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- March 2024
- Article
Investigation of Divergent Thinking among Surgeons and Surgeon Trainees in Canada (IDEAS): A Mixed-methods Study
By: Alex Thabane, Tyler McKechnie, Vikram Arora, Goran Calic, Jason W Busse, Ranil Sonnadara and Mohit Bhandari
Objective: To assess the creative potential of surgeons and surgeon trainees, as measured by divergent thinking. The secondary objectives were to identify factors associated with divergent thinking, assess confidence in creative problem-solving and the perceived effect... View Details
- Article
Surgeons and Administrators Co-Creating Value
By: Michael Nurok, Thoralf Sundt, Robert S. Kaplan and Bruce Gewertz
Most hospitals have arms-length relationships with physicians, viewing them as people they must ‘‘manage,’’ not as potentially valuable strategic partners. But surgeons make clinical decisions every day that have great influence on both patient outcomes and hospital... View Details
- April 2021
- Article
Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models
By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka
Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other... View Details
- Article
Development of a Deep Learning Algorithm for Periapical Disease Detection in Dental Radiographs
By: Michael G. Endres, Florian Hillen, Marios Salloumis, Ahmad R. Sedaghat, Stefan M. Niehues, Olivia Quatela, Henning Hanken, Ralf Smeets, Benedicta Beck-Broichsitter, Carsten Rendenbach, Karim R. Lakhani, Max Helland and Robert A. Gaudin
Periapical radiolucencies, which can be detected on panoramic radiographs, are one of the most common radiographic findings in dentistry and have a differential diagnosis including infections, granuloma, cysts, and tumors. In this study, we seek to investigate the... View Details
- Article
Navy Medicine Introduces Value-Based Health Care
By: Alee Hernandez, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III and Michael E. Porter
In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could... View Details
- August 2017
- Article
Effective Leadership of Surgical Teams: A Mixed Methods Study of Surgeon Behaviors and Functions
By: J. Stone, E. Aveling, M. Frean, M. Shields, C. Wright, F. Gino, T. Sundt and S.J. Singer
The importance of effective team leadership for achieving surgical excellence is widely accepted, but we understand less about the behaviors that achieve this goal. We studied cardiac surgical teams to identify leadership behaviors that best support surgical teamwork.... View Details
- May 2017
- Supplement
Boston Children's Hospital Process Map Video
By: Robert S. Kaplan and Mary Witkowski
The 13 minute video simulates a discussion among orthopedic surgeons and cast room technicians about the processes and resources used when applying long leg casts for patients. The video should be used when teaching Boston Children’s Hospital (Abridged) case, #914-407,... View Details
- Article
Time-Driven Activity-Based Costing for Surgical Episodes
By: Peter Najjar, Matt Strickland and Robert S. Kaplan
Health care costs related to surgical care account for 40% of all hospital and physician spending. Payers attempting to contain costs are replacing fee-for-service with value-based payment schemes that can encompass entire episodes of care, including physician services... View Details
- February 2016
- Teaching Note
Advanced Leadership Pathways: General Gale Pollock and Services for the Vision Impaired
By: Rosabeth M. Kanter, Tessa Natanay Hamilton and Ai-Ling Jamila Malone
Following a successful military career as an Army Nurse, achieving rank as Major General, becoming the first female Acting Surgeon General of the Army, and the 22nd Chief of the Army Nurse Corps, Pollock developed a vested interest in improving the lives of the... View Details
Keywords: Health
- 2016
- Teaching Note
Advanced Leadership Pathways: General Gale Pollock and Services for the Vision Impaired
By: Rosabeth M. Kanter, Tessa Natanay Hamilton and Ai-Ling Jamila Malone
Teaching note for case 314029. Following a successful military career as an Army Nurse, achieving rank as Major General, becoming the first female Acting Surgeon General of the Army, and the 22nd Chief of the Army Nurse Corps, Pollock developed a vested interest in... View Details
- December 2015
- Article
Task Shifting in Surgery: Lessons from an Indian Heart Hospital
By: Budhaditya Gupta, Robert S. Huckman and Tarun Khanna
We present a case study that illustrates task shifting, the transfer of activities from senior to junior colleagues, in the context of cardiac surgery at the Narayana Health City Cardiac Hospital (NH) in India. The case discusses the factors driving the adoption of... View Details
- November 2015
- Article
Influence of Experience and the Surgical Learning Curve on Long-term Patient Outcomes in Cardiac Surgery
By: Bryan M. Burt, Andrew W. ElBardissi, Robert S. Huckman, Lawrence H. Cohn, Marisa W. Cevasco, James D. Rawn, Sary F. Aranki and John G. Byrne
OBJECTIVE: We hypothesized that increased post-graduate surgical experience correlates with improved operative efficiency and long-term survival in standard cardiac surgery procedures.
