At Goizueta Business School, we are at the epicenter of healthcare innovation and research as a part of the Emory University's world-renowned health care community. Healthcare opportunities within a mile of the Business School include access to unique entities like Emory Healthcare's globally recognized hospital and research facilities, the Rollins School of Public Health and the Center for Disease Control (CDC). Additionally, Atlanta’s involvement in the healthcare industry spans from technology, to research, to treatment, to legislation, to consulting and places this city among the finest for careers in the healthcare industry.
The healthcare arena at Emory, affectionately known as the Clifton Corridor for its location along Clifton Road through the center of campus, houses some of the most influential healthcare elements in the nation. These include but are not limited to Emory University’s School of Medicine and Rollins School of Public Health – partners with Goizueta in our efforts to educate top minds to have an impact on the industry.
The School of Medicine, which celebrated its 150th anniversary in 2004, is ranked among the nation’s finest institutions for education, biomedical research and patient care. In addition to 480 medical students, the school trains 1,100 residents and fellows in 80 accredited programs. The faculty includes more than 2,000 members in basic science and clinical departments, and close to 1,000 volunteer members. The school has 13,000 alumni (including medical school and residency programs), and one of every four physicians trained in Georgia was trained at Emory. Over 7,000 physicians and other healthcare professionals came to Emory last year to participate in one of the nation’s largest and most successful continuing medical education programs.
The Rollins School of Public Health comprised of six academic department: behavioral sciences and health education, biostatistics, environmental and occupational health, epidemiology, health policy and management, global health, and hosts over 20 interdisciplinary centers. More than 180 full-time, doctoral-level faculty members teach and conduct research in areas such as mathematical modeling of infectious disease transmission, exploring relationships between nutrition and chronic disease, and investigating cancer causation and control. The School offers dual-degree program with the Goizueta Business School (MBA/MPH). There are more than 4,500 alumni of the school of public health. Research funds support major research efforts in health policy, cancer epidemiology, nutrition, environmental and occupational health, AIDS education and prevention, youth violence, antibiotic resistance, health care costs and allocation of health resources and micronutrient malnutrition. Many of the full-time faculty are linked by appointment or research grants with the nearby Centers for Disease Control and Prevention, The Carter Center, the American Cancer Society, CARE, the Arthritis Foundation, and numerous state and local public health agencies.
Goizueta Business School faculty has close professional ties to the staff and faculty of Emory Healthcare, one of the nation's leading health systems located in Atlanta. Emory Healthcare is the largest and most comprehensive healthcare system in the state of Georgia, with revenues in excess of $1 billion and over 10,000 employees. Since 1915, Emory University has been at the forefront of medical knowledge and research, pioneering many of the procedures that have changed the face of medical history. As part of that heritage, Emory Healthcare was established to provide improved access to the physicians, resources and facilities that have grown with Emory through the years. Today, the Emory Healthcare system encompasses:
- Emory University Hospital
- Emory University Hospital Midtown
- The Emory Clinic
- Wesley Woods Center
- Emory-Adventist Hospital (jointly owned by Adventist Health System)
- Saint Joseph's Hospital
- Emory Johns Creek Hospital
- Emory Children's Center
- Center for Rehabilitation Medicine
- Winship Cancer Institute of Emory University
- Emory University Orthopaedics and Spine Hospital
At Goizueta, students focused in the healthcare concentration are able to participate in a number of strategic programming opportunities, including:
Goizueta Healthcare Management Association: The Goizueta Business School has an active healthcare student organization in partnership with the Rollins School of Public Health. The Goizueta Healthcare Management Association focuses on enhancing students’ understanding of healthcare issues and exploring careers in the healthcare sector. Recent career development and networking events have included: Biotech Venture Capital Panel, Healthcare Career Panel, and an Atlanta Healthcare Networking event with Rollins School of Public Health.
Annual Healthcare Forum: The Goizueta Healthcare Management Association hosts an annual healthcare forum that focuses on major current healthcare issues. The 2012 Healthcare Forum focused on “New Strategic Initiatives in Healthcare” and was attended by more than 100 healthcare professional, students and Goizueta faculty. The keynote speaker was Dr. Catherine Palmier, MD, Chief Medical Officer for United Healthcare’s Southeast Region. Panelists participating in the forum included: Industry Consultant, Healthcare Attorney, Policy Professor and Chief of Medical Staff.
Annual Case Competition: The Goizueta Healthcare Management Association hosts a healthcare case competition among selected MBA programs each Spring Semester. Teams from across come to the country (including teams from Dartmouth, University of Chicago, and the University of Washington) come to Goizueta to participate in the one-day competition. A panel of judges made up from Atlanta's healthcare professionals rank the teams based on their public presentation. Prize money is paid to the top three teams.
