Power, shared goals and supplier flexibility: a study of the HUB-and-spoke supply chain

PurposeSupplier flexibility reflects a supplier's operations-related decisions in responsively providing the necessary inputs to the focal firm. Drawing on resource-dependency theory and transaction cost economics, this study develops a conceptual framework to explain the differential effects of a focal firm's power over supplier flexibility in the context of the hub-and-spoke supply chain (SC). This study also considers the goals shared between the focal firm and its suppliers as an important contingency factor within the framework.Design/methodology/approachThis study tests the proposed conceptual framework using dyadic survey data from a hub-and-spoke SC consisting of a large construction contractor and its 100 suppliers in Indonesia.FindingsThe findings show that coercive power has an inverted U-shaped effect on supplier flexibility, while legal-legitimate power has a U-shaped effect. Furthermore, shared goals positively moderate the U-shaped effect between legal-legitimate power and supplier flexibility.Originality/valueThis study differentiates between the impacts of coercive power and legal-legitimate power on supplier flexibility in the hub-and-spoke SC. It also demonstrates that shared goals play a moderating role in affecting the impacts of legal-legitimate power on supplier flexibility. These findings also have important implications with regard to integrating resource-dependency theory and transaction cost economics to explain these associations.

The impact of the SARS-CoV-2 pandemic on healthcare provision in Italy to non-COVID patients: a systematic review

Background Italy has been one of the countries most affected by the SARS-CoV-2 pandemic and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. We investigated the management of non-COVID-19 patients across all medical specialties in Italy. Methods A PRISMA guideline-based systematic review of the literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from 20 February to 22 June, 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialties in combination with our geographical focus (Italy) and COVID-19. Results Of the 4643 potentially eligible studies identified by the search, 247 studies were included. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialties have been affected by the reorganization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine. Conclusions Our work highlights the changes taking place in the Italian public healthcare system to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyze future directions for the healthcare system in the case of new pandemic scenarios.

Simulation Research on Risks of Entrepreneurship Platform Organization Complex Network

The risks of entrepreneurship platform are considered one of the most significant factors that affect regional economic development. However, the complexity of the constitutive relationship and the dynamics of the research process have made it difficult for studies to analyse the evolution and risks from the quantitative perspective. According to the analysis perspective of complex networks, this study determined the coupling relationship between the entrepreneurship platform network structure and complex network model. With the results studied and described in the paper, this study had constructed a platform structure model portraying the evolution process of the platform structure under two types of risks by using the simulation method. Three main conclusions are being drawn from the study: Firstly, endogenous and exogenous risks showed substantial results in affecting the changes in microentities and network relationship of enterprises within the platform, causing the robustness of platform to risk to differ significantly. Secondly, based on exogenous risks, the robustness distribution scaling from highest to lowest among three types of platforms studied is hub-and-spoke > mixed > market. Lastly, based on endogenous risk, the robustness distribution scaling from highest to lowest among the three types of platform studies is market > mixed > hub-and-spoke.

Overlapping Climate Clubs: Self-Enforcing R&D Networks to Mitigate Global Warming

Free riding incentives make it difficult to control climate change. To improve the chances of the Paris Agreement’s ambitious goal, many nations are forming scientific networks in carbon capture and storage (CCS). These networks take many forms (bilateral, hub-and-spoke, and multilateral). Studies of social interactions among scientists demonstrate that research networks are limited because of relational issues, such as lack of trust. This paper provides a rationale for the formation of various types of international CCS networks and examines their impacts on climate change. Our concept of stability focuses on Nash equilibria that are immune to coalitional deviations in overlapping networks. Players may belong to various research networks. A particular research network is a climate club. We show that in the absence of top-down coordination in clubs, the type of global network that forms depends on relational attrition. The complex task is to mitigate free riding while enhancing trust.

