Strategic Planning and Essential Steps for Establishing a Uterine Transplant and Rehabilitation Program: From Idea to Reality

UTx is performed to address absolute uterine infertility in the presence of uterine agenesis, a nonfunctional uterus, or after a prior hysterectomy. After the initial success of UTx resulting in a livebirth (2014) in Sweden, there are over 70 reported UTx surgeries resulting in more than 40 livebirths worldwide. Currently, UTx has been performed in over 10 countries. As UTx is transitioning from an "experimental procedure" to a clinical option, an increasing number of centers may contemplate a UTx program. This article discusses essential steps for establishment of a successful UTx program. These principles may be implemented in cis- and transgender UTx candidates.

Successful strategic planning

5 ideas for engaging clinical nurses in the strategic planning process.

Using modeling and scenario analysis to support evidence-based health workforce strategic planning in Malawi

BACKGROUND

A well-trained and equitably distributed workforce is critical to a functioning health system. As workforce interventions are costly and time-intensive, investing appropriately in strengthening the health workforce requires an evidence-based approach to target efforts to increase the number of health workers, deploy health workers where they are most needed, and optimize the use of existing health workers. This paper describes the Malawi Ministry of Health (MoH) and collaborators' data-driven approach to designing strategies in the Human Resources for Health Strategic Plan (HRH SP) 2018-2022.

METHODS

Three modelling exercises were completed using available data in Malawi. Staff data from districts, central hospitals, and headquarters, and enrollment data from all health training institutions were collected between October 2017 and February 2018. A vacancy analysis was conducted to compare current staffing levels against established posts (the targeted number of positions to be filled, by cadre and work location). A training pipeline model was developed to project the future available workforce, and a demand-based Workforce Optimization Model was used to estimate optimal staffing to meet current levels of service utilization.

RESULTS

As of 2017, 55% of established posts were filled, with an average of 1.49 health professional staff per 1000 population, and with substantial variation in the number of staff per population by district. With current levels of health worker training, Malawi is projected to meet its establishment targets in 2030 but will not meet the WHO standard of 4.45 health workers per 1000 population by 2040. A combined intervention reducing attrition, increasing absorption, and doubling training enrollments would allow the establishment to be met by 2023 and the WHO target to be met by 2036. The Workforce Optimization Model shows a gap of 7374 health workers to optimally deliver services at current utilization rates, with the largest gaps among nursing and midwifery officers and pharmacists.

CONCLUSIONS

Given the time and significant financial investment required to train and deploy health workers, evidence needs to be carefully considered in designing a national HRH SP. The results of these analyses directly informed Malawi's HRH SP 2018-2022 and have subsequently been used in numerous planning processes and investment cases in Malawi. This paper provides a practical methodology for evidence-based HRH strategic planning and highlights the importance of strengthening HRH data systems for improved workforce decision-making.

Medical Affairs and Innovative Medicinal Product Strategy Development

Innovative medicinal products are required for progress in many therapeutic areas, and in particular, oncology. For these products to succeed, pharmaceutical companies must generate the relevant and robust clinical data required to meet the needs of regulators and healthcare providers. In addition, real-world and health economic evidence is increasingly required to support pricing and reimbursement for innovative medicinal products. To incorporate all of these requirements into the innovative medicinal product strategy early in development, the core principles of how product strategies are developed and applied must be revisited and end-to-end strategic planning implemented. This paper reviews the hurdles faced during development of the integrated strategy for innovative medicinal products, particularly in the oncology field, and examines which functions of a pharmaceutical company should play the greatest role in addressing patient and different stakeholders' needs. It will then illustrate how Medical Affairs activities are evolving to take on this strategic leadership role.

The impact of sustainability strategic planning and management on the organizational sustainable performance: A developing-country perspective

The purpose of this article is to comprehensively describe the impact of sustainability strategic planning and management (SSPM) on organisational sustainable performance in a developing country context. A mixed method approach was adopted; data were collected using an interview and a survey targeting 126 organisations operating in the foremost polluting Palestinian manufacturing private sectors. The analyses were conducted employing thematic analysis and Partial Least Squares Structural Equation Modelling (PLS-SEM). The results from data analysis confirm that SSPM had a positive effect on the three dimensions of organisational sustainable performance (i.e. social, ecological and economic). Furthermore, the paper has developed a framework to facilitate integrating SSPM into the business model of manufacturing organisations in a developing country context. This paper is considered among the very few studies exploring the 'questioned' impacts of SSPM on organisational sustainable performance in a developing country.

