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This paper aims to propose a simulation-based performance evaluation model for the drone-based delivery of aid items to disaster-affected areas. The objective of the model is to perform analytical studies, evaluate the performance of drone delivery systems for humanitarian logistics and can support the decision-making on the operational design of the system – on where to locate drone take-off points and on assignment and scheduling of delivery tasks to drones.

This simulation model captures the dynamics and variabilities of the drone-based delivery system, including demand rates, location of demand points, time-dependent parameters and possible failures of drones’ operations. An optimization model integrated with the simulation system can update the optimality of drones’ schedules and delivery assignments.

An extensive set of experiments was performed to evaluate alternative strategies to demonstrate the effectiveness for the proposed optimization/simulation system. In the first set of experiments, the authors use the simulation-based evaluation tool for a case study for Central Florida. The goal of this set of experiments is to show how the proposed system can be used for decision-making and decision-support. The second set of experiments presents a series of numerical studies for a set of randomly generated instances.

The goal is to develop a simulation system that can allow one to evaluate performance of drone-based delivery systems, accounting for the uncertainties through simulations of real-life drone delivery flights. The proposed simulation model captures the variations in different system parameters, including interval of updating the system after receiving new information, demand parameters: the demand rate and their spatial distribution (i.e. their locations), service time parameters: travel times, setup and loading times, payload drop-off times and repair times and drone energy level: battery’s energy is impacted and requires battery change/recharging while flying.

Efficiency standards, similar to industrial measures like overall equipment effectiveness (OEE), are being used in healthcare systems more and more. Performance indicator models applied to machines assume a constant completion time. However, for human resources, the completion time of a task may vary depending on the stress experienced. This study seeks to bridge this gap by integrating the human behavior of the physician into the performance evaluation.

The paper presents a new algorithm called PerfoBalance that is intended to distribute waiting-patient values among doctors. By maximizing each physician’s stress zones, this method helps to improve their performance as a whole. A thorough case study with medical professionals is carried out to confirm the effectiveness of the suggested methodology. The PerfoBalance algorithm is used in a variety of contexts to divide waiting-patient values among doctors and optimize stress zones.

Experimental results demonstrate a significant improvement in physician efficiency when implementing the PerfoBalance algorithm. The algorithm strategically selects stress zones that contribute to higher performance rates for physicians by optimizing waiting-patient values.

By addressing the undervaluation of human performance difficulties in current efficiency models used in the healthcare industry, this research constitutes a significant contribution to the field. With its launch, the PerfoBalance algorithm offers a fresh viewpoint on waiting-patient value allocation and stress zone management in healthcare settings, hence representing a powerful method for increasing physician productivity.

Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of impact and context of an intervention to reduce waiting for first appointments in an outpatient epilepsy clinic.

The UK Medical Research Council framework was used as the theoretical basis for a process evaluation alongside an intervention trial. The intervention, Specific Timely Appointments for Triage (STAT), is a data-driven approach that combines a one-off backlog reduction strategy with methods to balance supply and demand. A mixed methods process evaluation synthesised routinely collected quantitative and qualitative data, which were mapped to the domains of implementation, mechanisms of impact and contextual elements.

The principles of the STAT model were implemented as intended without adaptation. The STAT model reached all patients referred, including long waiters and was likely generalisable to other medical outpatient clinics. Mechanisms of impact were increased clinic capacity and elimination of unwanted variation. Contextual elements included the complexity of healthcare systems and the two-tier triage practice that contributes to prolonged waiting for patients classified as non-urgent.

This process evaluation shows how a data-driven strategy was applied in a medical outpatient setting to manage demand. Improving patient flow by reducing waiting in non-urgent, outpatient care is a complex problem. Understanding how and why interventions work is important for improved timeliness of care, and sustainability of public health services.

Authorities have set up numerous security checkpoints during times of armed conflict to control the flow of commercial and humanitarian trucks into and out of areas of conflict. These security checkpoints have become highly utilized because of the complex security procedures and increased truck traffic, which significantly slow the delivery of relief aid. This paper aims to improve the process at security checkpoints by redesigning the current process to reduce processing time and relieve congestion at checkpoint entrance gates.

