Business Continuity Management towards Public Healthcare Systems during the Disaster

On September 10th, 2021, Chulalongkorn University organized an online seminar on the theme of “BCM concept towards Public Healthcare System during the Disaster.” The university was pleased to run the seminar in association with Kenya’s Jomo Kenyatta University of Agriculture and Technology. The seminar also enjoyed the support of the JICA Project for the ASEAN University Network/Southeast Asia Engineering Education Development Network and its “Sustainable Healthcare System through Business Continuity Management” program.

Successful broad-based seminars require the participation of experts from a range of different fields, and this event was very fortunate in this regard. Moreover, the success of the undertaking reflects not only the strong spirit of collaboration that exists between the two universities at the institutional level, but also the keen participation of several departments and faculties within Chulalongkorn University itself, including the Faculty of Engineering, the Faculty of Nursing, and the Graduate School’s Risk and Disaster Management Program.

The seminar gathered speakers with relevant knowledge and provided a space within which they could share their views on the relationship between the continuity of public healthcare and Business Continuity Management (BCM). The first speaker was Professor Watanabe Kenji from Nagoya Institute of Technology, Japan, who spoke on Japan’s critical infrastructure. Professor Watanabe was followed by Assistant Professor Natt Leelawat and Ms. Anne Omamo, who spoke on respectively BCM and Kenyan business management during the period of the crisis. The second group of speakers focused on the Thai and Kenyan public healthcare systems, and the presentations by Assistant Professor Police Sub-Lieutenant Pachanut Nunthaitaweekul and Dr. Caroline Ngugi were concerned with how public healthcare systems held up during the COVID-19 crisis.

The seminar’s welcoming address was given by Jing Tang, DEng, a lecturer in robotics and artificial intelligence engineering in the Faculty of Engineering; and the Risk and Disaster Management Program in the Graduate School, as well as being a member of Chulalongkorn University’s Disaster and Risk Management Information Systems Research Group.

The welcoming address included a discussion of the uncertainty around the current situation with COVID-19 and how this has directly affected the public healthcare system.

The topics on which speakers were to address the seminar thus offered a range of perspectives, as well as helping to outline both solutions and what are expected to be profitable areas for future studies.

Alongside its other goals, the seminar also supported the United Nations’ Sustainable Development Goals (SDGs), and in particular #SDG3 Good Health and Well-Being, #SDG8 Decent Work and Economic Growth, #SDG11 Sustainable Cities and Communities, and #SDG13 Climate Action.

The Importance of Local Supply Chain Resilience in Sustaining Public Healthcare Systems during a Disaster

Professor Watanabe Kenji, PhD, a professor in the Graduate School of Social Engineering at Nagoya Institute of Technology, was invited as a guest speaker in his capacity as a well-known expert on BCM.

Professor Watanabe gave an introduction to the importance of public healthcare systems, which included a discussion of ‘critical infrastructure’ (CI).

Although there tends to be considerable overlap between these, actual definitions of CI are made by each government independently, so for example, in Japan, CI is defined as ‘items that could have a significant impact on the lives of the people or socioeconomic activities of Japan if their functions were to be suspended, reduced, or rendered unusable’.

Within modern complex states, infrastructure systems cannot operate independently of one another, and this includes the public healthcare system, which is itself part of the CI. Thus, the different parts of the CI system can be deeply interdependent, giving these a role to play supporting each other and sustaining supply chains and economic activity. Professor Watanabe also described how different contexts affect the situation relative to particular instances of CI, and case studies showed how interdependencies operated in real-life situations, for example how caterers supplying food to schools and hospitals have had to overhaul their operations during the COVID-19 pandemic.

This session also included a discussion of the key factors involved in improving resilience in public healthcare systems, and Professor Watanabe gave examples of these, including the use of public-private partnership-based BCM, interdependent operations, and how drills and exercises are carried out among stakeholders.

Business Continuity Management and Area-Business Continuity Management

The next speaker was Assistant Professor Natt Leelawat, DEng, a lecturer in the Department of Industrial Engineering, the Director of the Risk and Disaster Management Program, and the Head of the Disaster and Risk Management Information Systems Research Group. Assistant Professor Leelawat addressed the topic of business and area-business continuity management and discussed opportunities for the development of specific systems.