Strategic planning, components and evolution in zoonotic diseases frameworks: one health approach and public health ethics

Zoonotic diseases are seen as a major public health concern. Routes of the rapid transmission of zoonotic diseases and the economic damage they cause to communities are all reasons why health institutions and systems need to pay more attention to these diseases. Strategic planning is one of the important tasks of policymakers in every organization and system. It is a very reliable and useful tool for leading all kinds of organizations, including health organizations. Countries with clear policy plans have succeeded in controlling and reducing zoonotic diseases. Such countries used appropriate strategic planning and pursued annual goals to control and prevent diseases. Three important steps (strategy development, strategy implementation and strategy evaluation) should be considered in developing a strategic planning for controlling and prevention of zoonotic diseases. Health systems need to develop strategic planning in order to upgrade their capabilities in combating zoonotic diseases. These programs must be flexible, in line with the one health approach, based on the current needs, and aligned with the new challenges faced with health systems. The strategic planning is directly related to national and international policies, organizational goals and missions, dynamism, degree of complexity, and organizational structure of each country's health system.

Evaluation of different strategic planning approaches in a forest plantation in the North of Misiones Province, Argentina

In this paper we evaluate different models and constraints to define strategic planning approaches. In addition, we analyze the best models to meet the expectations generated by the organization. A forest company situated in the province of Misiones, Argentina, provided the data. Hence, forest growth was simulated and, ultimately, optimized planning was used to evaluate different scenarios with 50-year horizon. The best results to stabilize log production were obtained when the harvest is relaxed in ±2 years. Relaxing the clear-cut age leads to a better balance in planting, thinning (1, 2, 3 and 4) and clear felling operations. We found that when maximizing the economic benefit, the NPV is slightly higher, however, this is not significant. In this sense, the planner chooses an economic or volumetric objective function. Furthermore, we demonstrated that model 1 presented better results than model 2 because it manages to stabilize production in the planning horizon. The results allow forest companies to see the implication of choosing the model for strategic planning.

A data management framework for strategic urban planning using blue-green infrastructure

Spatial planning of Blue-Green Infrastructure (BGI) should ideally be based on well-evaluated and context specific solutions. One important obstacle to reach this goal relates to adequate provisioning of data to ensure good governance of BGI, i.e., appropriate planning, design, construction, and maintenance. This study explores the gap between data availability and implementation of BGI in urban planning authorities in Sweden. A multi method approach including brainstorming, semi-structured interviews with urban planners and experts on BGI and Geographical Information System (GIS), and validating workshops were performed to develop a framework for structured and user-friendly data collection and use. Identified challenges concern data availability, data management, and GIS knowledge. There is a need to improve the organisation of data management and the skills of trans-disciplinary cooperation to better understand and interpret different types of data. Moreover, different strategic goals require different data to ensure efficient planning of BGI. This calls for closer interactions between development of strategic political goals and data collection. The data management framework consists of three parts: A) Ideal structure of data management in relation to planning process, data infrastructure and organisational structure, and B) A generic list of data needed, and C) The development of structures for data gathering and access. We conclude that it is essential to develop pan-municipal data management systems that bridge sectors and disciplines to ensure efficient management of the urban environment, and which is able to support the involvement of citizens to collect and access relevant data. The framework can assist in such development.

Expanding the repertoire of evaluation tools so that evaluation recommendations can assist nonprofits to enhance strategic planning and design of program operations

Data are the lifeblood of decision-making and provide a critical component into the complex mosaic from which decisions emerge. Evaluators and decision-makers should, therefore, continuously seek to explore the use of tools that can produce more meaningful, insightful, and useful data so that decision-making can be enhanced and improved. Traditional economic appraisal methods offer much and are very useful and relevant. Standard financial accounting reporting for tax purposes also provide insightful information on the organization's financial health and that of its individual programs. However, neither offer insight into cost behavior-an important consideration for making program operations more efficient and for long-term strategic planning, forecasting, and design of program operations. Before COVID-19, programs were already challenged with competition for donor dollars and the pursuit for financial sustainability. The COVID-19 environment has considerably exacerbated these challenges. In this current environment, it is more important than ever for nonprofits to optimize limited financial resources to do more societal good. This paper will illustrate how selected concepts from cost and management accounting can be used by both independent program evaluators to improve their recommendations, as well as program administrators in-charge of nonprofits to enhance decision-making.

