Benchmarking health-care supply chain by implementing Industry 4.0: a fuzzy-AHP-DEMATEL approach

Assessing the critical success factors for implementing industry 4.0 in the pharmaceutical industry: Implications for supply chain sustainability in emerging economies

The emerging technologies of Industry 4.0 (I4.0) are crucial to incorporating agility, sustainability, smartness, and competitiveness in the business model, enabling long-term sustainability practices in the pharmaceutical supply chain (PSC). By leveraging the latest technologies of I4.0, pharmaceutical companies can gain real-time visibility into their supply chain (SC) operations, allowing them to make data-driven decisions that improve SC performance, efficiency, resilience, and sustainability. However, to date, no research has examined the critical success factors (CSFs) that enable the pharmaceutical industry to adopt I4.0 successfully to enhance overall SC sustainability. This study, therefore, analyzed the potential CSFs for adopting I4.0 to increase all facets of sustainability in the PSC, especially from the perspective of an emerging economy like Bangladesh. Initially, sixteen CSFs were identified through a comprehensive literature review and expert validation. Later, the finalized CSFs were clustered into three relevant groups and analyzed using a Bayesian best-worst method (BWM)-based multi-criteria decision-making (MCDM) framework. The study findings revealed that "sufficient investment for technological advancement", "digitalized product monitoring and traceability", and "dedicated and robust research and development (R&D) team" are the top three CSFs to adopt I4.0 in the PSC. The study's findings can aid industrial practitioners, managers, and policymakers in creating effective action plans for efficiently adopting I4.0 in PSC to avail of its competitive benefits and ensure a sustainable future for the pharmaceutical industry.

Healthcare waste management practice and its predictors among health workers in private health facilities in Ilu Aba Bor Zone, Oromia region, South West Ethiopia: a community-based cross-sectional study

OBJECTIVES

A lack of safe healthcare waste management (HCWM) practice poses a risk to healthcare staff, patients and communities. In low-income countries like Ethiopia, studies on the level of safe HCWM practices in private healthcare facilities are limited. This study was designed to assess the level of good HCWM practice and associated factors among health workers in private health facilities.

METHODS

An institution-based cross-sectional study was conducted in the Ilu Aba Bor zone, South West Ethiopia. A random sample of 282 health workers from 143 private health facilities was included in the study. Data were collected using a pretested structured questionnaire that included sociodemographic characteristics, healthcare factors, knowledge assessment and an observation checklist adapted from WHO guidelines. The collected data were entered into EpiData V.3.1 and analysed with SPSS V.25.0. Multivariable logistic regression analysis was used to identify factors associated with HCWM practice. Variables with a p value of <0.05 at 95% CI were declared significant.

RESULTS

More than half (58.7%) of private-sector health workers had good HCWM practice. The presence of the HCWM committee (adjusted OR (AOR)=9.6, 95% CI 4.5 to 20.6), designated healthcare waste storage site (AOR=3.0, 95% CI 1.5 to 6.5), reading the HCWM manual (AOR=4.4, 95% CI 2.2 to 9.0) and having good knowledge of HCWM (AOR=2.6, 95% CI 1.06 to 6.15) were factors associated with good HCWM practice.

CONCLUSION

About three out of five health workers in private healthcare facilities were practising good HCWM. The presence of an HCWM committee, waste management utilities, reading HCWM guidelines and knowledge of health workers were the identified factors. Health workers should read guidelines to improve their knowledge, and the presence of committees and waste management utilities in private clinics should be followed to ensure compliance with safe HCWM practice.

Purchasing challenges in times of COVID-19: resilience practices to mitigate disruptions in the health-care supply chain

Purpose

This study aims to identify supply chain (SC) management practices applied to purchasing capable of improving the resilience of the health-care SC and mitigating the effects of material and service disruption during pandemics.

Design/methodology/approach

The approach adopted is qualitative and is based on a systematic literature review from the ScienceDirect, Emerald, Wiley and Web of Science databases. After selecting 705 documents, filters are applied, and 52 articles present problems faced by purchasing the health-care SC during the coronavirus disease 2019 (COVID-19) pandemic.

Findings

This article suggests five propositions of resilient practices that can increase purchasing resilience in the face of pandemics such as COVID-19. The proposed practices are collaboration, flexibility, visibility, agility and information sharing, which suggest a sequence for the adoption of management practices based on the number of occurrences and importance found in the analysed studies.