Investigation into the Hub-and-Spoke model using brand and frequent-flyer program

Purpose: This paper seeks to understand if customer acceptance on flying through a hub has changed today, compared to the findings from past research conducted many years ago. The study involves investigations of Singapore Airlines, a successful FSC in terms of its ability to generate sustainable profits for many consecutive years as reflected in its annual financial reports. The carrier also has a strong corporate brand, a world-class airport hub as well as a frequent flyer program, which makes it attractive to explore. Design/methodology/approach: The survey method is utilized in order to seek the answers to the three questions developed in the literature review. Descriptive statistics are employed to analyze 723 datasets using SPSS v20. Findings: Although the paper shows that some findings resonated past arguments, some others have changed. Brand has no longer become a significant factor for passengers when deciding to travel with a full-service carrier (FSC) via its hub, and an FFP that is likely to hold less compelling attractiveness with passengers with regard to purchasing consideration.Research limitations/implications: The research involved only passengers traveling two routes in Southeast Asia, therefore the generalization of the findings must be carried out with caution. Future studies to extend this research to different geographical markets are necessary to investigate if similar behaviours are also observed, as described in this study.Originality/value: This paper offers insights into in the hub-and-spoke airline business model discipline. The author suggests that the role of strong brands and frequent flyer program to attract passengers travelling via a hub have diminished. Nowadays, even FSC passengers are more concern with airfare.

Aging With Intellectual and Developmental Disabilities: When Dementia Is Diagnosed or Suspected

Individuals with lifelong intellectual and developmental disabilities (IDD) have unique needs associated with aging that pose challenges for them and their families. In particular, an increased likelihood for early onset Alzheimer’s disease is a major concern that can place individuals at risk for a host of biomedical, psychological, and social challenges. Faced with providers not trained in how to properly screen for, diagnose, and treat conditions, individuals and families are often left with inadequate care, services, and support. To address these concerns, education for professionals is essential in providing accurate information based on clinical best practices. This symposium presents an innovative and interprofessional model developed by a partnership of geriatrics and IDD educational and service organizations based on Project ECHO (Extension for Community Healthcare Outcomes) methodology. A virtual community is created in which participants both teach and learn from each other through a combination of didactic and case presentations. The first paper describes the ECHO model, including the development of the hub and spoke structure, recruitment of providers, and collaborative and multidisciplinary process of curriculum development. The second paper explores educational experiences of participating spoke agencies in the program, including professionals’ and clients’ outcomes. The third paper presents the implications of creating a foundation based on interprofessional education and networking principles to bridge the gap between health and social care disciplines and parallel service systems. The final paper provides recommendations and implications for developing and refining methods to address the need for provider education in this rapidly expanding field.

A Strategy Matching Tool for Boosting Implementation of Geriatric Telehealth Services in Rural CBOCs

Fifteen Veterans Administration Medical Centers (VAMCs) offer geriatric specialty care telehealth services through a hub and spoke model to patients at affiliated community-based outpatient clinics (CBOCs). These services are not used to the extent they could be. Through interviews with 50 staff and providers at rural CBOCs we identified several implementation facilitators and barriers. CBOC-level barriers included space constraints, low staffing, internet connection issues, and limited knowledge of services available and referral processes. Patient-level barriers included discomfort with technology, cognitive decline, and inability to travel to the CBOC. We found that champions within the CBOC and iterative, targeted outreach from the hub helped facilitate uptake of services. We entered the identified barriers into the CFIR-ERIC (Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change) Implementation Strategy Matching Tool to help generate targeted strategies that will be used to refine each hub’s implementation approach.

Providing Specialty Telehealth Care to Older, Rural Patients: Voices From Field

Older, rural adults have limited access to quality geriatric specialty care for several reasons including relatively few geriatric specialists in rural areas and lack of transportation options or patient ability to travel to more urban centers. GRECC Connect is a promising telehealth-hub and spoke model that provides rural patients access to teams of multidisciplinary geriatric specialists in more urban medical centers primarily by video connection with affiliated community-based outpatient clinics (CBOCs). This model provides a viable option for increasing access to geriatric specialty care for rural patients but is not used to the extent it could be. To date, much of our understanding of this model has come from the experts at the hub medical centers. To learn more about the experience of this model from the field we interviewed CBOC staff and providers as well as Veterans and their caregivers about geriatric specialty telehealth services. In this symposium we will discuss facilitators and barriers to implementing this model from the perspective of the field and then explore more deeply both the context of the CBOC environment and the older patient population served by rural CBOCs to further understand the challenges that are faced in attempting to connect older patients with telehealth services. Finally, we will share the perceived value of the service and alignment with local needs. This deeper understanding of the experience of the ‘spoke’ may help enhance access to much needed geriatric specialty care for rural veterans.