Organic-waste-derived butyric acid-to-biodiesel supply-chain network: Strategic planning design using a deterministic snapshot model

An integrated optimization model for an organic-waste-derived butyric acid-to-butanol supply-chain network (BABSCN) is proposed to minimize the total network cost by simultaneously optimizing both strategic biodiesel production and waste management planning decisions. This model is useful for ensuring effective organic-waste provision for large-scale biodiesel production and waste management. The proposed mixed-integer linear-programming model optimizes the activities ranging from organic-waste preprocessing to butyric acid (BA), transportation of BA to biorefinery, butanol (BuOH) production and mixing with diesel to the distribution of biodiesel. This model is useful for forecasting organic-waste management biodiesel supply chains in South Korea in 2030. The case study results show that a total network cost of $US 3.16/gallon of B3 contains 3% BuOH from organic waste products combined with diesel. The biorefinery-related cost accounts for 98.3% of the total network cost, followed by the organic waste procurement cost (1.1%) and biodiesel distribution cost (0.6%). A scenario-based analysis shows that a 7%-BuOH increase in biodiesel increases the total network cost by 18.8%.

MILESTONES AND PITFALLS IN STRATEGIC PLANNING OF HEALTHCARE IN CAPITAL CITY IN TRANSITION

A little is known about healthcare sector within Strategic plan of Kyiv, which is capital of Ukraine and a city in transition. The aim of this study was to investigate and evaluate implementation of strategic plan for Kyiv with the focus on healthcare sector. There were evaluated Strategic plan for Kyiv, Concept for healthcare development from the Department of Healthcare, City's target program "Health of Kyivers". Data analyses showed 13 (45%) out of 29 strategic initiatives were not implemented for healthcare sector. Data from statistical analyses indicated that low performance from Department of Healthcare was similar for all operational goals. Our findings demonstrated low implementation rate of strategic initiatives within the healthcare sector of city's Strategic plan. Possible causes of low strategic performance could be due to weak institutional relations between top and low executive levels, as well as inconsistency in strategic documents, stuff turnover.

Assessment of a Crowdsourcing Open Call for Approaches to University Community Engagement and Strategic Planning During COVID-19

IMPORTANCE

Reimagining university life during COVID-19 requires substantial innovation and meaningful community input. One method for obtaining community input is crowdsourcing, which involves having a group of individuals work to solve a problem and then publicly share solutions.

OBJECTIVE

To evaluate a crowdsourcing open call as an approach to COVID-19 university community engagement and strategic planning.

DESIGN, SETTING, AND PARTICIPANTS

This qualitative study assessed a crowdsourcing open call offered from June 16 to July 16, 2020, that sought ideas to inform safety in the fall 2020 semester at the University of North Carolina at Chapel Hill (UNC). Digital methods (email and social media) were used for promotion, and submissions were collected online for 4 weeks. Participation was open to UNC students, staff, faculty, and others.

MAIN OUTCOMES AND MEASURES

Submissions were evaluated for innovation, feasibility, inclusivity, and potential to improve safety and well-being. Demographic data were collected from submitting individuals, and submissions were qualitatively analyzed for emergent themes on challenges with and solutions for addressing safety and well-being in the fall semester. Data were shared with UNC leadership to inform decision-making.

RESULTS

The open call received 82 submissions from 110 participants, including current UNC students (56 submissions [68%]), people younger than 30 years (67 [82%]), women (55 [67%]), and individuals identifying as a racial/ethnic minority or as multiracial/ethnic (49 [60%]). Seven submissions were identified as finalists and received cash prizes with the encouragement to use these funds toward idea development and implementation. Seventeen runner-up teams were linked to university resources for further development. Thematic analysis of submissions regarding challenges with the fall semester revealed not only physical health concerns and the limitations of remote learning but also challenges that have been exacerbated by the pandemic, such as a lack of mental health support, structural racism and inequality, and insufficient public transportation. Solutions included novel ideas to support mental health among specific populations (eg, graduate students and racial/ethnic minorities), improve health equity, and increase transit access. All 24 finalists and runners-up indicated interest in implementation after being notified of the open call results.

CONCLUSIONS AND RELEVANCE

This study suggests that open calls are a feasible strategy for university community engagement on COVID-19, providing a stakeholder-driven approach to identifying promising ideas for enhancing safety and well-being. Open calls could be formally incorporated into university planning processes to develop COVID-19 safety strategies that are responsive to diverse community members' concerns.

