First Look

February 11, 2014

What's In Your Reusable Shopping Bag?

Grocery customers who bring their own reusable shopping bags tend to purchase more environmentally conscious goods (organic) but also more indulgent items (chips), according to new research by Uma R. Karmarkar and Bryan Bollinger. "These findings have implications for decisions related to product pricing, placement and assortment, store layout, and the choice of strategies to increase the use of reusable bags," according to the authors of BYOB: How Bringing Your Own Shopping Bags Leads to Treating Yourself, and the Environment.

Electronic Health Records And Doctor Productivity

Using electronic health records (EHR) can increase the productivity of clinicians, especially when some EHR work tasks are delegated to staff, according to research by Julia Adler-Milstein and Robert S. Huckman, published in the American Journal of Managed Care. One caveat: smaller practices are not so benefitted, and in fact physicians might experience productivity decreases by using flawed delegation processes.

Goldfinger In South Africa

The James Bond character Auric Goldfinger was fictional, but his inspiration in the mind of author Ian Fleming may have been real: American mining magnate Charles W. Engelhard. A new case study by Geoffrey G. Jones and Elliot R. Benton explores the political and ethical responsibilities of businesses in repressive regimes, in this case apartheid-era South Africa, where Engelhard has significant investments.

— Sean Silverthorne


  • August 2013
  • American Journal of Managed Care

The Impact of Electronic Health Record Use on Physician Productivity

By: Adler-Milstein, Julia, and Robert S. Huckman

Abstract—Objectives: To examine the impact of the degree of electronic health record (EHR) use and delegation of EHR tasks on clinician productivity in ambulatory settings. Study Design: We examined EHR use in primary care practices that implemented a web-based EHR from athenahealth (n = 42) over 3 years (695 practice-month observations). Practices were predominantly small and spread throughout the country. Data came from the athenahealth practice management system and EHR task logs. Methods: We developed monthly measures of EHR use and delegation to support staff from task logs. Productivity was measured using work relative value units (RVUs). Using fixed effects models, we assessed the independent impacts on productivity of EHR use and delegation. We then explored the interaction between these 2 strategies and the role of practice size. Results: Greater EHR use and greater delegation were independently associated with higher levels of productivity. An increase in EHR use of 1 standard deviation resulted in a 5.3% increase in RVUs per clinician workday; an increase in delegation of EHR tasks of 1 standard deviation resulted in an 11.0% increase in RVUs per clinician workday (P

  • August 2013
  • Journal of Development Economics

Evolution of Land Distribution in West Bengal 1967-2004: Role of Land Reform and Demographic Changes

By: Bardhan, Pranab, Michael Luca, Dilip Mookherjee, and Francisco Pino

Abstract—This paper studies how land reform and population growth affect land inequality and landlessness, focusing particularly on indirect effects owing to their influence on household divisions and land market transactions. Theoretical predictions of a model of household division and land transactions are successfully tested using household panel data from West Bengal spanning 1967-2004. The tenancy reform lowered inequality through its effects on household divisions and land market transactions, but its effect was quantitatively dominated by inequality-raising effects of population growth. The land distribution program lowered landlessness, but this was partly offset by targeting failures and induced increases in immigration.

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  • August 2013
  • Psychological Science

Evil Genius? How Dishonesty Can Lead to Greater Creativity

By: Gino, F., and S. Wiltermuth

Abstract—We propose that dishonest and creative behavior have something in common: they both involve breaking rules. Because of this shared feature, creativity may lead to dishonesty (as shown in prior work), and dishonesty may lead to creativity (the hypothesis we tested in this research). In five experiments, participants had the opportunity to behave dishonestly by overreporting their performance on various tasks. They then completed one or more tasks designed to measure creativity. Those who cheated were subsequently more creative than noncheaters, even when we accounted for individual differences in their creative ability (Experiment 1). Using random assignment, we confirmed that acting dishonestly leads to greater creativity in subsequent tasks (Experiments 2 and 3). The link between dishonesty and creativity is explained by a heightened feeling of being unconstrained by rules, as indicated by both mediation (Experiment 4) and moderation (Experiment 5).

