ABSTRACT
Critically ill polytrauma patients with hemorrhage require a rapid assessment to initiate hemostatic resuscitation in the shortest possible time with the activation of a massive transfusion or a critical hemorrhage management protocol. The hospital reality experienced during the COVID-19 pandemic in all countries was critical, as it was in Spain; according to the data published daily by the Ministry of Health on its website, during the period of this study, the occupancy rate of intensive care units (ICUs) by patients diagnosed with the novel coronavirus disease (COVID-19) rose to 23.09% in Spain, even reaching 45.23% at the end of January 2021. We aimed to analyze the changes observed during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic period regarding the effectiveness of Spanish ICUs in terms of mortality reduction. We present a cross-sectional study that compares two cohorts of patients admitted to ICUs across all autonomous communities of Spain with a diagnosis of polytrauma. Results: Only age was slightly higher at admission during the first wave of the pandemic (47.74 ± 18.65 vs. 41.42 ± 18.82 years, p = 0.014). The transfusion rate during the pandemic increased by 10.4% compared to the previous stage (p = 0.058). Regarding hemostatic components, the use of tranexamic acid increased from 1.8% to 10.7% and fibrinogen concentrates from 0.9% to 1.9%. In the case of prothrombin complex concentrates, although there was a slight increase in their use, there were no significant differences during the pandemic compared to the previous period. Conclusion: Mortality showed no difference before and during the pandemic, despite the observed change in the transfusion policy. In summary, the immediate and global implementation of patient blood management (PBM) based on clinical transfusion algorithms should be mandatory in all hospitals in our country.
ABSTRACT
Frugal innovation has become a requirement for success in resource-scarce environments, a situation that the COVID-19 pandemic has exacerbated. In this context, the literature has developed several frugal innovation approaches for promoting sustainability, but there is no a widely accepted theory nor a predominant paradigm given the incipient and relatively new nature of a research domain that requires further studies. There is also a high potential for under-exploited markets, represented by low-income consumers who no longer concentrate on developing countries and where there is a cumulative number of consumers with minimal spending capacity, rising income distribution inequality, and the increasing polarization of wealth and risk of poverty. This paper contributes to the literature by examining from a Resource-Based View perspective, the critical role of two key organizational capabilities, namely market-focused learning and organizational ambidexterity, to develop firms' innovation capability in low-end markets due to the unique characteristics of these markets. In doing so, the study employs partial least squares structural equation modeling (PLS-SEM) with a sample of 190 manufacturing firms to provide empirical support to our theoretical predictions that establish that: (1) market-focused learning capability drives organizational ambidexterity, (2) market-focused learning capability and organizational ambidexterity foster organizational innovation capability, which, ultimately, affects cash flow, and (3) market-focused learning capability has a stronger effect on organizational innovation capability in low-end markets. Contrary to our expectations, organizational ambidexterity has a stronger impact on organizational innovation capability in non-low-end markets, considering that this is the first step to shed light on this issue.
ABSTRACT
Frugal innovation has become a requirement for success in resource-scarce environments, a situation that the COVID-19 pandemic has exacerbated. In this context, the literature has developed several frugal innovation approaches for promoting sustainability, but there is no a widely accepted theory nor a predominant paradigm given the incipient and relatively new nature of a research domain that requires further studies. There is also a high potential for under-exploited markets, represented by low-income consumers who no longer concentrate on developing countries and where there is a cumulative number of consumers with minimal spending capacity, rising income distribution inequality, and the increasing polarization of wealth and risk of poverty. This paper contributes to the literature by examining from a Resource-Based View perspective, the critical role of two key organizational capabilities, namely market-focused learning and organizational ambidexterity, to develop firms’ innovation capability in low-end markets due to the unique characteristics of these markets. In doing so, the study employs partial least squares structural equation modeling (PLS-SEM) with a sample of 190 manufacturing firms to provide empirical support to our theoretical predictions that establish that: (1) market-focused learning capability drives organizational ambidexterity, (2) market-focused learning capability and organizational ambidexterity foster organizational innovation capability, which, ultimately, affects cash flow, and (3) market-focused learning capability has a stronger effect on organizational innovation capability in low-end markets. Contrary to our expectations, organizational ambidexterity has a stronger impact on organizational innovation capability in non-low-end markets, considering that this is the first step to shed light on this issue.
ABSTRACT
This report from ASCO's International Quality Steering Group summarizes early learnings on how the COVID-19 pandemic and its stresses have disproportionately affected cancer care delivery and its delivery systems across the world. This article shares perspectives from eight different countries, including Austria, Brazil, Ghana, Honduras, Ireland, the Philippines, South Africa, and the United Arab Emirates, which provide insight to their unique issues, challenges, and barriers to quality improvement in cancer care during the pandemic. These perspectives shed light on some key recommendations applicable on a global scale and focus on access to care, importance of expanding and developing new treatments for both COVID-19 and cancer, access to telemedicine, collecting and using COVID-19 and cancer registry data, establishing measures and guidelines to further enhance quality of care, and expanding communication among governments, health care systems, and health care providers. The impact of the COVID-19 pandemic on cancer care and quality improvement has been and will continue to be felt across the globe, but this report aims to share these experiences and learnings and to assist ASCO's international members and our global fight against the pandemic and cancer.