Healthcare Innovation Program (HIP) Annual Symposia Series: The HIP has provided a quarterly symposium series since 2011. This year topic is “U.S. Healthcare: What’s Broken & How to Fix It”. The general format of the symposium is for a guest key note speaker followed by a panel discussion associated with the keynote speaker’s topic. Click here for more information on the Symposia Series.
Direct Studies at Emory Healthcare: Goizueta Healthcare Concentration students can complete a three-hour direct studies at the Emory Clinic or one of the Hospitals in the Emory Healthcare System. Students desiring to complete a direct study are required to attend a one day matching program where Emory Healthcare managers present potential direct study projects and then Goizueta students indicate which projects they would be interested in completing. Emory Healthcare Managers then attempt to match students’ interests to projects presented to maximize the number of direct studies each semester. For more details on direct studies click on the link CITATION NEEDED.
Goizueta faculty are among the country's foremost thought leaders, and their resulting research has far-reaching influence. Below is a subset of recent research published in academic journals featuring members of our faculty:
Nurses Perceptions and Experiences with the Implementation of a Medication Administration System
Steven D. Culler, James Jose, Susan Kohler, and Kimberly Rask completed this study to describe facilitators and barriers to implementation of a commercially available electronic medication administration record system. At two pediatric hospitals, they conducted qualitative interviews with nurses working on either the medical-surgical or intensive care units. Their findings indicated that the most significant barrier to adoption was excessive time for logging into the system, however, respondent satisfaction increased considerably as modifications to the electronic medication administration record system were made resulting in increased productivity and enhanced patient safety.
Impact of a Dedicated Neurocritical Care Team in Treating Patients with Aneurysmal Subarachnoid Hemorrhage
Owen Samuals, Adam Webb, Steven D. Culler, Kathleen Martin, and Daniel Barrow worked to determine if hospital outcomes for patients admitted with aneurysmal subarachnoid hemorrhage changed after the introduction of a neurointensivist-led multidisciplinary neurocritical care team. Comparing the outcomes of patients treated prior to and following the development of a multidisciplinary neurocritical care team. Their findings showed that patients treated after the introduction of a neurocritical care team were significantly more likely to be discharged to home and less likely to be discharged to a rehab facility. Furthermore, they found that patients treated after introduction of a neurocritical care team were also more likely to receive definitive aneurysm treatment.
The Financial and Nonfinancial Costs of Implementing Electronic Health Records in Primary Care Practices
Neil Fleming, Steven D. Culler, Russell McCorkle, Edmond R. Becker, and David J. Ballard explored the consequences of incentives in the American Recovery and Reinvestment Act to expand the meaningful use of electronic health record systems have many health care professionals searching for information about the cost and staff resources that such systems require. After analyzing all associated costs for twenty-six primary care practices, they found that for an average five-physician practice, implementation cost an estimated $162,000, with $85,500 in maintenance expenses during the first year. They also estimate that the practice implementation team needed 611 hours, on average, to prepare for and implement the electronic health record system, and that end users needed 134 hours per physician, on average, to train to use the record system in clinical encounters.
Is There an Association Between Quality of In-Hospital Cardiac Care and Proportion of Low Income Patients?
Steven D. Culler, Linda Schieb, Michele Casper, Isaac Nwaise, and Paula W. Yoon examined whether there is an association between the quality of in-hospital cardiac care and a hospital's proportion of low-income patients. Using data from a retrospective analysis of 1979 versus 2005/2006 hospital quality care information to conduct regression analyses, they found a statistically significant negative association between the proportion of low-income patients and hospital performance after controlling for selected hospital characteristics. They concluded that hospital adherence to process measures declined as the proportion of low-income patients increased.
Knowledge Management Systems: Knowledge Application in an Emergency Department
In an effort with Steven Johnson and Youngjin Yoo of Temple University, Maryam Alavi collected an extensive body of research based on knowledge-based view of organizations. Considering the knowledge-intensive nature of the healthcare domain, the high rate of change and innovation, and the wide scope of knowledge needed by the professionals in this field, patient care can potentially benefit from advanced information technologies that facilitate storage, search, and timely access to the best available knowledge. Their paper reports on preliminary results of a field study on IT-enabled knowledge application in an emergency department (ED) of a hospital. More specifically, we investigate the relationship between the IT-enabled knowledge application by ED physicians and the related diagnostic and patient care outcomes and the emergency room charges.
The Effects of Focus on Performance: Evidence from California Hospitals
Diwas Singh KC and Christian Terwiesch use hospital-level discharge data from cardiac patients in California to estimate the effects of focus on operational performance. The authors examine focus at three distinct levels of the organization at the firm level, at the operating unit level, and the process flow level. They find that focus at each of these levels is associated with improved outcomes, namely, faster services at higher levels of quality, as indicated by lower lengths of stay (LOS) and reduced mortality rates. Next, the authors analyze the extent to which the superior operational outcome is driven by focused hospitals truly excelling in their operations or by focused hospitals simply cherry-picking easy-to-treat patients. After controlling for selective patient admissions, the previously observed benefits of firm level focus disappears; focused hospitals no longer demonstrate a statistically significant reduction in LOS or mortality rate. However, at more granular measures of focus within the hospital (e.g., operating unit level), the authors find that more focus leads to a shorter LOS, even after controlling for selective admission effects.