Research limitations/implications

This study does not find robust empirical evidence that could categorically state that the results can be replicated in organisations in general. Thus, as a continuation of research, more studies should use an empirical methodology and case analysis to organise different branches. As the human factor was decisive for the results observed in the literature, future research should dedicate part of the studies to the psychological area of professionals. Actions to combat the pandemic were implemented, impacting positively and negatively on the results obtained. Future research on combat actions could indicate which ones should be avoided.

Practical implications

As a result, disruptions are expected to be reduced, and consequently, the resilience of the SC will increase. Accordingly, purchasing processes and procedures can be redefined to positively influence the resilience of the health-care SC. Resilience is related to maintaining the flow of supply, as well as systems and actions aimed at mitigating the effects of disruptions in the hospital’s core business.

Social implications

Health systems need to respond to society’s needs even in the face of global crises, such as the one faced during the COVID-19 pandemic. The overload in hospitals and the exponential demand for specific medicines and services in the fight against the crisis caused by the COVID-19 pandemic require enormous coordination in procurement by the purchasing sector. This planning aims to ensure that the care provided by health services maintains the flow of value that serves hospitalised patients.

Originality/value

This study introduces a new approach to the recurrent problem of disruption of the health-care SC during a pandemic using a combination of five important management practices. This proves useful for mitigating disruptions and their effects on the health-care SC.

Adoption of modern technologies for implementing industry 4.0: an integrated MCDM approach

Purpose

Modern technologies are seen as an essential component of the fourth industrial revolution (industry 4.0) and their adoption is vital to transform the existing manufacturing system into industry 4.0-based manufacturing system. Therefore, the primary objective of this research explores the barriers of modern technology adoption and their mitigating solutions in order to align with Industry 4.0 objectives.

Design/methodology/approach

Barriers to adopting modern technologies and respective mitigating solutions are identified from the available literature. Further, these barriers are ranked with the help of expert opinions by using the BWM method appropriately. The identified solutions are ranked using the combined compromise solution (CoCoSo) method.

Findings

Several modern technologies and their capabilities are recognised to support the industry 4.0-based manufacturing systems. This study identifies 22 barriers to the effective adoption of modern technologies in manufacturing and 14 solutions to overcome these barriers. Change management, the high initial cost of technology and appropriate support infrastructure are the most significant barriers. The most prominent solutions to overcome the most considerable barriers are ‘supportive research, development and commercialisation environment’, ‘updated policy and effective implementation’ and ‘capacity building through training’ that are the top three solutions that need to be addressed.

Research limitations/implications

The barriers and solutions of modern technology adoption are obtained through a comprehensive literature review, so there is a chance to ignore some significant barriers and their solutions. Furthermore, ranking barriers and solutions is done with expert opinion, which is not free from biases.

Practical implications

This identification and prioritisation of barriers will help managers to understand the barriers so they can better prepare themselves. Furthermore, the suggested solutions to overcome these barriers are helpful for the managers and could be strategically adopted through optimal resource utilisation.

Originality/value

This study proposes a framework to identify and analyse the significant barriers and solutions to adopting modern technologies in the manufacturing system. It might be helpful for manufacturing organisations that are willing to transform their manufacturing system into industry 4.0.

A competitiveness measurement system of Brazilian start-ups

Purpose

The purpose of this paper is to propose a competitiveness measurement system for start-ups considering multiple critical success factors.

Design/methodology/approach

The methodological approach uses concepts from key performance indicators (KPIs) and multi-criteria decision analysis (MCDA) based on the fuzzy AHP (FAHP) methodology to weight the criteria related to fundamental points of view (FPVs) and critical success factors (CSFs).

Findings

Data collection was performed with 21 specialists and 28 start-ups, which returned the weights and performance of CSFs and FPVs related to the start-ups’ competitiveness. The results show only one start-up had a highly competitive global performance. In addition, all start-ups showed low competitiveness related to industry 4.0 technologies.

Originality/value

The article collaborates with existing research as a starting point for discussions on the subject, considering that previous research did not address the measurement of the start-ups’ competitiveness level through multiple factors, as developed in this article. In addition, we provide decision-makers and other stakeholders in the start-up ecosystem with a robust measurement system to assess business competitiveness and diagnose the company’s situation.

