scholarly journals Operations Management at the service of health care management: Example of a proposal for action research to plan and schedule health resources in scenarios derived from the COVID-19 outbreak

2020 ◽  
Vol 13 (2) ◽  
pp. 213 ◽  
Author(s):  
Juan A. Marin-Garcia ◽  
Jose P. Garcia-Sabater ◽  
Angel Ruiz ◽  
Julien Maheut ◽  
Julio J. Garcia-Sabater

Purpose: With this work, we intend to promote research on the application of Operations Management tools in order to assist with decision-making in health crisis situations. During the first six weeks of the COVID-19 crisis in Spain, we have contacted a large number of hospital and health department managers in the Valencian Community and other regions of Spain. The result is that very few, at least when contact was made and at the time of writing this article, had consulted staff members in the Operations Management area for advice on this situation, and they are quite reluctant to do so. This is in spite of the fact that some medical sources also consider this crisis to be one of resources, not merely a medical crisis. Our opinion is that Operations Management can make a useful and valuable contribution to anticipate and improve the management of scarce resources, even in times of crisis. If those responsible for public health or heads of hospitals do not see this usefulness, then there is a huge gap between research and practice in Operations Management and what is transmitted to the healthcare sector. Our aim is to help reduce this gap.Design/methodology/approach: In the first part of the article, we will justify that this crisis, besides being a medical crisis, is also a crisis in terms of resources. We will briefly review some of the Operations Management tools that we believe are appropriate for managing this crisis. We will focus on those that we will illustrate in the second part of the article as a practical example of the action research protocol (only the action planning phase), in which we are currently involved.Findings: Due to the peculiarities of the COVID-19 epidemic, it is reasonable to think that the evolution and duration of each outbreak, and the way it is dealt with, will be different in each hospital and/or each health department. Anticipating the number of patients who will require care and forecasting the consumption of resources over time is complex, due to the long and variable incubation times and the uncontrolled evolution of the treatments needed by each patient. Furthermore, since the evolution of new patient admissions is not homogeneous, the forecasting of requirements is difficult. Providing real-time support and detecting with a certain degree of anticipation the potential levels of demand for health care will enable hospitals to define what stages of the contingency plan to apply and how to (re)assign the available resources in the most efficient way possible.Research limitations/implications: Hardly any current data are available, not only publicly, but also through public health ministries and managers; those that are available are not very reliable and come from studies with non-representative samples. For this reason, all forecasts must be taken with a note of caution, and in particular, designing review mechanisms every time a new set of updated reliable data becomes available (something that occurs on a weekly basis).Originality/value: In this work, we will show an example of a proposal for the practical application of Operations Management tools. Our proposal may be useful to hospital managers and public administrators in the healthcare sector (regional ministries or their equivalents). Each health department, hospital or hospital group will generate the aggregate data that facilitate the calculation of needs as input parameters for the model (available and occupied beds, daily admissions, mean lengths of stay in each healing phase and the percent of patients who evolve from one stage to another in the progression of the disease/healing process) and will be able to analyze how the system responds and evaluate different strategies or mitigating actions. These tools have been shown to be useful and reliable in manufacturing and service contexts that show a strong seasonal demand (both occasional and recurring) requiring a great deal of resources. We believe these situations are analogous to those faced by hospitals and the healthcare system in an epidemic like COVID-19. With them, we could facilitate the aggregate planning of resources for hospital administrators in order to provide them operational support during the COVID-19 contingency plan. However, the array of useful tools for this crisis is not limited to those that we will illustrate. Our intent is to encourage the Operations Management academic community to demonstrate how they contribute to the service of society in this COVID-19 epidemic, providing knowledge that can be extrapolated to other similar situations in the future that we may be unfortunate enough to experience.

2021 ◽  
pp. 089719002110048
Author(s):  
Tyler Marie Kiles ◽  
Tracy Hagemann ◽  
Brianna Felts ◽  
Catherine Crill

Objectives: In order to meet the needs of the COVID-19 public health crisis and to actively engage students in patient care opportunities, the University of Tennessee Health Science Center College of Pharmacy in partnership with the Tennessee Health Department, developed a remote Public Health Advanced Pharmacy Practice Experience (APPE) Elective. The objectives of this paper are to describe the development of and students’ experiences and learning outcomes during the elective. Faculty preceptor and experiential administrator’s perspectives are also described. Methods: This month-long APPE was developed in mid-March and delivered in April and May of 2020. The students volunteered in-person with the State of Tennessee COVID-19 Hotline call centers and conducted topic discussions and assignments virtually with a remote preceptor. Results: A total of 16 students completed this rotation experience. Student ratings of the experience were positive, and their knowledge improved in all topic areas. Students collectively completed approximately 700 hours manning the COVID-19 hotline and logged over 1,000 phone calls. Conclusions: In a time of unprecedented disruption to experiential learning, the development of this unique public health APPE directly benefited the college, the students, and the citizens of our state. The APPE described in this paper could be replicated in additional waves of the pandemic or adapted for similar disaster response.


