MAGGOT DEBRIDEMENT THERAPY - griffith.edu.au DEBRIDEMENT THERAPY For compromised health care...
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BPMN SYSTEMS ANALYSIS REPHRASING TRANSCRIPTION OF INTERVIEWS NARRATIVE INTERVIEWS REFLECTIVE ANALYSIS COMPARATIVE ANALYSIS TYPOLOGY The wound care burden on low- and middle-income countries (LMICs) is steadily increasing due to motorisation of transport, cardiovascular disease, diabetes, violence, armed conflict, increasing cancer rates and disasters. Modern care of chronic and traumatic wounds relies heavily on the availability of antibiotics, sophisticated wound dressings and devices such as for hydrosurgical debridement or negative pressure therapy. However, resource poor health care providers in LMICs have limited access to medicine, modern dressings and medical devices. BACKGROUND MAGGOT DEBRIDEMENT THERAPY For compromised health care environments, wound care options are required that are relatively cheap, easy to use and have multiple therapeutic benefits. One such option is Maggot Debridement Therapy (MDT) where living fly larvae are used to remove dead tissue, to control infection and to stimulate wound healing (Sherman, 2009). KNOWLEDGE GAPS Our review of the literature has revealed that there is a growing body of work demonstrating the efficacy of MDT for the treatment of chronic wounds in modern western wound care settings, and case reports on MDT for the treatment of acute, infected or fungating wounds. However, there is little literature discussing the use of MDT in resource-poor healthcare settings. RESEARCH More concerning is the paucity of literature discussing the logistics and supply chain management issues pertinent to MDT. This is troubling because uptake of MDT in LMIC settings depends on reliable, efficient and affordable supply of medical maggots. Moreover, many healthcare professionals maintain a general dislike and distrust of MDT. In summary, research is needed that: • demonstrates MDT efficacy in the treatment of wounds other than ulcers; • explores the supply chain opportunities in compromised healthcare settings; and • explores the economic, social and psychological barriers to the uptake of MDT by healthcare professionals. Our research seeks to understand the supply chain management opportunities and challenges presented by MDT in humanitarian aid, and it includes: • a systematic review of the literature relevant to the MDT supply chain; • the development of an MDT supply chain model using Business Process Model Notation (BPMN) • demonstration of the benefits of MDT in disaster medicine (Stadler et al., 2016); • a multiple case study of four MDT supply chains in Kenya, Africa, involving semi-structured interviews with key supply chain stakeholders; and • an MDT supply chain trial to test the four case study supply chains by performing production and shipment trials with live medical maggots. ANALYSIS Qualitative data will be analysed with the documentary method (Trautrims et al., 2012) and two additional data analysis steps will complement this approach, including modelling of supply chain information with BPMN and analysis of emerging supply chain characteristics through systems thinking. Quantitative data will be subject to statistical analysis and serves to triangulate the qualitative research findings. References SHERMAN, R.A. 2009. J Diabetes Sci Technol, 3, 336-44 | STADLER, F. et al. 2016. Prehosp Disaster Med, 31, 79-84 | TRAUTRIMS, A. et al. 2012. International Journal of Physical Distribution & Logistics Management, 42, 828-842 | maggots on the move SUPPLY PRODUCTION DISTRIBUTION MAGGOT THERAPY DISPOSAL Figure 1) Diabetic ulcers are some of the most common wounds encountered in the low-resource setting. Figure 2) Research and knowledge deficit in relation to MDT supply chain management in compromised settings. The shaded curve represents the current knowledge space at corresponding supply chain steps and the exposed diabetic wound area the gap in knowledge that remains to be filled. From top to bottom: © Stephen Doggett © 2006 Johnson Ndungu (Photoshare) © Stephen Doggett © 2006 Katie Richey (Photoshare) © 1999 Arturo Sanabria (Photoshare) © Kenyatta National Hospital Figure 3) Analysis framework for qualitative research data collected by us. Note that the documentary method is expanded to include two extra research steps. Frank Stadler 1 , PhD Candidate, Student ID : s2701555 PRINCIPAL SUPERVISOR: Prof Peter Tatham 1 , Professor of Humanitarian Logistics CO-PRINCIPAL SUPERVISOR: Prof Ramon Shaban 2 , Professor of Infection Prevention and Control 1 Department of International Business and Asian Studies, Griffith University, 2 Menzies Health Institute Qld and Gold Coast Health Griffith Business School International Business and Asian Studies griffith.edu.au/gbs
Transcript of MAGGOT DEBRIDEMENT THERAPY - griffith.edu.au DEBRIDEMENT THERAPY For compromised health care...