Barriers to blockchain adoption for supply chain finance: the case of Indian SMEs

Small and medium enterprises (SMEs) in India are suffering from the long-standing challenges related to asymmetric information, high transaction costs, SMEs’ opacity and limited access to credit. Blockchain technology, which is still in its infancy in terms of adoption in India, can facilitate SMEs to counter these challenges. Fuelled by this motivation, the study aims to investigate the significant barriers to blockchain adoption in supply chain finance practices by Indian SMEs. Using fuzzy-analytic hierarchy process, sensitivity analysis, and fuzzy-decision-making trial and evaluation laboratory this paper identifies the blockchain barriers, prioritises them and examine their cause and effect relationships. The results of the study indicate that technology barriers are the most influential barriers that impede blockchain adoption. The findings will help the policymakers and practitioners to take suitable measures to overcome these barriers and fuel the adoption of blockchain in Indian SMEs.

Assessing the influence of COVID-19 protocol on online health information seeking intention of athletes in India

Purpose

The Internet is used as a tool to seek health information by individuals. Mental health concerns are the high prevalence of the novel coronavirus disease 2019 (COVID-19) and preventive steps are required to curb the illness. Therefore, to gain more insight into health concerns, it is now a common practice to seek health information on the Internet. This study propose an integrated theoretical model to explore the relationship between COVID-19 protocols and perceived online trust with online health information seeking intention (OHISI) and a moderating effect of perceived severity and perceived urgency.

Design/methodology/approach

Data are collected from 325 athletes in the category of individual and team sports through an online survey in a Likert-scale questionnaire. The analysis is performed with a quantitative methodology.

Findings

The study reveals the bright side of online health information (OHI), which brings athletes together and has played out with virtual happy hours, meetings and events. The bright side of OHI reflects social, cultural, technological and economic benefits. An OHI chatbot offers bright personalised side information to the individual seeker, which is more convenient and efficient than human capabilities.

Originality/value

The pivotal contribution is the integrated theoretical framework that is derived from multidisciplinary literature to capture the complexity of OHI. Also, it conceptualises the constructs in the context of OHI and COVID-19.

An analytic network process model for hospital facilities management performance evaluation

Purpose

This study aims to establish a rigorous model that can pragmatically evaluate the facilities management (FM) performance of hospitals.

Design/methodology/approach

Among the applicable performance indicators that were identified from extant literature, a focus group study shortlisted ten key performance indicators (KPIs) in four categories (safety, physical, financial and environmental) and verified their practicality. Using the analytic network process (ANP) method to process the focus group’s responses yielded importance weightings for the KPIs and developed the intended evaluation model. This model was then validated by a case study.

Findings

From the empirical data collected, two types of FM performance data and two scenarios of KPI scores were identified. To process these data and scores, a robust calculation method was devised and then proved useful in obtaining an overall score for holistic hospital FM performance. The case study confirmed the appropriateness and validity of the model developed.

Research limitations/implications

Through illustrating how the ANP method could be applied to develop an FM performance evaluation model, the study contributes knowledge to the multi-criteria decision-making domain. Despite the geographical limitation of the model established (i.e. centered around a group of hospitals investigated in Hong Kong), the study can serve as a reference for developing performance evaluation models for other buildings or infrastructures globally.

Practical implications

The model constitutes a practical tool for evaluating the FM performance of hospitals. Using this model on a regular basis will enable performance benchmarking and hence, continuous improvement of FM services.

Originality/value

The ANP model established is the first of its kind tailored for evaluation of hospital FM performance.

The implications of Industry 4.0 on supply chains amid the COVID-19 pandemic: a systematic review

Background: COVID-19 has caused significant disruptions in supply chains. It has increased the demand for products and decreased the supply of raw materials. This has interrupted many production processes. The emerging technologies of Industry 4.0 have the potential to streamline supply chains by improving time-sensitive customized solutions during this emergency. Purpose: This research examines the effects of the epidemic on supply chains and how these effects are reduced through Industry 4.0 technology. Design/methodology/approach: An extensive literature review using the "Preferred Reporting Items for Systematic Review and Meta-Analysis" method was carried out on the impact of the COVID-19 pandemic on supply chains and Industry 4.0 technologies. The study was undertaken by selecting keywords validated by experts and a search was conducted in the Scopus, ProQuest, and Google Scholar databases. Publications from the leading journals on these topics were selected. The bibliographical search resulted in 1484 articles followed by multiple layers of filtering. Finally, the most pertinent articles were selected for reviewing, and a total of 53 articles were analysed. Findings: This study discusses the impact of COVID-19 on the supply chain and how the emerging technologies of Industry 4.0 can help manufacturers to ease the impact. These technologies will enhance the production system through the automation and optimization of production flow convergence, enabling efficiencies and improvements among the suppliers, manufacturers, and consumers in the COVID-19 situation. Originality/value: The study summarizes the impact of the COVID-19 on supply chains and shows the potential of Industry 4.0 technologies to lessen the impact on manufacturing supply chains. This is valuable information for policymakers and practitioners so that they can get insights and take necessary actions.

