scholarly journals Responding to unforeseen disasters in a large health system

2020 ◽  
Author(s):  
Ryan J Hannan ◽  
Margaret K Lundholm ◽  
Dennis Brierton ◽  
Noelle R M Chapman
Keyword(s):  
Supply Chain ◽  
Health System ◽  
Disaster Response ◽  
Well Being ◽  
Lessons Learned ◽  
Strategic Decision ◽  
Pharmacy Services ◽  
Efficient System ◽  
Team Members

Abstract Purpose To describe how health systems may respond to sudden changes in operations by leveraging existing resources and to share one organization’s experience responding to the coronavirus disease (COVID-19) pandemic. Summary In a health system based in Illinois and Wisconsin, pharmacy services are provided by a single, integrated department responsible for all aspects of pharmaceutical care within the organization. Hospital, retail, ambulatory care, and population health services are all managed under one leadership team. All pertinent ancillary services are also managed within the department, including informatics, supply chain, and drug policy. During the COVID-19 pandemic, the pharmacy services leadership has successfully managed volume and capacity challenges by redirecting resources to where they are needed. A disaster response framework based on Federal Emergency Management Agency guidance was put in place, and change management principles were used to rapidly operationalize change. Components of the nimble response have included quickly increasing capacity, thoughtful and timely communication to all team members, strategic decision making with available data, creating an agile pool of labor, and maintaining an efficient system supply chain. Well-being and resilience are emphasized alongside reflection on lessons learned. Some changes made in the urgent response to the pandemic are being considered for long-term implementation. Conclusion Organizations have the potential to respond to almost any situation if they are integrated and teams work together to build flexibility. The keys to success are thoughtful maximization of existing resources and strong communication.

scholarly journals Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy

2019 ◽  
Vol 54 (3) ◽  
pp. 170-174
Author(s):  
Brian L. Erstad ◽  
Tina Aramaki ◽  
Kurt Weibel
Keyword(s):  
Health System ◽  
Health Systems ◽  
Integration Method ◽  
Medical Center ◽  
Academic Medical Center ◽  
Lessons Learned ◽  
Faculty Members ◽  
Pharmacy Services ◽  
Academic Medical ◽  
High Level

Objective: To provide lessons learned for colleges of pharmacy and large health systems that are contemplating or in the process of undergoing integration. Method: This report describes the merger of an academic medical center and large health system with a focus on the implications of the merger for pharmacy from the perspectives of both a college of pharmacy and a health system’s pharmacy services. Results: Overarching pharmacy issues to consider include having an administrator from the college of pharmacy directly involved in the merger negotiation discussions, having at least one high-level administrator from the college of pharmacy and one high-level pharmacy administrator from the health system involved in ongoing discussions about implications of the merger and changes that are likely to affect teaching, research, and clinical service activities, having focused discussions between college and health system pharmacy administrators on the implications of the merger on experiential and research-related activities, and anticipating concerns by clinical faculty members affected by the merger. Conclusion: The integration of a college of pharmacy and a large health system during the acquisition of an academic medical center can be challenging for both organizations, but appropriate pre- and post-merger discussions between college and health system pharmacy administrators that include a strategic planning component can assuage concerns and problems that are likely to arise, increasing the likelihood of a mutually beneficial collaboration.

scholarly journals The Ethical Dilemma of Safety Versus Self-Determination in Long-Term Care Community Residents During COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 160-160
Author(s):  
Rebecca Davis ◽  
Cheryl Monturo ◽  
Maria O'Reilly ◽  
Diana Sturdevant
Keyword(s):  
Long Term Care ◽  
Ethical Reasoning ◽  
Well Being ◽  
The United States ◽  
Lessons Learned ◽  
Self Determination ◽  
Term Care ◽  
Care Community ◽  
Basic Care

