ABSTRACT
Introduction. Lean process improvements are needed to meet the increased adult demand for COVID-19 vaccinations. The purpose of the study is to develop interventions to improve adult vaccination against COVID-19 based on lean manufacturing strategies. Material and methods. We conducted 200 timings of the COVID-19 vaccination process and surveyed 200 vaccinated people. The time of the process, the time of creation of the value stream was calculated, production losses were analyzed. Results. After optimizing the COVID-19 vaccination process, the process time decreased by 2.3 times (from 5474.3 ± 127.3 to 2354.6 ± 22.5 sec;p < 0.01). The time for the prophylactic vaccination against COVID-19 in the vaccination room was reduced by 3 times (from 600.6 ± 23.3 to 181.3 ± 25.6 sec;p < 0.01). Production losses in the form of overproduction, excessive data processing, and unnecessary movements are excluded from the activities of the doctor and the nurse at the vaccination room. The time to value stream creation during vaccination increased from 68% to 97% (p < 0.01). Limitations. The research materials are limited to the results of scientific research of the North-Western State Medical University named after I.I. Mechnikov received over 2021. Conclusion. The use of lean manufacturing technologies made it possible to identify the nature of production losses and analyze the causes of their occurrence in the process of vaccination of the adult population against COVID-19. The organizational measures taken in the form of patient flow management, standardization of work processes, redistribution of functional responsibilities, elimination of production losses contributed to a significant increase in the throughput of the vaccination room in the context of the COVID-19 pandemic. © AUTHORS, 2023.
ABSTRACT
A series of vaccine incidents have stimulated vaccine hesitance in China over the last decade. Many scholars have studied the institutional management of these incidents, but a qualitative study of stakeholders' perspectives on vaccine hesitancy in China is missing. To address this lacuna, we conducted in-depth interviews and collected online data to explore diverse stakeholders' narratives on vaccine hesitance. Our analysis shows the different perspectives of medical experts, journalists, parents, and self-defined vaccination victims on vaccination and vaccination hesitance. Medical experts generally consider vaccines, despite some flaws, as safe, and they consider most vaccine safety incidents to be related to coupling symptoms, not to vaccinations. Some parents agree with medical experts, but most do not trust vaccine safety and do not want to put their children at risk. Media professionals, online medical experts, and doctors who do not need to align with the political goal of maintaining a high vaccination rate are less positive about vaccination and consider vaccine hesitance a failure of expert-lay communication in China. Our analysis exhibits the tensions of medical expert and lay perspectives on vaccine hesitance, and suggests that vaccination experts 'see like a state', which is a finding consistent with other studies that have identified the over-politicization of expert-lay communication in Chinese public discourse. Chinese parents need space to express their concerns so that vaccination programs can attune to them.