Background: The reproduction number (R 0 ) is vital in epidemiology to estimate the number of infected people and trace close contacts. R 0 values vary depending on social activity and type of gathering events that induce infection transmissibility and its pathophysiology dependence. Objectives: In this study, we estimated the probable outbreak size of COVID-19 clusters mathematically using a simple model that can predict the number of COVID-19 cases as a function of time. Methods: We proposed a mathematical model to estimate the R 0 of COVID-19 in an outbreak occurring in both local and international clusters in light of published data. Different types of clusters (religious, wedding, and industrial activity) were selected based on reported events in different countries between February and April 2020. Results: The highest R 0 values were found in wedding party events (5), followed by religious gathering events (2.5), while the lowest value was found in the industrial cluster (2). In return, this will enable us to assess the trend of coronavirus spread by comparing the model results and observed patterns. Conclusions: This study provides predictive COVID-19 transmission patterns in different cluster types based on different R 0 values. This model offers a contact-tracing task with the predicted number of cases, to decision-makers; this would help them in epidemiological investigations by knowing when to stop.

Short discharge time from hospitals increases both bed availability and patients' and families' satisfaction. In this study, the Six Sigma process improvement methodology was applied to reduce patients' discharge time in a cancer treatment hospital. Data on the duration of all activities, from the physician signing the discharge form to the patient leaving the treatment room, were collected through patient shadowing. These data were analyzed using detailed process maps and cause-and-effect diagrams. Fragmented and unstandardized processes and procedures and a lack of communication among the stakeholders were among the leading causes of long discharge times. Categorizing patients by their needs enabled better design of the discharge processes. Discrete event simulation was utilized as a decision support tool to test the effect of the improvements under different scenarios. Simplified and standardized processes, improved communications, and system-wide management are among the proposed improvements, which reduced patient discharge time by 54% from 216 minutes. Cultivating the necessary ownership through stakeholder analysis is an essential ingredient of sustainable improvement efforts.

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