Coordination in humanitarian logistics through clusters

Purpose – In the field of humanitarianism, cluster thinking has been suggested as a solution to the lack of coordinated disaster response. Clusters for diverse functions, including sheltering, logistics and water and sanitation, can be viewed as an effort to achieve functional coordination. The purpose of this paper is to contribute to a greater understanding of the potential of cluster concepts using supply chain coordination and inter‐cluster coordination. The focus is on the conceptual level rather than on specific means of coordination. Design/methodology/approach – The cluster concept in humanitarian relief, along with some key empirical issues, is based on a case study. The concept is then compared to the literature on clusters and coordination in order to develop a theoretical framework with propositions on the tradeoffs between different types of coordination. Findings – The results provide important reflections on one of the major trends in contemporary development of humanitarian logistics. This paper shows that there is a tradeoff between different types of coordination, with horizontal coordination inside cluster drawing attention away from important issues of the supply chain as well as the need to coordinate among the clusters. Research limitations/implications – There is a need for more in‐depth case studies of experiences with clusters in various operations. Various perspectives should be taken into account, including the field, responding agencies, beneficiaries, donors, military and commercial service providers, both during and between disasters. Practical implications – The paper presents the tradeoffs between different types of coordination, in which basic aims such as standardisation through functional coordination, must be balanced with cross‐functional and vertical coordination in order to more successfully serve the users' composite needs. Originality/value – The focus on possible trade‐offs between different types of coordination is an important complement to the literature, which often assumes simultaneous high degrees of horizontal and vertical coordination.

Theory development in humanitarian logistics : A framework and three cases

Purpose: There is a need for theory development within the field of humanitarian logistics to understand logistics needs in different stages of a crisis and how to meet these. This paper aims to discuss three dimensions identified in logistics and organization theories and how they relate to three different cases of humanitarian logistics operations - the regional concept of the International Federation of Red Cross Red Crescent Societies, the development and working of the United Nations Joint Logistics Centre and coordination challenges of military logistics in UN mandated peacekeeping operations. The purpose is to build a framework to be used in further studies. Design/methodology/approach: A framework for the study of humanitarian logistics along three dimensions is developed, followed by a discussion of the chosen cases in relation to these dimensions. The framework will be used as basis for the case studies to be undertaken for the purpose of understanding and identification of new questions and needs for other or revised concepts from theory. Findings: The paper shows the relevance of a wide literature to the issues pertinent to humanitarian logistics. There is considerable promise in extant literature on logistics, SCM and coordination, but this needs to be confronted with the particular issues seen in the humanitarian logistics setting to achieve further theory development. Originality/value: The major contribution of the paper lies in its breadth of theoretical perspectives presented and combined in a preliminary theoretical framework. This is applied more specifically in the three case studies described in the paper.

The effect of a Computerised Decision Support System (CDSS) on compliance with the prehospital assessment process: results of an interrupted time-series study

BACKGROUND: Errors in the decision-making process are probably the main threat to patient safety in the prehospital setting. The reason can be the change of focus in prehospital care from the traditional "scoop and run" practice to a more complex assessment and this new focus imposes real demands on clinical judgment. The use of Clinical Guidelines (CG) is a common strategy for cognitively supporting the prehospital providers. However, there are studies that suggest that the compliance with CG in some cases is low in the prehospital setting. One possible way to increase compliance with guidelines could be to introduce guidelines in a Computerized Decision Support System (CDSS). There is limited evidence relating to the effect of CDSS in a prehospital setting. The present study aimed to evaluate the effect of CDSS on compliance with the basic assessment process described in the prehospital CG and the effect of On Scene Time (OST). METHODS: In this time-series study, data from prehospital medical records were collected on a weekly basis during the study period. Medical records were rated with the guidance of a rating protocol and data on OST were collected. The difference between baseline and the intervention period was assessed by a segmented regression. RESULTS: In this study, 371 patients were included. Compliance with the assessment process described in the prehospital CG was stable during the baseline period. Following the introduction of the CDSS, compliance rose significantly. The post-intervention slope was stable. The CDSS had no significant effect on OST. CONCLUSIONS: The use of CDSS in prehospital care has the ability to increase compliance with the assessment process of patients with a medical emergency. This study was unable to demonstrate any effects of OST.