The implications of Industry 4.0 on supply chains amid the COVID-19 pandemic: a systematic review

Background: COVID-19 has caused significant disruptions in supply chains. It has increased the demand for products and decreased the supply of raw materials. This has interrupted many production processes. The emerging technologies of Industry 4.0 have the potential to streamline supply chains by improving time-sensitive customized solutions during this emergency. Purpose: The study identifies the core technologies of Industry 4.0 and the role and impact of these technologies in managing the disruption caused by the COVID-19 outbreak in strengthening the supply chain resilience. Design/methodology/approach: An extensive literature review using the "Preferred Reporting Items for Systematic Review and Meta-Analysis" method was carried out on the impact of the COVID-19 pandemic on supply chains and Industry 4.0 technologies. The study was undertaken by selecting keywords validated by experts, and a search was conducted in the Scopus, ProQuest, and Google Scholar databases. Publications from the leading journals on these topics were selected. The bibliographical search resulted in 1484 articles, followed by multiple layers of filtering. Finally, the most pertinent articles were selected for review, and a total of 42 articles were analyzed. Findings: The findings of the study showed that the majority of the articles emphasized the digitalization of supply chain management, acknowledging the fundamentals, applications, and prospects, revealing the drivers and challenges of Industry 4.0 technologies to manage disruptions. Most of the authors identified IoT, big data, cloud computing, additive manufacturing, and blockchain to maintain the supply chain resilience. Originality/value: Existing literature on epidemics lacks the basics and practices of utilizing Industry 4.0 technologies in the supply chain recovery process. To fill this research gap, the study summarizes the potential of Industry 4.0 technologies to lessen supply chain disruptions caused by COVID-19. The study findings are valuable for policymakers and practitioners and contribute to supply chain management studies.

Drivers of sustainable healthcare supply chain performance: multi-criteria decision-making approach under grey environment

Purpose

This paper aims to explore the drivers of sustainable healthcare supply chain (SHCSC) performance measurement through extensive literature review and experts' opinions. The drivers are then scrutinized and their priority vector is calculated to provide quality and cost-effective healthcare supply chain (HCSC) services.

Design/methodology/approach

The drivers of the SHCSC performance measurement are validated using the grey-Delphi technique. After validating the drivers, they are prioritized using the grey-analytic hierarchy process (G-AHP), a multi-criteria decision-making tool.

Findings

The findings of the study highlight the prioritized drivers based on the preferences given by the experts. The findings of the study highlight the most prioritized drivers of healthcare (HC) by-product management system, coordinating and facilitating green suppliers in the HCSC and green packaging of pharmaceutical as well as other essential items.

Practical implications

The HCSC managers should coordinate with all the stakeholders across the supply chain and involve them in the decision-making process to make products and services greener and become complicit in complying with the sustainable policy guidelines. The study highlights the strategic policy and managerial implications for implementing sustainability in the HCSC.

Originality/value

The validation and prioritization of the drivers of SHCSC in developing nations' contexts is the key contribution of the study. Grey-AHP enables a practical approach towards enhancing the sustainability of the HCSC and opening the doors for generalizing the study for future research works.

Procurement 4.0 to the rescue: catalysing its adoption by modelling the challenges

Purpose

The pandemic crisis has resulted in global chaos that had caused massive disruption to the supply chain. The pharmaceutical industry, in particular, has been working tirelessly to ensure that they can cater to the people who need them. With restrictions being imposed to prevent the spread of the COVID-19 virus, the movement of raw materials required has been affected, thus creating the need for the procurement function to be innovative. This study proposes the application of Industry 4.0 concepts into the procurement activities of an organization to make it more resilient and efficient.

Design/methodology/approach

To study the intensity of the challenges, Total Interpretive Structural Modelling is used alongside the “Matrice des Impacts Croises Multiplication Appliquee a un Classement” (MICMAC) technique.

