A fuzzy decision framework of lean-agile-green (LAG) practices for sustainable vaccine supply chain

Leagility in the healthcare research: a systematic review

BACKGROUND

Expenditure of healthcare services has been growing over the past decades. Lean and agile are two popular paradigms that could potentially contain cost and improve proficiency of the healthcare system. However no systematic review was found on leagilty in the healthcare research. This study aims at synthesizing the extant literature of leagility in the healthcare area to consolidate its potential and identify research gaps for future study in the field.

METHODS

A systematic literature review is conducted following the PRISMA checklist approach. Studies were searched in multiple databases. The selection of articles was executed by dual-scanning of two researchers to ensure quality of data and relevance to the topic. Scientific articles published between January 1999 and November 2023 concerning leagile healthcare are analysed using Microsoft Excel and VOSviewer (version 1.6.18).

RESULTS

Out of 270 articles identified from the inclusion and exclusion criteria, 24 were included in the review. A total of 11 target areas were identified in leagility applications in healthcare. Success and limiting factors of leagile healthcare were classified into macro and micro aspects and further categorized into six dimensions: policy, organization, human resources, marketing, operation management and technology. Moreover, four research gaps were revealed and suggestions were provided for future study.

CONCLUSION

Leagility in the healthcare context is still being in its infancy. Few empirical validation was found in leagile healthcare literature. Further exploration into the application of theory in various sectors under the scope of healthcare is appealed for. Standardization and modularization, leadership support, skillfulness of professionals and staff training are the factors most frequently mentioned for a successful implementation of leagility in the healthcare sector.

Upscaling vaccine manufacturing capacity - key bottlenecks and lessons learned

The COVID-19 pandemic put enormous pressure on the vaccine production chain as billions of vaccines had to be produced in the shortest timeframe possible. Vaccine production chains struggled to keep up with demand, resulting in disruptions and production delays. This study aimed to make an inventory of challenges and opportunities that occurred in the production chain of the COVID-19 vaccine. Insights derived through approximately 80 interviews and roundtable discussions were combined with findings from a scoping literature review. Data were analysed through an inductive process where barriers and opportunities were linked to specific facets of the production chain. Key bottlenecks identified include a lack of manufacturing facilities, a lack of tech-transfer personnel, inefficient arrangement of production stakeholders, critical shortages in raw materials, and restricting protectionist measures. A need for a central governing body to map out shortages and to coordinate allocation of available resource became evident. Other suggested solutions were to repurpose existing facilities and to build in more flexibility in the production process by making materials interchangeable. Also, simplification of the production chain could be achieved through geographical reengagement of processes. Three overarching themes were identified, impacting overall functioning of the vaccine production chain: regulatory and visibility, collaboration and communication, and funding and policy. The results in this study showed a multitude of interdependent processes underlying the vaccine production chain, executed by diverse stakeholders with differing objectives. It characterizes the global complexity of the pharmaceutical production chain and highlights its extreme vulnerability to disruptions. More resilience and robustness must be integrated into the vaccine production chain, and low-middle income countries should be empowered to manufacture vaccines themselves. In conclusion, there's a need to rethink the production system for vaccines and other essential medicines in order to become better prepared for future health crises.

Supply chain risk factor assessment of Indian pharmaceutical industry for performance improvement

Purpose

The purpose of the present work is to improve the industry performance by identifying and quantifying the risks faced by the Indian pharmaceutical industry (IPI). The risk values for the prominent risks and overall industry are determined based on the four risk parameters, which would help determine the most contributive risks for mitigation.

Design/methodology/approach

An extensive literature survey was done to identify the risks, which were also validated by industry experts. The finalized risks were then evaluated using the fuzzy synthetic evaluation (FSE) method, which is the most suitable approach for the risk assessment with parameters having a set of different risk levels.

Findings

The three most contributive sub-risks are counterfeit drugs, demand fluctuations and loss of customers due to partners' poor service performance, while the main risks obtained are demand, financial and logistics. Also, the overall risk value indicates that the industry faces medium to high risk.

Practical implications

The study identifies the critical risks which need to be mitigated for an efficient industry. The industry is most vulnerable to the demand risk category. Therefore, the managers should minimize this risk by mitigating its sub-risks, like demand fluctuations, bullwhip effect, etc. Another critical sub-risk, the counterfeit risk, should be managed by adopting advanced technologies like blockchain, artificial intelligence, etc.

