scholarly journals Restarting elective endoscopy safely amidst an evolving pandemic and the impact of patient perception

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher Nguyen ◽  
Kevin T. Kline ◽  
Shehzad Merwat ◽  
Sheharyar Merwat ◽  
Gurinder Luthra ◽  
...  
Keyword(s):  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Transmission Risk ◽  
Dynamic Monitoring ◽  
Successful Model ◽  
Outpatient Procedures ◽  
Risk Patients ◽  
Risk Mitigation Strategies ◽  
Spread Of Infection ◽  
The Impact

Abstract Background The COVID-19 pandemic has led to disruptions in elective and outpatient procedures. Guidance from the Centers for Medicare and Medicaid Services provided a framework for gradual reopening of outpatient clinical operations. As the infrastructure to restart endoscopy has been more clearly described, patient concerns regarding viral transmission during the procedure have been identified. Moreover, the efficacy of the measures in preventing transmission have not been clearly delineated. Methods We identified patients with pandemic-related procedure cancellations from 3/16/2020 to 4/20/2020. Patients were stratified into tier groups (1–4) by urgency. Procedures were performed using our hospital risk mitigation strategies to minimize transmission risk. Patients who subsequently developed symptoms or tested for COVID-19 were recorded. Results Among patients requiring emergent procedures, 57.14% could be scheduled at their originally intended interval. COVID-19 concerns represented the most common rescheduling barrier. No patients who underwent post-procedure testing were positive for COVID-19. No cases of endoscopy staff transmission were identified. Conclusions Non-COVID-19 related patient care during the pandemic is a challenging process that evolved with the spread of infection, requiring dynamic monitoring and protocol optimization. We describe our successful model for reopening endoscopy suites using a tier-based system for safe reintroduction of elective procedures while minimizing transmission to patients and staff. Important barriers included financial and transmission concerns that need to be addressed to enable the return to pre-pandemic utilization of elective endoscopic procedures.

scholarly journals Biofuel supply chain risk mitigation strategy framework: Expert interview based Approach

2020 ◽  
Vol 13 (1) ◽  
pp. 179
Author(s):  
Tedy Wachyudi ◽  
Arief Daryanto ◽  
Machfud Machfud ◽  
Yandra Arkeman
Keyword(s):  
Supply Chain ◽  
Risk Mitigation ◽  
Business Practice ◽  
Mitigation Strategies ◽  
Security Framework ◽  
Supply Chain Risk ◽  
Expert Interview ◽  
Risk Mitigation Strategies ◽  
The Impact

Purpose: The purpose of this case study is to develop and framework supply chain characteristics and risk mitigation strategies in the context of biodiesel downstream supply chain.Design/methodology/approach: This study employs an expert interview-based approach as a qualitative approach with a multi-perspectives view.Findings: There are vary strategies among perspectives, such as perspectives of organization and business types, stakeholder types, times and methods. These also shows that business strategy of collaborative, coordinative, and cooperative arise as alternative strategies for each perspective and each level of stakeholder. Those business strategies may apply in a vary operation strategies which linking through an energy security framework element as company’s competitive priorities.Research limitations/implications: The research scope includes only a certain area of the country’s territory and the target company’s supply chain areas of activity. The research method includes only internal stakeholders and experts as respondents and data sources. The level of analysis was only at corporate level in the corporate case study context. The research also targets only a downstream activities of biodiesel supply chain context. The interview-based approach as a qualitative approach faces some subjectivity challenges among respondents.Practical implications: The research result provides some positive implications for business practice, includes how to minimize the impact of supply chain risk on company’s business activities and performance, how supply chain experts and practitioners used risk mitigation practices, how to formulate strategic plans to minimize the impact of supply chain risk and enhance the effectivity and sustainability of the supply chain activities.Social implications: The implication for business practice was that company’s leaders implemented supply chain risk mitigation strategies that provide positive impacts on the more valuable relationship among supply chain actors and stakeholders.Originality/value: The first, is an activities areas and operation schemes-based of biodiesel supply chain point of view. The second, is a multi-perspectives-based biodiesel supply chain characteristics framework. The third, is an energy security framework-based biodiesel risk mitigation strategies framework.

scholarly journals The Facility Infection Risk Estimator™: A web application tool for comparing indoor risk mitigation strategies by estimating airborne transmission risk

