- 23 Aug 2016
- First Look
August 23, 2016
We get less productive when left to order our own tasks ... Demythologizing sustainable investing ... Can a great customer service company clone itself?
- 04 Nov 2015
- Working Paper Summaries
Cohort Turnover and Operational Performance: The July Phenomenon in Teaching Hospitals
Hummy Song, Robert S. Huckman, and Jason R. Barro study the impacts of the annual July turnover of doctors in teaching hospitals on qualty of care.
- 10 Jun 2014
- Working Paper Summaries
Cohort Turnover and Productivity: The July Phenomenon in Teaching Hospitals
Nearly all managers must deal with the consequences of employee turnover within their organizations. Despite the importance of this issue, several authors have observed that academic attention has been disproportionately focused on the causes rather than consequences of turnover. To investigate consequences more closely, the authors of this paper focus on the effects of turnover in a particularly high-stakes setting: teaching hospitals. Specifically, the authors examine the effects on productivity of cohort turnover-the planned simultaneous exit of a large number of experienced employees-in this case, medical residents and fellows-and a similarly sized entry of new residents and fellows. Typically, at (or slightly before) the beginning of every July, the most senior residents at teaching hospitals move on to permanent medical positions or fellowships at other hospitals, and recent medical school graduates arrive as first-year residents. The authors examine the impact of the July turnover on hospital productivity using data on all patient admissions from a large, multi-state sample of American hospitals over a 16-year period. By comparing trends in teaching hospitals to those for non-teaching hospitals over the course of the year, they find significant negative effects of the residency turnover on hospital efficiency as measured by risk-adjusted, average length of stay. Overall, the cohort turnover of resident physicians in teaching hospitals reduces medical productivity by increasing resource utilization and, to a lesser degree, decreasing quality. The authors discuss implications for labor turnover in other types of organizations. Key concepts include: Examples of cohort turnover include turnover between military units in combat, political administrations, and residents and fellows in teaching hospitals. The performance of major teaching hospitals relative to non-teaching facilities is at its lowest level in July, the month of the year when there tends to be cohort turnover of medical residents and fellows. Cohort turnover has negative implications for productivity. These effects generally increase with the intensity of the turnover, though not always in a linear fashion. Cohort turnover of resident physicians in teaching hospitals reduces medical productivity by increasing resource utilization and, to a lesser degree, decreasing quality. The months leading up to the July turnover also appear significant. Major teaching hospitals seem to experience a gradual increase in resource utilization and a concurrent decrease in quality. Closed for comment; 0 Comment(s) posted.
- 26 Mar 2014
- Research & Ideas
How Electronic Patient Records Can Slow Doctor Productivity
Electronic health records are sweeping through the medical field, but some doctors report a disturbing side effect. Instead of becoming more efficient, some practices are becoming less so. Robert Huckman's research explains why. Open for comment; 12 Comment(s) posted.
- 15 Jul 2013
- Research & Ideas
Five Imperatives for Improving Health Care
Leaders from Harvard's medical and business schools are exploring ways to improve health care delivery. In a new study, their Forum on Healthcare Innovation delivers five key imperatives. Closed for comment; 13 Comment(s) posted.
- 10 Apr 2013
- Research & Ideas
Learning Curve: Making the Most of Outsourcing
Companies that view outsourcing as an easy way to offload commodity work are missing powerful improvements to be gained by working closely with service providers, says Professor Robert S. Huckman. Open for comment; 5 Comment(s) posted.
- 09 Jan 2013
- Sharpening Your Skills
Sharpening Your Skills: Understanding Customers
In these previous articles, professors discuss a range of topics about customers: why they are not always right; understanding their motivations; providing them dramatically enhanced services; and making things right when you don't meet their expectations. Open for comment; 1 Comment(s) posted.
- 03 Jul 2012
- Research & Ideas
HBS Faculty on Supreme Court Health Care Ruling
We asked three Harvard Business School faculty members, all experts in the health care field, to provide their views on various facets of one of this country's most important and complex problems. Open for comment; 12 Comment(s) posted.
- 04 Apr 2011
- Research & Ideas
Attention Medical Shoppers: What Health Care Can Learn from Walmart and Amazon
At a Harvard Business School panel discussion on health care management, experts looked to the retail industry as a possible model for delivering medical services more effectively. Open for comment; 7 Comment(s) posted.
