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...

Despite over a decade of attention on reducing medical errors sparked by the Institute of Medicine report, medical errors in hospitals remain prevalent. A plethora of potential solutions are suggested, yet their adoption rate is slow, partly due to implementation challenges, such as the tradeoff...

Healthcare has traditionally focused on medical outcomes and financial performance. The big question is always, "How much is it going to cost?" What would happen, though, if healthcare also considered the question of "How does the patient feel?" This case looks at the Cleveland Clinic's attempt...

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...

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...

Hospital managers struggle with the day-to-day variability in patient admissions to different clinical services, each of which typically have a fixed allocation of hospital beds. In response, many hospitals engage in capacity pooling by assigning patients from a service whose designated beds are...

Hospitals with Coronavirus disease (COVID-19) demand surges at the onset of the pandemic report medication shortages, a worrisome phenomenon as inadequate medication supplies negatively affect patient outcomes. The popular press implicates a lack of raw ingredients and spikes in purchases but...

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...

We conduct a series of experiments to study the impact of three different types of relative performance feedback (RPF) on middle-ranked workers’ output on a skill-based task. Few studies investigate the impact of RPF on middle-ranked workers, which is a substantial omission given that they...