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  • August 2013
  • Contemporary Perspectives on Organizational Social Networks

Bringing Agency Back Into Network Research: Constrained Agency and Network Action

By: Gulati, Ranjay, and Sameer B. Srivastava

Abstract—We propose a framework of constrained agency grounded in the actors' resources and motivations within their structurally constrained context. Structural positions influence the resources available to actors and color the motivations that shape their actions. Resources equip actors to exert agency, while motivations propel them to do so. We derive a typology of network actions and illustrate how the form of constrained agency through which a particular network action is taken can affect actors' ensuing structural positions and the nature of the constraints they subsequently face. Our conceptualization of constrained agency identifies new sources of endogenous change in network structure.

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  • August 2013
  • Computer

Applying KISS to Healthcare Information Technology

By: Herzlinger, Regina E., Margo Seltzer, and Mark Gaynor

Abstract—Current public and private healthcare information technology initiatives have failed to achieve secure integration among providers. Applying the "keep it simple, stupid" principle offers the key guidance for solving this problem.

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  • August 2013
  • Notizie di Politeia

Multinational Corporations, Global Justice and Corporate Responsibility: A Question of Purpose

By: Hsieh, Nien-hê

Abstract—Do multinational corporations (MNCs) have a responsibility to address unjust conditions-not simply by refraining from contributing to injustice, but also by actively working to bring about a just state of affairs? This paper examines whether this question can be meaningfully addressed without having to engage two contentious debates in contemporary scholarship: the debate about the moral agency of corporations and the debate about the purpose of the for-profit corporation. Finding it difficult to avoid the second debate, the paper examines the extent to which prevailing accounts of corporate purpose (e.g., shareholder primacy, stakeholder theory, corporate citizenship) support attributing responsibilities of justice to MNCs. The paper concludes that a more promising account is one that frames the purpose of the for-profit corporation in terms of its function in allowing members of society to meet their wants and needs by coordinating labor and capital in the production of goods and services.

  • August 2013
  • The Handbook of Global Ethics

Corporate Social Responsibility and Multinational Corporations

By: Hsieh, Nien-hê, and Florian Wettstein

Abstract—A central question that arises from the perspective of global ethics is what standards ought to apply to the activities of multinational corporations (MNCs). This chapter surveys the contemporary theoretical literature on this question. The first section provides background on MNCs and their rise. Section two summarizes attempts to promulgate global standards for MNCs in relation to human rights, labour, bribery, and the natural environment. Section three surveys the literature on the theory and practice of corporate social responsibility (CSR)-those corporate activities and policies that are not legally mandated and are framed in terms of the corporation's impact on society. The remaining sections consider the ethical dimensions of the question. Section four introduces the debate surrounding the universality of moral standards in the context of business activity. Section five describes attempts to specify standards for MNCs that involve taking a position on two key debates in the broader literature: the debate over the purpose of the for-profit business corporation and debate about the moral agency of corporations. The sixth section of the chapter summarizes accounts that aim to specify standards for MNCs without having to take a position on the purpose of the corporation or the moral agency of corporations.

  • August 2013
  • Review of Economics and Statistics

Agglomerative Forces and Cluster Shapes

By: Kerr, William R., and Scott Duke Kominers

Abstract—We model spatial clusters of similar firms. Our model highlights how agglomerative forces lead to localized, individual connections among firms, while interaction costs generate a defined distance over which attraction forces operate. Overlapping firm interactions yield agglomeration clusters that are much larger than the underlying agglomerative forces themselves. Empirically, we demonstrate that our model's assumptions are present in the structure of technology and labor flows within Silicon Valley and its surrounding areas. Our model further identifies how the lengths over which agglomerative forces operate influence the shapes and sizes of industrial clusters; we confirm these predictions using variations across patent technology clusters.

