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The importance of a lean health-care supply chain is increasingly discussed. However, it is still not very clear how lean practices relate to resilience capabilities, as there are synergies and divergences between them. This study aims at identifying the relationship between lean practices and resilience capabilities in the health-care supply chain.

This study conducted a scoping review based on five databases, which allowed the content analysis of 44 articles. Such analysis allowed the verification of trends and volume of studies on this topic. Further, the descriptive numerical and thematic analyses enabled the proposition of a conceptual framework, relating the adoption of lean practices to the development of resilience capabilities according to the tiers of the health-care supply chain in different value streams.

Three research directions were derived from this scoping review: empirical validation of the contribution of lean practices to resilience capabilities in the health-care supply chain; systemic implementation of lean practices across tier levels of the health-care supply chain; and complementary approaches to lean implementation toward a more resilient health-care supply chain.

The understanding of these relationships provides health-care managers arguments to prioritize the application of lean practices to improve desired resilience capabilities in the entire health-care supply chain.

To the best of the authors’ knowledge, there is no similar study in the literature.

The purpose of this study was to elucidate facilitators and barriers to health system resilience and resilient responses at local and regional levels during the first year of the COVID-19 pandemic in Finland.

The authors utilized a qualitative research approach and conducted semi-structured interviews (n = 32) with study participants representing five different regions in Finland. Study participants were recruited using purposive and snowball sampling. All study participants had been in management and civil servant positions during the first year of the pandemic, representing municipalities, municipalities' social and healthcare services, hospital districts and regional state administrative agencies. All interviews were completed remotely from April to December 2021 and the recordings transcribed verbatim. The authors coded the transcripts in ATLAS.ti 9.1 using directed content analysis.

The findings highlighted a wide range of localized responses to the pandemic in Finland. Facilitators to health system resilience included active networks of cooperation, crisis anticipation, transitioning into crisis leadership mode, learning how to incorporate new modes of operation, as well as relying on the competencies and motivation of health workforce. The authors found several barriers to health system resilience, including fragmented organization and management particularly in settings where integrated health care systems were not in place, insufficient preparedness to a prolonged crisis, lack of reliable information regarding COVID-19, not having plans in place for crisis communication, pandemic fatigue, and outflux of health workforce to other positions with better compensation and working conditions.

Factors affecting health system resilience are often studied at the aggregate level of a nation. This study offers insights into what resilient responses look like from the perspective of local and regional actors in a decentralized health system. The results highlight that local capacities and context matter greatly for resilience. The authors call for more nuanced analyses on health systems and health system resilience at the sub-national level.

This study aims to identify supply chain (SC) management practices applied to purchasing capable of improving the resilience of the health-care SC and mitigating the effects of material and service disruption during pandemics.

The approach adopted is qualitative and is based on a systematic literature review from the ScienceDirect, Emerald, Wiley and Web of Science databases. After selecting 705 documents, filters are applied, and 52 articles present problems faced by purchasing the health-care SC during the coronavirus disease 2019 (COVID-19) pandemic.

This article suggests five propositions of resilient practices that can increase purchasing resilience in the face of pandemics such as COVID-19. The proposed practices are collaboration, flexibility, visibility, agility and information sharing, which suggest a sequence for the adoption of management practices based on the number of occurrences and importance found in the analysed studies.

This study does not find robust empirical evidence that could categorically state that the results can be replicated in organisations in general. Thus, as a continuation of research, more studies should use an empirical methodology and case analysis to organise different branches. As the human factor was decisive for the results observed in the literature, future research should dedicate part of the studies to the psychological area of professionals. Actions to combat the pandemic were implemented, impacting positively and negatively on the results obtained. Future research on combat actions could indicate which ones should be avoided.

As a result, disruptions are expected to be reduced, and consequently, the resilience of the SC will increase. Accordingly, purchasing processes and procedures can be redefined to positively influence the resilience of the health-care SC. Resilience is related to maintaining the flow of supply, as well as systems and actions aimed at mitigating the effects of disruptions in the hospital’s core business.