He began his presentation by describing the concept of the BCM and how this could prevent disasters from damaging operations and so ensure the continuity of the organization.

The discussion emphasized how good practices depend on a ‘BCM flow’, which starts with the establishment of policy, and then moves through analysis, strategy finalization and the laying out of a formal plan. After establishing the plan, further steps include the development of proactive measures, implementation and review, which then leads into how the plan can be developed and improved in the future.

Assistant Professor Leelawat’s presentation also introduced several case studies, including the recent explosion at a chemical plant (Leelawat & Vilaivan, 2021), and included a discussion of his team’s work on research and trends in BCM (Charoenthammachoke et al., 2020) and the key factors determining the success of BCM implementation, based on a particular case study (Sapapthai et al., 2021).

It is essential to carefully consider just who the stakeholders are in any BCM process, and this should be addressed before beginning any further analysis. There are a number of methods for carrying out stakeholder analysis, and a systematic review of the latter (Sapapthai et al., 2020) can be a useful starting point.

Assistant Professor Leelawat also talked about the Area-BCM concept, an idea that began life in Japan (Baba et al., 2014). The idea behind Area-BCM is to set a scalable scope for an area that is to be focused on, rather than looking at individual companies or organizations. At present, Chulalongkorn University, Nagoya Institute of Technology, and other academic institutions and public organizations in Thailand and Japan are working on the project ‘Regional Resilience Enhancement through the Establishment of Area-BCM at Industry Complexes in Thailand’. Insights gained from the project include the use of the dependent activities elicitation method for designing Area-BCM activities (Kodaka et al., 2020), and an understanding of the factors affecting the perceived usefulness of the Area-BCM model (Meechang et al., 2021).

Business Management in Kenya during Disasters

The next speaker was Ms. Anne Omamo, a lecturer in Jomo Kenyatta University of Agriculture and Technology, who discussed business management in Kenya during disasters. Ms. Omamo started her session by giving some background on disasters in Kenya, together with details of specific risks, the effects of disasters on business, and the extent of loss and disruption to property and assets, public health and services.

All the risks discussed posed a threat to infrastructure and through this to the whole supply chain, and so knowledge regarding CI and BCM was required to limit damages and to maintain services during uncertain situations. The effects of disasters on businesses were also enumerated.

Ms. Omamo shared suggestions for strategies for business management during disasters, and these included planning in advance and training individuals to give them the knowledge needed to help themselves and others and to prevent further damage.

In the next session, speakers discussed the public healthcare systems in Thailand and Kenya.

The Thai Public Healthcare System

Beginning with a discussion of Thailand’s public healthcare system, Assistant Professor Police Sub-Lieutenant Pachanut Nunthaitaweekul, PhD, a lecturer in the Faculty of Nursing and on the Risk and Disaster Management Program, introduced Thailand’s disaster management planning and regulation system.

Assistant Professor Nunthaitaweekul then described how disaster management combined with the public healthcare system in the preparedness phase of the disaster management cycle.

Thailand has systems and protocols that are implemented during this phase of a disaster, including measures such as preparing equipment and coordinating the work of stakeholders. Clearly, the most pressing current challenge to public healthcare stems from the COVID-19 pandemic, and so Thailand’s Ministry of Public Health has cooperated with international organizations to develop solutions that address the new requirements for operating healthcare facilities. This ‘new normal’ also extends to include conceptual frameworks for healthcare facility preparedness that focus on responses and early recovery, which in turn requires both cooperation between responsible organizations and support from outsiders.

In Thailand, knowledge about BCP in public healthcare systems has come from the establishment of relevant committees, which plan how to work after a crisis hits at the regional level and how to then sustain hospital services through social networks. At the end of her presentation, the speaker also discussed tools and suggestions for maintaining operations during the unusual situation of the COVID-19 pandemic.

The Effect of COVID-19 on the Kenyan Public Healthcare System

Also from Kenya, Caroline Ngugi, PhD, a lecturer in the Department of Medical Microbiology at Jomo Kenyatta University of Agriculture and Technology, gave an overview of the public healthcare system in her country. This is similar to Thailand with regard to the hierarchy of operation management, beginning with community care and running up to high-performance hospital referrals.

The description of the Kenyan healthcare system included a discussion of the level of investment as a share of GDP, information on the various types of health insurance, and other sources of funding from the government that support the public healthcare system.