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  • August 2013
  • Permanente Journal

Designed for Workarounds: A Qualitative Study of the Causes of Operational Failures in Hospitals

By: Tucker, Anita L., W. Scott Heisler, and Laura D. Janisse

Abstract—Frontline care providers in hospitals spend at least 10% of their time working around operational failures, which are situations where information, supplies, or equipment needed for patient care are insufficient. However, little is known about underlying causes of operational failures and what hospitals can do to reduce their occurrence. To address this gap, we examined the internal supply chains at two hospitals with the aim of discovering organizational factors that contribute to operational failures. We conducted in-depth qualitative research, including observations and interviews of over 80 individuals from 4 nursing units and the ancillary support departments that provide equipment and supplies needed for patient care. We found that a lack of interconnectedness among interdependent departments' routines was a major source of operational failures. The low levels of interconnectedness occurred because of how the internal supply chains were designed and managed rather than because of employee error or a shortfall in training. Thus, we propose that the time that hospital staff spend on workarounds can be reduced through deliberate efforts to increase interconnectedness among hospitals' internal supply departments. Four dimensions of interconnectedness include (1) hospital-level-rather than department-level-performance measures; (2) internal supply department routines that respond to specific patients' needs rather than to predetermined stocking routines; (3) knowledge that is necessary for efficient handoffs of materials is translated across departmental boundaries; and (4) cross-departmental collaboration mechanisms that enable improvement in the flow of materials across departmental boundaries.

  • August 2013
  • Production and Operations Management

The Effectiveness of Management-By-Walking-Around: A Randomized Field Study

By: Tucker, Anita L., and Sara J. Singer

Abstract—Management-By-Walking-Around (MBWA) is a widely adopted technique in hospitals that involves senior managers directly observing frontline work. However, few studies have rigorously examined its impact on organizational outcomes. This paper examines an improvement program based on MBWA in which senior managers observe frontline employees, solicit ideas about improvement opportunities, and work with staff to resolve the issues. We randomly selected 19 hospitals to implement the 18-month long MBWA-based improvement program; 56 work areas participated. We find that the program, on average, had a negative impact on performance. To explain this surprising finding, we use mixed methods to examine the impact of the work area's problem-solving approach. Results suggest that prioritizing easy-to-solve problems was associated with improved performance. We believe this was because it resulted in greater action taking. A different approach was characterized by prioritizing high-value problems, which was not successful in our study. We also find that assigning to senior managers responsibility for ensuring that identified problems get resolved resulted in better performance. Overall, our study suggests that senior managers' physical presence on their organizations' frontlines was not helpful unless it enabled active problem solving.

Working Papers

Abstract—General Motors was once regarded as one of the best managed and most successful firms in the world, but between 1980 and 2009 its share of the U.S. market fell from 62.6% to 19.8%, and in 2009 the firm went bankrupt. In this paper we argue that the conventional explanation for this decline-namely high legacy labor and health care costs-is seriously incomplete, and that GM's share collapsed for many of the same reasons that many of the other highly successful American firms of the 50s, 60s, and 70s were forced from the market, including a failure to understand the nature of the competition they faced and an inability to respond effectively once they did. We focus particularly on the problems GM encountered in developing the relational contracts essential to modern design and manufacturing. We discuss a number of possible causes for these difficulties: including GM's historical practice of treating both its suppliers and its blue collar workforce as homogeneous, interchangeable entities, and its view that expertise could be partitioned so that there was minimal overlap of knowledge amongst functions or levels in the organizational hierarchy and decisions could be made using well-defined financial criteria. We suggest that this dynamic may have important implications for our understanding of the role of management in the modern, knowledge-based firm, and for the potential revival of manufacturing in the United States.