Health systems need to respond to society’s needs even in the face of global crises, such as the one faced during the COVID-19 pandemic. The overload in hospitals and the exponential demand for specific medicines and services in the fight against the crisis caused by the COVID-19 pandemic require enormous coordination in procurement by the purchasing sector. This planning aims to ensure that the care provided by health services maintains the flow of value that serves hospitalised patients.

This study introduces a new approach to the recurrent problem of disruption of the health-care SC during a pandemic using a combination of five important management practices. This proves useful for mitigating disruptions and their effects on the health-care SC.

The learning outcomes are as follows: identify and evaluate the impact of risk factors for health-care organizations during crisis; evaluate the role of different organizational factors in building resilient health-care organizations; define organizational resilience in a health-care context; and apply the effect-strategy-impact resilience framework.

September 2022 found Ranjan Thakur, the Hospital Director at Manipal Hospital, Jaipur (MHJ) reflecting on MHJ’s resilience toward future health-care crises. MHJ was established in the capital city Jaipur of the Indian state of Rajasthan in 2014, as a 225-bed multispecialty unit of the nationally renowned Manipal Health Enterprises Ltd. As the Hospital Director, Thakur had been responsible for navigating his team and the hospital through the multiple health-care related challenges exacerbated by the multiple waves of the Covid-19 pandemic in a large Indian state with a sizable rural and semiurban population. Though Thakur and his team of doctors had worked through the vulnerabilities of their health-care ecosystem, mapping the risks and mitigating the same, Thakur asked himself if they had done enough. He wondered how a health-care institution such as theirs could sustain effective health-care delivery during future crises situations to deliver high-quality health care to the vulnerable communities. Had they effectively mapped MHJ’s vulnerabilities and built resilience into the hospital’s functioning? The backdrop of the case is public health in the state of Rajasthan (Jaipur), and the case is rich in detailing social factors such as behavior issues of patients, doctors and nurses; operational factors such as standardization of treatment and standard operating procedures, availability of resources, clinical concerns; leadership and management of the hospital through the pandemic. This case can be used by instructors to teach organizational resilience building in the health-care context.

Graduate- and executive-level courses in managing change during crisis in health-care context; health-care management/leadership.

Teaching notes are available for educators only.

CSS 7: Management Science.

The purpose of this study was to investigate how Lean Six Sigma (LSS) may help mitigate the impact of COVID-19 within health care environments. The goals of this study were to understand the current knowledge of LSS and COVID-19 through a systematic review of the current literature, identify the gap in the current knowledge of LSS in COVID-19 mitigation within health care environments and define the principles of LSS, within organizational resilience that support a health care organization’s ability to mitigate the impact of COVID-19.

A narrative literature review was conducted to identify relevant research. A total of 21 subject matter experts (SMEs) meeting the inclusion criteria were approached through a guided interview process. Content analysis was conducted to describe how LSS principles contribute to supporting health care organizations operating in the era of COVID-19.

Study results report that personal safety is the primary subject, followed by supporting dimensions of process redesign, and telemedicine. LSS topics that directly relate to COVID-19 are in four thematic areas: tools, applications, benefits and challenges. Particular areas of application, techniques, challenges and benefits are identified and discussed that could be applied proactively and reactively, to organizational and supply chain resilience to recover from COVID-19.

There were a number of limitations to the generalizability of this work. The sample size was small and purposeful, thus, external validity of the study results are not determined. The SMEs in this study have not implemented the practices noted in the results at the time of the study, and knowledge of results is limited to the study aims.

This study of LSS principles and COVID-19 has implications for practitioners and offers specific guidance for areas of health care adoption of LSS techniques and tools that benefit patient safety, challenges for the user to be mindful of and potential benefits in resilience of operations in the era of COVID-19.