2021 ◽  
pp. 1420326X2110395
Author(s):  
Marcel Harmon ◽  
Josephine Lau
Keyword(s):  
Web Application ◽  
Risk Mitigation ◽  
Infection Risk ◽  
Mitigation Strategies ◽  
Transmission Risk ◽  
Physical Parameters ◽  
Airborne Transmission ◽  
Risk Mitigation Strategies ◽  
Risk Estimator ◽  
Number Of Individuals

The COVID-19 pandemic created needs for (a) estimating the existing airborne risk of infection from SARS-CoV-2 in existing facilities and new designs and (b) estimating and comparing the impacts of engineering and behavioural strategies for contextually reducing that risk. This paper presents the development of a web application to meet these needs, the Facility Infection Risk Estimator™, and its underlying Wells–Riley based model. The model specifically estimates (a) the removal efficiencies of various settling, ventilation, filtration and virus inactivation strategies and (b) the associated probability of infection, given the room physical parameters and number of individuals infected present with either influenza or SARS-CoV-2. A review of the underlying calculations and associated literature is provided, along with the model's validation against two documented spreading events. The error between modelled and actual number of additional people infected, normalized by the number of uninfected people present, ranged from roughly –18.4% to +9.7%. The more certain one can be regarding the input parameters (such as for new designs or existing buildings with adequate field verification), the smaller these normalized errors will be, likely less than ±15%, making it useful for comparing the impacts of different risk mitigation strategies focused on airborne transmission.

scholarly journals TP10.2.7Reintroduction of elective colorectal cancer surgery following the first wave of Covid-19 in the UK – an audit of risk mitigation strategies and review of patient outcome

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Francesca Malcolm ◽  
James Chean Khun Ng ◽  
William Speake
Keyword(s):  
Colorectal Cancer ◽  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Colorectal Cancer Surgery ◽  
Mortality And Morbidity ◽  
Defunctioning Ileostomy ◽  
Operative Strategies ◽  
Risk Mitigation Strategies ◽  
The Uk ◽  
The Impact

Abstract Aim Perioperative acquisition of Covid-19 is associated with high mortality and morbidity. We have analysed the effectiveness of newly designed ‘green’ pathway for elective colorectal cancer (CRC) patients, which aimed to minimise risk of Covid-19. Method Data collected with concurrent implementation of ‘green’ pathway for all patients undergoing CRC surgery over a 6 week period following the ‘first wave’ of the Covid-19 pandemic. The standard audited were appropriately timed pre-operative CT chest, Covid-19 swabs and shielding adherence. The impact of positive pre-operative swabs and post-operative complications were analysed. Additional risk mitigation strategies included dual consultant operating, open operating, and defunctioning ileostomy for high risk anastomoses. Results 49 operations performed of 56 planned. 1 cancelled due to patient being positive for Covid-19, 5 due to progression of cancer on restaging CT, 1 required further medical optimisation. All had a 2 week pre-operative swab and then shielded until the day of the operation. 48/49 had swab 2 days pre-op. CT chest performed in all, 37 (66.7%) were to restage. 4 (8%) had post-operative complication graded as ≥ 2 on Clavien-Dindo score; none of which were Covid related. 1 patient tested positive for Covid-19 post-operatively but remained asymptomatic. All procedures were open and performed by 2 consultants. Conclusion We demonstrate an effective pathway and various operative strategies which can be employed to reduce risk for patients undergoing CRC surgery in the midst of the ongoing global pandemic.

scholarly journals A novel approach for evaluating contact patterns and risk mitigation strategies for COVID-19 in English Primary Schools with application of Structured Expert Judgement

2020 ◽  
Author(s):  
Stephen RJ Sparks ◽  
William P Aspinall ◽  
Ellen Brooks-Pollock ◽  
Leon Danon ◽  
Roger Cooke ◽  
...  
Keyword(s):  
Primary Schools ◽  
Risk Mitigation ◽  
Expert Elicitation ◽  
Mitigation Strategies ◽  
Teaching Staff ◽  
Older Children ◽  
Social Distancing ◽  
Contact Patterns ◽  
Risk Mitigation Strategies ◽  
The Impact

