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A sustainable-resilience healthcare network for handling COVID-19 pandemic.

ABSTRACT: In this paper, a new production, allocation, location, inventory holding, distribution, and flow problems for a new sustainable-resilient health care network related to the COVID-19 pandemic under uncertainty is developed that also integrated sustainability aspects and resiliency concepts. Then, a multi-period, multi-product, multi-objective, and multi-echelon mixed-integer linear programming model for the current network is formulated and designed. Formulating a new MILP model to design a sustainable-resilience healthcare network during the COVID-19 pandemic and developing three hybrid meta-heuristic algorithms are among the most important contributions of this research. In order to estimate the values of the required demand for medicines, the simulation approach is employed. To cope with uncertain parameters, stochastic chance-constraint programming is proposed. This paper also proposed three meta-heuristic methods including Multi-Objective Teaching-learning-based optimization (TLBO), Particle Swarm Optimization (PSO), and Genetic Algorithm (GA) to find Pareto solutions. Since heuristic approaches are sensitive to input parameters, the Taguchi approach is suggested to control and tune the parameters. A comparison is performed by using eight assessment metrics to validate the quality of the obtained Pareto frontier by the heuristic methods on the experiment problems. To validate the current model, a set of sensitivity analysis on important parameters and a real case study in the United States are provided. Based on the empirical experimental results, computational time and eight assessment metrics proposed methodology seems to work well for the considered problems. The results show that by raising the transportation costs, the total cost and the environmental impacts of sustainability increased steadily and the trend of the social responsibility of staff rose gradually between - 20 and 0%, but, dropped suddenly from 0 to + 20%. Also in terms of the on-resiliency of the proposed network, the trends climbed slightly and steadily. Applications of this paper can be useful for hospitals, pharmacies, distributors, medicine manufacturers and the Ministry of Health.

Supplementary information

The online version contains supplementary material available at 10.1007/s10479-021-04238-2.

SUBMITTER: Goodarzian F

PROVIDER: S-EPMC8497050 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundResilience, in the field of Resilience Engineering, has been identified as the ability to maintain the safety and the performance of healthcare systems and is aligned with the resilience potentials of anticipation, monitoring, adaptation, and learning. In early 2020, the COVID-19 pandemic challenged the resilience of US healthcare systems due to the lack of equipment, supply interruptions, and a shortage of personnel. The purpose of this qualitative research was to describe resilience in the healthcare team during the COVID-19 pandemic with the healthcare team situated as a cognizant, singular source of knowledge and defined by its collective identity, purpose, competence, and actions, versus the resilience of an individual or an organization.MethodsWe developed a descriptive model which considered the healthcare team as a unified cognizant entity within a system designed for safe patient care. This model combined elements from the Patient Systems Engineering Initiative for Patient Safety (SEIPS) and the Advanced Team Decision Making (ADTM) models. Using a qualitative descriptive design and guided by our adapted model, we conducted individual interviews with healthcare team members across the United States. Data were analyzed using thematic analysis and extracted codes were organized within the adapted model framework.ResultsFive themes were identified from the interviews with acute care professionals across the US (N = 22): teamwork in a pressure cooker, consistent with working in a high stress environment; healthcare team cohesion, applying past lessons to present challenges, congruent with transferring past skills to current situations; knowledge gaps, and altruistic behaviors, aligned with sense of duty and personal responsibility to the team. Participants' described how their ability to adapt to their environment was negatively impacted by uncertainty, inconsistent communication of information, and emotions of anxiety, fear, frustration, and stress. Cohesion with co-workers, transferability of skills, and altruistic behavior enhanced healthcare team performance.ConclusionWorking within the extreme unprecedented circumstances of COVID-19 affected the ability of the healthcare team to anticipate and adapt to the rapidly changing environment. Both team cohesion and altruistic behavior promoted resilience. Our research contributes to a growing understanding of the importance of resilience in the healthcare team. And provides a bridge between individual and organizational resilience.

Project description:IntroductionGlobally, the coronavirus disease 2019 (COVID-19) pandemic tested the resilience of the health system and its shock-absorbing capacity to continue offering healthcare services. The available evidences does not provide comprehensive insight into primary health care (PHC) system functioning across low- and middle- income countries (LMICs) during the pandemic. Therefore, the objective of this scoping review was to generate evidence on the resilience of PHC systems in LMICs during the COVID-19 pandemic.MethodsA scoping review was carried out utilizing an iterative search strategy using the National Library of Medicine (NLM) and the WHO COVID-19 electronic databases. Data from the identified studies in LMICs were charted in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist in the first step. The analysis framework was adapted and modified using COVID-19 and health systems resilience framework developed by Sagan et al., Blanchet et al., and the WHO position paper on 'Building health systems resilience for universal health coverage and health security during the COVID-19 pandemic and beyond'. A total of 26 documents were included on the basis of predefined eligibility criteria for our analysis.ResultsOur review explored data from 44 LMICs that implemented strategies at the PHC level during the COVID-19 pandemic. Most of the LMICs developed national guidelines on sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH). Most of the countries also transformed and reoriented PHC service delivery by introducing digital healthcare services to continue essential services. Task shifting, task sharing, and redeployment of retired staff were some frequently adopted health workforce strategies adopted by most of the countries. Only a few of the countries demonstrated the availability of necessary monetary resources to respond to the pandemic.ConclusionsThe functionality of the PHC system during the COVID-19 pandemic was demonstrated by a variety of resilience strategies across the six building blocks of the health system. To strengthen PHC resilience, we recommend strengthening community-based PHC, cross-sectoral collaboration, establishing surveillance systems, capacity building in financial risk planning, and investing in strengthening the digital healthcare system.

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A sustainable-resilience healthcare network for handling COVID-19 pandemic.

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