Transforming the provision of healthcare through emerging technology: A strategic transformation

Why has the health care delivery paradigm and its integral transactions and interactions been left to muddle through, using archaic, 20th century modes and processes of delivery that are overlaid with byz antine medical record databases that pass for "cut ting-edge" technology? What is stalling the digital revolution in the provision of health care services to consumers? Understanding how and why this has happened requires that we briefly explore the evo lution of health care in the United States. Topics discussed include (1): morbidity and mortality: the public health era: (2) Medicare era: the advance of diagnostic and therapeutic technology; (3) the power of the consumer: patient-centered informatics; and (4) planning and execution of strategic transformation of provision of care informatics. Without an informatics focus, our health care system will continue limping along, costing more money and delivering many years of disability. Our most viable solutions revolve around using informatics to measure, guide and become the transformation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Parallels and Mutual Lessons in Tuberculosis and COVID-19 Transmission, Prevention, and Control

The coronavirus disease (COVID-19) pandemic has had unprecedented negative effects on global health and economies, drawing attention and resources from many other public health services. To minimize negative effects, the parallels, lessons, and resources from existing public health programs need to be identified and used. Often underappreciated synergies relating to COVID-19 are with tuberculosis (TB). COVID-19 and TB share commonalities in transmission and public health response: case finding, contact identification, and evaluation. Data supporting interventions for either disease are, understandably, vastly different, given the diseases' different histories. However, many of the evolving issues affecting these diseases are increasingly similar. As previously done for TB, all aspects of congregate investigations and preventive and therapeutic measures for COVID-19 must be prospectively studied for optimal evidence-based interventions. New attention garnered by the pandemic can ensure that knowledge and investment can benefit both COVID-19 response and traditional public health programs such as TB programs.

Application of Testing-Tracing-Treatment Strategy in Response to the COVID-19 Outbreak in Seoul, Korea

BACKGROUND

Following the coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China, a total of 637 patients had been diagnosed with the disease in Seoul as of May 2, 2020. Our study aimed to describe the impact of the 3T strategies (preemptive testing, prompt tracing and proper treatment) on the epidemiological characteristics of COVID-19 in Seoul.

METHODS

The descriptive and explanatory analysis was carried out on critical indicators such as epidemiological characteristics and key duration of patient status change from January 24 to May 2 in Seoul before and after preemptive testing for patients under investigation associated with COVID-19 clusters.

RESULTS

Preemptive testing increased the positive test rate (3.9% to 4.2%), an asymptomatic case at diagnosis (16.9% to 30.6%), and reduced the time from symptom onset to quarantine (4.0 to 3.0 days). Prompt tracing decreased unknown sources of infection (6.9% to 2.8%), the mean number of contacts (32.2 to 23.6), and the time-varying reproduction number R(t) (1.3 to 0.6). With proper treatment, only 2 cases of mortality occurred, resulting in a fatality rate of just 0.3%.

CONCLUSION

In the first wave of the COVID-19 pandemic lasting 100 days, the effect of the 3T strategies flattened the curve and decreased the time during which infected individuals were contagious, thereby lowering the R(t) below 1 in Seoul.

Surge activation by the emergency department for COVID-19

In March 2020, the American College of Emergency Physicians (ACEP) published a national strategic plan for COVID-19, which provides general guidelines yet leaves logistical details for institutions to determine. Key capabilities from this plan provided a crucial foundation for a 16-day Emergency Department (ED) surge planning process at one pediatric institution. This paper describes critical milestones and lessons learned during this brief period, including derivation of criteria for ED surge activation, a full-scale surge drill, and the resultant ED surge protocol. The framework of real-time evaluation was used throughout the planning process and involved constant and iterative synthesis of real-time feedback from multidisciplinary stakeholders for responsive decision-making. Ultimately, the objective of this paper is to provide timely and readily actionable information to other institutions seeking guidance to apply the ACEP strategic plan for COVID-19.

Strategic planning of the integrated urban wastewater system using adaptation pathways

