low risk of stock outages. The conclusion proposes a differentiated forecasting and inventory strategy depending on the product lifecycle stage. The developed market-oriented procurement planning model provides guidance for inventory managers regarding how to optimize their operations as an opportunity within the fourth industrial revolution to develop information technology (IT) systems to gather and utilize demand and inventory data with real-time efficiency.