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- October 1998 (Revised April 2000)
- Background Note
Complexity and Error in Medicine
By: Richard M.J. Bohmer
Reviews the issues underlying the rate of error in medical practice and discusses the range of potential management interventions to decrease the risk of error. View Details
Keywords: Health Care and Treatment; Management Practices and Processes; Risk and Uncertainty; Complexity
Bohmer, Richard M.J. "Complexity and Error in Medicine." Harvard Business School Background Note 699-024, October 1998. (Revised April 2000.)
- September 2009
- Case
The Risk Management Foundation of the Harvard Medical Institutions, Inc.
By: Richard M.J. Bohmer, Stephen P. Bradley and Natalie Kindred
Through its uniquely proactive approach to medical malpractice risk management, the Risk Management Foundation (RMF) has decreased claims—and premiums—for the Harvard hospitals it insures. The RMF is the captive medico-legal insurer of the Harvard medical institutions... View Details
Keywords: Cost Management; Insurance; Health Care and Treatment; Risk Management; Performance Improvement; Safety; Health Industry; Insurance Industry; Boston
Bohmer, Richard M.J., Stephen P. Bradley, and Natalie Kindred. "The Risk Management Foundation of the Harvard Medical Institutions, Inc." Harvard Business School Case 610-014, September 2009.
- January 2025
- Technical Note
AI vs Human: Analyzing Acceptable Error Rates Using the Confusion Matrix
By: Tsedal Neeley and Tim Englehart
This technical note introduces the confusion matrix as a foundational tool in artificial intelligence (AI) and large language models (LLMs) for assessing the performance of classification models, focusing on their reliability for decision-making. A confusion matrix... View Details
Keywords: Reliability; Confusion Matrix; AI and Machine Learning; Decision Making; Measurement and Metrics; Performance
Neeley, Tsedal, and Tim Englehart. "AI vs Human: Analyzing Acceptable Error Rates Using the Confusion Matrix." Harvard Business School Technical Note 425-049, January 2025.
- Article
Agree to Disagree: Frank Discussion, Attention to Cultural Fit Can Help Avoid Recruiting Errors
Almost everyone in health care has heard this story: With great fanfare a hospital recruits an outside star to lead a clinical program, academic department, or division. Within months it is clear to almost everyone that the marriage is a failure. To better understand... View Details
Jain, Sachin H. "Agree to Disagree: Frank Discussion, Attention to Cultural Fit Can Help Avoid Recruiting Errors." Modern Healthcare 39, no. 8 (February 23, 2009).
- Research Summary
Overview
Professor Myers studies the ways people learn from their own—and others’—experiences at work, with a particular emphasis on learning in health care organizations and emergency medical contexts. Though his interest is in individual-level learning, he focuses in... View Details
Keywords: Learning And Development; Learning Organizations; Learning By Doing; Health Care Industry; Innovation; Identity Construction; Medical Error; Knowledge Development; Knowledge Sharing; Knowledge Work; Learning; Leadership Development; Knowledge Management; Collaborative Innovation and Invention; Health Industry; United States; Singapore; Asia
- February 2016
- Case
Express Scripts: Promoting Prescription Drug Home Delivery (A)
By: John Beshears, Patrick Rooney and Jenny Sanford
The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details
Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Health Care and Treatment; Order Taking and Fulfillment; Compensation and Benefits; Pharmaceutical Industry
Beshears, John, Patrick Rooney, and Jenny Sanford. "Express Scripts: Promoting Prescription Drug Home Delivery (A)." Harvard Business School Case 916-026, February 2016.
- February 2016 (Revised March 2022)
- Case
Express Scripts: Promoting Prescription Drug Home Delivery (B)
By: John Beshears, Patrick Rooney and Jenny Sanford
The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details
Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Health Care and Treatment; Service Delivery; Decision Choices and Conditions; Order Taking and Fulfillment; Compensation and Benefits
Beshears, John, Patrick Rooney, and Jenny Sanford. "Express Scripts: Promoting Prescription Drug Home Delivery (B)." Harvard Business School Case 916-040, February 2016. (Revised March 2022.)
- March 2015
- Case
The I-PASS Patient Handoff Program
By: Robert S. Huckman and Michael Norris
In 2015, the I-PASS Patient Handoff Program Team, led by six pediatricians around the U.S., had to determine the best way to disseminate their program that had been proven to reduce communication errors in patient handoffs in hospital settings. Should they turn it into... View Details
Keywords: Health Care; Hospitals; Operations Improvement; Entrepreneurship; Health Care and Treatment; Health Industry; United States
Huckman, Robert S., and Michael Norris. "The I-PASS Patient Handoff Program." Harvard Business School Case 615-069, March 2015.
