Case Information
Henceforth, we will present the operation of COVID-19 vaccination in a Birmingham (UK) site.
The vaccination site is set in a large theatre of a conference center. The theater has a seating
capacity of 1,500. This capacity was reduced to 250 seats from May 2020 to October 2021, to
comply with distancing rules. Since November 2021, the seating capacity has been increased
to 500.
Citizens book appointments through the NHS portal. Citizens can only book one appointment
at a time. Citizens must provide their NHS number and date of birth. Citizens can book one
appointment for the next 14 days. Citizens must bring the booking reference with them on the
day of the appointment. The service is free. Citizens are recommended to cancel
appointments as soon as they know they cannot attend. There is no penalty for citizens not
showing up.
Capacity is capped at 500 citizens per timeslot. The NHS portal automatically eliminates the
option to book the appointment for a given timeslot after the 500th booking.
In theory, citizens are not allowed to walk in without an appointment. The head operations
manager Norman Esiason, however, is not fully enforcing this rule. He admits: “Some days, we
have room to get more people vaccinated, so why be rigid I have instructed others to accept
walk-ins if (a) this doesn’t create any overcrowding and (b) they can provide their NHS number
and date of birth. The rule of thumb is: don’t stop accepting new patients until we reach 400
citizens in a timeslot”.
During the workweek (Monday-Friday), the vaccination site receives approximately 350
requests per day. On average, 50 citizens book in the 7am-9am timeslot; 75 citizens book in
the 9am-12pm timeslot; 100 citizens book in the 12pm-2pm timeslot; 100 citizens book in the
2pm-6pm timeslot; 25 in the 6pm-8pm timeslot.
On Saturdays, the vaccination site receives approximately 400 requests. On average, 100
citizens book in the 7am-9am timeslot; 100 citizens book in the 9am-12pm timeslot; 100
citizens book in the 12pm-2pm timeslot; 100 citizens book in the 2pm-6pm timeslot. There is
no 6pm-8pm timeslot.
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On Sundays, the vaccination site is closed. Analysist Jeff Blake disputes: “We cannot use the
theater on Sundays due to other commitments. This is a shame because a recent survey shows
that several citizens who book very early or very late during the week would very much prefer
to get the jab on a Sunday morning, if that was possible”.
The Birmingham site only offers the vaccine jab, and no other consultation service. It offers
two different types of COVID-19 vaccine, either Pfizer or Moderna. They are regarded as
identical options. Vaccine vials are stored in ad-hoc fridges at 2-8°C. Vials can be kept in a
fridge for a maximum of 30 days, but are usually consumed within 10 days from supply. The
suppliers replenish vaccines and syringes every 7 days following their demand forecast.
Citizens are not allowed to choose between these two options. Only doctors choose whether
a Pfizer or Moderna vaccine will be used.
The operation can be described as follows:
Document Check: Volunteers check the booking reference through printed paper or
through smartphone. The volunteers work in parallel. The volunteers identify the
booking number and double-check the name and surname of the citizen with their NHS
programme. The vaccination site provides three tablets to the volunteers. The number
of volunteers changes depending on the timeslot. 4 volunteers are used during the
7am-9am timeslot, the 12pm-2pm timeslot and 2pm-6pm timeslot. 2 volunteers are
used during the 9am-12pm and 6pm-8pm timeslot. The time required to check each
document is 2 min/u.
Manual allergy and medication check: Doctors ask information about allergies,
medications and vaccination reactions to each citizen. The doctors work in parallel.
Each doctor asks a total of 5 questions to each citizen and fill the checklist. The time
required to fill the checklist is 10 min/u. The number of doctors changes depending on
the timeslot. 5 doctors are used during the 7am-9am timeslot and the 12pm-2pm
timeslot. 4 doctors are used during the 9am-12pm and 2pm-6pm timeslot. 2 doctors
are used during the 6pm-8pm timeslot.
Automated allergy and medication check: during the manual check, another doctor
checks the online database through a laptop, and identifies information about
allergies, medications and vaccination reactions for each citizen. These results are
quickly double-checked with the doctors operating the manual check to identify
possible inconsistencies. The time required to check each document is 1 min/u.
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Allocation of vaccine type: once both manual and automated checks are completed,
a doctor allocates the citizen to a vaccine type. A doctor hands citizens a blue symbol
if they will be given a Pfizer vaccine, and a red symbol if they will be given a Moderna
vaccine. The time required to allocate the vaccine type is negligible. As noted earlier,
Moderna and Pfizer are regarded as identical choices in terms of quality and safety.
Vaccine jab: finally, each citizen is given the jab. The process is identical for Pfizer and
Moderna, but takes a different amount of time. A nurse asks a citizen about allergies,
medications and vaccination, then gives them some information about the vaccine and
some instruction about possible consequences. Then, the nurse administers the
vaccine. The vaccination area consists of 10 tents, each including two chairs, a bed, a
desk, and a laptop, plus boxes with syringes, gloves and masks. The number of nurses
changes depending on the timeslot. 6 nurses are dedicated to Pfizer jabs, and 4 nurses
are dedicated to Moderna jabs during the 7am-9am timeslot, the 9am-12pm timeslot
and 12pm-2pm timeslot. 4 nurses are dedicated to Pfizer jabs, and 4 nurses are
dedicated to Moderna jabs during the other timeslots. The nurses work in parallel. One
doctor supervises the nurses at any given time (this supervising doctor cannot be
moved to other destinations). The time required for a Moderna vaccine jab is 10 min/u;
the time required for a Pfizer vaccine jab is 12 min/u.
Post-jab check: each citizen is asked to wait 15 minutes to check the possible
occurrence of negative reactions to the vaccine. The citizens are asked to wait in one
of the 500 seats in the theatre
Please note that every timeslot uses a different group of volunteers, doctors, operations
managers and nurses. If the citizens are ok, they can leave the vaccination site.
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Questions:
Based on the information provided in the case study, please:
[Question 1]
Draw a transformation model of the operation, making relevant hypotheses when necessary.
Please be as specific as possible, and please provide a brief description of its content.
(15 marks)
[Question 2]
Perform a 4V analysis, making relevant hypotheses when necessary. Please provide also a
graphical representation of the 4Vs, identify the most relevant process type for the volumevariety configuration, and discuss whether the actual process type described in the case is
appropriate.
(15 marks)
[Question 3]
Identify an S.M.A.R.T. list of KPIs to measure the performance of this process.
(15 marks)
[Question 4]
Explain the type of capacity management plan and the type of process orientation (i.e.
demand reaction, pull, or push) adopted in this case. Please discuss if and how both are
consistent with the nature and variation of demand in this service.
(15 marks)
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[Question 5]
Find the cycle time(s) of the overall operation, and discuss whether the operation is adequate
to address the demand over the day and during the week.
Please specify: the number of stages in the operation, the type of configuration (i.e. long-thin
or short-fat); the cycle time of each individual stage of the operation; the bottleneck(s). Please
be careful to consider the changes in resources demand during the day and during the week
in separate scenarios.
(25 marks)
[Question 6]
Discuss how you would improve and optimise this operation. Please describe the interventions
that you would make, the theories/principles/methods that inspired you, and possible
limitations of your recommendations.
(15 marks)
End of Paper
