Toward a More Strategic National Stockpile

The COVID–19 pandemic exposed major deficiencies in the United States’ approach to stockpiling for emergencies. States, cities, and hospitals across the country had meager inventories of critical medical items on hand when the pandemic first reached U.S. soil, and the federal government’s Strategic National Stockpile proved far too small to serve the country’s needs in the first several months of the crisis. As nationwide shortages spread, many state governments were compelled to bid against each other to procure scarce medical supplies—a distribution approach that disadvantaged low-income and minority communities and left countless healthcare professionals and staff ill-equipped to protect themselves against a deadly virus. These severe supply shortages, which hindered the country’s early pandemic response, have since generated an unprecedented push to reform the nation’s stockpiling policy structure. This Article uses a simple cost-benefit model to highlight shortcomings in the existing U.S. stockpiling policy regime and to identify specific avenues for addressing them. Among other things, U.S. stockpiling policies need to better account for important differences in the rotatability of supplies and should incentivize more private stockpiling of the most rotatable emergency items. Targeted reforms of commandeering laws and price-gouging restrictions could further strengthen private incentives to stockpile and may even help to clarify how states and the federal government share responsibilities in the nation’s stockpiling effort. And much more federal support is needed to incentivize the build-out and maintenance of domestic supply chains for the least-rotatable emergency goods. Such tailoring of policies and programs to better fit the unique attributes of stockpiling activities can help ensure the nation is far better equipped to respond the next time disaster strikes

The Unexpected Impact of Information-Sharing on US Pharmaceutical Supply-Chains

This paper examines the introduction of information-sharing into the supply chains for pharmaceutical products in the United States. This introduction was unusual for several reasons. First, it was catalyzed from outside the industry, by a Securities and Exchange Commission (SEC) investigation into improper financial reporting by a single manufacturer. Second, it was initiated by pharmaceutical manufacturers in order to keep distributor inventories low. Third, although its effect on pharmaceutical distributors has been profound, evidence indicates that information-sharing has had no impact on pharmaceutical manufacturers' own inventorymanagement practices.

Operations research in disaster preparedness and response: The public health perspective

Operations research is the scientific study of operations for the purpose of better decision making and management. Disasters are defined as events whose consequences exceed the capability of civil protection and public health systems to provide necessary responses in a timely manner. Public health science is applied to the design of operations of public health services and therefore operations research principles and techniques can be applied in public health. Disaster response quantitative methods such as operations research addressing public health are important tools for planning effective responses to disasters. Models address a variety of decision makers (e.g. first responders, public health officials), geographic settings, strategies modelled (e.g. dispensing, supply chain network design, prevention or mitigation of disaster effects, treatment) and outcomes evaluated (costs, morbidity, mortality, logistical outcomes) and use a range of modelling methodologies. Regarding natural disasters the modelling approaches have been rather limited. Response logistics related to public health impact of disasters have been modelled more intensively since decisions about procurement, transport, stockpiling, and maintenance of needed supplies but also mass vaccination, prophylaxis, and treatment are essential in the emergency management. Major issues at all levels of disaster response decision making, including long-range strategic planning, tactical response planning, and real-time operational support are still unresolved and operations research can provide useful techniques for decision management.-JRC.G.2-Global security and crisis managemen

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2008

Examines ten indicators to assess progress in state readiness to respond to bioterrorism and other public health emergencies. Evaluates the federal government's and hospitals' preparedness. Makes suggestions for funding, restructuring, and other reforms

H1N1 Challenges Ahead

Examines capacities and challenges in preparing for and responding to an H1N1 flu pandemic, including vaccine issues, confusion with seasonal flu, strain on medical systems, and erosion of public health infrastructure. Makes recommendations

Stockpiling and resource allocation for influenza preparedness and manufacturing assembly