Abstract The pandemic profoundly affected the care of older adults in long term care communities (LTCC) across the world. More than one third of pandemic deaths were linked to nursing homes. Most nations and states had strict guidelines on visitation, with many, especially in the United States, totally prohibiting visitation for over an entire year. Well-intentioned measures to protect through isolation caused a profound ethical tension between safety and self-determination. The aim of the project was to examine this dilemma using a case study and the Madison Collaborative Ethical Reasoning in Action Framework. Eight key questions of fairness, outcomes, rights, responsibilities, character, liberty, empathy, and authority were applied in the context of federal and state mandates in the US and Australia. Results highlighted issues of ageism, paternalism vs empathy, regulatory vs family authority, a focus on short-term outcomes while forfeiting long-term outcomes, community responsibilities to the resident trumped individual resident rights, the potential loss of community character in lieu of basic care provision, a loss of personal freedoms, and the emphasis of physical well-being over holistic well-being. The results of this analysis can inform future policy and provide lessons learned for the future.

scholarly journals The Max Access Solution: A 'No Patient Left Behind' Model for Treatment Access

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 29s-29s
Author(s):  
Ann K. Novakowski ◽  
Pat Garcia-Gonzalez
Keyword(s):  
Supply Chain ◽  
Conflicts Of Interest ◽  
The United States ◽  
Lessons Learned ◽  
Noncommunicable Disease ◽  
Treatment Access ◽  
Assistance Program ◽  
Disease Spectrum ◽  
Patient Assistance

Purpose The Max Foundation has led the development and implementation of the widely recognized model for patient assistance programs by which manufacturers make available some of their innovative products to patients in low- and middle-income countries. Recognizing that a limitation of a pharmaceutical patient assistance program is the focus on a particular product while a patient’s cancer need is company agnostic, the Max Access Solution borrows from all the lessons learned from developing and managing access programs while shifting the focus from the drug to the patient. This innovative long-term access approach provides a bridge to treatment to individually identified patients in countries where the treatment is not otherwise locally available. Methods The initiative focuses on the patient and his or her needs across the disease spectrum, harnessing the power of multisector collaborations, including drug manufacturers, international distributors, diagnostics companies, ministries of health, ministries of health hospitals, cancer centers and other public institutions in recipient countries, and local nongovernmental organizations and patient organizations, as well as cancer research centers in the United States. We established the following measurable objectives: identify all treatments approved for a particular cancer, identify the supportive care needed to successfully treat the disease, identify local and international stakeholders for the success of the initiative, develop collaborative agreements with each of them, and establish an end-to-end validated supply chain into each country/cancer institution. Results In the first year of implementation, The Max Foundation delivered more than 700,000 required daily doses of oral cancer medication for CML to more than 10,000 patients in 65 countries, made 2,500 molecular tests available to patients, executed more than 220 collaboration agreements, and established a gross domestic product–validated supply chain into 90 cancer-treating institutions. Conclusion The Max Access Solution is a unique and innovative approach to cancer care access. An aim of The Max Foundation in developing the Max Access Solution for CML was as a proof of concept as well as to develop systems and impact measurements, with the long-term vision of expanding the model to other cancers. This model may be replicated in a variety of noncommunicable disease areas, including breast cancer and other cancers, to reduce health disparities globally. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

scholarly journals (P1-9) Multinational Disaster Response Exercise: Critical Look and Lessons Learned

2011 ◽  
Vol 26 (S1) ◽  
pp. s101-s101
Author(s):  
T. Norii ◽  
Y. Terasaka ◽  
M. Miura ◽  
T. Nishinaka ◽  
R. Lueken ◽  
...  
Keyword(s):  
Disaster Response ◽  
Lessons Learned ◽  
Medical Team ◽  
Team Members ◽  
Disaster Assistance ◽  
Us Military ◽  
Military Members ◽  
Response Team ◽  
Medical Teams ◽  
National Disaster

