Biotechnology → Health →
- 05 Nov 2010
- Research & Ideas
The Work-Around Culture: Unintended Consequences of Organizational Heroes
Professor Anita Tucker shares findings from her research on the problems caused by "work-around cultures" in hospitals. Key concepts include: Work-around cultures are pervasive in health care. Frequent work-arounds can be costly and impair organizational effectiveness. There are benefits to work-arounds which can be compelling on the individual level. Organizational policies and managerial behavior create a culture for work-arounds or systemic problem solving. The solution to work-arounds is an improvement-oriented culture. Closed for comment; 0 Comments.
- 15 Sep 2010
- Working Paper Summaries
From Bench to Board: Gender Differences in University Scientists’ Participation in Commercial Science
Does gender affect whether a university scientist will be invited to work with for-profit companies? Indeed it does. A new paper finds that male professors receive more opportunities than their female counterparts to join scientific advisory boards and start new companies. Research, focusing on the biotechnology field, was conducted by Haas School of Business professor Waverly W. Ding, MIT Sloan professor Fiona Murray, and HBS professor Toby E. Stuart. Key concepts include: University-employed scientists helped to found at least half of the publicly traded biotech firms in existence today. Women scientists receive far fewer invitations than men to join scientific advisory boards, and so male scientists are more than twice as likely as female scientists to become formal board advisors. When female scientists do receive invitations to join boards, they generally come from small start-ups with limited financial backing, rather than from high-profile companies backed by high-status venture capitalists. The corporate gender gap increases among scientists employed at elite universities or academic departments. However, the gender gap decreases at schools with formal technology transfer offices, indicating that institutional support can help women overcome obstacles to entry into commercial science. Closed for comment; 0 Comments.
- 09 Sep 2010
- Working Paper Summaries
Boundary Spanning in a For-Profit Research Lab: An Exploration of the Interface Between Commerce and Academe
In science-based industries, innovation requires bridging the boundary between universities and companies. As entrepreneurial faculty venture into the world of commerce by building relationships and reputations in industry, company researchers and dealmakers seek access to the distributed knowledge base that resides within the community of scholars. But what happens within organizations when scientists venture deeply into the world of academe? In this look at one influential life sciences company, Christopher C. Liu of the Rotman School of Management and Toby E. Stuart of Harvard Business School find important connections between publishing, the allocation of rewards within the company, and the structure of the communication network inside and beyond the borders of the organization. Key concepts include: Researchers who publish successfully were rewarded by the company with an increased bonus. These publishers not only received more remuneration, they also attracted more of their managers' attention than did non-publishers. Publishers had significantly more correspondents in universities than do non-publishers. E-mail data provide direct evidence that publishing correlated with a company's access to the informal networks of the broader scientific community. However, publishers made a potentially negative tradeoff: As they spanned boundaries with the academic community, their importance in their company's communication network was weakened. Employees who are the best networked beyond the firm's boundaries should be precisely those people who would ideally occupy central positions within the firm. Yet in the study, these same individuals seemed to shift the locus of their interaction toward communities away from the firm. Closed for comment; 0 Comments.
- 30 Aug 2010
- Research & Ideas
Turning Employees Into Problem Solvers
To improve patient safety, hospitals hope their staff will use error-reporting systems. Question is, how can managers encourage employees to take the next step and ensure their constructive use? New research by Julia Adler-Milstein, Sara J. Singer, and HBS professor Michael W. Toffel. Key concepts include: Patient-safety information campaigns can help hospital staff do more than just report problems when they occur. Thanks to information campaigns, frontline workers increased the rate of suggesting constructive solutions to problems by 74 percent. The frequency increased even more when unit managers joined in problem solving. By serving as role models, managers who actively engage in problem solving can lead their frontline workers to create and share solutions. Closed for comment; 0 Comments.
- 25 Aug 2010
- Working Paper Summaries
Managerial Practices That Promote Voice and Taking Charge among Frontline Workers
How can front-line workers be encouraged to speak up when they know how to improve an organization's operation processes? This question is particularly urgent in the US health- care industry, where problems occur often and consequences range from minor inconveniences to serious patient harm. In this paper, HBS doctoral student Julia Adler-Milstein, Harvard School of Public Health professor Sara Singer, and HBS professor Michael W. Toffel examine the effectiveness of organizational information campaigns and managerial role modeling in encouraging hospital staff to speak up when they encounter operational problems and, when speaking up, to propose solutions to hospital management. The researchers find that both mechanisms can lead employees to report problems and propose solutions, and that information campaigns are particularly effective in departments whose managers are less engaged in problem solving. Key concepts include: Front-line workers offer more solutions to operational problems in departments whose managers are more engaged in problem solving. Information campaigns that promote process improvement generate more solutions from front-line workers, especially from workers whose managers are less routinely engaged in problem solving. Efforts at the organizational level can compensate for managers who cannot or do not create an environment that inspires front-line workers to speak up. Closed for comment; 0 Comments.
