scholarly journals Developing a Decision-Making Framework to Improve Healthcare Service Quality during a Pandemic

2021 ◽  
Vol 5 (1) ◽  
pp. 3
Author(s):  
Gowthaman Sivakumar ◽  
Eman Almehdawe ◽  
Golam Kabir

The COVID-19 pandemic has significantly impacted almost every sector. This impact has been especially felt in the healthcare sector, as the pandemic has affected its stability, which has highlighted the need for improvements in service. As such, we propose a collaborative decision-making framework that is capable of accounting for the goals of multiple stakeholders, which consequently enables an optimal, consensus decision to be identified. The proposed framework utilizes the best–worst method (BWM) and the Multi-Actor Multi-Criteria Analysis (MAMCA) methodology to capture and rank each stakeholder’s preferences, followed by the application of a Multi-Objective Linear Programming (MOLP) model to identify the consensus solution. To demonstrate the applicability of the framework, two hypothetical scenarios involving improving patient care in an intensive care unit (ICU) are considered. Scenario 1 reflects all selected criteria under each stakeholder, whereas in Scenario 2, every stakeholder identifies their preferred set of criteria based on their experience and work background. The results for both scenarios indicate that hiring part-time physicians and medical staff can be the effective solution for improving service quality in the ICU. The developed integrated framework will help the decision makers to identify optimal courses of action in real-time and to select sustainable and effective strategies for improving service quality in the healthcare sector.

2018 ◽  
Vol 12 (18) ◽  
pp. 4172-4181 ◽  
Author(s):  
Mohammad Jooshaki ◽  
Ali Abbaspour ◽  
Mahmud Fotuhi-Firuzabad ◽  
Moein Moeini-Aghtaie ◽  
Matti Lehtonen

2021 ◽  
Author(s):  
◽  
Judith Helen Lawrence

<p>The ability of decision makers to respond to climate change impacts such as sea-level rise and increased flood frequency is challenged by uncertainty about scale, timing, dynamic changes that could lead to regime shifts, and by societal changes. Climate change adaptation decision making needs to be robust and flexible across a range of possible futures, to provide sufficient certainty for investment decisions in the present, without creating undue risks and liabilities for the near and long-term futures. A country’s governance and regulatory institutions set parameters for such decisions. The decision-making challenge is, therefore, a function of the uncertainty and dynamic characteristics of climate change, a country’s institutional framework, and the ways in which actual decision-making practice delivers on the intention of the framework.  My research asks if the current decision-making framework, at national and sub-national scales, and practices under it are adequate to enable decision makers to make climate change adaptation decisions that sufficiently address the constraints posed by climate change uncertainty and dynamic change. The focus is on New Zealand’s multi-scale governance and institutional framework with its high level of devolution to the local level, the level assumed as the most appropriate for climate change adaptation decisions. Empirical information was collected from a sample of agencies and actors, at multiple governance scales reflecting the range of geographical characteristics, governance types, organisational functions and actor disciplines. Data were collected using a mix of workshops, interviews and document analyses. The adequacy of the institutional framework and practice was examined using 12 criteria derived from the risk-based concepts of precaution, risk management, adaptive management and transformational change, with respect to; a) understanding and representing uncertainty and dynamic climate change; b) governance and regulations; and c) organisations and actors.  The research found that the current decision-making framework has many elements that could, in principle, address uncertainty and dynamic climate change. It enables long-term considerations and emphasises precaution and risk-based decision making. However, adaptive and transformational objectives are largely absent, coordination across multiple levels of government is constrained and timeframes are inconsistent across statutes. Practice shows that climate risk has been entrenched by misrepresentation of climate change characteristics. The resulting ambiguity is compounded at different governance scales, by gaps in the use of national and regional instruments and consequent differences in judicial decisions. Practitioners rely heavily upon static, time-bound treatments of risk, which reinforce unrealistic community expectations of ongoing protections, even as the climate continues to change, and makes it difficult to introduce transformational measures. Some efforts to reflect changing risk were observed but are, at best, transitional measures. Some experimentation was found in local government practice and boundary organisations were used as change-agents. Any potential improvements to both the institutional framework and to practices that could enable flexible and robust adaptation to climate change, would require supporting policies and adaptive governance to leverage them and to sustain decision making through time.  This thesis contributes to understanding how uncertainty and dynamic climate change characteristics matter for adaptation decision making by examining both a country-level institutional framework and practice under it. The adequacy analysis offers a new way of identifying institutional barriers, enablers and entry points for change in the context of decision making under conditions of uncertainty and dynamic climate change.</p>


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ahmed Karam ◽  
Kristian Hegner Reinau ◽  
Christian Richter Østergaard