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Abstract—As concerns about climate change and resource availability become more central in public discourse, using reusable grocery bags has been strongly promoted as an environmentally and socially conscious virtue. In parallel, firms have joined policy makers in using a variety of initiatives to reduce the use of plastic bags. However, little is known about how adopting reusable bags might alter consumers' in-store behavior. Using scanner panel data from a single California location of a major grocery chain, and completely controlling for consumer heterogeneity, we demonstrate that bringing your own bags simultaneously increases your purchases of environmentally conscious and indulgent (hedonic) items. Supporting these effects, we use experimental methods to demonstrate that participants who imagined shopping with their own bags are more likely to spontaneously consider purchasing chips or dessert items and indicate relatively higher willingness to pay for foods in these categories, as well as for organic foods. Furthermore, we show that the impact on organic and indulgent items is dissociable in a manner dependent on the consumers' motivation for bringing bags. These findings have implications for decisions related to product pricing, placement and assortment, store layout, and the choice of strategies to increase the use of reusable bags.

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Abstract—The November 2013 "interim" nuclear deal between Iran and the "P5+1"-the United States, Russia, China, Britain, France, and Germany-raises challenging questions. Will the initial deal function as a stepping stone toward a more comprehensive deal? Or will it drift into becoming a stopping point that leaves Iran dangerously close to nuclear weapons capability with the sanctions regime in decline? Or will it devolve to a slippery slope that would end up requiring a painful choice for key players between either acquiescing to a nuclear-capable Iran or attacking Iran's nuclear facilities? With Iran and the P5+1 each splintered into contending factions, a successful stepping stone strategy requires converting enough "persuadable skeptics" on each side to forge a "winning coalition" on behalf of the next nuclear deal. This supportive group must be strong enough to overcome the potent "blocking coalition" that will oppose virtually any larger, next-stage agreement. The best chance for the interim accord to become a stepping stone to a more valuable deal calls for a two-prong negotiating strategy with both value-enhancing and cost-imposing elements. The first prong of this strategy should strive to craft the most valuable possible next deal that credibly offers Iran a range of benefits, not limited to sanctions relief, that are greater and much more salient than those available from the interim agreement. The second prong should significantly worsen the consequences of failing to reach the next nuclear deal by automatically imposing enhanced sanctions if negotiations toward an acceptable, but relatively narrow, nuclear agreement do not succeed by a reasonable but firm deadline.

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Cases & Course Materials

  • Harvard Business School Case 714-431

Walmart around the World

After reaching the limits of its successful expansion in the United States in the early 1990s, Walmart sought growth opportunities in markets abroad. This case describes Walmart's attempts to replicate its successful U.S. business model in Mexico, Canada, Brazil, Argentina, Central America, China, South Korea, Japan, Germany, the UK, and Africa. Students reflect on the mixed results of these ventures and identify elements in the company's location choices, times of entry, and modes of entry that may explain the outcomes observed. They then formulate a set of recommendations for Walmart to maximize its chances of success when the company expands into India in 2013.

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  • Harvard Business School Case 914-016

eBay Partner Network (D)

Supplements the (A) case.

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  • Harvard Business School Case 714-436

Multi-Sided Platforms: Foundations and Strategy

This note offers an analysis of four fundamental strategic decisions and associated tradeoffs that set MSPs apart from other types of businesses (e.g., product firms) and that every MSP entrepreneur and investor should carefully consider. In the last section I also discuss an important boundary condition: when is the MSP business model dominated by related-but distinct-business models?

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This case considers the strategies of Charles W. Engelhard, an American mining magnate who made large investments in apartheid-era South Africa. Engelhard was widely believed to have been the model for the James Bond villain Auric Goldfinger. During the 1950s and 1960s Engelhard, who was well-connected with the leadership of the Democratic Party in the United States including President Lyndon B. Johnson, was one of the largest American investors in that country. His close relationship with Harry Oppenheimer, the head of the Anglo-American Corporation, gave him substantial influence within the South African business system. The case starts with anti-apartheid demonstrators protesting outside a ceremony awarding him a prize in Newark, New Jersey. It provides an opportunity to debate the political and ethical responsibilities of businesses in repressive regimes as well as the challenges faced by entrepreneurs operating in countries with different value systems and political regimes.

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  • Harvard Business School Case 714-021

Note on Wind Energy

No abstract available.

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