Background Contact patterns are the drivers of close-contacts infections, such as COVID-19. In an effort to control COVID-19 transmission in the UK, schools were closed on 23 March 2020. With social distancing in place, Primary Schools were partially re-opened on 1 June 2020, with plans to fully re-open in September 2020. The impact of social distancing and risk mitigation measures on childrens contact patterns is not known. Methods We conducted a structured expert elicitation of a sample of Primary Headteachers to quantify contact patterns within schools in pre-COVID-19 times and how these patterns were expected to change upon re-opening. Point estimates with uncertainty were determined by a formal performance-based algorithm. Additionally, we surveyed school Headteachers about risk mitigation strategies and their anticipated effectiveness. Results Expert elicitation provides estimates of contact patterns that are consistent with contact surveys. We report mean number of contacts per day for four cohorts within schools along with a range at 90% confidence for the variations of contacts among individuals. Prior to lockdown, we estimate that, mean numbers per day, younger children (Reception and Year 1) made 15 contacts [range 8..35] within school, older children (Year 6) 18 contacts [range 5..55], teaching staff 25 contacts [range 4..55) and non-classroom staff 11 contacts [range 2..27]. Compared to pre-COVID times, after schools re-opened the mean number of contacts were reduced by about 53% for young children, about 62% for older children, about 60% for classroom staff and about 64% for other staff. Contacts between teaching and non-teaching staff reduced by 80%, which is consistent with other independent estimates. The distributions of contacts per person are asymmetric indicating a heavy tail of individuals with high contact numbers. Conclusions We interpret the reduction in childrens contacts as a consequence of efforts to reduce mixing with interventions such as forming groups of children (bubbles) who are organized to learn together to limit contacts. Distributions of contacts for children and adults can be used to inform COVID-19 transmission modelling. Our findings suggest that while official DfE guidelines form the basis for risk mitigation in schools, individual schools have adopted their own bespoke strategies, often going beyond the guidelines.

scholarly journals Happy New Year! Do New Year’s Eve Festivities Influence the Workload of the Emergency Department of an Urban Hospital?

2019 ◽  
Vol 34 (s1) ◽  
pp. s133-s134
Author(s):  
Annelies Scholliers ◽  
Stefan Gogaert ◽  
Dimitri De Fré ◽  
Inge D’haese ◽  
Carine Vandycke
Keyword(s):  
Emergency Department ◽  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Urban Hospital ◽  
Young Males ◽  
The North ◽  
Long Time ◽  
Risk Mitigation Strategies ◽  
New Year’S Eve ◽  
The Impact

Introduction:Bruges is the largest city in the province of West-Flanders in Belgium. Because of its ample canals, it is sometimes referred to as “Venice of the North.” As such, it is a major tourist destination, and during New Year’s Eve, there are many festivities. The AZ Sint-Jan is the largest hospital providing medical care to the area.Aim:To examine the impact of the New Year’s Eve festivities on the workload of the emergency department of AZ Sint-Jan.Methods:Data was analyzed for every patient presenting to the emergency department from the 31st of December starting from 06:00 PM until the 1st of January 08:00 AM from 2009 until 2018. The time of entry, type of injury, gender, age, and whether the patient was intoxicated were evaluated. Ten other dates in this time period were obtained for comparison via a random date generator. Data were analyzed using Jasp©.Results:There were 826 patients included for analysis. On average, 41 patients presented themselves to the emergency department on New Year’s Eve between 06:00 PM and 08:00 AM. On a random day, there were only 31 patients. Most of the patients on New Year’s Eve arrived between 00:00 AM and 08:00 AM. 57% of all patients were male. 22% of all patients were intoxicated with alcohol. From 00:00 AM until 08:00 AM, one in three patients were intoxicated. The average age on admission was 36 years.Discussion:During New Year’s Eve there is a consistently higher workload in the emergency department. There is an influx of young males who are intoxicated. These patients tend to stay a long time to “sleep it off” and put considerable stress on the available resources. More attention should be given to risk mitigation strategies tailored to this group to prevent excessive drinking.

The impact of COVID-19 on stock returns of listed firms on the stock market: Ghana's experience

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kenneth Ofori-Boateng ◽  
Williams Ohemeng ◽  
Elvis Kwame Agyapong ◽  
Ben Justice Bribinti
Keyword(s):  
High Risk ◽  
Stock Returns ◽  
Stock Exchange ◽  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Content Type ◽  
Negative Effect ◽  
Risk Mitigation Strategies ◽  
Ghana Stock Exchange ◽  
The Impact

