Lessons learned from the pandemic: expanding the collaboration between clinical and logistics activities in a hospital.

PURPOSE: The Covid-19 pandemic generated significant changes in the operating methods of hospital logistics departments. The objective of this research is to understand how these changes took place, what collaboration mechanisms were developed with clinical authorities and, to what extent, logistics and clinical care activities should be decoupled to maximize each area's contribution? DESIGN/METHODOLOGY/APPROACH: The case study is selected to investigate practices implemented during the COVID-19 pandemic in hospitals in Canada. The pandemic presented an opportunity to contrast practices implemented in response to this crisis with those historically used in this environment. FINDINGS: The strategy of decoupling logistical tasks of an operational nature from clinical activities is well-founded and helps free clinical staff from tasks for which they are not trained. However, the decoupling of operational tasks should be combined with an integration of the clinical information flow to the logistics hub players. With this clinical information, the logistics hub can generate its full potential enabling better inventory management decisions to be made. ORIGINALITY/VALUE: The concept of decoupling is studied to identify configurations that offer the best benefits for clinical staff.

The management of personal protective equipment during the COVID-19 pandemic: The case of the province of Quebec.

Like other Canadian provinces, Quebec managed shortages of Personal Protective Equipment (PPE) in the early weeks of the COVID-19 pandemic. Two years later, with hindsight, what lessons can we learn from this logistics crisis? It is precisely to better understand the decisions made by the supply chain players in the province of Quebec that this paper was written. To fully understand the events, this paper first describes the Quebec healthcare system. Then it retraces the series of events and actions during the first wave, at a time when it was most challenging to procure PPE. It also specifies the main characteristics of the supply chain in the Quebec healthcare sector. Finally, it analyzed these data to come up with recommendations to help public decision makers adopt better supply chain management practices.

The Integrated Performance Management System: A Key to Service Trajectory Integration.

INTRODUCTION: This article presents an experience of deploying an integrated performance management system as a catalyst for the integration of a service trajectory for children in vulnerable situations. Called ''Jimmy'', the project identifies how the integrated performance management system makes it possible to improve accessibility, continuity of services and well-being at work among stakeholders. METHODS: An action research was conducted in a large healthcare organization in Canada, between August 2016 and October 2018. Data was systematically collected throughout the various cycles of research using field notes, more than 350 hours of observations, 15 interviews and 3 focus groups. RESULTS: This research supports using an integrated performance management system as a model for collaborative management that supports both horizontal and vertical integration in the service trajectory. The use of visual boards and status sheet meetings were determining factors for service integration and the functioning of integrated teams. This also led to improvements in accessibility and continuity of services, as well as in employee well-being. DISCUSSION AND CONCLUSION: Supported by the various tools of the integrated performance management system, Project ''Jimmy'' reinforces the implementation of linkage and coordination models, which in turn helps create strong connections among teams. The status sheet meetings and visual boards are tools that vertically integrate different hierarchical levels and horizontally integrate various front-line stakeholders through the user-oriented trajectory.

Problem-solving behaviour of nurses in a lean environment.

AIM: To investigate how the extensiveness of a lean implementation-that is, the extent to which lean as a new practice is adopted across nursing departments-relates to second-order problem solving behaviour of nurses. BACKGROUND: Lean implementation is expected to stimulate nurses' second-order problem-solving behaviour. METHOD: We used a vignette-based survey to look for differences in second-order problem-solving behaviour in early-adopter and late-adopter departments at two hospitals with differing degrees of extensiveness of lean implementation. RESULTS: At the hospital with an extensive lean implementation, nurses at the early-adopter department showed 71 second-order problem-solving responses from 50 problem scenarios, as compared with 39 responses from 37 scenarios in the late-adopter department. At the hospital with a less extensive lean implementation, these numbers were 16 from 23 compared with 18 from 19. CONCLUSIONS: The nurses in the hospital with an extensive lean implementation show more second-order problem-solving behaviour than those in the hospital with a stand-alone approach in a single department. IMPLICATIONS FOR NURSING MANAGEMENT: Extensive lean implementation where management clearly shows its belief in lean is a more favourable environment for changing the problem-solving behaviour of nurses.