Mass production methods for mass vaccination: improving flow and operational performance in a COVID-19 mass vaccination centre using Lean.
Smith IM; Newcastle University Business School, University of Newcastle upon Tyne, Newcastle upon Tyne, Tyne and Wear, UK firstname.lastname@example.org.
Smith DTL; Lancashire and South Cumbria Integrated Care System, East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK.
BMJ open quality [BMJ Open Qual] 2021 Sep; Vol. 10 (3).
The COVID-19 pandemic has infected tens of millions of people worldwide causing many deaths. Healthcare systems have been stretched caring for the most seriously ill and lockdown measures to interrupt COVID-19 transmission have had adverse economic and societal impacts. Large-scale population vaccination is seen as the solution.In the UK, a network of sites to deploy vaccines comprised National Health Service hospitals, primary care and new mass vaccination centres. Due to the pace at which mass vaccination centres were established and the scale of vaccine deployment, some sites experienced problems with queues and waiting times. To address this, one site used the Lean systematic improvement approach to make rapid operational improvements to reduce process times and improve flow.The case example identifies obstacles to flow experienced by a mass vaccination centre and how they were addressed using Lean concepts and techniques. Process cycle times were used as a proxy metric for efficiency and flow. Based on daily demand volume and open hours, takt time was calculated to give a process completion rate to achieve flow through the vaccination centre.The mass vaccination centre achieved its aim of reducing process times and improving flow. Administrative and clinical cycle times were reduced sufficiently to increase throughput and the number of queues and queueing time were reduced improving client experience.The design and operational management of vaccination centre processes contribute to client experience, efficiency and throughput. Lean provides a systematic approach that can improve operational processes and facilitate client flow through mass vaccination centres.
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Neurology and neuropsychiatry of COVID-19: a systematic review and meta-analysis of the early literature reveals frequent CNS manifestations and key emerging narratives.
Authors Rogers J.P.; Watson C.J.; Badenoch J.; Cross B. et al.
Source Journal of neurology, neurosurgery, and psychiatry; Sep 2021; Vol. 92 (9)
Abstract There is accumulating evidence of the neurological and neuropsychiatric features of infection with SARS-CoV-2. In this systematic review and meta-analysis, we aimed to describe the characteristics of the early literature and estimate point prevalences for neurological and neuropsychiatric manifestations.
Comparison of four high-throughput, automated immunoassays for the detection of SARS-CoV-2 antibodies
Author(s) Oakey J.; Haslam S.; Houghton B.; Brown A.; Eglin J. et al.
Source Annals of Clinical Biochemistry; 2021
Background: A number of immunoassays have been developed to measure antibodies specific to SARS-CoV-2. More data is required on their comparability, particularly among those with milder infections and in the general practice population. The aim of this study was to compare four high-throughput automated anti-SARS-CoV-2 assays using samples collected from hospitalized patients and healthcare workers with confirmed SARS-CoV-2 infection. In addition, we collected general practice samples to compare antibody results and determine seroprevalence.
Patient and clinician satisfaction with video consultations during the COVID-19 pandemic: an opportunity for a new way of working
Author(s) Byrne E.; Watkinson S.
Source Journal of orthodontics; Nov 2020
Publication Date Nov 2020
OBJECTIVE: To assess satisfaction of patients and clinicians with virtual appointments using Attend Anywhere for their orthodontic consultation and to identify any areas where the technology could be further utilised.
Author(s) Anderson D.C.; Grimes D.S.
Source Clinical Medicine, Journal of the Royal College of Physicians of London; Nov 2020; vol. 20 (no. 6)
Publication Date Nov 2020
Author(s) Badenoch J.; Cross B.; Hafeez D.; Song J.; Watson C.; Butler M.; Nicholson T.R.; Rooney A.G.
Source Psychological medicine; Nov 2020 ; p. 1-5
Publication Date Nov 2020
The effect of COVID-19 on general anaesthesia rates for caesarean section. A cross-sectional analysis of six hospitals in the north-west of England
Author(s) Bhatia K.; Columb M.; Bewlay A.; Eccles J.; Hulgur M. et al.
Source Anaesthesia; 2020
Publication Date 2020
At the onset of the global pandemic of COVID-19 (SARS-CoV-2), guidelines recommended using regional anaesthesia for caesarean section in preference to general anaesthesia. National figures from the UK suggest that 8.75% of over 170,000 caesarean sections are performed under general anaesthetic. We explored whether general anaesthesia rates for caesarean section changed during the peak of the pandemic across six maternity units in the north-west of England. We analysed anaesthetic information for 2480 caesarean sections across six maternity units from 1 April to 1 July 2020 (during the pandemic) and compared this information with data from 2555 caesarean sections performed at the same hospitals over a similar period in 2019. Primary outcome was change in general anaesthesia rate for caesarean section. Secondary outcomes included overall caesarean section rates, obstetric indications for caesarean section and regional to general anaesthesia conversion rates. A significant reduction (7.7 to 3.7%, p < 0.0001) in general anaesthetic rates, risk ratio (95%CI) 0.50 (0.39-0.93), was noted across hospitals during the pandemic. Regional to general anaesthesia conversion rates reduced (1.7 to 0.8%, p = 0.012), risk ratio (95%CI) 0.50 (0.29-0.86). Obstetric indications for caesarean sections did not change (p = 0.17) while the overall caesarean section rate increased (28.3 to 29.7%), risk ratio (95%CI) 1.02 (1.00-1.04), p = 0.052. Our analysis shows that general anaesthesia rates for caesarean section declined during the peak of the pandemic. Anaesthetic decision-making, recommendations from anaesthetic guidelines and presence of an on-site anaesthetic consultant in the delivery suite seem to be the key factors that influenced this decline.Copyright © 2020 Association of Anaesthetists
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