- 21 Jan 2011
- Working Paper Summaries
Learning from Customers in Outsourcing: Individual and Organizational Effects
In farming out work to an external service provider, companies often count on volume-based learning--the idea that outsourced workers will build experience and improve their productivity if there is a large volume of work for them to do, and that the bigger the volume, the more productive and efficient they'll eventually become. However, there are several factors that challenge that education process. This paper explores whether and how repetition can breed competence in a business setting, using data from a provider of outsourced radiological services. Research was conducted by Harvard Business School professor Robert S. Huckman, Jonathan R. Clark (HBS PhD 2010) of Pennsylvania State University, and Bradley R. Staats (HBS MBA 2002, DBA 2009) of the University of North Carolina at Chapel Hill. Key concepts include: In addition to technical aspects of the task, volume-based learning depends on the interpersonal interactions between the individual completing the task and the customer. The rate at which a worker learns depends independently on the customer, knowledge domain, and technology within which the worker accumulates volume-based experience. Workers learn faster from completing an individual task for a specific customer than they do from completing multiple tasks for multiple customers. Spreading a worker's experience over multiple customers may hinder the learning process, particularly with respect to the needs of specific customers. Closed for comment; 0 Comment(s) posted.
- 17 Sep 2009
- Working Paper Summaries
Input Constraints and the Efficiency of Entry: Lessons from Cardiac Surgery
Many professions rely on highly and variably skilled individuals. If a new firm is looking to enter a specific market, in addition to setting up a physical facility the company needs to hire or contract with specialized labor. In the short term, the supply of these specialists is relatively inelastic. From the point of view of economics, there remains a well-known potential for free entry to be inefficient when firms make entry decisions without internalizing the costs associated with the business they "steal" from incumbent firms. In 1996 Pennsylvania eliminated its certificate-of-need (CON) policy that had restricted entry by hospitals into expensive clinical programs, such as coronary artery bypass graft (CABG) programs—leading to an increase from 43 to 63 in the number of hospitals providing this service. HBS professor Robert Huckman and coauthors examine the welfare implications of entry in the market for cardiac surgery. Key concepts include: Following the introduction of new CABG programs in Pennsylvania, volume shifted from incumbent programs to entrants and from lower- to higher-quality surgeons, thereby improving the overall quality of surgical outcomes. The repeal of CON in Pennsylvania improved the market for cardiac surgery by directing more volume to better doctors and increasing access to treatment. The benefit of reduced mortality from the increased use of high-quality surgeons roughly offset the fixed costs associated with free entry. Closed for comment; 0 Comment(s) posted.
- 30 Jul 2009
- Working Paper Summaries
Fluid Teams and Fluid Tasks: The Impact of Team Familiarity and Variation in Experience
In the context of team performance, common wisdom suggests that performance is maximized when individuals complete the same work with the same people. Although repetition is valuable, at least up to a point, in many settings such as consulting, product development, and software services organizations consist largely of fluid teams executing projects for different customers. In fluid teams, members bring their varied experience sets together and attempt to generate innovative output before the team is disassembled and its individual members move on to new projects. Using the empirical setting of Wipro Technologies, a leading firm in the Indian software services industry, this study examines the potential positive and negative consequences of variation in team member experience as well as how fluid teams may capture the benefits of variation while mitigating the coordination costs it creates. Key concepts include: As organizations continue to depend on the output of teams, and teams, in turn, rely on members with varied prior experience, it becomes critical for teams to manage these differences and dependencies successfully. If the most valuable assets of many companies are their employees, then organizations need to shift from only thinking about their project portfolio to also considering their employee-experience portfolio. Managing employee-experience portfolios will require managers to consider the breadth of types of experience (e.g., customer, technology, etc.) captured across the members of a team as well as their familiarity with each other. Doing so may offer managers an important new lever for improving organizational performance. Closed for comment; 0 Comment(s) posted.
- 13 Jul 2009
- Research & Ideas
Diagnosing the Public Health Care Alternative
With deep experience in health insurance reform, HBS faculty describe how improved competition in insurance plans could improve value for patients. Professors Regina E. Herzlinger, Robert Huckman, and Michael E. Porter take the pulse of a debate. Key concepts include: "A government market with an underpriced Medicare would likely lead to the death of private-sector markets and products," say Professor Regina E. Herzlinger and coauthor Tom Coburn (R-OK). Patients would like the option of a public insurance plan, according to Professor Robert Huckman. Competition among insurers should be based on improving patients' health outcomes achieved per dollar spent, writes Professor Michael E. Porter. Closed for comment; 0 Comment(s) posted.