The chapter summarizes key literature, including emerging ideas, that is pertinent to the question of how organizations and their leadership deal with and are resilient through crises – highlighting what works in surviving unexpected crises. The chapter presents an illustration of organizational response; it concludes with an analysis of what is missing from the literature and recommends a path forward to expanding actionable knowledge in this area. Multiple, interdependent factors that foster resilience are identified including (1) being sensitive to possible threats – even seemingly small failures, (2) not relying on simple interpretations of events but rather seeking diversity to create a complete view of the environment, (3) leadership that embraces communication, transparency, and continuous learning, (4) valuing expertise and allowing expert staff to make decisions during a crisis, and (5) a cultural commitment to a resiliency mindset that accepts failures as opportunities to learn and improve. Emerging concepts that may foster resilience but require more research include managing paradox, emotional ambivalence and diversity. Additional areas for fruitful research include: the impact of short-term versus long-term, or successive, crises; external versus internal shocks and the framing of the source of shocks; how crisis affect the pace of innovation and change; the role of diversity in organizational responses to crises; and a set of methodological opportunities to leverage natural experiments or simulations in ways that allow for longitudinal data illuminating the full cycle of crises across organizations from anticipation, to response, to longer-term adaptation to the new normal.

This paper aims to present a review of the current COVID-19 pandemic with particular emphasis on developing countries in Africa. It aims to demonstrate how facilities management (FM) services delivery in public hospitals can be improved for the fight against the COVID-19 pandemic.

This paper embraces a review of current literature on COVID-19 and FM together with credible media updates. The paper critically synthesizes knowledge on the pandemic to position a technical view on how FM can be improved in the fight against the COVID-19 pandemic.

The COVID-19 pandemic presents unprecedented challenges and realities to the health-care system of most African countries. Despite the significant efforts being made by various governments, there appears to be a lack of a coherent and strategic FM plan to fight the pandemic. To create the necessary antivirus built environment, actionable and timely FM interventions are needed.

The report herein is case guarded, based on the prevailing data and information as at the time of writing the paper. Nevertheless, the recommendations from the paper are useful for a worse future trajectory of the pandemic.

Knowledge of the proposed interventions will inform and assist health-care facilities managers in the fight against the COVID-19 pandemic.

The paper presents the first step towards encapsulating knowledge on FM and the COVID-19 pandemic. It sets forth recommendations that are useful for most developing countries’ public hospitals’ FM practices in the fight against this global pandemic. The authors intend to follow-up with future empirical studies for more objective assessments of FM and the COVID-19 pandemic.

The purpose of this paper is to understand how the hospital staff (nurses and physicians) at two hospital wards have coped with everyday work having leaders in conflict or longer periods without one or the other leader and whether the way the staff handled the challenges was resilient.

Through semi-structured interviews with the staff at the two wards, the authors analysed how the staff were working, if they had cooperation and interdisciplinary cooperation, how they would handle uncertainties and how they coped with the absence of their leaders.

The staff at both wards were handling the everyday work in a resilient way. The authors argue that to increase the resilience in an organisation, leaders should acknowledge the need to establish strong emotional ties among staff and at the same time ensure role structures that make sense in the everyday work.

This study reports on original work and shows what decision makers could do to increase resilience in an organisation. This paper shows that the organisational context is important for the staff to act resiliently. As leaders come and go, it can be important for the stability of the organisation to promote the staff in acting resiliently independent of the leader situation.

To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future research and implementation studies can use this to further operationalize the concept and promote healthcare resilience.

The authors first provide an overview of and discuss the main approaches to healthcare resilience and research on management and resilience. Second, the authors provide examples on how managers work to promote healthcare resilience during a one-year Norwegian longitudinal intervention study following managers in nursing homes and homecare services in their daily quality and safety work. They use this material to propose a model of management and resilience.

The authors consider managerial strategies to support healthcare resilience as the strategies managers use to engage people in collaborative and coordinated processes that adapt, enhance or reorganize system functioning, promoting possibilities of learning, growth, development and recovery of the healthcare system to maintain high quality care. The authors’ model illustrates how managers influence the healthcare systems ability to adapt, enhance and reorganize, with high quality care as the key outcome.

In this study, the authors argue that managerial strategies should be considered and operationalized as part of a healthcare system's overall resilience. They propose a new model of managers' role in supporting resilience to be used in practice, interventions and future research projects.