Coordination Of Efforts Research Articles

School Leadership in Volatile Environments: The Zimbabwean Experience

School heads in Zimbabwe face relentless changes in the environment in which they operate. Volatility, uncertainty, complexity and ambiguity (VUCA) created by the diversity, intensity and rapidity of these changes present challenges on ways to effectively lead as existing methods apparently prove inadequate. This study examines the major sources of volatility that affect school operations in Zimbabwe. It explores the challenges faced by school heads as they live through volatility in their operational environments. It further explores the strategies that have been put in place to ensure that schools counter these challenges. The study employs a mixed design methodology that involves the use of both qualitative and quantitative methods complementing each other. The study employed convenience sampling to select twenty school heads that formed the study sample. The theoretical framework guiding this study was the chaos theory. The study found the major sources of volatility and resultant challenges were economic crisis, political interference, globalization, poor technology and disasters (both natural and manmade). The study found that agility, that is, the ability to communicate across the organization and to move quickly to apply solutions, was the key strategy school leaders could employ to cope and win in volatile environments. Resource planning was also found to be an important strategy to win in volatile environments characterized by many changes that affect the normal operations of schools. Perhaps the major finding was that complex problems in schools could be resolved through deliberate coordination, interventions and creative effort. System oriented thinking was found to enhance such interaction and engagement. The key recommendation for this study was the need for school heads to employ readiness strategies in turbulent environments and organizational resilience principles in line with this study’s findings.

An analysis of price, service and commission rate decisions in online sales made through E-commerce platforms

E-commerce platforms provide different companies a sales platform to access global markets. The relationship between the e-commerce platform and the companies making online sales through the e-commerce platform creates several challenges. Competition between the sellers and the coordination efforts of the e-commerce platform managers lead to different pricing, service level and commission decisions in this system. We consider a system that includes two sellers that make online sales of the same product through the same e-commerce platform, by paying a certain commission rate from their sales revenues to the e-commerce platform. The demand of the sellers in this system can be altered by changing the prices or by providing different service levels. Since the service in these systems can be provided by either the sellers themselves or by the e-commerce platform, we analyze both settings and compare their results with each other. We analyze the pricing, service level and commission rate decisions considering different settings using game theoretic models. We determine the optimal decisions and corresponding system results through analytical analysis and also by detailed numerical experiments. We also investigate the effects of the parameters on the system results. Our findings show that competition between the sellers benefit the e-commerce platform, and the sellers can increase their profits if they can coordinate their operations. In addition, we determine the characteristics of the services and the conditions of the system for which it is better for the e-commerce platform to provide the service instead of the sellers themselves.

Understanding the Circular Economy: Overview of the Issues

This essay tries to synthesize a recent discussion on circular economics, aiming to clarify the concept, its relationship with the notion of “decoupling”, and how technology, business, and economic policy influence it. In essence, circular economy means turning waste into something valuable. The concept encompasses some previous notions, such as bioeconomy. Technology of Fourth Industrial Revolution helps to decoupling growth from resource use. The reach of decoupling is disparate between growth optimistic and growth pessimistic thinkers. Business models comprehended in circular economy vary from eliminating waste, maximizing use extension of capital and durable consumption goods, until recovering materials and energy from process and products, turning goods into services by sharing, and replacing property by lease or pay-per-use models. Policies to induce or incentivize circular economy includes fiscal incentives through taxation and subsidization, command and control measures, and voluntary coordination efforts at the international level.

Letter to the Editor: Pivoting Care Coordination Efforts Based on Risk and Return.

Letter to the Editor: Pivoting Care Coordination Efforts Based on Risk and Return.

Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement

Individual-level social needs have been shown to substantially impact emergency department (ED) care transitions of older adults. The Geriatric Emergency care Applied Research (GEAR) Network aimed to identify care transition interventions, particularly addressing social needs, and prioritize future research questions. GEAR engaged 49 interdisciplinary stakeholders, derived clinical questions, and conducted searches of electronic databases to identify ED discharge care transition interventions in older adult populations. Informed by the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) framework, data extraction and synthesis of included studies included the degree that intervention components addressed social needs and their association with patient outcomes. GEAR convened a consensus conference to identify topics of highest priority for future care transitions research. Our search identified 248 unique articles addressing care transition interventions in older adult populations. Of these, 17 individual care transition intervention studies were included in the current literature synthesis. Overall, common care transition interventions included coordination efforts, comprehensive geriatric assessments, discharge planning, and telephone or in-person follow-up. Fourteen of the 17 care transition intervention studies in older adults specifically addressed at least one social need within the PRAPARE framework, most commonly related to access to food, medicine, or health care. No care transition intervention addressing social needs in older adult populations consistently reduced subsequent health care utilization or other patient-centered outcomes. GEAR stakeholders identified that determining optimal outcome measures for ED-home transition interventions was the highest priority area for future care transitions research. ED care transition intervention studies in older adults frequently address at least one social need component and exhibit variation in the degree of success on a wide array of health care utilization outcomes.