- 28 Jun 2010
- HBS Case
Cincinnati Children’s Hospital Medical Center
A recent Harvard Business School case by HBS professors Amy C. Edmondson and Anita Tucker explores how one hospital implemented its own version of health-care reform, taking overall performance levels from below average to the top 10 percent in the industry. From the HBS Alumni Bulletin. Key concepts include: The case offers valuable takeaways for future managers of any complex service organization. A key takeaway for students is the power of transparency as a mechanism for change. Benchmarking themselves to an internal standard helped the group get beyond rationalizing poor performance as an unavoidable consequence of the complexity of patient care. Closed for comment; 0 Comments.
- 14 Apr 2010
- Working Paper Summaries
The Economic Crisis and Medical Care Usage
The global economic crisis has taken a historic toll on national economies and household finances around the world. What is the impact of such large shocks on individuals and their behavior, especially on their willingness to seek routine medical care? In this research, Annamaria Lusardi of Dartmouth College, Daniel Schneider of Princeton University, and Peter Tufano of Harvard Business School find strong evidence that the economic crisis—manifested in job and wealth losses—has led to large reductions in the use of routine medical care. Specifically, more than a quarter of Americans reported reducing their use of such care, as did between 5 and 12 percent of Canadian, French, German, and British respondents. Key concepts include: Large shares of Americans reduced their use of routine medical care since the economic crisis. These reductions were strongly related to economic distress brought on by the global financial crisis as measured by wealth loss and unemployment. The across-the-board reduction in medical care usage by Americans may speak to behavioral changes that reflect the national psyche broadly: The economic crisis in the United States—deeper and more widespread than elsewhere—may have touched the population at large, perhaps via negative expectations about the future. The cutbacks in health-care usage by people losing wealth or jobs, even in countries with "universal" systems, may reflect the fact that seeking care entails not only out-of-pocket expenses, but also costs of time away from work or job hunting. Reductions in routine care today might lead to undetected illness tomorrow and reduced individual health and well-being in the more distant future. Closed for comment; 0 Comments.
- 22 Feb 2010
- Research & Ideas
Manager Visibility No Guarantee of Fixing Problems
Managers who merely put in time "walking the floor" are not doing enough when it comes to problem solving; in fact, it can make employees feel worse about their situation, says HBS professor Anita Tucker. Key concepts include: Communicating with frontline workers can backfire if managers make only a token effort to resolve issues. Identifying more problems is not necessarily better if the organization then ignores the majority of the concerns. Solving issues as they arise with intense and substantive actions is more productive in creating a climate where it is clear that the manager is concerned. Closed for comment; 0 Comments.
- 21 Jan 2010
- Working Paper Summaries
Going Through the Motions: An Empirical Test of Management Involvement in Process Improvement
How can managers better lead their organizations to improve work processes? Describing their study of hospitals over an 18-month period, HBS professor Anita L. Tucker and Harvard School of Public Health professor Sara J. Singer detail how and why managers' taking action was more effective than their communicating about actions taken. Findings suggest, first, that taking action on known problems in specific work areas on at least a quarterly basis may improve the organizational climate for improvement. Second, the study indicates that managers would be well advised to take action-preferably substantive and intense action-in response to frontline workers' communications about problems. Overall, the research provides insight for senior managers who want to improve their organization's climate for process improvement. Key concepts include: Resolving a small number of problems is better than collecting data about many problems. Giving feedback to employees about actions taken can worsen their perceptions of the climate for improvement if the actions were superficial or punitive. In other words, managers do not fool frontline workers by going through the motions of process improvement. The risk of surfacing a large number of problems is twofold: (1) identifying many problems simultaneously may overwhelm people with a new awareness of the full extent of problems within the organization, complicating and slowing decision processes and spreading already-stretched resources, and (2) it may reinforce cynicism among frontline workers that managers are uncommitted to improving the organizations' work systems. Closed for comment; 0 Comments.
- 23 Nov 2009
- Research & Ideas
Management’s Role in Reforming Health Care
Health care managers are the missing link in debate over reform. Their skills and ideas are needed to sustain and improve upon multiple advances in the delivery of health care for the benefit of patients. An interview with HBS professor Richard M.J. Bohmer, MD, and an excerpt from his book Designing Care: Aligning the Nature and Management of Health Care. Key concepts include: Many health-care delivery issues are managerial rather than policy issues. Much debate on the U.S. stage assumes the current health-care delivery system is a given. Yet innovations in care delivery could potentially help patients and the U.S. health-care system overall. Bohmer's book explains how to create more knowledgeable, flexible, and responsive delivery organizations. Routine medical practice is a fertile source of innovations in care, in both what to do and how to do it. Closed for comment; 0 Comments.