- November–December 2015
- Article
Active Postmarketing Drug Surveillance for Multiple Adverse Events
By: Joel Goh, Margrét V. Bjarnadóttir, Mohsen Bayati and Stefanos A. Zenios
Postmarketing drug surveillance is the process of monitoring the adverse events of pharmaceutical or medical devices after they are approved by the appropriate regulatory authorities. Historically, such surveillance was based on voluntary reports by medical... View Details
Keywords: Drug Surveillance; Health Care; Stochastic Models; Queueing; Diffusion Approximation; Brownian Motion; Health Care and Treatment; Analytics and Data Science; Analysis
Goh, Joel, Margrét V. Bjarnadóttir, Mohsen Bayati, and Stefanos A. Zenios. "Active Postmarketing Drug Surveillance for Multiple Adverse Events." Operations Research 63, no. 6 (November–December 2015): 1528–1546. (Finalist, 2012 INFORMS Health Applications Society Pierskalla Award.)
- March 2016 (Revised March 2022)
- Teaching Note
Express Scripts: Promoting Prescription Drug Home Delivery (A) and (B)
By: John Beshears
The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. The case associated with this teaching note follows Bob Nease, chief scientist at Express Scripts, as he... View Details
Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Consumer Behavior; Distribution Channels; Health Care and Treatment; Service Industry; Pharmaceutical Industry
- January 2020
- Article
Assessing the Safety of Electronic Health Records: A National Longitudinal Study of Medication-related Decision Support
By: A Jay Holmgren, Zoe Co, Lisa Newmark, Melissa Danforth, David Classen and David Bates
Background Electronic health records (EHR) can improve safety via computerised physician order entry with clinical decision support, designed in part to alert providers and prevent potential adverse drug events at entry and before they reach the patient.... View Details
Keywords: Hospital; Electronic Health Records; Health Care and Treatment; Information Technology; Safety; Performance; Quality; Performance Improvement
Holmgren, A Jay, Zoe Co, Lisa Newmark, Melissa Danforth, David Classen, and David Bates. "Assessing the Safety of Electronic Health Records: A National Longitudinal Study of Medication-related Decision Support." BMJ Quality & Safety 29, no. 1 (January 2020): 52–59.
- Article
National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018
By: David Classen, A Jay Holmgren, Zoe Co, Lisa Newmark, Diane Seger, Melissa Danforth and David Bates
Importance Despite the broad adoption of electronic health record (EHR) systems across the continuum of care, safety problems persist.
Objective To measure the safety performance of operational EHRs in hospitals across the country during a 10-year period.
Design,... View Details
Keywords: Electronic Health Record Systems; Health Care and Treatment; Information Technology; Performance; Safety; Measurement and Metrics; United States
Classen, David, A Jay Holmgren, Zoe Co, Lisa Newmark, Diane Seger, Melissa Danforth, and David Bates. "National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018." JAMA Network Open 3, no. 5 (May 2020).
- 26 Mar 2014
- Research & Ideas
How Electronic Patient Records Can Slow Doctor Productivity
care providers who demonstrate "meaningful use" of digital records. The legislation came from the belief that EHRs used in certain ways—such as medication order entry that would alert a clinician about drug-to-drug interactions—could... View Details
- April 12, 2022
- Article
Evaluation of Individual and Ensemble Probabilistic Forecasts of COVID-19 Mortality in the United States
By: Estee Y. Cramer, Evan L. Ray, Velma K. Lopez, Johannes Bracher, Andrea Brennen, Alvaro J. Castro Rivadeneira, Michael Lingzhi Li and et al.
Short-term probabilistic forecasts of the trajectory of the COVID-19 pandemic in the United States have served as a visible and important communication channel between the scientific modeling community and both the general public and decision-makers. Forecasting models... View Details
Keywords: COVID-19; Forecasting and Prediction; Health Pandemics; Mathematical Methods; Partners and Partnerships
Cramer, Estee Y., Evan L. Ray, Velma K. Lopez, Johannes Bracher, Andrea Brennen, Alvaro J. Castro Rivadeneira, Michael Lingzhi Li, and et al. "Evaluation of Individual and Ensemble Probabilistic Forecasts of COVID-19 Mortality in the United States." e2113561119. Proceedings of the National Academy of Sciences 119, no. 15 (April 12, 2022). (See full author list here.)
