Infrastructure
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- 21 Jan 2020
- Working Paper Summaries
The Impact of the General Data Protection Regulation on Internet Interconnection
While many countries consider implementing their own versions of privacy and data protection regulations, there are concerns about whether such regulations may negatively impact the growth of the internet and reduce technology firms’ incentives in operating and innovating. Results of this study suggest limited effects of such regulations on the internet layer.
- 07 Aug 2019
- Research & Ideas
Big Infrastructure May Not Always Produce Big Benefits
Government spending on bridges, roads, and other infrastructure pieces does not always ignite economic good times, say William Kerr and Ramana Nanda. The key question: Are financiers nearby? Open for comment; 0 Comments.
- 29 Jun 2019
- Working Paper Summaries
Infrastructure and Finance: Evidence from India's GQ Highway Network
In India, the Golden Quadrilateral highway network connects four major cities. This study of the relationship between the infrastructure project and development of the local financial sector finds that, in districts along and near the GQ, initial levels of financial development shaped how, and where, infrastructure investment could jumpstart real economic activity.
- 02 Mar 2018
- Working Paper Summaries
Evidence of Decreasing Internet Entropy: The Lack of Redundancy in DNS Resolution by Major Websites and Services
Stabilizing the domain name resolution (DNS) infrastructure is critical to the operation of the internet. Single points of failure become more consequential as a larger proportion of the internet's biggest sites are managed by a small number of externally hosted DNS providers. Providers could encourage diversification by requiring domain owners to select a secondary DNS provider.
- 03 Apr 2017
- What Do You Think?
How About Investing in Human Infrastructure?
As long as we’re talking about a trillion-dollar government-industry initiative on infrastructure, why not invest in humans as well as bridges? asks James Heskett. What do YOU think? Open for comment; 0 Comments.
- 20 Jul 2015
- Research & Ideas
Globalization Hasn’t Killed the Manufacturing Cluster
In today's global markets, companies have many choices to procure what they need to develop, build, and sell product. So who needs a manufacturing cluster, such as Detroit? Research by Gary Pisano and Giulio Buciuni shows that in some industries, location still matters. Open for comment; 0 Comments.
- 11 Sep 2014
- Working Paper Summaries
Chief Sustainability Officers: Who Are They and What Do They Do?
A number of studies document how organizations go through numerous stages as they increase their commitment to sustainability over time. However, we still know little about the role of the Chief Sustainability Officer (CSO) in this process. Using survey and interview data, the authors of this paper analyze how CSOs' authority and responsibilities differ across organizations that are in different stages of sustainability commitment. The study documents the increased authority that CSOs have in companies that are in more advanced stages of sustainability. But while CSOs assume more responsibilities initially as the organization's commitment to sustainability increases, CSOs decentralize decision rights and allocate responsibilities to the different functions and business units. Furthermore, the authors document that a firm's sustainability strategy becomes significantly more idiosyncratic in the later stages of sustainability, a factor that influences significantly where in the organization responsibility for sustainability issues is located. The study also reflects on the best avenues for future research about CSOs and transformation at the institutional, organizational, and individual levels. This article is a chapter of the forthcoming book Leading Sustainable Change (Oxford University Press). Key concepts include: As a CSO gains more authority, she becomes less central in in the organization by allocating decision rights and responsibilities to the functions and business units. While most companies have fairly generic sustainability strategies in the initial stages, it is in the latter Innovation stage that different organizations more closely customize their sustainability strategy to the needs of the organization. The sustainability strategy is driven by the demands of the markets where an organization has a presence or plans to expand in the future. Closed for comment; 0 Comments.