Stratifying for Value: An Updated Population Health Risk Stratification Approach.

Most risk stratification approaches attempt to predict clinical outcomes rather than value. For a provider organization or health system to have financial success in value-based contracting, future risk models must analyze costs as well as disease burden. The purpose of this study was to create a customized risk stratification algorithm that considered a patient's medical spend alongside disease burden while delivering a scoring system that improves the efficiency of a care coordination program. The authors focused on University Hospitals (UH) Health System's Accountable Care Organization population of 554,805 because this patient cohort is engaged with UH's primary care network and has the most robust data. The 5-category risk algorithm was found to be meaningful and impactful after integrating the foundation of the Minnesota Tiering system with an expanded comorbidity list and weighting the result by the previous 12 months of medical spend. This new technique can identify patients in need of intensive care coordination. The complex risk tier of the stratification system reduces the number of patients from 551,045 to 27,552, or 5% of the patient population, and accounts for 67.9% ($1,107,822,887) of total annual medical spend. Expanding care coordination efforts to patients in the top 2 tiers would account for 15% of the patients and 83.2% ($1,357,545,872) of annual medical spend. The novelty of the new approach allows clinical teams to focus intense resources on a smaller sample of the patient population and to identify chronic conditions contributing to costs, and feel confident that they have greater explanatory power regarding value.

The importance of water quality in classifying basic water services: The case of Ethiopia, SDG6.1, and safe drinking water.

IntroductionSustainable Development Goal (SDG) 6 aims to coordinate international efforts toward “clean water and sanitation.” However, water contaminated with pathogenic bacteria or thermotolerant coliforms (TTC) will not achieve the SDG target of clean water in the lives of people around the world. The aim of this study is to assess the water quality parameters of basic water services in Amhara and Afar regions of Ethiopia as well as the role and importance of local managerial committees in ensuring basic water functionality.MethodsThis mixed methods research, conducted in January-June 2019, sampled 22 districts from food-insecure areas in the Amhara and Afar regions of Ethiopia. From the 22 districts, which represent nearly one third of all districts in each region, 111 water services classified as “basic” were randomly selected. For each selected water service, research included: water quality sample testing, visual observation of water services, interviews and focus group discussions with the associated water managerial committee members. Descriptive statistics frequency, percent, mean, median, standard deviations, normal tables, cross-tables and graphs are used to present the data.ResultsAlthough the international water standard for thermotolerant coliform (TTC) levels is 0 CFU/100ml, in our sample of 111 water services, the maximum TTC counts were 71 CFU/100 ml and the mean was 4 CFU/100 ml. Thermotolerant coliform counts were above the permissible standard values for nearly 40% (n = 111) of the basic water services. TTC was detected in 44 (39.64%) (n = 111) basic water services. Of these, 38 (34.23%) were operationally functional while 6 (5.41%) were not functional. Approximately one third of the basic water services sampled, deemed “functional” by international standards, do not provide potable water due to thermotolerant coliform (TTC) levels.ConclusionOur findings from the Amhara and Afar regions of Ethiopia demonstrate that water quality parameters are not currently considered in classifying basic water services. This suggests that international efforts to address SDG 6 should incorporate water quality as a key parameter to better track international progress toward “clean water and sanitation” efforts. We discuss two potential pathways for stronger inclusion of water quality parameters in international definitions: (1) to mandate water quality within “functional” and “non-functional” definitions or (2) to add a ladder rung titled “safe basic water services” to the international drinking water ladder. Our findings from Ethiopia suggest that additional research should be undertaken in development contexts to assess whether or not “functional” basic water services provide safe drinking water to users.