Findings

Resilience can be achieved through the collaboration between the organization and its network of suppliers. This is however easier said than done. High and unclear investments have been identified as the challenge that is taking a toll on all technological investments in the pandemic era. The study also shows that organizational inertia which is present in established and structured firms are a deterrent as well.

Originality/value

This study is based on the application of procurement 4.0 to ensure that pharmaceutical supply chains stay least affected since they are essentials. This study using a multi-criteria decision-making approach to prioritize the challenges. This will help practitioners make decisions faster.

Developing a framework for sacred grove management using stakeholder analysis: evidence from sacred groves in Gujarat, India

Purpose

The purpose of this study is to use the framework of stakeholder analysis in a participatory democracy, used in forest management planning, for arriving at the best management option for selected sacred groves of Kachchh. This is achieved by accounting for economic, cultural and ecological values and the resulting outcomes in the complex institutional mechanism. Additionally, this study provides a framework for complex decision-making that characterizes the management of sacred groves involving multiple criteria and options accounting for multiple stakeholders that involve conflicting interests.

Design/methodology/approach

The analytical hierarchy process was used to calculate the global priorities of management options using the relative importance of stakeholders, weights of different decision criteria to arrive at the best management practice for selected groves of Kachchh. The global priorities of management options rank management practices based on stakeholders' values and their effects on the choice of management strategy as well as on the potential to attain a compromise between competing interests. For this purpose, survey responses of 141 individuals belonging to seven different stakeholder categories were analyzed. Along with focus group discussions, and personal interviews, a stratified random sampling technique was used to survey respondents.

Findings

Based on the global priority weights of the alternatives, it is determined that the restoration management option (guggal is restored by planting new guggal sapplings, cattle grazing is prohibited and high levels of ecosystem goods and services are provided) had the highest score, followed by the preservation management option (grazing is allowed on the periphery, juvenile guggal is preserved and moderate ecosystem goods and services are provided). Therefore, restoration of sacred groves is the best management practice of sacred groves in West Kachchh, offering a compromise between maximizing provision of ecosystem services and economic benefits in terms of allowing cattle grazing.

Originality/value

Though there are several studies on best management practices for community-owned forests, irrigation systems, and pasture lands, and the role of local institutions in sustaining these common-pool resources; such studies for sacred groves are absent, despite sacred groves being one of the longest surviving common-pool resources that has sustained it over several decades. This is the first study that uses the framework of stakeholder analysis to arrive at the best management practice for sacred groves. The uniqueness of the study lies in a comprehensive evaluation of ecological–economic–cultural interests of multiple stakeholders toward management of sacred groves.

An integrated framework for analysing performance indicators of Indian microfinance institutions: a multi-stakeholder perspective

Purpose

An amalgamation of Decision-Making Trial and Evaluation Laboratory (DEMATEL) and Analytical Network Process (ANP) has been performed to develop a decision-making framework for improving the overall performance of the microfinance institutions. A primary survey was conducted to collect real-time data from the heterogeneous stakeholders of microfinance institutions across India. The validation of the proposed framework is performed by comparing the results against the conventional method of Analytical Hierarchy Process (AHP).

Design/methodology/approach

This study identifies various dimensions and indicators for measuring the performance of Indian microfinance institutions. Additionally, the ranking and prioritisation of the performance dimensions and indicators is obtained by considering the mutual interrelation between them.

Findings

The study indicates that there exists a significant dyadic relationship between financial performance and social performance for improving the overall performance of the microfinance institutions. Governance is found to unidirectionally influence both financial and social performance. Among all the considered dimensions, financial performance of a microfinance institution is the most critical dimension for improving the overall performance. The top five performance indicators of the Indian microfinance institutions are funding source, borrowing and overhead cost, size of the firm, end-use of the money and depth of outreach.

Research limitations/implications

The study was conducted in the context of Indian microfinance institutions; hence the scope of generalisation of the results is limited. This research considers both subjective and objective aspect of the performance dimensions and indicators from the perspective of multiple stakeholders (i.e. firm, society and regulator). The integrated framework is expected to aid in improving overall performance of microfinance institutions by focusing on the most critical (high prioritised) performance indicators.

Originality/value

An integrated DEMATEL-ANP framework is used in the domain of microfinance to assess the performance dimensions. This study is unique in terms of analysing performance of microfinance institutions from the perspective of heterogeneous stakeholders.