Introduction
Since its outbreak in 2019, the novel Coronavirus has spread rapidly, affecting many countries around the world, including the United States. The widespread contraction of the virus led the World Health Organization (WHO) to declare the disease a global pandemic (Riley et al., 2020). While the US government has been striving to adopt measures to curb the transmission of the virus and provide care to the infected patients, the healthcare sector has been overwhelmed due to the high infection rates (Emanuel et al., 2020). Besides, the government is also required to facilitate the development of a vaccine and adopt measures to manage the spread of the disease. Maintaining a low mortality rate and minimizing the economic effect of the viral spread should be the government biggest priority. The prevalence of COVID-19 cases in the United States is a quality problem that would require good quality management to find a solution for mitigation. According to Dr Joseph M Juran, quality management requires quality actions to be planned out, improved and controlled (Neyestani, 2017). The mitigation process will achieve control at one level of quality performance. Then, plans are laid out to improve the project on a project by project basis. The Define-Measure-Analyze-Improve-Control (DMAIC) process will be used to determine the root causes of COVID-19’s effects on the United States healthcare sector.
Define
The novel Coronavirus was declared a global pandemic on March 11, 2020. The virus, which causes serious clinical manifestation, has produced a high case of severe illness that has overwhelmed the health care infrastructure (Liew et al., 2020; Emanuel et al., 2020). The viral pandemic has placed extraordinary demand on the public health and health systems and on providers of the primary community services. Due to the rapid transmission of COVID-19, the healthcare system does not have adequate kits to conduct mass testing (Anderson et al., 2020). In addition, the number of nurse practitioners in medical facilities is inadequate to handle the severe cases of COVID-19, where patients exhibit pneumonic symptoms. To effectively mitigate the effects of Coronavirus, the United States government need to adopt measures that will facilitate quality services delivery by the health care sector. According to the Pandemic Influenza Plan, by the US Department of Health and Human Services, which was first developed in 2005 and subsequently updated after the 2009 outbreak and in 2007, a moderate pandemic can infect up to 64 million American citizens, with about 1.25% requiring medication (Emanuel et al., 2020). Therefore, based on the Pandemic Influenza Plan, the current health system capacity, in the form of ICU beds, ventilators, personnel, and diagnostic interventions cannot meet the demand created by the global pandemic (Anderson et al., 2020; Ebrahim et al., 2020). The government need to control the spread, develop plans to improve the health system and conduct subsequent improvements to the health system (Hanafi et al., 2019).
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Quality Improvement
Quality Planning
Quality control
Measure
The effective management of the global pandemic will require a fair allocation of resources to the health care facilities around the United States. Currently, the American health system capacity does not meet the demand set by the virus outbreak. There is a shortage of hospital beds, ICU beds, and ventilators. In addition, the number of medical personnel has also reduced because some of them are getting infected and quarantined because of the virus. Furthermore, technical and governmental failures in the United States, particularly the shortage of personal protective equipment (PPE) and N-95 masks have resulted in the persistent scarcity of tests (Emanuel et al., 2020). Public health measures, particularly social distancing, cough etiquette, and hand hygiene, should be adopted to control the spread of the virus to uninfected individuals. In addition, since the world demand for tests kits is greater than their production, there is a need to prioritize patients. Additional measures, in the form of supplementary budget allocation to improve health system capacity and the development of a vaccine would help prepare the health care system for any future outbreaks.
Analyze
S hortage of hospital and ICU beds, and ventilators
Coughing Etiquette
Hand washing
Social distancing
Inadequate Medical Personnel and equipment
Scarcity of tests
No existing vaccines
The novelty of the virus has slowed down the effort of vaccine development
Inadequate budget allocation to the healthcare sector
For effective mitigation, there is a need to determine the root cause of the widespread transmission of the Coronavirus within the United States (Nagamine & Williams, 2005). The high number of severe and critical cases of COVID-19 exceed the health system capacity. Also, due to inadequate creation of public awareness about the virus, the public health measures have not been adhered to effectively. Recommendations on social distancing, coughing etiquette and hand hygiene have not been fully adopted. Furthermore, the lack of a COVID-19 virus makes the control against the spread difficult. Finally, government policies on health insurance in addition to inadequate resource allocation to the healthcare sector, has contributed to the lack of quality health services.
Improve
Inadequate time and information on the COVID-19 pandemic necessitate the need to give priority to patients who are more likely to survive treatment and thus maximize the number of patients who will survive. However, to improve the quality of service in healthcare, the government should allocate emergency fund to the healthcare sector to cater for the increased demand. The fund should help in the acquisition of new ventilators as well as payment of medical personnel who will be required to work extra shifts (Atkeson et al., 2020). In addition, there will be a need for the production of test kits in large volumes to facilitate mass testing. The quality of the test kit should also be monitored to prevent errors during mass testing. Essential medical equipment, including N-95 masks and personal protective equipment, should be availed for the medical personal, to protect them from contracting the virus. Furthermore, medical research to develop a vaccine for the virus will be required. While there is an urgent need for a working vaccine, the government, along with other relevant regulations, should ensure that the development of the vaccine adheres to the required medical research procedures.
Control
Control measures should be adopted throughout the process of mitigating the effects of COVID-19. The first objective of the mitigation process will be the control of the spread. Measure to prevent the spread includes quarantining and isolating infected individuals, as well as the adoption of various public health measures such as cough etiquette, hand hygiene, and social distance. Upon the adoption of these preventive measures, the progress and effectiveness of these methods will be measured through the analysis of recorded new infections. These measures should reduce the rate of the spread. The health system capacity will be measured in relation to the population. The ratio of medical personnel to patients should range between 1:4 to 1:6 depending on speciality. In addition, the improved budgetary allocation should help increase the levels of recovery and the hospital capacity in general. The development of the vaccine should be completed within a given timeline. The development should follow due to drug development processes, including clinical studies. The people who participate in the research to ascertain the safety and effectiveness of vaccine and effectiveness of the developed vaccine should be given priority for the coronavirus interventions.
References
Anderson, R. M., Heesterbeek, H., Klinkenberg, D., & Hollingsworth, T. D. (2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic?. The Lancet , 395 (10228), 931-934.
Atkeson, A., & Atkeson, A. (2020). What Will be the Economic Impact of COVID-19 in the US. Rough Estimates of Disease Scenarios. Federal Reserve Bank of Minneapolis Staff Report , 595 .
Ebrahim, S. H., Ahmed, Q. A., Gozzer, E., Schlagenhauf, P., & Memish, Z. A. (2020). Covid-19 and community mitigation strategies in a pandemic.
Emanuel, E. J., Persad, G., Upshur, R., Thome, B., Parker, M., Glickman, A., ... & Phillips, J. P. (2020). Fair allocation of scarce medical resources in the time of Covid-19.
Hanafi, N. A., Kowang, T. O., & Fei, G. C. (2019). Categorization of Lean Six Sigma Tools and Techniques Based on DMAIC Framework. Journal of Information , 4 (13), 01-12.
Liew, M. F., Siow, W. T., MacLaren, G., & See, K. C. (2020). Preparing for COVID-19: early experience from an intensive care unit in Singapore. Critical Care , 24 (1), 1-3.
Nagamine, J., & Williams, M. (2005). Quality tools: root cause analysis (RCA) and failure modes and effects analysis (FMEA). Hospitalist , 9 , 19-22.
Neyestani, B. (2017). Principles and Contributions of Total Quality Management (TQM) Gurus on Business Quality Improvement. Available at SSRN 2950981 .