Programmatic Costs of the Telehealth Ostomy Self-Management Training: An Application of Time-Driven Activity-Based Costing

ObjectivesProgrammatic cost assessment of novel clinical interventions can inform their widespread dissemination and implementation. This study aimed to determine the programmatic costs of a telehealth Ostomy Self-Management Training (OSMT) intervention for cancer survivors using Time-Driven Activity-Based Costing (TDABC) methodology. MethodsWe demonstrated a step-by-step application of TDABC based on a process map with core OSMT intervention activities and associated procedures and determined resource use and costs, per unit procedure. We also assessed per-patient costs from a payer perspective and provided estimates of total hours and costs by personnel, activity, and procedure. ResultsThe per-patient cost of the OSMT was $1758. Personnel time accounted for 91% of the total cost. Site supervisor and information technology technician time were the most expensive personnel resources. Telehealth technical and communication equipment accounted for 8% of the total cost. Intervention coordination and monitoring efforts represented most of the total time cost (62%), followed by the intervention delivery (35%). The procedures with the highest cost were communication via phone or virtual meetings (24%), email exchanges (18%), and telehealth session delivery (18%). ConclusionsFuture efforts to replicate, disseminate, and implement the OSMT intervention should anticipate funding for nonclinical components of the intervention, including coordination and monitoring, and consider how these activities can be performed most efficiently. For institutions without established telemedicine programs, selection of videoconferencing platforms and adequate staffing for participant technical support should be considered. Our step-by-step application of TDABC serves as a case study demonstrating how interventionists can gather data on resource use and costs of intervention activities concurrently with their collection of trial data.

How Suboptimal Consolidation of Care During the COVID-19 Pandemic Can Teach Us to Do Better.

How Suboptimal Consolidation of Care During the COVID-19 Pandemic Can Teach Us to Do Better.

Assessing joint commitment as a process in great apes

SummaryMany social animals interact jointly, but only humans experience a specific sense of obligation toward their co-participants, a joint commitment. However, joint commitment is not only a mental state but also a process that reveals itself in the coordination efforts deployed during entry and exit phases of joint action. Here, we investigated the presence and duration of such phases in N = 1,242 natural play and grooming interactions of captive chimpanzees and bonobos. The apes frequently exchanged mutual gaze and communicative signals prior to and after engaging in joint activities with conspecifics, demonstrating entry and exit phases comparable to those of human joint activities. Although rank effects were less clear, phases in bonobos were more moderated by friendship compared to phases in chimpanzees, suggesting bonobos were more likely to reflect patterns analogous to human “face management”. This suggests that joint commitment as process was already present in our last common ancestor with Pan.

Clinician Wellness—Self-Care for Staying Healthy: Implementation of a Wellness Calendar and Programming for Health Care Workers in Response to COVID-19

Clinician Wellness—Self-Care for Staying Healthy: Implementation of a Wellness Calendar and Programming for Health Care Workers in Response to COVID-19

Decomposition and optimization of linear structures using meta models

Monolithic optimization of large mechanical systems can be expensive and cumbersome. Drivers of computational cost and integration effort are, e.g., the size of the design problem and the number of different components, models, and disciplines. Distributed optimization schemes decompose large problems into smaller subproblems; however, they typically require intense coordination effort. This paper proposes an approach for complete decoupling by decomposing a monolithic optimization into independent optimization subproblems that can be solved without need for coordination. This is accomplished by sampling the space of component performance, here represented by eigenvalues and eigenvectors of stiffness matrices, and establishing meta models that map the relevant component performance values onto feasibility and mass estimates. The optimization procedure consists of two steps: First, a system optimization problem is solved by assigning stiffness requirements to components that are approximately feasible and mass-optimal. Second, the component optimization problems are solved independently of each other such that stiffness requirements are satisfied. As information on feasibility and mass is provided during system optimization by meta models, the approach will be referred to as informed decomposition. The effectiveness of the approach is demonstrated by minimizing the mass of a simple two-component linear structure subject to a requirement on total stiffness. This is done for three different component models, a beam with constant cross-section, a beam with varying cross-sections, and an arbitrary 2-dimensional body, using parametric and topology optimization, respectively. The approach produces results that are at most 1 % heavier than the results obtained by monolithic optimization.

Artificial intelligence-powered remote monitoring of patients with chronic obstructive pulmonary disease.

Artificial intelligence-powered remote monitoring of patients with chronic obstructive pulmonary disease.

