This Project Report documents the accomplishments of an extraordinary group of students, faculty, and staff at the Arizona state University, who participated in a year-long, multidisciplinary, first-of-its-kind academic endeavor entitled “The Making of a COVID Lab.” The lab that is the focus of this project is the ASU Biodesign Clinical Testing Laboratory, known simply as the ABCTL.
Under the direction of Dr. Carolyn Compton, a group of seven Barrett honors students have embarked on a truly unique team thesis project to create a documentary on the process of creating a COVID-19 testing laboratory. This documentary tells the story of the ASU Biodesign Clinical Testing Laboratory (ABCTL), the first lab in the western United States to offer public saliva testing to identify the presence of COVID-19.
In the first chapter, a supply chain operating model that breaks away from the traditional healthcare supply chain structures is examined. Consolidated Service Centers (CSCs) embody a shared services strategy, consolidating supply chain functions across multiple hospitals (i.e. horizontal integration) and disintermediating several key roles in healthcare supply chains such as the group purchasing organizations and national distributors. Through case studies, key characteristics of CSCs that enable them to reduce the level of supply chain complexity are examined.
The second chapter investigates buyer-supplier relationships in healthcare (i.e. supplier integration), where a high level of distrust exists between hospitals and their suppliers. This context is leveraged to study both enablers and barriers to buyer-supplier trust. The results suggest that contracting counteracts the negative effects of dependence on trust. Furthermore, the study reveals that hospital buyers may, in some situations, perceive dedicated resource investments made by suppliers as trust barriers, associating such investments with supplier upselling and entrenchment tactics. This runs contrary to how dedicated investments are perceived in most other industries.
In the third chapter, the triadic relationship between the hospital, supplier, and physician is taken into consideration. Given their professional autonomy and power, physicians commonly undermine hospital efforts in supply base rationalization and standardization. This study examines whether physician-hospital integration (i.e. customer integration) can drive physicians towards supply selection practices that align with the hospital’s sourcing strategies and ultimately result in better supply chain performance. This study utilizes theory on agency triads and professionalism and tests hypotheses through a random effects regression model applied to data about hospital financial performance and physician-hospital arrangements.
Dehalococcoides mccartyi strains are of particular importance for bioremediation due to their unique capability of transforming perchloroethene (PCE) and trichloroethene (TCE) to non-toxic ethene, through the intermediates cis-dichloroethene (cis-DCE) and vinyl chloride (VC). Despite the widespread environmental distribution of Dehalococcoides, biostimulation sometimes fails to promote dechlorination beyond cis-DCE. In our study, microcosms established with garden soil and mangrove sediment also stalled at cis-DCE, albeit Dehalococcoides mccartyi containing the reductive dehalogenase genes tceA, vcrA and bvcA were detected in the soil/sediment inocula. Reductive dechlorination was not promoted beyond cis-DCE, even after multiple biostimulation events with fermentable substrates and a lengthy incubation.
However, transfers from microcosms stalled at cis-DCE yielded dechlorination to ethene with subsequent enrichment cultures containing up to 109 Dehalococcoides mccartyi cells mL-1. Proteobacterial classes which dominated the soil/sediment communities became undetectable in the enrichments, and methanogenic activity drastically decreased after the transfers. We hypothesized that biostimulation of Dehalococcoides in the cis-DCE-stalled microcosms was impeded by other microbes present at higher abundances than Dehalococcoides and utilizing terminal electron acceptors from the soil/sediment, hence, outcompeting Dehalococcoides for H2. In support of this hypothesis, we show that garden soil and mangrove sediment microcosms bioaugmented with their respective cultures containing Dehalococcoides in high abundance were able to compete for H2 for reductive dechlorination from one biostimulation event and produced ethene with no obvious stall. Overall, our results provide an alternate explanation to consolidate conflicting observations on the ubiquity of Dehalococcoides mccartyi and occasional stalling of dechlorination at cis-DCE; thus, bringing a new perspective to better assess biological potential of different environments and to understand microbial interactions governing bioremediation.