- 03 Sep 2014
- Working Paper Summaries
Supply Chain Screening Without Certification: The Critical Role of Stakeholder Pressure
Companies are increasingly being held accountable for their suppliers' labor and environmental performance. The reputation of Apple, for example, suffered after harsh working conditions were exposed at Foxconn, one of its key suppliers in China. Despite the possibility of major reputational risk when problems are revealed, however, companies face tough challenges managing this risk because obtaining information about suppliers' labor and environmental practices can be very costly. Furthermore, buyers can seldom discern whether the information suppliers provide a fair representation of their performance or whether it glosses over problem areas. The authors investigate whether and how "commit-and-report" voluntary programs, which require companies to make public commitments and to issue public progress reports (instead of requiring costly third-party audits), can serve as a reliable screening mechanism for buyers. Studying the decisions of 2,043 firms headquartered in 42 countries of whether to participate in the UN Global Compact, the authors find the risk of stakeholder scrutiny deters companies with misrepresentative disclosures from participating in the Global Compact. Moreover, this deterrence effect is especially strong 1) for smaller companies and 2) in countries with stronger activist pressures and stronger norms of corporate transparency. Overall, this research reveals the critical role for stakeholder scrutiny to enable buyers to use "commit-and-report" voluntary programs as a reliable mechanism for screening suppliers. Key concepts include: The potential for stakeholder scrutiny deters companies whose prior reports misrepresent their performance from joining a commit-and-report voluntary program. Smaller companies whose reports are misrepresentative are especially deterred from joining commit-and-report programs. Commit-and-report programs can serve as credible screening mechanisms, especially in countries with more activist pressure and stronger norms of corporate transparency. Closed for comment; 0 Comments.
- 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; 0 Comments.
- 31 Jan 2014
- Working Paper Summaries
The Diseconomies of Queue Pooling: An Empirical Investigation of Emergency Department Length of Stay
Improving efficiency and customer experience are key objectives for managers of service organizations including hospitals. In this paper, the authors investigate queue management, a key operational decision, in the setting of a hospital emergency department. Specifically, they explore the impact on throughput time depending on whether an emergency department uses a pooled queuing system (in which a physician is assigned to a patient once the patient is placed in an emergency department bed) or a dedicated queuing system (in which physicians are assigned to specific patients at the point of triage). The authors measured throughput time based on individual patients' length of stay in the emergency department, starting with arrival to the emergency department and ending with a bed request for admission to the hospital or the discharge of a patient to home or to an outside facility. The findings show that, on average, the use of a dedicated queuing system decreased patients' lengths of stay by 10 percent. This represented a 32-minute reduction in length of stay—a meaningful time-savings for the emergency department and patients alike. The authors argue that physicians in the dedicated queuing system had both the incentive and ability to make sure their patients' care progressed efficiently, so that patients in the waiting room could be treated sooner than they otherwise would have. Key concepts include: This study tests the impact of a queuing system structure on the throughput time of patients in an emergency department that had recently switched from a pooled queuing system to a dedicated queuing system. Patients experienced faster throughput times when physicians were working in a dedicated queuing system as opposed to a pooled queuing system. The benefits of a dedicated queuing system may be due to greater visibility into one's workload and the increased ability for physicians to manage patient flow. Closed for comment; 0 Comments.
- 01 Oct 2013
- Working Paper Summaries
Organizational Factors that Contribute to Operational Failures in Hospitals
Despite a pressing need to do so, hospitals are struggling to improve efficiency, quality of care, and patient experience. Operational failures—defined as instances where an employee does not have the supplies, equipment, information, or people needed to complete work tasks—contribute to hospitals' poor performance. Such failures waste at least 10 percent of caregivers' time, delay care, and contribute to safety lapses. This paper seeks to increase hospital productivity and quality of care by uncovering organizational factors associated with operational failures so that hospitals can reduce the frequency with which these failures occur. The authors, together with a team of 25 people, conducted direct observations of nurses on the medical/surgical wards of two hospitals, which surfaced 120 operational failures. The team also shadowed employees from the support departments that provided materials, medications, and equipment needed for patient care, tracing the flow of materials through the organizations' internal supply chains. This approach made it possible to discover organizational factors associated with the occurrence and persistence of operational failures. Overall, the study develops propositions that low levels of internal integration among upstream supply departments contributed to operational failures experienced by downstream frontline staff, thus negatively impacting performance outcomes, such as quality, timeliness, and efficiency. Key concepts include: To avoid workarounds or the need to keep large stocks of materials on the units, managers should create a method for customer-facing employees to request and receive patient-specific supplies in a timely fashion. Employees are unlikely to discern the role that their department's routines play in operational failures, which hinders solution efforts. Failures and causes may be dispersed over a wide range of factors. Thus, removing failures will require deliberate cross-functional efforts to redesign workspaces and processes so they are better integrated with patients' needs. Closed for comment; 0 Comments.