- 07 May 2009
- Working Paper Summaries
Broadening Focus: Spillovers and the Benefits of Specialization in the Hospital Industry
What is the optimal scope of operations for firms? This question has particular relevance for the US hospital industry, because understanding the effects of focus and spillovers might help hospitals determine how they should balance focusing in a single clinical area with building expertise in related areas. While some scholars argue that narrowing an organization's set of activities improves its operational efficiency, others have noted that seemingly unfocused operations perform at a high level and that a broader range of activities may in fact increase firm value. This study by HBS doctoral student Jonathan Clark and professor Robert Huckman highlights the potential role of spillovers—specifically complementary spillovers—in generating benefits from focus at the operating unit level. Key concepts include: Hospitals devoting a greater portion of their business to treating patients in related service categories (i.e., those with the potential for knowledge spillovers) experience higher returns to specialization in a focal service. Ultimately, these results provide a potential explanation for why there might be decreasing returns to focusing an organization on a single operating activity (or narrow set of activities), especially when it is possible to invest in other activities that complement the organization's area of concentration. Closed for comment; 0 Comment(s) posted.
- 22 Oct 2008
- Working Paper Summaries
Variation in Experience and Team Familiarity: Addressing the Knowledge Acquisition-Application Problem
Team familiarity helps team members successfully locate knowledge within a group, share the knowledge they possess, and respond to the knowledge of others. While team familiarity may help all teams to better coordinate their actions, it may play a particularly important role for teams with individuals looking to apply knowledge from their varied experience. This possibility leads to the question that provides the foundation for this paper: Does team familiarity moderate the relationship between variation in experience and performance? Prior research attempting to link variation in experience and performance has found effects ranging from positive to neutral to negative. Huckman and Staats explain these differential results by drawing on related work from learning, knowledge management, and social networking. Key concepts include: Managers may benefit from a more detailed understanding of the types of experience that are relevant in their setting (e.g., market, technology). If the most valuable assets of many companies are their employees, then organizations may need to shift from thinking about their project portfolio to their employee-experience portfolio. Conditions that assist in the acquisition of useful knowledge, such as variation in experience, will not guarantee—and may even deter—the eventual application of that knowledge. It is important to separate the processes of knowledge acquisition and knowledge application. Closed for comment; 0 Comment(s) posted.
- 31 Mar 2008
- HBS Case
JetBlue’s Valentine’s Day Crisis
It was the Valentine's Day from hell for JetBlue employees and more than 130,000 customers. Under bad weather, JetBlue fliers were trapped on the runway at JFK for hours, many ultimately delayed by days. How did the airline make it right with customers and learn from its mistakes? A discussion with Harvard Business School professor Robert S. Huckman. Key concepts include: JetBlue's dependence on a reservations system that relied on a dispersed workforce and the Web broke down when thousands of passengers needed to rebook at once. A crisis forces an organization to evaluate its operating processes rapidly and decide where it needs to create greater formalization or structure. Closed for comment; 0 Comment(s) posted.
- 01 Oct 2007
- Working Paper Summaries
Team Familiarity, Role Experience, and Performance:Evidence from Indian Software Services
In contexts ranging from product development to service delivery, a significant amount of an organization's work is conducted by "fluid teams" that strive for innovative output. Fluid project teams exist only for the duration of a single project, and are comprised of members who may join or leave a team during the course of a project. In such settings, simple measures of cumulative output may not accurately capture team experience, particularly when changes in team composition are substantial over time. This study of an Indian software services firm, Wipro Technologies, considers an approach for capturing the experience held by fluid teams. It extends the concept of team fluidity in a way that allows for greater granularity in the measurement of team experience and a finer understanding of the determinants of team performance. Key concepts include: The findings underscore the need to use caution in assuming cumulative output wholly captures experience when team membership is not constant from one project to the next. These results build on previous research on team familiarity by considering longitudinal data on the individual members of teams. The findings also emphasize the importance of considering role experience and studying experience at different levels of seniority. Closed for comment; 0 Comment(s) posted.
- 13 Jun 2005
- Research & Ideas
From Turf Wars to Learning Curves: How Hospitals Adopt New Technology
Turf wars and learning curves influence how new technology is adopted in hospitals. HBS professors Gary Pisano and Robert Huckman discuss the implications of their research for your organization. Closed for comment; 0 Comment(s) posted.
Why Productivity Suffers When Employees Are Allowed to Schedule Their Own Tasks
Deviating from an organization’s prescribed task schedule tends to erode productivity, even among the most experienced workers, according to new research from María R. Ibáñez, Jonathan R. Clark, Robert S. Huckman, and Bradley R. Staats. Open for comment; Comment(s) posted.