2021 ◽  
pp. 002073142110637
Author(s):  
Shahjahan Bhuiyan

The coronavirus (COVID-19) pandemic has been spreading around the world, causing a major public health crisis that has already claimed hundreds of thousands of lives. Street-level bureaucrats­—health workers, teachers, street cleaners, police officers­, and so forth—are at the forefront in fighting against the pandemic. Of these, public health care workers, due to the nature of their involvement, should know and understand why they are risking their lives to save others during this pandemic. Based on the preliminary data gleaned from interviews with public health care workers in Bangladesh and Egypt, this ongoing research suggests they are risking their lives for reasons such as altruistic behavior, service to profession, adherence to bureaucratic accountability, and a desire to help mankind. The findings contribute to the existing literature about street-level bureaucratic behavior in atypical times such as these of the pandemic. This study is unique in that it comprehends that public health care workers of two culturally and geographically distinct countries are risking their lives for the same public-spirited cause.


Author(s):  
Maria José Lucena e Vale ◽  
Filipa Vale

The existence of adequate and reliable information to assess population health is essential to build solid strategies for public health promotion and social care, as to help demonstrate efficient investment in these areas. There are several health-related databases, covering different scales: World, Europe, or National, including several datasets with different details. These different datasets should be reviewed and selected on the basis of their ability to support efficient strategies associated with monitoring population health and their usefulness in the promotion of health care efficiency. To understand the relevance of these database infrastructures when integrated with Web-based, geographical information management tools, and use these to improve the knowledge of health issues, this chapter integrates examples related to enhancing the performance analysis of this collaborative spatial data infrastructure in three distinct areas: national health systems and health care; disease prevalence studies in different countries, and integrated analysis of environment quality and public health.


Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1331-1346 ◽  
Author(s):  
Steven P Cohen ◽  
Zafeer B Baber ◽  
Asokumar Buvanendran ◽  
Brian C McLean ◽  
Yian Chen ◽  
...  

Abstract Background It is nearly impossible to overestimate the burden of chronic pain, which is associated with enormous personal and socioeconomic costs. Chronic pain is the leading cause of disability in the world, is associated with multiple psychiatric comorbidities, and has been causally linked to the opioid crisis. Access to pain treatment has been called a fundamental human right by numerous organizations. The current COVID-19 pandemic has strained medical resources, creating a dilemma for physicians charged with the responsibility to limit spread of the contagion and to treat the patients they are entrusted to care for. Methods To address these issues, an expert panel was convened that included pain management experts from the military, Veterans Health Administration, and academia. Endorsement from stakeholder societies was sought upon completion of the document within a one-week period. Results In these guidelines, we provide a framework for pain practitioners and institutions to balance the often-conflicting goals of risk mitigation for health care providers, risk mitigation for patients, conservation of resources, and access to pain management services. Specific issues discussed include general and intervention-specific risk mitigation, patient flow issues and staffing plans, telemedicine options, triaging recommendations, strategies to reduce psychological sequelae in health care providers, and resource utilization. Conclusions The COVID-19 public health crisis has strained health care systems, creating a conundrum for patients, pain medicine practitioners, hospital leaders, and regulatory officials. Although this document provides a framework for pain management services, systems-wide and individual decisions must take into account clinical considerations, regional health conditions, government and hospital directives, resource availability, and the welfare of health care providers.


Author(s):  
Yousuf A Vawda ◽  
Farhana Variawa

South Africa is renowned for having a progressive Constitution with strong protection of human rights, including protection for persons using the public health system. While significant recent discourse and jurisprudence have focused on the rights of patients, the situation and rights of providers of health care services have not been adequately ventilated. This paper attempts to foreground the position of the human resources personnel located at the centre of the roll-out of the government's ambitious programme of anti-retroviral (ARV) therapy. The HIV/AIDS epidemic represents a major public health crisis in our country and, inasmuch as various critical policies and programmes have been devised in response, the key to a successful outcome lies in the hands of the health care professionals tasked with implementing such strategies. Often pilloried by the public, our health care workers (HCWs) face an almost Herculean task of turning the tide on the epidemic. Unless the rights of HCWs are recognised and their needs adequately addressed, the best laid plans of government will be at risk. This contribution attempts to identify and analyse the critical challenges confronting HCWs at the coalface of the HIV/AIDS treatment programme, in particular the extent to which their own rights are under threat, and offers recommendations to remedy the situation in order to ensure the successful realisation of the ARV rollout.


2021 ◽  
Vol 2 (4) ◽  
pp. 29-35
Author(s):  
Arianna Omaña-Covarrubias ◽  
Michelle Acosta Meneses ◽  
Adrián Moya- Escalera ◽  
Lydia López -Pontigo

The term bioethics can be defined as a discipline that studies the dimensions of morals, decisions, behaviour and policies of the life sciences and health care. Its objective is auxiliary, guiding on the implications of phenome, where infinite dilemmatic situations arise. The crisis that is currently facing the current pandemic is a public health crisis. The priority in the face of this crisis should be the health system and its professionals. To overcome this crisis, it is not only a matter of public authorities and powers. It is essential that the entire population implements the bioethics exercise, complying with the isolation and hygiene measures, whatever has been determined where they have been adopted.


