Problem definition: Despite their frequency, there is scant research studying how substitutions in response to pharmaceutical supply chain disruptions impact medication errors in hospitals. To address this gap, we study this causal relationship using a natural experiment: hurricane damage to...

Comparative effectiveness research (CER) can provide valuable information for patients, providers and payers. These stakeholders differ in their incentives to invest in CER. To maximize benefits from public investments in CER, it is important to understand the value of CER from the perspectives...

Senior manager participation is a key success driver for process improvement programs. To increase their participation, we designed an intervention in which senior managers worked with frontline staff to identify and solve safety-related problems over an 18-month period. On average, the 20...

The case describes an organization's use of the science of improvement to transform their process quality from below average to top 10% in their industry. The case outlines the protagonist's strategy of developing internal experts who are trained in a common methodology for making improvement...

Triage is the first step of emergency care, where patients are classified based on their urgency and their anticipated resource usage. Although triage nurses follow a standard classification algorithm, worker judgement plays a significant part in how urgent patients are perceived. In this paper,...

We study the role of process friction in increasing efficiency of service provisions. We examine one potential lever for reducing the provision of discretionary services: “justification”—an otherwise non-value-added process step that introduces process friction by forcing workers to...

Healthcare policymakers use wait-time metrics to encourage hospital managers to improve the patient experience. In 2002, Massachusetts mandated that hospital managers develop processes to respond to boarding crises, which occur when emergency department (ED) patients experience long waits for...