METHODS: Utilizing a prospectively collected retrospective database,... View Details
METHODS: Utilizing a prospectively collected retrospective database,... View Details
- August 2015 (Revised August 2015)
- Case
Hoag Orthopedic Institute
By: Robert S. Kaplan and Jonathan Warsh
Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the... View Details
- Article
Teaming: An Approach to the Growing Complexities in Health Care: AOA Critical Issues
By: Haseeb Nawaz, Amy C. Edmondson, Tony H. Tzeng, Jamal K. Saleh, Kevin J. Bozic and Khaled J. Saleh
Confronted with rising costs and patients who often have multiple comorbidities, the orthopaedic surgeon needs to face the challenge of providing high-quality health care. One solution is to increase and improve coordination, communication, and teamwork. The... View Details
- November 2013
- Article
Learning from My Successes and from Others' Failures: Evidence from Minimally Invasive Cardiac Surgery
By: D. KC, B. Staats and F. Gino
Learning from past experience is central to an organization's adaptation and survival. A key dimension of prior experience is whether an outcome was successful or unsuccessful. While empirical studies have investigated the effects of success and failure in... View Details
- September 2013
- Case
Boston Children's Hospital: Measuring Patient Costs (Abridged)
By: Robert S. Kaplan
The case describes a pilot project on applying activity-based costing to measure the cost of treating patients. After an overview of Boston Children's Hospital and its local health care market environment, the case presents process maps and financial data relating to... View Details
- June 2013
- Case
Ron Ventura at Mitchell Memorial Hospital
By: Frank V. Cespedes and Heide Abelli
Mitchell Memorial Hospital is a 750-bed regional academic medical center in Ohio. Andy Prescott, Chief of the Cardiovascular Center, is reviewing the performance evaluations of his star vascular surgeon Ron Ventura. The evaluations, the result of a 360-degree... View Details
- June 2012
- Case
Reconfiguring Stroke Care in North Central London
By: Michael E. Porter, James Mountford, Kamalini Ramdas and Samuel Takvorian
In 2006, surgeon Ara Darzi identified several key areas, including acute stroke care, for improving health care across London. In response to his seminal call to action, stroke care was reorganized around eight hyper-acute stroke units covering London's five sectors,... View Details
- March 2012 (Revised January 2013)
- Case
Boston Children's Hospital: Measuring Patient Costs
By: Robert S. Kaplan, Mary L. Witkowski and Jessica A. Hohman
The case describes two pilot projects on applying activity-based costing to measuring the cost of treating patients. It presents process maps and financial data relating to the processes used during (1) an office visit to a plastic surgeon for three different diagnoses... View Details
- September 2011
- Supplement
Narayana Hrudayalaya Heart Hospital
By: Tarun Khanna and Tanya Bijlani
Narayana Hrudayalaya (NH) is one of the world's busiest heart hospitals, where surgeons perform 30-35 complex cardiac surgeries daily. With an average cost of $1,800 per surgery, the hospital treats patients at affordable prices, and does not turn away even the poorest... View Details