Enhancing healthcare supply chain resilience: decision-making in a fuzzy environment

• DOI: https://doi.org/10.1108/IJLM-01-2021-0004
• Published date: 12 July 2021
• Date: 12 July 2021
• Pages: 520-546
• Subject Matter: Management science & operations,Logistics
• Author: Obaid ur Rehman,Yousaf Ali

Enhancing healthcare supply chain

resilience: decision-making in a

fuzzy environment

Obaid ur Rehman and Yousaf Ali

School of Management Sciences,

GIK Institute of Engineering Sciences and Technology, Topi, Pakistan

Abstract

Purpose –Resilience is a fundamental component of healthcare supply chains, as the quality and endurance of

human life are dependent on them. However, there are numerous resilience-building measures, and there is a

need for prioritization of those strategies. This research study aims to prioritize resilience strategies for

healthcare supply chains while considering the risks that most severe, probable to occur and have the

lengthiest periods of recovery.

Design/methodology/approach –This research study has used multi-criteria decision-making (MCDM)

techniques for analysis. Initially, the criteria for prioritization of risks, i.e. severity, probability of occurrence

and recovery time were assigned with importance weights through the fuzzy analytical hierarchy process

(AHP). Then, these weights were used in the fuzzy technique for order preference by similarity to ideal solution

(TOPIS) analysis for prioritization of risks. Subsequently, the identified risks were used for highlighting the

appropriate resilience strategies through the fuzzy quality function deployment (QFD) technique.

Findings –Results indicate that Industry 4.0, multiple sourcing, risk awareness, agility and global

diversification of suppliers, markets and operations are the most significant resilience strategies.

Research limitations/implications –This study’s limitation is that it is conductedin a general perspective,

rather than reducing the context to a developing or developed country. Different areas have variable market

factors, due to which potential risks occur in a different form. Moreover, resilience strategies work differently in

different environments. Therefore, for future endeavors, the studies should be carried out in a limited context.

Originality/value –This research study proposes a novel MCDM-based approach for ranking resilience

strategies, in light of the most probable, severe and long-lasting risks. In addition, this approach has been

employed for the enhancement of resilience in healthcare supply chains.

Keywords Healthcare supply chains, Risks, Resilience, Fuzzy AHP, Fuzzy TOPSIS, Fuzzy QFD

Paper type Research paper

Introduction

Modern supply chains have assumed the role of driving factors behind economies and

societies. With the introduction of developing countries into the manufacturing sectors and

the primary consumersbeing in the developed world, supply chains are increasinglyexposed

to numerous kinds of disruptions. Moreover, over time, supply chains have developed

intricate connectivitypatterns and are, therefore, significantly affected by variousrelated and

unrelated activities (Ivanov, 2020). Thus, the supply chain management must be on guard

regarding the differentrisks that can emerge within the supply chain ecosystems.In a supply

chain context, risk can be defined as an eventwhose future direction cannot be ascertained,

and thus it may compromisethe aims and goals of the organization (Abdel-Bassetet al., 2019).

Another studyhas defined risk as an uncertain development, which can be a cause of potential

loss for a supply chainorganization in the form of a reduction of its efficiency and effectiveness

(Heckmann et al., 2015).In order to mitigate the potential risks and ensure the normal function

of operations in case of disruptions,supply chains need to work on increasing their resilience.

Resilience is the ability of supplychains to deal with those risks that cannot be circumvented

IJLM

33,2

520

This paper forms part of a special section “Resilient supply chains through innovative logistics

management”, guest edited by Peggy S. Chen and Jiangang Fei.

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/0957-4093.htm

Received 4 January 2021

Revised 5 May 2021

14 June 2021

Accepted 24 June 2021

The International Journal of

Logistics Management

Vol. 33 No. 2, 2022

pp. 520-546

© Emerald Publishing Limited

0957-4093

DOI 10.1108/IJLM-01-2021-0004

and thus recover back to the pre-disruption level of the operations (Anbumozhi et al.,2020).

Resilience can also be defined as the adaptive capability of the supply chains to predict,

identify, respond to and recover from the realized risks while maintaining control over the

various variables involved (Ponomarov and Holcomb, 2009). In the modern economy, where

innumerable economic activities have become interdependent, a halt in the supply chain

operations can quickly transfer the consequences to other sections of the market. Therefore,

special emphasis is laid on the enhancement of resilience in supply chain operations.

Healthcare supply chains play a substantial role in the day-to-day operations of the

healthcare sector. Therefore, it is apposite for these supply chains to develop the ability to

function in almost every kind of situation. Moreover, in hazardous calamities where supply

chains must face disruptions; human life is at stake, and thus healthcare supply chains do not

have an option to suspend operations. One such case is COVID-19, a novel form of the

coronavirus, which causes respiratory issues in humans. The virus originated in Wuhan,

China in December 2019 (WHO, 2020), and by March 2020, it was declared as a global

pandemic (Ducharme, 2020). This virus’ability to survive easily within human bodies and its

high rate of transmission posed significant challenges to human societies and economies. In

order to curb the virus, various kinds of restrictions were imposed to ensure social distancing.

This resulted in the closure of industries and other establishments, initially in China and later

in much of Europe and the American countries (Deloitte, 2020). The COVID-19 adversely

affected the global supply chains in an unprecedented manner, as in other disruptions, a

mitigation response would ensure normalization; however, the pandemic had been causing

constant disruptions, and thus the responses were not sufficient (Cecere, 2020).

Moreover, as Chinahas transformed itself into the world’sproduction center over the past

few decades, the closure of major industries caused a wave of supply chain disruptions and

shortages all over the world (Betti and Ni, 2020). Healthcare is one amongthe various sectors

affected by the falloutof COVID-19. Healthcare supply chains suddenly observed a shocking

risein demand as various countries struggledto obtain the necessarymedicines and equipment

(Kaplan, 2020).On the other hand, closed borders and theclosing of tier 1 and tier 2 suppliers

halted the operations significantly. In addition, a lack of preparedness and coordination was

observed in the healthcare supply chains (Vecchi and Cusumano, 2020). The impact was

realizedin the form that even in April 2020,the European Union (EU) faced an acuteshortage of

100 plus medications that were urgently required (Guarascio, 2020). Thus, the pandemic’s

fallout has furtherstressed the enhancement of resiliencein the healthcare supply chains.

This study aims to identify the resilience strategies that should be prioritized by the

healthcare supply chains. As there are numerous resilience-building measures, each designed

to tackle a specific class of risks. However, owing to the cost and time constraints, only these

measures should be incorporated in the risk mitigation framework, which could lead to

neutralizing the maximum possible and most harmful risks. There are multiple ways to

identify appropriate and dedicated resilience-building measures, for a specific kind of supply

chain. However, multi-criteria decision-making (MCDM) techniques can be of considerable

advantage for this purpose, as the identification of resilience strategies has to be based on

multiple risks. In addition, there are multiple aspects of gauging the importance of risks.

Thus, there are two steps involved in this procedure. The first step is to identify the most

important risks, and the second step is to identify the most appropriate resilience strategies.

In this study, an MCDM-based methodology has been proposed for the said purpose.

Subsequently, the proposed methodology has been used for highlighting suitable resilience-

building measures for healthcare supply chains.

In this study, the first stage identifies risks with the fuzzy MCDM, while the second stage

uses fuzzy quality function deployment (QFD) to rank resilience strategies for the healthcare

supply chains. The fuzzy set theory was first introduced by (Zadeh, 1965) to deal with data

imprecision and vagueness. In this study, Fuzzy MCDM has been used as a hybrid

Enhancing

healthcare

supply chain

resilience

521