Emerging threats such as climate change and urbanisation pose an unprecedented challenge to the integrated management of urban wastewater systems, which are expected to function in a reliable, resilient and sustainable manner regardless of future conditions. Traditional long term planning is rather limited in developing no-regret strategies that avoid maladaptive lock-ins in the near term and allow for flexibility in the long term. In this study, a novel adaptation pathways approach for urban wastewater management is developed in order to explore the compliance and adaptability potential of intervention strategies in a long term operational period, accounting for different future scenarios and multiple performance objectives in terms of reliability, resilience and sustainability. This multi-criteria multi-scenario approach implements a regret-based method to assess the relative performance of two types of adaptation strategies: (I) standalone strategies (i.e. green or grey strategies only); and (II) hybrid strategies (i.e. combined green and grey strategies). A number of adaptation thresholds (i.e. the points at which the current strategy can no longer meet defined objectives) are defined to identify compliant domains (i.e. periods of time in a future scenario when the performance of a strategy can meet the targets). The results obtained from a case study illustrate the trade-off between adapting to short term pressures and addressing long term challenges. Green strategies show the highest performance in simultaneously meeting near and long term needs, while grey strategies are found less adaptable to changing circumstances. In contrast, hybrid strategies are effective in delivering both short term compliance and long term adaptability. It is also shown that the proposed adaption pathways method can contribute to the identification of adaptation strategies that are developed as future conditions unfold, allowing for more flexibility and avoiding long term commitment to strategies that may cause maladaptation. This provides insights into the near term and long term planning of ensuring the reliability, resilience and sustainability of integrated urban drainage systems.

Impact of Local Boards of Health on Local Health Department Accreditation, Community Health Assessment, Community Health Improvement Planning, and Strategic Planning

INTRODUCTION

Local health departments (LHDs) are increasingly using national standards to meet the challenges presented by the complex environments in which these agencies operate. Local boards of health (LBoHs) might play an instrumental role in improving LHDs' engagement in activities to meet these standards.

OBJECTIVES

To assess the impact of LBoH performance of governance functions on LHDs having a current (completed within 5 years) community health assessment (CHA), community health improvement plan (CHIP), strategic plan, and level of engagement in the Public Health Accreditation Board (PHAB) accreditation program.

METHODS

Binary and multinomial logistic regression models were used to analyze linked data from 329 LHDs participating in both the 2015 Local Board of Health Survey and the 2016 National Profile of LHDs Survey.

RESULTS

Higher performance of LBoH governance functions, measured by an overall scale of LBoH taxonomy consisting of 60 items, had a significant positive effect on LHDs having completed CHA (P < .001), CHIP (P = .01), and strategic plan (P < .001). LHDs operating in communities with a higher score on the overall scale of LBoH taxonomy had significantly higher odds (P = .03) of having higher level of participation in the PHAB national voluntary accreditation program-that is, being accredited, having submitted application for accreditation, or being in the e-PHAB system (eg, by submitting a letter of intent).

CONCLUSIONS

LBoHs serve as governance bodies for roughly 71% of LHDs and can play a significant role in encouraging LHDs' participation in these practices. That positive influence of LBoHs can be seen more clearly if the complexity and richness of LBoH governance functions and other characteristics are measured appropriately. The study findings suggest that LBoHs are a significant component of the public health system in the United States, having positive influence on LHDs having a CHA, CHIP, strategic plan, and participation in accreditation.

A Practical Guide to Performance Improvement: Implementation of Systematic Methodologies

This article discusses performance improvement (PI) and the various methods that PI teams can use to provide a framework for improvement. Teams that complete successful PI projects use a systematic methodology that guides them through the process in a step-by-step manner, with each step building upon the previous one using data collection methods and analytics. Personnel involved with PI projects may need to use various methodologies to achieve improvement. These tools range from Plan-Do-Study-Act cycles to more complex methods such as Six Sigma, which uses a define, measure, analyze, improve, and control process as its foundation. This article includes examples of how PI project team members can implement various methodologies and analysis tools to improve processes across the PI project continuum. After reviewing this article, the reader should have a better understanding of the systematic methodologies supporting the PI process. This is the third article of a six-part series about performance improvement.

'All In': a pragmatic framework for COVID-19 testing and action on a global scale

Current demand for SARS-CoV-2 testing is straining material resource and labor capacity around the globe. As a result, the public health and clinical community are hindered in their ability to monitor and contain the spread of COVID-19. Despite broad consensus that more testing is needed, pragmatic guidance toward realizing this objective has been limited. This paper addresses this limitation by proposing a novel and geographically agnostic framework (the 4Ps framework) to guide multidisciplinary, scalable, resource-efficient, and achievable efforts toward enhanced testing capacity. The 4Ps (Prioritize, Propagate, Partition, and Provide) are described in terms of specific opportunities to enhance the volume, diversity, characterization, and implementation of SARS-CoV-2 testing to benefit public health. Coordinated deployment of the strategic and tactical recommendations described in this framework has the potential to rapidly expand available testing capacity, improve public health decision-making in response to the COVID-19 pandemic, and/or to be applied in future emergent disease outbreaks.