AbstractIn the freight transport sector, competing companies horizontally collaborate through establishing Collaborative Transport Networks (CTNs). Fruitful implementation of CTNs will leverage environmental and socio-economic goals of sustainable development in the freight transport sector. The benefits of CTNs in horizontal collaborative settings have been widely demonstrated through several modelling approaches. However, in practice, the real applications of CTNs have been challenging and most did not achieve satisfactory performances. Some studies have addressed this issue by identifying different barriers to CTN implementation. However, a conceptual framework for the barriers is not well-established. In addition, the literature lacks a decision-making framework for the CTN implementation which considers the different barriers. To address this gap, this paper conducted a literature review of the barriers to CTN implementation. In total, 31 different barriers were identified. A conceptual barrier framework is developed by grouping the 31 barriers into five categories: the business model, information sharing, the human factors, the Collaborative Decision Support Systems (CDSSs), and the market. The paper additionally proposes a stage-gate model integrating the conceptual barrier framework into the CTN implementation decision-making process. The current work contributes to the existing literature by developing both theoretical and practical understandings of the barriers to implementing CTNs and will support decision makers in CTN implementation to maximize the CTN benefits and minimize the risk of CTN failure.


Author(s):  
Iftikhar U. Sikder ◽  
Aryya Gangopadhyay

There are numerous technical and organizational challenges in the design and implementation of spatial decision support systems. Part of the problem stems from the distributed and uncoordinated land management practices of individual decision-makers. For example, in environmental planning, multiple decision makers with conflicting goals may need to make collective decisions. This requires collaborative decision-making tools and conflict resolution capabilities. In this chapter, we identify the research issues related to the design and implementation of Web- based collaborative spatial decision-making support systems in the context of distributed environmental planning. We implemented a Web-based Spatial Decision Support System called GEO-ELCA (Exploratory Land Use Change Assessment) for typical decision-making tasks by urban or municipal planning agencies where resource managers or stakeholders of different interest groups can express their options for future land use changes and assess the resulting hydrological impacts in a collaborative environment.


2017 ◽  
Vol 33 (2) ◽  
pp. 781-801 ◽  
Author(s):  
Mehmet Unal ◽  
Gordon P. Warn

Infrastructure networks can be damaged during earthquakes. These damaged links can disrupt network operations resulting in significant economic and social losses. Depending on the distribution and extent of damage, and constraints on resources, decision-makers must decide how best to restore a network. Their aim is typically to minimize impacts to the community while negotiating competing objectives of multiple stakeholders, for example, minimizing costs, travel delays and environmental impacts. Thus, restoration decision-making is necessarily complex requiring input from multiple stakeholders throughout the decision-making process. Much of the literature has adopted point-based approaches to restoration whereby algorithms are used to identify solution(s) without broad exploration of the design space. In this paper, a set-based approach is developed following the “Design by Shopping” paradigm in which a full enumeration of restoration designs is generated and visualized allowing decision-makers to broadly “shop” the design space and eliminate the worst designs based on evolving preferences. The merits of set-based design are broad exploration of the design space, design freedom in the initial stages of decision–making, and applying constraints throughout the set-reduction process.


2021 ◽  
Vol 2042 (1) ◽  
pp. 012091
Author(s):  
Nuoa Lei ◽  
Zhu Cheng ◽  
Zhi Cao ◽  
Eric Masanet

Abstract Intelligent load scheduling is an emerging approach that has the potential to facilitate extreme sustainable data center (DC) operation. However, scarcity of straightforward tools in the public domain challenges decision makers performing quantitative analysis of the DC load planning and its potential benefits. In this work, a novel integrated decision-making framework was developed to address this issue, which provides the basis for the multi-objective optimization of carbon-, water-, and economic-intelligent load scheduling. The proposed framework was demonstrated with a case study DC in California, which showed the usefulness of the proposed framework in informing sustainable DC operations.


2020 ◽  
Vol 25 (2) ◽  
pp. 235-255
Author(s):  
Seng Hansen ◽  
Pratama HR Siregar ◽  
Jevica

This article presents a study of the contractors' preference for formwork system selection in Indonesian context. As decision makers, contractors are faced with challenges in choosing the formwork system for a particular project. While conventional timber formwork has been the most used formwork system in Indonesia, aluminium formwork is present although it has not been widely used. Thus, this research investigates the current practices of available formwork systems and its selection criteria in Indonesia. A decision-making framework (DMF) is developed by considering the appropriate assessment criteria for formwork system selection. This framework is then implemented through analytic hierarchy process technique. The result shows that contractors tend to choose aluminium formwork with a preference at 79% compared to conventional timber formwork with a preference at 21%. These findings can be used as considerations for contractors to start using aluminium formwork due to its excellence compared to conventional timber formwork. This study also proves that the proposed DMF can be applied and provides a sound decision related to formwork system selection.


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