Supplier Satisfaction in Buyer–Supplier Relationships: Assessment from Supplier Perspective

ABSTRACT Purpose A long-lasting buyer–supplier relationship is vital for any business organization to be successful. The purpose of this study is to explore the factors that affect the supplier satisfaction in buyer–supplier relationships and to explore their causal relationships. Methodology The work is an attempt to probe the issue of supplier satisfaction in a purchasing relationship and the various factors that might have a bearing on this relationship. An instrument, developed for this purpose after conducting wide-ranging discussions with Heads and Operations Officers of supplier firms as also the available literature on the subject, was validated through pilot testing. A selection of nearly 300 Indian suppliers comprised the respondent firms in our study who were invited to participate in our online or paper-based survey. Partial Least-Squares path modeling (PLS) was the technique chosen to evaluate the proposed model. Findings The paper builds on earlier research on the topic to replicate their study in a new context. The major findings of our research relate to the following aspects: (a) assess the importance of supplier satisfaction for the buying firm to receive preferred customer status, (b) re-establish the importance of cooperation as a precursor for managing the buyer–supplier relationship, and (3) apply the PLS analyses method to evaluate the factors and their order in terms of their contribution to the overall supplier satisfaction level. The results show that the important positive effects on supplier satisfaction in buyer–supplier relationships are the ones linked to cooperation, coordination, payment policy, and purchasing policy by this order. Research implications This study extends previous meta-analyses suggesting that proper cooperation could be the source of a competitive advantage enjoyed by the firms on both sides of the supply chain. The present study provides a guidance toward conducting future research on satisfaction measurement in buyer–supplier relationships from the perspectives of both buyers and suppliers. Practical implications The present study explores how factors like conducive policy, transparent communication, and coordination efforts by the buyer affect the value in the buyer–supplier relationships. Our findings present three direct implications for managers of buyer firms. First, the work provides an empirically grounded argument for making conscious efforts toward improving cooperation with supplier firms to achieve better supplier satisfaction. Second, the work provides guidelines to the managers for prioritizing synergetic investments in developing sustainable and fruitful relationships with suppliers. Third, the study results indicate a word of caution for managers who aim to simultaneously improve the buyer firm’s information technology (IT) capability while ignoring its integration with the IT infrastructure or the lack of it that exists in the supplier firms. Originality/Value This paper investigates why supplier satisfaction is relevant for buyer–supplier relationships and what are the relevant factors associated in this context. The findings expand the current understanding of these concepts by building upon practitioner inputs and survey results.

The role of coordination costs in mode choice decisions: A case study of German cities

Abstract In times of accelerating urbanization and environmental pollution, mode choice decisions (MCD) are a critical parameter in a city’s appearance and its environmental impacts. Simultaneously, the emerging smartphone multimodal traveller information systems (SMTIS) simplifies the usage of multimodal trips and, therefore, enhance the options in MCD. Current MCD models, in addition to considering classic parameters like travel time and cost, also consider socioeconomic variables and latent variables, such as modal preferences or mode-specific characteristics. However, from the users’ perspective, one main influence is currently still not sufficiently considered in these models: Coordination costs for planning the trip, such as looking-up time tables for public transport. Consequently, we introduced this variable in a multinomial logit model and made a representative survey in Germany for measuring the coordination effort and evaluating our model. Our results support our hypothesis that coordination costs have a significant impact on MCD. We therefore conclude that further developments in information systems together with supporting policies may influence the MCD and, hence, lead to more sustainable cities in the future.

Readiness and early response to COVID-19: achievements, challenges and lessons learnt in Ethiopia

Declaration of the novel coronavirus disease as a Public Health Emergency of International Concern necessitated countries to get ready to respond. Here, we describe key achievements, challenges and lessons learnt...

Use Cases of Real-Time Locating Systems for Factory Planning and Production Monitoring

Production companies operate in an increasingly dynamic and unpredictable market environment. The ever shorter innovation cycles and the associated decreasing product life cycles require production systems and processes to change continuously. Furthermore, rising complexity in market enfactories through product variety leads to an increased coordination effort in factory operations. To stay competitive, decision making in factory planning as well as production planning and control (PPC) must be done target-oriented and in the shortest time possible. A fundamental basis in this respect is a reliable and consistent database, needed for the overall and holistic improvement of the logistics performance of a company’s internal supply chain. However, the collection and preparation of data is associated with a high expenditure of time and thus represents a great challenge. Additionally, required data in practice is often inhomogeneous or inconsistent, which makes it difficult to track ongoing processes precisely. Due to the continuous availability of exact positions at any time, Real-Time Locating Systems (RTLS) offer the potential to provide movement data of essential elements of the production system such as material supply, resources and workforce with comparatively little effort. To demonstrate the resulting potentials for factory planning and PPC, use cases for RTLS have been identified and implemented in the Learning Factory of the Institute for Production Systems and Logistics (IFA). After a short introduction of the IFA Learning Factory and the principle of Real-Time Locating Systems, the use cases in factory planning, factory operation and production monitoring are described. Having summarized the achieved benefits provided for the training participants in the IFA Learning Factory a summarizing conclusion is given, underlining the great possibilities of real-time localization in production environments and providing an outlook on further research activities.