- 05 Nov 2009
- Research & Ideas
A Market for Human Cadavers in All but Name?
A shortage of cadavers has hampered medical education and training, a market that entrepreneurs are stepping forward to address. HBS professor Michel Anteby argues that scholars must learn more about the market dynamics of this uncomfortable subject in order to inform political debate. Closed for comment; 0 Comments.
- 23 Sep 2009
- Working Paper Summaries
Operational Failures and Problem Solving: An Empirical Study of Incident Reporting
Operational failures occur within organizations across all industries, with consequences ranging from minor inconveniences to major catastrophes. How can managers encourage frontline workers to solve problems in response to operational failures? In the health-care industry, the setting for this study, operational failures occur often, and some are reported to voluntary incident reporting systems that are meant to help organizations learn from experience. Using data on nearly 7,500 reported incidents from a single hospital, the researchers found that problem-solving in response to operational failures is influenced by both the risk posed by the incident and the extent to which management demonstrates a commitment to problem-solving. Findings can be used by organizations to increase the contribution of incident reporting systems to operational performance improvement. Key concepts include: Operational failures that trigger more financial and liability risks are associated with more frontline worker problem-solving. By communicating the importance of problem-solving and engaging in problem-solving themselves, line managers can stimulate increased problem-solving among frontline workers. Even without managers' regular engagement in problem-solving, communication about its importance can promote more problem-solving among frontline workers. By explaining some of the variation in responsiveness to operational failures, this study empowers managers to adjust their approach to stimulate more problem-solving among frontline workers. Closed for comment; 0 Comments.
- 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 Comments.
- 07 Aug 2009
- What Do You Think?
Why Can’t Americans Get Health Care Right?
Change is desperately needed, agreed readers of Professor Jim Heskett's online forum. But how to make that change remains in doubt. What can Americans learn from solutions implemented by other countries? (Forum now closed; next forum begins September 4.) Closed for comment; 0 Comments.
- 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 Comments.
- 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 Comments.
- 08 Apr 2009
- Research & Ideas
Clayton Christensen on Disrupting Health Care
In The Innovator's Prescription, Clayton Christensen and his coauthors target disruptive innovations that will make health care both more affordable and more effective. From the HBS Alumni Bulletin. Closed for comment; 0 Comments.
- 03 Apr 2009
- Working Paper Summaries
Applying the Care Delivery Value Chain: HIV/AIDS Care in Resource Poor Settings
The prevention and treatment of a complex disease such as HIV/AIDS in resource‐poor settings presents enormous challenges. Many of the social and economic factors that make populations living in these settings vulnerable to HIV/AIDS such as poverty, malnutrition, and political instability conspire to create barriers to effective care delivery. Understanding how interventions are related to each other and how local socioeconomic factors influence them is critical to effective program design. The Care Delivery Value Chain (CDVC) looks at care as an overall system, not as a series of discrete interventions, and describes the activities required to deliver care, illustrating their sequence and organization. Government agencies, philanthropic organizations, and non‐governmental organizations can use the framework to improve HIV/AIDS care delivery. Key concepts include: The CDVC framework allows one to outline and analyze the process of care delivery for a medical condition and provide maximize value for patients. The CDVC framework can map the activities associated with HIV/AIDS care delivery in resource-poor settings to illuminate effective linkage and coordination. The CDVC framework allows synthesis of knowledge about the overall system of care delivery and provides a common language for improving it. Closed for comment; 0 Comments.
- 09 Mar 2009
- Research & Ideas
How to Revive Health-Care Innovation
Simple solutions to complex problems lead to breakthroughs in industries from retailing to personal computers to printing. So let's try health care, too. According to HBS professor Clayton M. Christensen and coauthors of The Innovator's Prescription, such disruption to an industry might look like a threat, but it "always proves to be an extraordinary growth opportunity." Book excerpt. Key concepts include: Most disruptions have three enablers: a simplifying technology, a business model innovation, and a disruptive value network. Business model innovations are almost always forged by new entrants to an industry. Disruption of an industry rarely happens piecemeal. It is more common that entirely new value networks arise, displacing the old. Always, the technological enablers of disruption are successfully deployed against an industry's simplest problems first. Health care is no different. Closed for comment; 0 Comments.
How to Fix a Broken Marketplace
Alvin E. Roth was a co-winner of the Nobel Prize in Economic Science this week for his Harvard Business School research into market design and matching theory. This article explores his research. Key concepts include: Successful marketplaces must be "thick, uncongested, and safe." Sufficient "thickness" means there are enough participants in the market to make it thrive. "Congestion" is what can happen when markets get too thick too fast: there are heaps of potential players, but not enough time for transactions to be made, accepted, or rejected effectively. "Safety" refers to an environment in which all parties feel secure enough to make decisions based on their best interests, rather than attempts to game a flawed system. Closed for comment; 0 Comments.