- 27 Sep 2013
- Working Paper Summaries
The Impact of Conformance and Experiential Quality on Healthcare Cost and Clinical Performance
This study examines the relationship between hospital's focus on both conformance and experiential dimensions of quality and their impact on financial and clinical outcomes. Conformance quality measures the level of adherence to evidence-based standards of care achieved by the hospitals. Experiential quality, on the other hand, measures the extent to which caregivers consider the specific needs of the patient in care and communication, as perceived by the patient. These are important dimensions to investigate because hospitals may face a tension between improving clinical outcomes and maintaining their financial bottom-line. However, little has been known on the joint impact of these dimensions on hospital performance in terms of cost and clinical quality. The authors' study, which examined data from multiple sources for the 3,458 U.S. acute care hospitals, is a first step towards understanding these relationships. Results show that hospitals with high levels of combined quality are typically associated with higher costs, but better clinical outcomes, as measured by length of stay and readmissions. These results suggest that hospitals face a tradeoff between cost performance and clinical outcomes. The study also finds that the effect of conformance quality on length of stay is dependent on the level of experiential quality. Taken together, these findings underline the important synergy that exists between conformance and experiential quality with regards to clinical outcomes, a topic that has been completely overlooked in the extant literature. Key concepts include: Hospitals with high levels of combined quality are typically associated with higher costs, but better clinical outcomes, as measured by length of stay and readmissions. Integrating experiential quality into the delivery of care requires caregivers to understand that conformance quality is important, but just one part of achieving excellent clinical outcomes. Experiential quality requires ensuring that patients have a voice in their own care. This might trigger cultural resistance given the inherent bias towards conformance quality. The need for hospitals to promote such radically new representation, despite its clear health benefits, implies an inevitable cost-quality tradeoff. However, this tradeoff might diminish over time, as the culture slowly shifts and caregivers learn to better integrate both process quality dimensions in a more supportive environment. This study addresses a missing gap on the benefit for a systemic approach to learning in care delivery.h Closed for comment; 0 Comments.
- 24 Jul 2013
- Op-Ed
Detroit Files for Bankruptcy: HBS Faculty Weigh In
After a long period of economic decline, the city of Detroit filed for bankruptcy protection last week. John Macomber, Robert Pozen, Eric Werker, and Benjamin Kennedy offer their views on some down-the-road scenarios. Closed for comment; 0 Comments.
- 08 Jul 2013
- Research & Ideas
Everything Must Go: A Strategy for Store Liquidation
Closing stores requires a deliberate, systematic approach to price markdowns and inventory transfers. The result, say Ananth Raman and Nathan Craig, is significant value for the retailer and new opportunities for others. Closed for comment; 0 Comments.
- 18 Apr 2013
- Working Paper Summaries
The Impact of Pooling on Throughput Time in Discretionary Work Settings: An Empirical Investigation of Emergency Department Length of Stay
Improving the productivity of their organizations' operating systems is an important objective for managers. Pooling—an operations management technique—has been proposed as a way to improve performance by reducing the negative impact of variability in demand for services. The idea is that pooling enables incoming work to be processed by any one of a bank of servers, which deceases the odds that an incoming unit of work will have to wait. Does pooling have a downside? The authors analyze data from a hospital's emergency department over four years. Findings show that, counter to what queuing theory would predict, pooling may actually increase procesdsing times in discretionary work settings. More specifically, patients have longer lengths of stay when emergency department physicians work in systems with pooled tasks and resources versus dedicated ones. Overall, the study suggests that managers of discretionary work systems should design control mechanisms to mitigate behaviors that benefit the employee to the detriment of customers or the organization. One mechanism is to make the workload constant regardless of work pace, which removes the benefit of slowing down. Key concepts include: This research offers practical insights for workplace managers and health care policymakers. In workplaces where workers have discretionary control, the potential negative effects of designing pooled systems must be carefully considered. This has implications for designing and managing staffing structures and workflows, particularly in the context of service delivery organizations. Managers should consider implementing group incentives rather than individual incentives to motivate workers. This may encourage fast workers to reduce their speed just enough so that they will not negatively affect the productivity of others by over-utilizing shared resources. While workplaces often seek to incentivize workers through pay-for-performance programs that focus on individual productivity, a group-level approach may help counteract the negative effects that fast workers exhibit on overall productivity levels. In health care, emergency departments may benefit from implementing non-pooled work systems in which patients are assigned to a doctor-nurse team immediately upon arrival. Closed for comment; 0 Comments.