A decision-support tool (clearing function distribution model [CFDM]) is used to minimize the effects of security checkpoint congestion on the entire humanitarian supply network using a hybrid simulation-optimization approach. By using a business process simulation, the current and reengineered processes are both simulated, and the simulation output was used to estimate the clearing function (capacity as a function of the workload). For both the AS-IS and TO-BE models, key performance indicators such as distribution costs, backordering and process cycle time were used to compare the results of the CFDM tool. For this, the Kerem Abu Salem security checkpoint south of Gaza was used as a case study.

The comparison results demonstrate that the CFDM tool performs better when the output of the TO-BE clearing function is used.

The efforts will contribute to improving the planning of any humanitarian network experiencing congestion at security checkpoints by minimizing the impact of congestion on the delivery lead time of relief aid to the final destination.

Community health centres (CHCs) play a vital role in healthcare service delivery in rural India and act as a crucial link between the primary and tertiary healthcare systems. The rural population in the union territory of Jammu and Kashmir primarily depends on CHCs for healthcare services due to the scarcity of private healthcare infrastructure and the lack of access to tertiary hospitals. The purpose of this study is to analyse the impact of management capability, staff competence, waiting time and patient satisfaction on revisit intention among patients visiting CHCs for care needs. It further examines the mediational role of patient satisfaction between antecedents of patient satisfaction and revisit intention.

A survey by questionnaire was used to collect data from 318 inpatients and outpatients visiting CHCs. Partial least square-structural equation modelling was performed with the help of SmartPLS 3 software to evaluate the causal relationships between variables.

The findings of the study ascertain that staff competence and waiting time are strong predictors of patient satisfaction while management capability was reported as an insignificant factor. Patient satisfaction significantly affects revisit intention and successfully mediates the impact of management capability, staff competence and waiting time on revisit intention.

CHCs play a significant role in bridging the gap between primary healthcare and tertiary healthcare and in delivering healthcare services to the vast rural population in India. This study necessitates the active participation of management to ensure the smooth functioning of CHCs. There is a need to provide adequate staff and necessary infrastructural facilities to reduce the treatment waiting time.

This study aims to investigate how to identify and address production levelling problems in assembly lines utilising an intensive manual workforce when higher productivity levels are urgently requested to meet market demands.

A mixed-methods approach was used in the research design, integrating case study analysis, interviews and qualitative/quantitative data collection and analysis. The methodology implemented also introduces to the literature on operational performance a novel combination of data analysis methods by introducing the use of the Natural Language Understanding (NLU) methods.

First, the findings unveil the impacts on operational performance that transportation, limited documentation and waiting times play in assembly lines composed of an intensive workforce. Second, the paper unveils the understanding of the role that a limited understanding of how the assembly line functions play in productivity. Finally, the authors provide actionable insights into the levelling problems in manual assembly lines.

This research supports industries operating assembly lines with intensive utilisation of manual workforce to improve operational performance. The paper also proposed a novel conceptual model prescriptively guiding quick and long-term improvements in intensive manual workforce assembly lines. The article assists industrial decision-makers with subsequent turnaround strategies to ensure higher efficiency levels requested by the market.

The paper offers actionable findings relevant to other manual assembly lines utilising an intensive workforce looking to improve operational performance. Some of the methods and strategies examined in this study to improve productivity require minimal capital investments. Lastly, the study contributes to the empirical literature by identifying production levelling problems in a real context.

This research investigates how to optimize storage location assignment to decrease the order picking time and the waiting time of orders in the staging area of low-temperature logistics centers, with the goal of reducing food loss caused by temperature abuse.

The authors applied ABC clustering to the products in a simulated database of historical orders modeled after the actual order pattern of a large cold logistics company; then, the authors mined the association rules and calculated the sales volume correlation indices of the ordered products. Finally, the authors generated three different simulated order databases to compare order picking time and waiting time of orders in the staging area under eight different storage location assignment strategies.

All the eight proposed storage location assignment strategies significantly improve the order picking time (by up to 8%) and the waiting time of orders in the staging area (by up to 22%) compared with random placement.

The results of this research are based on a case study and simulated data, which implies that, if the best performing strategies are applied to different environments, the extent of the improvements may vary. Additionally, the authors only considered specific settings in terms of order picker routing, zoning and batching: other settings may lead to different results.

