A Pandemic Panorama: Balancing Huntington's Disease Clinical Care and Research in Ireland

ABSTRACT

Ireland had one of the highest levels of COVID-19 in Europe and the numbers of cases and deaths were high especially in residential care settings. Since the onset of the pandemic, entire healthcare and research operations had to be reset, to prevent and manage COVID-19 in a Huntington's Disease (HD) residential care facility in Ireland. Lean Management principles were successfully used initially to manage the clinical caseload and eventually research during the pandemic. The strategy was to cut out the eight areas of 'wastes' as per the Lean Methodology. Initially these principles were applied in HD clinical care and eventually in research when it could be resumed during the pandemic. The first waste 'Waiting' was dealt with by creating of COVID-19 specific ward and buffer zone, 'Inventory' was managed by optimising the procurement and management of Personal protective equipment(PPE), the third waste 'defects' were minimized by continuous in-house training of personnel relevant to minimizing errors and optimizing care for COVID-19, the fourth waste 'transportation' was managed by transitioning the clinical and research visits to remote mode by deploying technology, the waste 'motion' was managed with segregated staff accommodation rosters and technology, 'Overproduction' was managed by optimizing clinical operations using emergency clinical governance initiatives, 'Overprocessing' was managed by eliminating repetitive, redundant, or less than valuable processes and finally 'untapped human potential' was tapped into by retraining and redeployment of staff in transdisciplinary roles. Research operations were completely optimised so that pandemic related restrictions had little effect on achieving research deliverables successfully.