Working with Capacity Limitations: Operations Management in Critical Care
Christian Terwiesch, Diwas KC, and Jeremy Kahn examines how a hospital’s ICU director can solve the ongoing problems with ICU bed availability. The ICU seems to be constantly full, and trauma patients in the emergency department sometimes wait up to 24 hours before receiving a bed. Additionally, the cardiac surgeons were forced to cancel several elective coronary-artery bypass graft cases because there was not a bed available for postoperative recovery. The hospital administrators ask whether you can decrease your ICU length of stay, and wonder whether they should expand the ICU to include more beds. This paper reviews how operations management researchers would define, examine and optimize your ICU’s throughput.
An Econometric Analysis of Patient Flows in the Cardiac Intensive Care Unit
Diwas Singh KC and Christian Terwiesch explores the rationing of bed capacity in a cardiac intensive care unit (ICU). The study finds that the length of stay for patients admitted to the ICU is influenced by the occupancy level of the ICU. In particular, a patient is likely to be discharged early when the occupancy in the ICU is high. This in turn leads to an increased likelihood of the patient having to be readmitted to the ICU at a later time. Such bounce-backs have implications for the overall ICU effective capacity an early discharge immediately frees up capacity, but at the risk of a (potentially much higher) capacity requirement when the patient needs to be readmitted. The paper also sheds light on the question of whether an ICU should apply an aggressive discharge strategy or if it should follow the old quality slogan and do it right the first time. By comparing the total capacity usage for patients who were discharged early versus those who were not, the authors show that an aggressive discharge policy applied to patients with lower clinical severity levels frees up capacity in the ICU. However, we find that an increased number of readmissions of patients with high clinical severity levels occur when the ICU is capacity constrained, thereby effectively reducing peak bed capacity.
Accumulating a Portfolio of Experience: The Effect of Focal and Related Tasks on Surgeon Performance
Diwas Singh KC and Brad Staats examine one key driver of improvement in surgical outcomes. Is a surgeon's prior experience? However, research notes that not all experience provides equal value for performance. How, then, should surgeons accumulate experience to improve quality outcomes? In this paper, the authors investigate the differential effects of focal and related (i.e., tasks similar to, but not identical to, the focal task) experience. They open up the black box of the volume-outcome relationship by going beyond just dividing experience into focal and related categories, but also considering how subtasks and context (i.e., the organization in which the work takes place) affect performance. To understand these issues, the authors assemble a novel data set on 71 cardiothoracic surgeons who performed more than 6,500 procedures during a period of 10 years after the introduction of a breakthrough surgical procedure. They find that, as compared to related experience, surgeon focal experience has a greater effect on surgeon performance. We also demonstrate that subtask experience has different, nonlinear performance relationships for focal and related experience. Finally, the paper finds that focal experience is more firm specific than related experience and that nonfirm experience reduces the learning rate for both focal and related experience.
A Multi-level Analysis of the Impact of Health Information Technology on Hospital Performance
Hyeyoung Hah and Anandhi Bharadwai examine the impact of health information technology (HIT) implementation and meaningful use on hospital productivity and financial performance. The paper proposes hypotheses predicting a hospital’s operating and financial performance as a function of HIT capital, meaningful use of HIT, and the complementary effect of hosptial information exchanges (HIE) coordination with HIT use. Secondary survey data from 2008-2010 on various HIT and hosptial performance measures collected from 2,557 U.S. hospitals were analyzed using hierarchical linear modeling approach. The authors find reasonably good support for their hypotheses linking HIT capital and meaningful use of HIT to productivity metrics and to financial performance. These findings show that it is important to track and measure meaningful use over and beyond simply looking at HIT adoption statistics.
Power Differentials and Performative Deviation Paths in Practice Transfer: The Case of Evidence-Based Medicine
Roopa Raman and Anandhi Bharadwaj seek to provide a fine-grained analysis of the nature of performative deviation paths through which practice transfer processes unfold by focusing on the role of power differentials. The authors find that power differentials among transfer participants can cause the unfolding practice transfers to deviate from prescribed processes along one of two alternative paths - the agency-based performative deviation path or the knowledge-baded performative deviation path. Although the agencuy-based performative deviation path hinders successful practice transfer, the knowledge-based performative deviation path can actually be helpful to organizations. The authors draw on the dual-nature framework of organizational routines and the pluralist lens of power as their theoretical foundation and evidence-based medicine in healthcare as their empirical context to derive a set of propositions about the different performative deviation paths through which practice transfer processes unfold, based on the nature of power differentials among work roles involved in practice transfer and the different outcomes that result.