Originality/value

There is insufficient literature focusing on risk quantification. Therefore, this work addresses this gap and obtains the industry's most critical risks. It also discusses suitable mitigation strategies for better industry performance.

Modeling a sustainable vaccine supply chain for a healthcare system

This study develops a vaccine supply chain (VSC) to ensure sustainable distribution during a global crisis in a developing economy. In this study, a multi-objective mixed-integer programming (MIP) model is formulated to develop the VSC, ensuring the entire network's economic performance. This is achieved by minimizing the overall cost of vaccine distribution and ensuring environmental and social sustainability by minimizing greenhouse gas (GHG) emissions and maximizing job opportunities in the entire network. The shelf-life of vaccines and the uncertainty associated with demand and supply chain (SC) parameters are also considered in this study to ensure the robustness of the model. To solve the model, two recently developed metaheuristics-namely, the multi-objective social engineering optimizer (MOSEO) and multi-objective feasibility enhanced particle swarm optimization (MOFEPSO) methods-are used, and their results are compared. Further, the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) model has been integrated into the optimization model to determine the best solution from a set of non-dominated solutions (NDSs) that prioritize environmental sustainability. The results are analyzed in the context of the Bangladeshi coronavirus disease (COVID-19) vaccine distribution systems. Numerical illustrations reveal that the MOSEO-TOPSIS model performs substantially better in designing the network than the MOFEPSO-TOPSIS model. Furthermore, the solution from MOSEO results in achieving better environmental sustainability than MOFEPSO with the same resources. Results also reflect that the proposed MOSEO-TOPSIS can help policymakers establish a VSC during a global crisis with enhanced economic, environmental, and social sustainability within the healthcare system.

Multicriteria Approach for Supplier Selection: Evidence from a Case Study in the Fashion Industry

Worldwide manufactures are redesigning supply chains, often outsourcing with the aim of maintaining a competitive advantage and gaining market share. When selecting and purchasing fabrics, firms should actively cooperate with suppliers, to meet customers’ needs. In this view, the supplier selection process plays a key role in keeping a competitive edge in global markets. Therefore, this study proposes a multicriteria decision-making model (MCDM) to ease supplier evaluation and selection. Supply chain operation reference metrics (SCOR metrics) and fuzzy technique for order of preference by similarity to ideal solution (FTOPSIS) are combined to build a model for supplier selection. The former allows us to conduct a very thorough fact-based analysis of all features in the supply chain, while the combination of fuzzy theory and SCOR model allows us to deal with uncertainty. The main novelty of this method is that it incorporates a consolidated supply chain management criteria within the framework of fuzzy set theory and multicriteria decision-making model (MCDM) facilitating their application into practice. The proposed approach is tested by considering the case of a manufacturing firm in the fashion industry willing to designate the most appropriate supplier within a set of three potential ones.

A LAG-based framework to overcome the challenges of the sustainable vaccine supply chain: an integrated BWM–MARCOS approach

Purpose

Each individual needs to be vaccinated to control the spread of the COVID-19 pandemic in the shortest possible time. However, the vaccine distribution with an already strained supply chain in low- and middle-income countries (LMICs) will not be effective enough to vaccinate all the population in stipulated time. The purpose of this paper is to show that there is a need to revolutionize the vaccine supply chain (VSC) by overcoming the challenges of sustainable vaccine distribution.

Design/methodology/approach

An integrated lean, agile and green (LAG) framework is proposed to overcome the challenges of the sustainable vaccine supply chain (SVSC). A hybrid best worst method (BWM)–Measurement of Alternatives and Ranking According to COmpromise Solution (MARCOS) methodology is designed to analyze the challenges and solutions.

Findings

The analysis shows that vaccine wastage is the most critical challenge for SVSC, and the coordination among stakeholders is the most significant solution followed by effective management support.

Social implications

The result of the analysis can help the health care organizations (HCOs) to manage the VSC. The effective vaccination in stipulated time will help control the further spread of the virus, which will result in the normalcy of business and availability of livelihood for millions of people.

Originality/value

To the best of the author's knowledge, this is the first study to explore sustainability in VSC by considering the environmental and social impact of vaccination. The LAG-based framework is also a new approach in VSC to find the solution for existing challenges.