This introduction was followed by a discussion of the COVID-19 situation in Kenya and how this has developed since March 15th, 2020, when the first local case was reported. There have since been four waves of infection in the country, and these have caused more than 4,000 deaths, but the government has tried to increase the reach of its vaccination program, and as of September 6th, 2021, almost 3 million people had been vaccinated.

The Kenyan public healthcare system has clearly been disrupted by COVID-19, but the speaker also described how the pandemic had exposed gaps in its operations and revealed how services were falling short, for example with regard to a lack of information needed to make informed decisions, as well as shortages of equipment and resources. In Both Kenya and Thailand, much of the rural population relies on community healthcare volunteers and primary healthcare services, though in the case of Kenya, this covers the full 70% of the population who live in rural areas.

The last part of the discussion focused on how political considerations are an important influence determining how policy supports the operation of the public healthcare system. Policy, investment and operations all need to be coordinated to improve the system and to ensure that it runs more efficiently, especially during disasters.

What’s Next?

This joint Chulalongkorn University-Jomo Kenyatta University of Agriculture and Technology seminar marked the first step in improving Thai-Kenyan academic collaboration in the areas of BCM and public healthcare systems, and we are confident that this seminar has helped all participants to develop a deeper understanding of the concepts discussed. We thank all participants for their universally interesting, important and valuable contributions.

Links

• More information about the Risk and Disaster Management Program of Chulalongkorn University, please visit http://www.rdm.grad.chula.ac.th/
• More information about the Disaster and Risk Management Information Systems Research Group of Chulalongkorn University, please visit http://drmis.eng.chula.ac.th/

References

Baba, H., Watanabe, T., Nagaishi, M., & Matsumoto, H. (2014). Area business continuity management, a new opportunity for building economic resilience. Procedia Economics and Finance, 18, 296-303. https://doi.org/10.1016/S2212-5671(14)00943-5

Charoenthammachoke, K., Leelawat, N., Tang, J., & Kodaka, A. (2020). Business continuity management: A preliminary systematic literature review based on ScienceDirect database. Journal of Disaster Research, 15 (5), 546-555. https://doi.org/10.20965/jdr.2020.p0546

Kodaka, A., Ono, T., Watanabe, K., Leelawat, N., Chintanapakdee, C., Tang, J., Ino, E., & Kohtake, N. (2020, October 12-14). A dependent activities elicitation method for designing area business continuity management. 2020 IEEE International Symposium on Systems Engineering (ISSE 2020), Vienna, Austria. IEEE. https://doi.org/10.1109/ISSE49799.2020.9272221

Leelawat, N., & Vilaivan, T. (2021). A polystyrene foam factory fire in a Bangkok satellite city: Incident and lessons learned. ACS Chemical Health & Safety. https://doi.org/10.1021/acs.chas.1c00071

Meechang, K., Leelawat, N., Tang, J., Ino, E., Kodaka, A., Chintanapakdee, C., & Watanabe, K. (2021). Affecting factors on perceived usefulness of area-business continuity management: A perspective from employees in industrial areas in Thailand. In S. P. Boret, A. Suppasri, E. Mas, & E. Maly (Eds.), IOP Conference Series: Earth and Environmental Science: Vol. 630. 12th Aceh International Workshop and Expo on Sustainable Tsunami Disaster Recovery (AIWEST-DR 2019) 7-8 November 2019, Tohoku, Japan (012016), Bristol: IOP Publishing. https://doi.org/10.1088/1755-1315/630/1/012016

Sapapthai, S., Leelawat, N., Tang, J., Kodaka, A., Chintanapakdee, C., Ino, E., & Watanabe, K. (2020). A stakeholder analysis approach for area business continuity management: A systematic review. Journal of Disaster Research, 15 (5), 588-598. https://doi.org/10.20965/jdr.2020.p0588

Sapapthai, S., Leelawat, N., Tang, J., Kodaka, A., & Ino, E. (2021, April). Successful factors of business continuity management implementation using analytic hierarchy process-A case of an automotive part company in Ayutthaya Province, Thailand. In 2021 3rd International Conference on Management Science and Industrial Engineering (MSIE 2021) (pp. 132-138), Osaka, Japan. ACM, New York, NY, USA. https://doi.org/10.1145/3460824.3460845