PurposeIn Ghana, even though scholars and experts in the field of economics and finance have expressed their opinions and perceptions on the effect of the pandemic on the Ghana Stock Exchange, there has been no study conducted to that effect. This study, therefore, aimed at examining the impact of COVID-19 on the stock returns on the Ghana stock exchange. This would help policy makers and investors in making efficient decisions.Design/methodology/approachThe outbreak of the novel COVID-19 has been a thorn in the flesh of the world in its entirety, affecting many aspects of life including the stock market. This study, therefore, examined the impact of the outbreak on the stock returns of the Ghana Stock Exchange. The study utilized data from the All Share Prices of the Ghana stock exchange, commonly known as the Ghana stoke exchange composite index (GSECI) for analysis. The data covered the period before the outbreak of COVID-19 and during the outbreak. It was revealed that the Ghana stock exchange experienced better returns on the market before the outbreak of the virus. The outbreak of COVID-19 has led to wide variations in the market increasing the risk of investments. The exponential General Autoregressive Conditional Heteroscedasticity (EGARCH) (1, 1) model also reveals that the outbreak of COVID-19 has a significant negative effect on the returns in the market. The market in these periods of COVID-19 is highly volatile. It is recommended that investors should carefully consider risk mitigation strategies to enable them diversify their investments effectively and efficiently against the high risk associated with the market in this COVID-19 era.FindingsIt was revealed that the Ghana stock exchange experienced better returns on the market before the outbreak of the virus. The outbreak of COVID-19 has led to wide variations in the market increasing the risk of investments. The EGARCH (1, 1) model also revealed that the outbreak of COVID-19 had a significant negative effect on stock returns in the market. The market during these periods of COVID-19 was viewed as highly volatile.Research limitations/implicationsThe outbreak of COVID-19 is hence deduced to have a negative impact on the Ghana stock exchange. However, the knowledge of how the market has been affected by the disease, it is important that financial risk mitigation studies be undertaken. This goes beyond what this study has done. The study can further be expanded to include other important economic variables such as GDP, inflation, exchange rates and the likes in to the model.Practical implicationsInvestors should carefully consider risk mitigation strategies to enable them diversify their investments effectively and efficiently against the high risk associated with the market in this COVID-19 era.Social implicationsIt is also important that investors consider diversification of their investments in order to reduce the risk in their investments. It will be more appropriate for most investors to invest with companies such as banks and the telecommunications companies listed on the on the market. This is because most of the telecommunication companies in these times have taken advantage and are making good profit on their businesses. Likewise, some of the financial institutions are considered essential institution in these times. Investing in industries such as manufacturing and the oil and gas sector may be more risky.Originality/valueThe decline in economic and financial market indicators could be credited to the failure of most business entities, organizations and firms which are struggling to sustain their operations in these times of COVID-19. These also include firms listed on the Ghana stock exchange with whom investors transact their daily businesses. However, about 70% of the Ghanaian economy heavily depends on these business and firms found in the private and informal sector. According to the Ghana Statistics Service COVID-19 Business Tracker Survey, about 131,000 businesses expressed their uncertainties with the business environment and also faced the challenge of financial accessibility. The study is appropriate to unearth the true effect and offer policy interventions.

Supply chain risk mitigation strategies during COVID-19: exploratory cases of “make-to-order” handloom saree apparel industries

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vishwas Dohale ◽  
Priya Ambilkar ◽  
Angappa Gunasekaran ◽  
Priyanka Verma
Keyword(s):  
Supply Chain ◽  
Risk Mitigation ◽  
Apparel Industry ◽  
Mitigation Strategies ◽  
Supply Chain Risk ◽  
Content Type ◽  
Make To Order ◽  
Risk Mitigation Strategies ◽  
Multiple Case ◽  
The Impact

PurposeThis study attempts to identify the supply chain risks (SCRs) induced during the COVID-19 disruption in an Indian handloom saree industry and determine suitable risk mitigation strategies (RMSs) to overcome the impact of the epidemic disruption.Design/methodology/approachThis work determined 11 SCRs through an extensive literature review in the context of the handloom apparel industry and validated through the experts. Further, a multiple case-based approach is used in this research. Within case and cross-case analyses of four relevant Indian handloom “make-to-order” saree manufacturing firms are conducted to determine the severity of the SCRs considering the pandemic situations to identify appropriate strategies to mitigate the shock of SCRs.FindingsThis study identified the critical SCRs in the context of the Indian handloom “make-to-order” saree industries that emerged during the COVID-19 and proposed a risk mitigation strategy matrix (RMSM) to address the SCRs based on their criticality and predictability dimensions.Research limitations/implicationsThe study provides a novel contribution to the body of knowledge on supply chain risk management (SCRM) in the form of the RMSM tool. Supply chain managers from the different sectors can extend the proposed RMSM to overcome the SCRs. Multiple case analyses facilitate supply chain professionals working in handloom apparel industries to benchmark and adopt the proposed RMSs in their firm.Originality/valueThis research is one of its kind that carried exploratory investigation of the handloom apparel industry cases to assess and determine the strategies for mitigating the SCRs caused during a pandemic outbreak.