Air pollution in Northeast Asia: can framing of public messages influence beliefs and attributions?

ABSTRACT Public support for any policy is often influenced by communications highlighting aspects of it – such as a policy’s perceived “costs” or “benefits” to people. This paper tests for these attitudinal differences as they relate to the transboundary air pollution problem in South Korea where cross-national coordination efforts among China, South Korea, and Japan have done little to alleviate the problem. We conduct an emphasis framing experiment launched in mid-2019, testing whether the importance of cooperation with China decreases or increases with exposure to different frames, such as Korea working alone to address the problem or Korea and China working together. While the message frames utilised in our study did not show a powerful direct impact on respondents, a secondary analysis reveals differences across pre-existing beliefs and attitudes. For Korean policy makers to effectively respond to both domestic and foreign demands related to the air pollution problem in Northeast Asia, there must be acknowledgement of this variance throughout the policy making process. This study thus highlights a tension for policy makers: trying to shift public beliefs through specific messages or allowing change in policy design by engaging the public in a more bottom-up deliberative approach.

Supporting Wildfire Response During a Pandemic in the United States: the COVID-19 Incident Risk Assessment Tool

The onset of the global pandemic in 2020 significantly increased the complexity and uncertainty of wildfire incident response in the United States, and there was a clear role for decision support to inform and enhance coordination and communication efforts. Epidemiological modeling suggested the risk of COVID-19 outbreak at a traditional large fire camp could be substantial and supported the broadscale implementation of mitigations, and management of COVID-19 required expanding the response network to interface with entities such as local public health agencies, hospitals, and emergency operations centers. Despite the early issuance of medical and public health guidance to support wildfire management functions under a COVID-19 modified operating posture, an identified gap was a scale- and scope-appropriate tool to support incident-level assessment of COVID-19 risk. Here we review the development and application of a COVID-19 Incident Risk Assessment Tool intended to fill that gap. After prototyping with fire managers and risk practitioners, including early-season use on several incidents, we built an online dashboard that was used operationally throughout the 2020 fire season. We summarize usage statistics, provide some examples of real use on wildfire incidents, and report feedback from users. The tool helped to fill a critical information gap and was intended to support risk-informed decision-making regarding incident logistics, operations, and COVID-19 mitigations.

Creation of a primary breast cancer culture repository from patients with a BMI >30 kg/m2: A Mexican endeavor.

e12574 Background: Currently there are no primary cultures or cell lines derived from patients with breast cancer and obesity. It has been postulated that breast cancer in obese women behaves differently as it does in non-obese women, as is composed of distinct biological features, as was generated in a different metabolic environment, as well as pertains to a different prognosis and different response to chemotherapy, lower rates of overall survival and a greater probability of recurrence. By creating a primary breast cancer culture bank of breast cancer tumors from women with obesity (BMI > 30kg/m2), we will establish a cell line exclusive to obese women in Mexico, where targeted therapy may be tested and treatment may be individualized depending on the characteristics of the patient. Methods: This study recruited 32 women with breast cancer and a BMI > 30 kg/m2, matched by 6 controls with are non-obese women with breast cancer. Elegibility criteria was determined by women with breast cancer confirmed by pathology, who had not been subjected to prior treatment regarding the neoplasm. The breast cancer removing surgeries and the patients were selected from the ABC Medical Center in Mexico City and all procedures were approved by the research and ethics committee of the hospital in question. Results: Through extensive communication a cooperative protocol was established between the departments of surgery, oncology, pathology and nursing to coordinate efforts and be able to take a 2 – 5 mm sample of the breast tumor removed from the patient. To be able to distinguish cancer cells from non-cancer cells (epithelial cells, fibroblasts, adipocytes) the Hayflick limit was be utilized. Once a primary breast cancer culture was established, 12 million cells will be injected into the subscapular area of athymic, nu-nu mice to be able to monitor tumoral growth in vivo and conduct a subsequent cellular analysis, determining it still pertains to the same characteristics of the tumor from which it was obtained. Conclusions: A primary breast cancer culture repository from patients with a BMI > 30 kg/m2 was established. This is the first primary breast cancer culture for both Mexican and obese women with breast cancer, the first in vitro method of analysis of specific characteristics typical of the Mexican population. Translational research may now be conducted on these new tumoral cultures to create individualized therapy for women with the distinct, aforementioned characteristics.