IntroductionInternational collaboration for disaster response is an increasing phenomenon. Japan-United States joint field exercises have been conducted annually since 2004, triggered by an incident in which a US helicopter crashed into a university campus in Okinawa, Japan. The fifth Japan-US disaster field exercise was conducted testing the disaster response of the Okinawa government and US military.MethodsThe simulated exercise involved a US Navy aircraft that crashed into a city center in Okinawa, Japan. There were 16 simulated casualties that included US military members and Japanese citizens. The participants in this exercise were US military members, including the Disaster Assistance Response Team (DART) and local rescue and medical teams including the Okinawa Disaster Medical Assistance Team (DMAT). Data were gathered from the joint debriefing session held by both medical teams. Furthermore, interviews with team leaders from both nations were conducted and feedback obtained.ResultsLack of communication and inaccurate communication remained the root of most problems encountered. There were several miscommunications at the scene due to the language barrier and ignorance of different medical teams' capability and method of practice. Due to the unclear signage of the initial triage zone, another triage zone was developed later by a second medical team. Confusion regarding gathering information and order of transport also was witnessed. The capabilities of team members were not well known between teams, resulting in inappropriate expectations and difficulty in effective cooperation.ConclusionsUnderstanding the systems and backgrounds of each medical team is essential. Signs or symbols of key elements including triage areas should be clear, universal, and multilingual. Communication remains the Achilles' heel of multi-national disaster response activities.

scholarly journals See with Your Eyes, Hear with Your Ears and Listen to Your Heart: Moving from Dyadic Teamwork Interaction towards a More Effective Team Cohesion and Collaboration in Long-Term Spaceflights under Stressful Conditions

2020 ◽  
Vol 4 (3) ◽  
pp. 18
Author(s):  
Aggeliki Vlachostergiou ◽  
Andre Harisson ◽  
Peter Khooshabeh
Keyword(s):  
Well Being ◽  
Team Cohesion ◽  
Team Members ◽  
The Past ◽  
Interactional Context ◽  
One Step ◽  
Underlying Mechanisms ◽  
Amount Of Knowledge ◽  
The Relationship

The scientific study of teamwork in the context of long-term spaceflight has uncovered a considerable amount of knowledge over the past 20 years. Although much is known about the underlying factors and processes of teamwork, much is left to be discovered for teams who operate in extreme isolation conditions during spaceflights. Thus, special considerations must be made to enhance teamwork and team well-being for long-term missions during which the team will live and work together. Being affected by both mental and physical stress during interactional context conversations might have a direct or indirect impact on team members’ speech acoustics, facial expressions, lexical choices and their physiological responses. The purpose of this article is (a) to illustrate the relationship between the modalities of vocal-acoustic, language and physiological cues during stressful teammate conversations, (b) to delineate promising research paths to help further our insights into understanding the underlying mechanisms of high team cohesion during spaceflights, (c) to build upon our preliminary experimental results that were recently published, using a dyadic team corpus during the demanding operational task of “diffusing a bomb” and (d) to outline a list of parameters that should be considered and examined that would be useful in spaceflights for team-effectiveness research in similarly stressful conditions. Under this view, it is expected to take us one step towards building an extremely non-intrusive and relatively inexpensive set of measures deployed in ground analogs to assess complex and dynamic behavior of individuals.

scholarly journals A model for sustainable, partnership-based telehealth services in rural India: An early process evaluation from Tuver village, Gujarat

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261907
Author(s):  
Shoba Ramanadhan ◽  
Krishnan Ganapathy ◽  
Lovakanth Nukala ◽  
Subramaniya Rajagopalan ◽  
John C. Camillus
Keyword(s):  
Rural Communities ◽  
Process Evaluation ◽  
Low Income ◽  
Local Development ◽  
Well Being ◽  
Power Sharing ◽  
Strategic Decision ◽  
Quality Healthcare ◽  
Local Staff

Background Telehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability. Methods A demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach. Results Findings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects. Conclusion Overall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.