Containing smart water metering risks

2021 ◽  
Vol 6 (1) ◽  
pp. 1-14
Author(s):  
Edgar Johnson
Keyword(s):  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Smart Metering ◽  
Smart Water ◽  
Technological Developments ◽  
Risk Mitigation Strategies ◽  
Optimal Information ◽  
Rich Data ◽  
The Impact ◽  
Water Metering

Implementing smart water metering systems has numerous potential benefits for both a utility and its customers. Despite the benefits, implementing smart metering systems also introduces asset anomalies and data errors associated with unusual and abstruse technological aspects of these systems. The various technologies required for each component of the data chain, as well as the multiple interfaces through which the data are filtered, condensed, or altered, impose limitations on the amount and quality of the data that are ultimately made available to the utility. A selected sample of technological aspects of smart metering systems was examined within a holistic framework of risk assessment and components of a generic data chain/pathway. Anomalies were identified that have seldom been addressed in literature before. The perception that implementing smart metering will automatically result in rich data and optimal information, is therefore not necessarily correct. A particular smart metering solution is generally a compromise, because of current technology developments, regulations and the relevance of applicable standards. This ‘bottom-up’ approach used, is technologically agnostic and can also assess future technological developments. Highlighting these technological aspects in this paper facilitates the identification of risk mitigation strategies to reduce or eliminate the impact of the asset anomalies.

The push effect of risks on supply chain performance: service-oriented firms

2019 ◽  
Vol 25 (7) ◽  
pp. 1734-1758
Author(s):  
Huy Truong Quang ◽  
Yoshinori Hara
Keyword(s):  
Supply Chain ◽  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Content Type ◽  
Demand Chain ◽  
Road Map ◽  
Competitive Model ◽  
Service Oriented ◽  
Risk Mitigation Strategies ◽  
The Impact

Purpose The purpose of this paper is to examine the push effect of risk on supply chain (SC) performance, a new concept in the SC risk body of literature, at service-oriented firms. Design/methodology/approach Two models were compared: first, contains relationships between risks that show the mechanism of the push effect, i.e. the theoretical model. The other, only exists in direct effects of risks on SC performance, i.e. the competitive model. Findings Test results proved that the mechanism of the push effect can increase the degree of impact of each and all risks on outputs. By the push effect, risks can explain up to 65 percent variance of SC performance compared with 52 percent of the model without push effect. Moreover, the research found two kinds of the push effect: positive – increasing the impact of “pushed” factors on outputs and vice versa for negative. Research limitations/implications The mechanism of the push influence will be broken if mutual interaction among risks was minimized. Practitioners and managers can apply the resultant model as a “road map” in their context to achieve this purpose. Originality/value Vargo and Lusch (2008) argued that service-oriented firms will be a new trend since the modern-day industry tends to more focus on customer demand. SC management gradually shifted toward demand chain management that organizations will not make and sell units of output but producing customized services to customers (Walters, 2008). This transformation has led to the emergence of new risks, the impact of risk on the SC also varies and the mismatch of the current risk mitigation strategies (Lusch et al., 2007). Dealing with these changes is the purpose of this research.

scholarly journals Implementasi House of Risk dalam Strategi Mitigasi Penyebab Risiko pada Aktivitas di Bagian Produksi PT. XYZ

Jurnal METRIS ◽  
2021 ◽  
Vol 20 (1) ◽  
pp. 58-70
Author(s):  
Chendrasari W. Octavia ◽  
Riana Magdalena ◽  
Wibawa Prasetya
Keyword(s):  
Risk Management ◽  
Supply Chain ◽  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Competitive Environment ◽  
Supply Chain Network ◽  
Risk Approach ◽  
Risk Mitigation Strategies ◽  
The Impact

In the current competitive environment, every company is required to have a strong supply chain network as part of the company's strategy to survive in the company environment. However, the establishment of a strong supply chain network is not a guarantee of risk free. Risk is the impact of an event, an event occurs due to uncertainty that cannot be predicted by stakeholders. In this study aims to identify and map risk events and causes of risk, and provide proposed actions to minimize risk mitigation strategies with the House of Risk approach. The House of Risk approach is part of risk management in the supply chain where this method is able to identify and map risks and events of risk, and provide proposed mitigation strategies. The results of this study obtained 10 risk events and 17 risk causes with the proposed mitigation actions 7 actions.

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