A storage location assignment strategy that adopts dispersion and takes into consideration ABC clustering and shipping frequency provides the best performance in minimizing order picker's travel distance, order picking time, and waiting time of orders in the staging area. Other strategies may be a better fit if the company's objectives differ.

Previous research on optimal storage location assignment rarely considered item association rules based on sales volume correlation. This study combines such rules with several storage planning strategies, ABC clustering, and two warehouse layouts; then, it evaluates their performance compared to the random placement, to find which one minimizes the order picking time and the order waiting time in the staging area, with a 30-min time limit to preserve the integrity of the cold chain. Order picking under these conditions was rarely studied before, because they may be irrelevant when dealing with temperature-insensitive items but become critical in cold warehouses to prevent temperature abuse.

Ensuring adequate access to healthcare services is a priority across European countries. The EU has developed performance indicators to compare access using self-reported unmet need. Cross-country comparisons require adjustment for factors outside the health systems' control. We address two research questions to improve the comparability of unmet need for medical and dental care across the EU and the comparability of socio-economic inequalities in unmet need across the EU. First, we explore the role of risk adjustment for demographic and socio-economic factors, which are outside health systems' control, for both overall unmet need and unmet need due to affordability, waiting lists and distance. Second, we compare differences in unmet need by socio-economic status, and investigate whether different forms of risk adjustment affect such comparison. We show that adjusting for age, gender and chronic conditions reduces dispersion of unmet need for medical care across the EU. Controlling for income further reduces the dispersion, mostly due to affordability. When comparing socio-economic inequalities across countries, risk adjustment for age, gender and chronic conditions play a limited role. Socio-economic inequalities by income and education vary by reason of unmet need: the income gradient, even controlling for education, is mostly due to affordability rather than waiting list or distance. For dental care, the main reason for unmet need is affordability. Risk adjustment for age, gender, chronic conditions and education plays a limited role. The income and education gradients are more pronounced for dental than medical care.

Health-care organisations face many challenges in delivering safe, high-quality services while experiencing significant pressure to increase productivity and reduce costs. In this context, hospitals have implemented lean six sigma (LSS) programmes to improve their performance. This study aims to explore the application of LSS in three different non-profit Ecuadorian hospitals to comprehend the effectiveness of the methodology under this context.

A multiple-case analysis was performed in four phases: selecting the cases, defining a data collection protocol, performing a within-case analysis of each case and performing a cross-case analysis.

This research found that the LSS application positively impacts hospital performance indicators by reducing service time. The most frequently used tools include the supplier input process output customer diagram, value stream mapping, cause-and-effect diagram, five-why analysis, Gemba walk and paired two-sample test. Lastly, the results show that the most common challenges faced were lack of top management engagement, technical training and data availability.

The study is limited by the constraint of a single Latin American country from which the cases were analysed. Collaboration with external partners, like universities, and government policies promoting training in continuous improvement methodologies are crucial for success. Academic implications stress the importance of integrating soft skills in LSS implementation and engineering education.

This study shows a multiple-case analysis of LSS in a Latin American country highlighting the most commonly used tools, their impact on performance and the challenges of implementing LSS in health-care organisations in non-profit Ecuadorian hospitals.

The pupose of this study is to systematically review the current literature on the value stream mapping (VSM) application in the construction industry to investigate the evolution observed over time and the results obtained by adopting this tool. In addition, special attention was given to the potential of VSM in identifying loss and waste, as well as their main causes.

The study analyses papers in literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses research protocol. As a result, 383 papers were initially identified, and 47 papers were selected.

It was observed that the number of studies addressing this topic has been increasing over the past decade and findings related to the evolution, application and the benefits obtained from the VSM application in context of construction were presented. Additionally, the authors found that the two most cited lean wastes were waiting and defects in the production chain. The main causes of this waste and loss were also identified in this work.

This paper contributes by presenting the applicability of VSM as a tool in the construction as found in the literature. For academics, it will be possible to clearly observe research gaps and for industry managers, to identify the main sources of waste and assess the performance of the tool’s application.

The study uses a systematic review to analyze the application of the VSM tool in the construction industry and provides guidance for future research by identifying research gaps, in addition to conducting an extensive analysis of the tool’s potential in waste identification in the studied papers and their primary causes.