- September 2013 (Revised August 2015)
- Background Note
Leadership and Teaming
By: Ethan Bernstein
Small differences in the leadership of teams can have large consequences for the success of their efforts. Many initiatives fail not because of a fatal error in judgment or insufficient ideas, knowledge, motivation, or capabilities to deliver a solution. They fail... View Details
Keywords: Teams; Teaming; Leadership And Managing People; Leadership; Team Effectiveness; Team Performance; Team Design; Team Leadership; Teamwork; Team Process; Team Function; Team Launch; 60/30/10 Rule; Team Boundary; Distribution Of Leadership Authority; Self-Managed Teams; Virtual Teams; Unbounded Teams; Acts Of Leadership; Execution Teams; Decision Making Teams; Creativity Teams; Team Size; Task Design; Team Timeline; Team Roles; Team Representation; Diversity; Team Familiarity; Collective Intelligence; Team Stages Of Development; Team Coaching; Performance Pressure; X-Teams; Team Focus; Interaction; Management Teams; Managerial Roles; Management Systems; Management Style; Management Skills; Management Practices and Processes; Organizational Design; Organizational Structure; Performance Effectiveness; Performance Efficiency; Performance Productivity; Groups and Teams; Networks; Social Psychology; Behavior; Conflict and Resolution; Creativity; Social and Collaborative Networks; Satisfaction; Prejudice and Bias; Power and Influence; Personal Characteristics; Familiarity; Cognition and Thinking; Attitudes; Projects; Organizational Culture; Organizational Change and Adaptation; Leadership Development; Leadership Style; Leading Change; Knowledge Use and Leverage; Knowledge Sharing; Collaborative Innovation and Invention; Innovation and Management; Innovation Leadership; Design; Interpersonal Communication; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Medical Devices and Supplies Industry; Asia; North and Central America; South America; Atlantic Ocean; Central Asia; Europe; Latin America; Middle East; Oceania; West Indies
Bernstein, Ethan. "Leadership and Teaming." Harvard Business School Background Note 414-033, September 2013. (Revised August 2015.)
- 30 Mar 2010
- First Look
First Look: March 30
people believe the risk decreases (negative recency) but at the same time exhibit more cautious behavior (positive recency). The rest of the difference is consistent with two well established mechanisms: judgment error and the use of... View Details
Keywords: Sean Silverthorne
- May 15, 2012
- Article
Ensuring Quality Cancer Care: A Follow-Up Review of the Institute of Medicine’s 10 Recommendations for Improving the Quality of Cancer Care in America
By: Tracy E. Spinks, Heidi W. Albright, Thomas W. Feeley, Ron Walters, Thomas W. Burke, Thomas Aloia, Eduardo Bruera, Aman Buzdar, Lewis Foxhall, David Hui, Barbara Summers, Alma Rodriguez, Raymond DuBois and Kenneth I. Shine
Responding to growing concerns regarding the safety, quality, and efficacy of cancer care in the United States, the Institute of Medicine (IOM) of the National Academy of Sciences commissioned a comprehensive review of cancer care delivery in the US health care system... View Details
Keywords: Cancer; Quality; Cancer Care In The U.S.; Quality Improvement; Health Care and Treatment; Health Industry; North and Central America
Spinks, Tracy E., Heidi W. Albright, Thomas W. Feeley, Ron Walters, Thomas W. Burke, Thomas Aloia, Eduardo Bruera, Aman Buzdar, Lewis Foxhall, David Hui, Barbara Summers, Alma Rodriguez, Raymond DuBois, and Kenneth I. Shine. "Ensuring Quality Cancer Care: A Follow-Up Review of the Institute of Medicine’s 10 Recommendations for Improving the Quality of Cancer Care in America." Cancer 118, no. 10 (May 15, 2012): 2571–2582.
- 22 Jul 2014
- First Look
First Look: July 22
use process mapping and time-driven activity-based costing to measure the costs of treating patients over a complete cycle of care for a specific medical condition. With valid outcome and cost information, managers and clinicians can... View Details
Keywords: Sean Silverthorne
- 23 Nov 2009
- Research & Ideas
Management’s Role in Reforming Health Care
Despite the urgency of debate on the U.S. national stage about health-care reform, an issue now before the U.S. Senate, one crucial element of change has been less visible: advances in the delivery of medical services. Innovations in... View Details
- 05 Sep 2023
- Book
Thriving After Failing: How to Turn Your Setbacks Into Triumphs
that the more people in a team agreed with that statement, the higher the team’s rate of medical errors. Could it be that the teams that worked well together didn’t necessarily make more errors, but rather reported more View Details
Keywords: by Michael Blanding