RESUMEN
Despite the increased importance attributed to distributed improvisation in major crises, few studies investigate how central authorities can promote a harmonic, coordinated national response while allowing for distributed autonomy and improvisation. One idea implicit in the literature is that central authorities could help track and tackle common decision bottlenecks as they emerge across "improvising" local authorities as a result of shared, dynamic external constraints. To explore this idea we map central functions needed to roll-out vaccines to local populations and identify and classify bottlenecks to decision-making by local authorities managing COVID-19 vaccine roll-out in Norway. We found five bottlenecks which emerged as vaccine roll-out progressed, three of which could feasibly have been addressed by changing the local authorities' external constraints as the crisis developed. While the national crisis response strategy clearly allowed for distributed improvisation, our overall findings suggest that there is potential for central authorities to address external constraints in order to ease common bottlenecks as they emerge across local authorities responding to the crisis. More research is to explore alternative centralized response strategies and assess how well they effectively balance centralized and distributed control. The study contributes to the growing literature examining the interaction between local and centralized response in crisis management.
RESUMEN
OBJECTIVE: The purpose of this study is to investigate the efficiency of the Iranian Red Crescent Society (IRCS) in managing their nonmonetary resources involved in coronavirus disease 2019 (COVID-19) response. METHODS: For this purpose, the data envelopment analysis approach was used to measure the efficiency, considering the number of personnel and vehicles and screened passengers as the input and output parameters, respectively. It was examined the efficiency of 10 IRCS's branches given 17 d of screening operation. For the analysis, the DEA SolverPro software 15a version was used. RESULTS: The results show that only 1 branch had been fully efficient in using the resources, while 5 branches showed less than 50% efficiency. This study reveals that it is unnecessary to use a fixed number of volunteers at different stations with different passenger numbers. CONCLUSIONS: Using resources without efficient planning can lead to direct costs such as food, transportation, and maintenance, as well as indirect costs such as burnout, fatigue, and stress when responding to the COVID-19 pandemic. This analysis should support IRCS's managers to move their valuable resources from inefficient to efficient centers to increase the screening rate and reduce the fatigue of aid workers for the next pandemic rounds.
RESUMEN
OBJECTIVE: Coronavirus disease 2019 (COVID-19) screening stations set up by Iranian Red Crescent Society have been available for 17 d with the aim of identifying and treating people with coronavirus, reducing road trips, and sensitizing people to the problem. This study aims to investigate the challenges of the procedure. METHODS: A qualitative study was used to find the challenges of the COVID-19 screening centers. Volunteers, branch managers, and headquarter managers of the Iranian Red Crescent Society participated in this study applying snowball sampling. Data were collected by means of in-depth semi-structured telephone interviews in April 2020 after completion of the fever screening plan. All interviews were recorded and transcribed verbatim, always with prior permission of interviewees. RESULTS: The interviews with 20 participants in the plan indicated 6 relevant challenges, including logistics, lack of planning, lack of coordination, legal challenges, mental health, and ethical challenges. CONCLUSIONS: The results indicated that, although establishing fever detection centers in Iran was a rapid response to COVID-19, it had significant flaws in the structure and adversely affected volunteers' and staff's health and financial resources. Therefore, well-structured protocols are required for similar responses in the future.