2021 ◽  
Author(s):  
Sharath Chandra Guntuku ◽  
Jonathan Purtle ◽  
Zachary F Meisel ◽  
Raina M Merchant ◽  
Anish Agarwal

BACKGROUND As policy makers continue to shape the national and local responses to the COVID-19 pandemic, the information they choose to share and how they frame their content provide key insights into the public and health care systems. OBJECTIVE We examined the language used by the members of the US House and Senate during the first 10 months of the COVID-19 pandemic and measured content and sentiment based on the tweets that they shared. METHODS We used Quorum (Quorum Analytics Inc) to access more than 300,000 tweets posted by US legislators from January 1 to October 10, 2020. We used differential language analyses to compare the content and sentiment of tweets posted by legislators based on their party affiliation. RESULTS We found that health care–related themes in Democratic legislators’ tweets focused on racial disparities in care (odds ratio [OR] 2.24, 95% CI 2.22-2.27; <i>P</i>&lt;.001), health care and insurance (OR 1.74, 95% CI 1.7-1.77; <i>P</i>&lt;.001), COVID-19 testing (OR 1.15, 95% CI 1.12-1.19; <i>P</i>&lt;.001), and public health guidelines (OR 1.25, 95% CI 1.22-1.29; <i>P</i>&lt;.001). The dominant themes in the Republican legislators’ discourse included vaccine development (OR 1.51, 95% CI 1.47-1.55; <i>P</i>&lt;.001) and hospital resources and equipment (OR 1.22, 95% CI 1.18-1.25). Nonhealth care–related topics associated with a Democratic affiliation included protections for essential workers (OR 1.55, 95% CI 1.52-1.59), the 2020 election and voting (OR 1.31, 95% CI 1.27-1.35), unemployment and housing (OR 1.27, 95% CI 1.24-1.31), crime and racism (OR 1.22, 95% CI 1.18-1.26), public town halls (OR 1.2, 95% CI 1.16-1.23), the Trump Administration (OR 1.22, 95% CI 1.19-1.26), immigration (OR 1.16, 95% CI 1.12-1.19), and the loss of life (OR 1.38, 95% CI 1.35-1.42). The themes associated with the Republican affiliation included China (OR 1.89, 95% CI 1.85-1.92), small business assistance (OR 1.27, 95% CI 1.23-1.3), congressional relief bills (OR 1.23, 95% CI 1.2-1.27), press briefings (OR 1.22, 95% CI 1.19-1.26), and economic recovery (OR 1.2, 95% CI 1.16-1.23). CONCLUSIONS Divergent language use on social media corresponds to the partisan divide in the first several months of the course of the COVID-19 public health crisis.


2018 ◽  
Vol 12 (6) ◽  
pp. 689-691
Author(s):  
Syra Madad ◽  
Anna Tate ◽  
Maytal Rand ◽  
Celia Quinn ◽  
Neil M. Vora ◽  
...  

ABSTRACTThe Zika virus was largely unknown to many health care systems before the outbreak of 2015. The unique public health threat posed by the Zika virus and the evolving understanding of its pathology required continuous communication between a health care delivery system and a local public health department. By leveraging an existing relationship, NYC Health+Hospitals worked closely with New York City Department of Health and Mental Hygiene to ensure that Zika-related processes and procedures within NYC Health+Hospitals facilities aligned with the most current Zika virus guidance. Support given by the public health department included prenatal clinical and laboratory support and the sharing of data on NYC Health+Hospitals Zika virus screening and testing rates, thus enabling this health care delivery system to make informed decisions and practices. The close coordination, collaboration, and communication between the health care delivery system and the local public health department examined in this article demonstrate the importance of working together to combat a complex public health emergency and how this relationship can serve as a guide for other jurisdictions to optimize collaboration between external partners during major outbreaks, emerging threats, and disasters that affect public health. (Disaster Med Public Health Preparedness. 2018;12:689-691)


2020 ◽  
Vol 210 ◽  
pp. 17011
Author(s):  
Tatyana Tagaeva ◽  
Lidiya Kazantseva

The article considers the stages of healthcare sector reforms in Russia and the impact of this process on public health as the main indicator of the social state. A definition of public health is given; the scientific significance and relevance of the research are justified. The works of foreign and domestic authors, their approaches to the study of factors affecting public health are analysed. The analysis of the state of public health in 80s-90s of the last century during the political and economic crisis is made; the transition process from the so-called “budget-funded” financing model to the “insurance” one is described. Based on statistics and expert assessments, as well as international confrontations, conclusions are drawn about the multi-year underfunding of the healthcare sector, primarily from the state budget. A new stage of reforms is analysed: since 2014, the Russian government has begun the so-called “optimization” of healthcare. Its goals, results, feedbacks from doctors and patients are stated. They show the new reform is a negative process for health system. The blunders of health care reform have been sharply marked with the beginning of the pandemic of coronavirus infection. The facts of the self-sacrificing work of the doctors and nursing personnel during the pandemic period, the measures of the Government and the society to support medical workers were described.


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