Defense Supply Chain Operations

2019 ◽  
pp. 277-300
Author(s):  
Greg H. Parlier
Keyword(s):  
Supply Chain ◽  
Operations Research ◽  
Strategic Decision ◽  
Management Innovation ◽  
Engineering Systems ◽  
Us Army ◽  
The Us ◽  
Enterprise Transformation

This chapter explains the origination, evolution, emerging results, and potential long-term impacts of one particularly daunting enterprise transformation effort within the US Department of Defense. It offers a unique case study for a multi-disciplinary endeavor referred to as the project to Transform US Army Supply Chains (TASC Project). The TASC project pursued comprehensive and creative applications using a variety of Operations Research methods, advanced analytics, and management innovation to improve tactical, operational, and strategic decision making for the military's global sustainment enterprise. This chapter may be of interest to those confronting supply chain and other complex enterprise transformation challenges: national security officials; aerospace, defense, and industrial professionals; university graduate students and professors of engineering systems, operations research, and management. The strategy described herein offers potential solutions broadly applicable to other public institutions and government bureaucracies as well.

From Economic Abuse to Economic Empowerment: Piloting a Financial Literacy Curriculum With Women Who Have Experienced Domestic and Family Violence

Affilia ◽  
2019 ◽  
Vol 34 (4) ◽  
pp. 498-517
Author(s):  
Amy Warren ◽  
Trudi Marchant ◽  
Darcee Schulze ◽  
Donna Chung
Keyword(s):  
Domestic Violence ◽  
Family Violence ◽  
Financial Literacy ◽  
Well Being ◽  
Lessons Learned ◽  
Literacy Programs ◽  
Literacy Curriculum ◽  
Economic Abuse ◽  
Women And Children

Economic abuse as a form of men’s violence against women has only been recently recognized as a form of violence in its own right. It is known to further exacerbate the detrimental long-term impacts of domestic and family violence on women and children. There is evidence to suggest the effectiveness of financial literacy programs in mitigating some of these impacts and improving women’s financial well-being in the longer term; however, there are very few domestic violence–informed, empirically evaluated programs internationally. This article reports the findings of a specialist domestic violence financial literacy curriculum, which was developed and piloted in Western Australia using pre–post measures and focus groups. These findings suggest that such financial literacy programs delivered in refuge settings have effective short-term outcomes among women. Lessons learned from the pilot and the implications for future implementation and scaling up of programs and research are also discussed.

scholarly journals Lessons Learned from the COVID-19 Pandemic Exposing the Shortcomings of Current Supply Chain Operations: A Long-Term Prescriptive Offering

2020 ◽  
Vol 12 (14) ◽  
pp. 5858 ◽  
Author(s):  
Guiyang Zhu ◽  
Mabel C. Chou ◽  
Christina W. Tsai
Keyword(s):  
Supply Chain ◽  
Supply Chains ◽  
General Public ◽  
Respiratory Virus ◽  
Lessons Learned ◽  
Just In Time ◽  
Safety Stock ◽  
The World ◽  
The Relationship

COVID-19 is a highly infectious respiratory virus that has posed a great threat to the general public. In order to prevent its spread, many governments have enacted stringent measures. Supply chains around the world are facing major disruptions and difficulties adjusting to the new demands and needs of a locked down world. In this paper, we will address the relationship between supply chain operations and the ongoing COVID-19 pandemic. Given current global shortages in essential goods such as medication, we explore the connection between said shortage and supply chain issues, such as the lack of supply chain transparency and resilience, as well as unsustainable just-in-time manufacturing. To mitigate the effects of these issues and protect supply chain operations, we propose some recommendations, such as nationalizing the medical supply chains, adopting a plus one diversification approach, and increasing safety stock. These recommendations are given to not only mitigate current consequences in relation to the ongoing crisis, but also to suggest measures that will provide firms the resiliency needed to weather similar potential shortages in the future.

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