BPMN
SYSTEMS ANALYSIS
REPHRASING
TRANSCRIPTIONOF INTERVIEWS
NARRATIVEINTERVIEWS
REFLECTIVE ANALYSIS
COMPARATIVE ANALYSIS
TYPOLOGY
The wound care burden on low- and middle-income countries (LMICs) is steadily increasing due to motorisation of transport, cardiovascular disease, diabetes, violence, armed conflict, increasing cancer rates and disasters. Modern care of chronic and traumatic wounds relies heavily on the availability of antibiotics, sophisticated wound dressings and devices such as for hydrosurgical debridement or negative pressure therapy. However, resource poor health care providers in LMICs have limited access to medicine, modern dressings and medical devices.
BACKGROUND
MAGGOT DEBRIDEMENT THERAPYFor compromised health care environments, wound care options are required that are relatively cheap, easy to use and have multiple therapeutic benefits. One such option is Maggot Debridement Therapy (MDT) where living fly larvae are used to remove dead tissue, to control infection and to stimulate wound healing (Sherman, 2009).
KNOWLEDGE GAPSOur review of the literature has revealed that there is a growing body of work demonstrating the efficacy of MDT for the treatment of chronic wounds in modern western wound care settings, and case reports on MDT for the treatment of acute, infected or fungating wounds. However, there is little literature discussing the use of MDT in resource-poor healthcare settings.
RESEARCH
More concerning is the paucity of literature discussing the logistics and supply chain management issues pertinent to MDT. This is troubling because uptake of MDT in LMIC settings depends on reliable, efficient and affordable supply of medical maggots. Moreover, many healthcare professionals maintain a general dislike and distrust of MDT.
In summary, research is needed that:• demonstrates MDT efficacy in the treatment of wounds other than ulcers; • explores the supply chain opportunities in compromised healthcare settings; and • explores the economic, social and psychological barriers to the uptake of MDT by healthcare professionals.
Our research seeks to understand the supply chain management opportunities and challenges presented by MDT in humanitarian aid, and it includes:
• a systematic review of the literature relevant to the MDT supply chain;• the development of an MDT supply chain model using Business Process Model
Notation (BPMN)• demonstration of the benefits of MDT in disaster medicine (Stadler et al., 2016);• a multiple case study of four MDT supply chains in Kenya, Africa, involving
semi-structured interviews with key supply chain stakeholders; and• an MDT supply chain trial to test the four case study supply chains by
performing production and shipment trials with live medical maggots.
ANALYSISQualitative data will be analysed with the documentary method (Trautrims et al., 2012) and two additional data analysis steps will complement this approach, including modelling of supply chain information with BPMN and analysis of emerging supply chain characteristics through systems thinking. Quantitative data will be subject to statistical analysis and serves to triangulate the qualitative research findings.
References SHERMAN, R.A. 2009. J Diabetes Sci Technol, 3, 336-44 | STADLER, F. et al. 2016. Prehosp Disaster Med, 31, 79-84 | TRAUTRIMS, A. et al. 2012. International Journal of Physical Distribution & Logistics Management, 42, 828-842 |
ma g gots on the move
SUPPLY PRODUCTION DISTRIBUTION MAGGOT THERAPY DISPOSAL
Figure 1) Diabetic ulcers are some of the most common wounds encountered in the low-resource setting.
Figure 2) Research and knowledge deficit in relation to MDT supply chain management in compromised settings. The shaded curve represents the current knowledge space at corresponding supply chain steps and the exposed diabetic wound area the gap in knowledge that remains to be filled.
From top to bottom:© Stephen Doggett
© 2006 Johnson Ndungu (Photoshare)© Stephen Doggett
© 2006 Katie Richey (Photoshare)© 1999 Arturo Sanabria (Photoshare)
© Kenyatta National HospitalFigure 3) Analysis framework for qualitative research data collected by us. Note that the documentary method is expanded to include two extra research steps.
Frank Stadler1, PhD Candidate, Student ID : s2701555PRINCIPAL SUPERVISOR: Prof Peter Tatham1, Professor of Humanitarian Logistics
CO-PRINCIPAL SUPERVISOR: Prof Ramon Shaban2, Professor of Infection Prevention and Control 1Department of International Business and Asian Studies, Griffith University,
2Menzies Health Institute Qld and Gold Coast Health
Griffith Business SchoolInternational Business and Asian Studies griffith.edu.au/gbs
