Fathima Nisha Begum Samad and David Cordova Jimenez, both MPhil students in Industrial Systems Manufacture and Management (ISMM) have been drafted to bring their knowledge of industrial practices to the front line of the Coronavirus pandemic here in Cambridge.
Normally, as part of their coursework ISMM students work with companies, reviewing their manufacturing and business processes. “We go into a company and identify the key driving parameters that are causing efficiency to be low or operations to be unsuccessful,” says David, “essentially we can learn about any manufacturing system and suggest improvements to efficiency, productivity and costs.”
A friend of David told them that Honda was making ventilators for the hospital and that it might make a good dissertation project for him. When Course Director Dr Florian Urmetzer heard the idea he realised that his students have the perfect skills to help the hospital maximise its processes.
“At the moment, the priority is testing the health care personnel at the hospital to ensure they are safe to return to work,” says Tom Ridgman, Emeritus Fellow of Wolfson and former Course Director of the ISMM program. “They set up three cabins at Addenbrooke’s so they could test people as they drive through in their cars, but they have to test a lot of people. We knew that our students could help figure out how to improve the efficiency of this process.”
Nisha and David spent several days observing the layout of the drive-through testing and interviewing the personnel involved, as well as those being tested. The testing involves taking a nasal swab from the employee, which is then amplified using PCR (polymerase chain reaction) to detect the presence of the viral RNA. If the test is positive then the person must continue to self-isolate. If no RNA is found during the test the employee can return to work. The results of the test currently take 24 hours.
“A lot of hospital staff are self-isolating because they have symptoms or someone in their household has symptoms and this is leading to staff shortages at the hospital,” says Nisha “But basically, they had to implement their setup very quickly and they cannot test the staff quickly enough.”
The students identified several areas where improvements could be made to the process. “We looked at the layout of the testing and we could see that not only were people confused about where they should go, but there were issues of cross-infection,” says Nisha and David. We suggested they improve the signage and introduce a new entrance gate and waiting area so that people can go in and out more quickly and avoid intermingling.” They also suggested a new layout for the drive-through.
“We did a statistical analysis on the booking slots and realised that they had allocated twice as much time as necessary to complete the test on each individual. We suggest they lower each slot to 5 minutes."
There was also a problem with the system set up to allocate those booking slots. They needed to categorise people into low, medium or higher risk and the process was too labour intensive. With improved efficiencies, David and Nisha predict that they can double swab taking from 144 people to 288 per day
The message and the messenger
Much of manufacturing is operations planning, and using modelling and simulation as well as data analysis to examine processes. Both Nisha and David have undergraduate degrees in Engineering with a focus on aerospace, so they are familiar with this approach.
“In a crisis, you have a lot of confused people looking at a load of stuff,” says Tom Ridgman. “Modelling is all about unknowns. In a crisis you have to focus on a relatively small number of pieces of information. Our job is to try and work out what information they need and how we present it so it can be interpreted with the best possible information to make decisions.”
To that end, Nisha and David have framed their recommendations within the concept of health and safety. “In a hospital setting they might not be as focused on efficiency as they are on outcomes,” says Nisha. “But their concerns about cross-contamination and minimising the risk of infection are a priority.”
Next, the pair will be reviewing the testing procedures at the new lab set up by Wolfson Fellow Dr Stephen Baker. Dr Baker’s lab has developed a new method of preparing the nasal swabs for PCR testing that first deactivates the virus. This means that the PCR testing can be done in laboratories with less stringent requirements for containment. Nisha and David have visited the lab and we’ll be reporting on the next stage of their work soon.
David Cordova Jimenez is the first recipient of the Wolfson College Tom Ridgman Bursary in Industrial Systems, Manufacture and Management.