- 01 Mar 2013
- Working Paper Summaries
Hurry Up and Wait: Differential Impacts of Congestion, Bottleneck Pressure, and Predictability on Patient Length of Stay
This paper quantifies and analyzes trends related to the effects of increased workload on processing time across more than 250 hospitals. Hospitals are useful settings because they have varying levels of workload. In addition, these settings have high worker autonomy, which enables workers to more easily adjust their processing times in response to workload. Findings show that heavy load plays a significant role in processing times. Congestion is associated with longer lengths of stay. More surprisingly, when there is a high load of incoming patients from a low pressure area (emergency medical patients), current hospital inpatients' stays are longer compared to when incoming patients are from a high pressure area (emergency surgical patients). Furthermore, high predictability of the incoming patients (e.g. scheduled surgical patients) is associated with shorter lengths of stays for the current inpatients than when the incoming patients are less predictable (emergency surgical patients). In this study, there was no decrease in quality of care for patients with shorter lengths of stay. Key concepts include: High congestion increases patients' length of stay by up to 0.81 days, which indicates inefficiency due to overloading of resources. Incoming inventory load with high predictability reduces patients' length of stay by up to 0.45 days, which is enabled by the ability of a worker to plan in advance for a new work assignment by discharging a patient to make room for the incoming one. With highly predictable incoming patients and no congestion on the day before expected discharge, there is a shift toward discharging patients currently in the hospital one day earlier than expected. A hospital would benefit from adding or allocating additional resources to the inpatient hospital units, and counter-intuitively, targeting a lower occupancy level to increase productivity. To further improve productivity, the allocated inpatient hospital resources could include adding a nurse on the hospital floors who is solely responsible for discharges and admissions. Closed for comment; 0 Comments.
- 03 Oct 2012
- What Do You Think?
Can We Bring Back the “Industrial Commons” for Manufacturing?
Summing Up: Does the US have the political will or educational ability to remake its manufacturing sector on the back of an 'industrial commons?' Professor Jim Heskett's readers are dubious.
- 07 Aug 2012
- Working Paper Summaries
When Supply-Chain Disruptions Matter
Disruptions to a firm's operations and supply chain can be costly to the firm and its investors. Many companies have been subjected to such disruptions, and the impact on company value varies widely. Do disruption and firm characteristics systematically influence the impact? In this paper, the authors identify factors that cause some disruptions to be more damaging to firm value than others. Insight into this issue can help managers identify exposures and target risk-mitigation efforts. Such insights will also help investors determine whether a company is exposed to more damaging disruptions. Key concepts include: The type of disruption matters in identifying the magnitude of a disruption's impact on a firm's share price. Disruptions attributed to factors within the firm or its supply chain are far more damaging than disruptions attributed to external factors. A higher rate of improvement in operating performance aggravates the impact of internal disruptions but not external disruptions. Management should be prudent about decisions to streamline operations and to reduce buffers and excess capacity. Some efficiency improvements may be attractive during periods of relative operational stability, but firms with high rates of improvement in operational performance could face distressing reductions in market value if they subsequently experience an internal disruption. Closed for comment; 0 Comments.
- 16 Apr 2012
- Research & Ideas
The Inner Workings of Corporate Headquarters
Analyzing the e-mails of some 30,000 workers, Professor Toby E. Stuart and colleague Adam M. Kleinbaum dissected the communication networks of HQ staffers at a large, multidivisional company to get a better understanding of what a corporate headquarters does, and why it does it. Closed for comment; 0 Comments.
10 Trends to Watch in 2024
Employees may seek new approaches to balance, even as leaders consider whether to bring more teams back to offices or make hybrid work even more flexible. These are just a few trends that Harvard Business School faculty members will be following during a year when staffing, climate, and inclusion will likely remain top of mind.