textStockpiling resources is a pervasive way to handle demand uncertainty and future demand surges. However, stockpiling is subject to costs, including warehousing costs, inventory holding costs, and wastage of expired resources. Hence, how to stockpile in an economically efficient manner is an important topic to study. Furthermore, if the inventoried supply is insufficient for a surge in demand, how to best allocate available resources becomes a natural question to ask. In this dissertation, we consider three applications of stockpiling and resource allocation: (i) we stockpile ventilators both centrally and regionally for an influenza pandemic; (ii) we allocate limited vaccine doses of various types to target populations for an influenza pandemic; and, (iii) we investigate inventory needs for low cost, high usage (class C) parts in an engine assembly plant. First, we describe and analyze a model for estimating the number of ventilators that the Texas Department of State Health Services (DSHS), and eight health service regions in Texas, should stockpile for an influenza pandemic. Using a probability distribution governing peak-week demand for ventilators across the eight health service regions, an optimization model allows investigation of the tradeoff between the cost of the total stockpile and the expected shortfall of ventilators under mild, moderate, and severe pandemic scenarios. Our analysis yields the surprising result that there is little benefit to DSHS holding a significant stockpile, even when those centrally held ventilators can be dispatched to regions after observing the peak-week demand realization. Three factors contribute to this result: positively correlated regional demands, a relatively low coefficient of variation, and wastage of the central stockpile once it is dispatched to the regions. Second, we formulate an optimization model for allocating various types of vaccines to multiple priority groups in 254 counties in the state of Texas that DSHS can use to distribute its vaccines for an influenza pandemic. For reaching the public, vaccines are allocated to the state’s Registered Providers (RPs), Local Health Departments (LHDs), and Health Service Regions (HSRs). The first two allocations are driven by requests from RPs and LHDs while HSR allocation is at DSHS’s discretion. The optimization model aims to achieve proportionally fair coverage of priority groups across the 254 counties, as informed by user-specified weights on those priority groups, using the HSR doses. With proportional fairness as our primary goal, the optimal allocation also counts policy simplicity and regional equity. Sensitivity analysis on the portion of the state’s vaccines reserved for HSRs shows that a small portion can effectively shrink the gap of vaccination coverage between urban and rural counties. Finally, we derive short-cut formulae for estimating the extra inventory needed for managing class C parts in units of bins that an engine assembly plant can use to achieve a desired fill rate at workstations. The plant orders a class C part from its supplier based on the part’s aggregated next-day demand across all workstations. After receiving the part, the plant first stores the supply in the warehouse and delivers the part to workstations in bins whenever the line-side inventory at a workstation is empty. We study four cases of various information availability in the order quantity calculation and derive associated formulae for estimating the extra inventory needed due to demand aggregation and bin delivery. We demonstrate the performance of our short-cut formulae, showing the tradeoff between extra inventory needed and the associated risk of not satisfying all workstation requests. Our sensitivity analysis shows that workstation demand variation and bin size have little or no influence on the performance of our short-cut formulae.Operations Research and Industrial Engineerin

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2009

Based on ten indicators, assesses progress in the readiness of states, federal government, and hospitals to respond to public health emergencies, with a focus on the H1N1 flu. Outlines improvements and concerns in funding, accountability, and other areas

OM Forum-challenges and strategies in managing nonprofit operations: an operations management perspective

The operations management (OM) community is paying increasing attention to the analysis of nonprofit operations. However, what is it about this type of operation that makes it particularly interesting to OM scholars? We address this question by studying the objectives, actors, and main activities of nonprofit operations and the most common challenges they face. In addition, we suggest tactical and operational strategies to address these challenges by considering works in the for-profit sector and in different applied areas. The ultimate goal of this paper is to inspire and stimulate OM researchers to develop significant theoretical and empirical models in this novel stream of literature

Three Essays on the Effect of Scarcity on Consumer Behavior and Firm Performance

Studies have consistently shown that scarcity plays a significant role in shaping decision making. Under conditions of scarcity, individuals tend to behave impulsively, and firms are inclined to redefine their set of priorities and strategies, ultimately impacting their performance. Considering the scant investigation of the mechanisms and effects of scarcity in the supply chain management literature, this dissertation aimed to investigate the roles of scarcity in shaping consumer behavior and firm strategy in three essays. The first essay investigated the effect of post-stockout scarcity disclosures on consumer responses to stockouts through the lens of product scarcity and signaling theory. The results of the experimental analysis indicate that post-stockout disclosures increase consumer perceived scarcity, reduce consumer satisfaction with the stockout situation, yet increase consumer purchase intention. However, the results of a time-effect analysis show that consumers\u27 perceived scarcity and purchase intention decrease over time when stockouts persist. These results indicate that effectively communicating the reasons for the stockout, as well as actions being undertaken for replenishing the product can serve as a powerful tool to retain customers exposed to stockouts. The second essay explored the role of retail product rationing (limit buys) in preventing stockpiling of essential products at retail stores during natural disasters through the lens of regret theory and anchoring effect. Results of an experimental investigation through manipulation of the number of items a consumer can buy and the presence/absence of disclosures highlighting social norms – or nudges, indicate that when consumers\u27 needs were less than the retailer\u27s set purchase limit, the purchase limit increased consumer stockpiling propensity. Additionally, though no significant effect of social nudges in the presence of a purchase quantity limit was found, social nudges significantly reduced consumer stockpiling propensity when no limits were placed. The third essay studied the effect of a firm\u27s financial and operational slack on its green supply chain management (GSCM) performance by using the natural resource-based view and conceptualizing slack as a capability needed by a firm to reach its green supply chain goals. Results of a random effect model analysis indicate that the firm\u27s absorbed slack and unborrowed slack (financial slacks), and capacity slack (operational slack) have a positive effect with diminishing returns on its GSCM performance. In contrast, inventory slack (a different kind of operational slack) has a negative effect with diminishing returns on a firm\u27s GSCM performance. Moreover, we found that the firm\u27s operating environment scarcity positively moderates the relationship between inventory slack and absorbed slack on GSCM performances GSCM performance. Environmental scarcity promotes a more efficient use of slack resources in the pursuit of green SCM efforts