Hssp89a: Internship and Analysis Brandeis University Spring 2018

HSSP89a: Internship and Analysis | Brandeis University | Spring 2018 Wednesday: 3:30 PM–4:50 PM Olin-Sang Amer Civ Ctr112 Instructor: Mayada Saadoun, MD, MPH, MSc Lecturer and internship instructor | Health: Science, Society, and Policy program Brandeis University, office: Heller G52 E-mail: [email protected] Instructor office hours: W 1PM-3PM at G52 by appointment

Course overview

In the United States, much of health care delivery, innovation, and reform is dictated by public and private organizations who seek to increase health care quality, access, and value. Because organizations (and organizational efficiency) is so central to this mission, the Health: Science, Society, and Policy (HSSP) Internship and Analysis course presents a framework for organization analysis and leadership in healthcare settings. lectures and readings will provide you with an opportunity to learn about the interaction of business practices and important health care aspects such as innovation, information technology, and social media. The course will examine the tools and techniques utilized to analyze healthcare organizations from a business perspective, and it will help you to develop your managerial and leadership skills. The classroom would be a safe environment to share your opinion and to reflect on your internship experience, course readings, and theories you learned from other HSSP coursework.

In class, we will utilize conceptual frameworks, case studies, exercises, and your internship experience to fulfill the course objectives.

Course objectives As each of you have completed, or currently completing work at a healthcare organization, the main objective of this course is to broaden your horizon around some important elements of healthcare industry and to teach you about organization issues.  To advance your analytical thinking skills around high profile healthcare topics.  To learn how well organization function and to understand organization issues.  To understand and analyze strategic design, politics, and culture of organizations and to assess the fit of organization to its goals and surrounding environment.

Assignments In Class participation 35% Journals 20% Policy Brief (group work) 20% Second Essay (individual) 15% Internship Presentation 5% Case Challenge 5%

Workload Success in this four-credit course is based on the expectation that students will spend a minimum of 10 hours per week in preparation for each class (e.g., reading and other required pre-class preparation, and the completion of course assignments). In the case of HSSP89a, time spent at an approved internship also counts as preparation.

Course materials Harvard Business School Cases. Please purchase the cases at http://cb.hbsp.harvard.edu/cbmp/access/73488117. Assigned materials:  Eli Lilly and Co.: Innovation in Diabetes Care  Pharmacy Service Improvement at CVS (A)  Boldly Go: Character Drives Leadership at Providence Healthcare 1 Updated: 五/十一/一八七:一七十一五/P 五 HSSP89a: Internship and Analysis | Brandeis University | Spring 2018 Wednesday: 3:30 PM–4:50 PM Olin-Sang Amer Civ Ctr112  Marie Trellu-Kane at Unis-Cité: Establishing Youth Service in France,  Philip Chase: An Organizational Power  The Merger of UCSF Medical Center and Stanford Health Services  Riot Games: Can Culture Survive Growth?

Assignment descriptions In-class participation Individual contribution consists of your presence in class and your comments in discussions. Missing classes affects your participation grade unless it is a medical or family emergency. While attending all sessions is mandatory, you are allowed to miss one class without affecting your participation grade. Please contact me a head of time if you are unable to make it to class. Pre-class preparation is part of your participation grade. Online write-ups are short assignments that ask you to apply the course concepts to relevant cases and readings. The main objective of these assignment is to enrich the class discussion, and to increase your participation. Each write-up will be structured around a set of questions posted on an online forum on Latte. You could either answer the questions or comment on your peer’s answers. Each student is required to have an input in each write- up. Write-ups will not be graded separately. The quality of your write-up will boost participation grade.

Journals Most of you have completed this assignment before the course. If you are completing the journal during the semester, please submit your entries according to the guidelines and schedule provided to you in your internship approval e-mail. Grading journals is based on completion and timeliness submission. Absent any late penalties, you will receive an “A” for your journal.

Essays Policy Brief (Group Essay): After being exposed to experts’ opinion addressing high profile topics in healthcare, you are expected to analyze various health issues critically. This assignment provides you with an opportunity to analyze a health-related issue of your interest. Each group will work together to deliver a succinct policy brief that includes;  Summary  Statement of the problem

 In a chronological method summarize previous policy interventions, and their impact.

 Recommend two to three policies that could resolve the issue and overcome shortfalls in previous policies, and mention positive and negative externalities to your proposed solutions.

The paper should be 10-12 pages, Times New Romans font-12, double space. Detailed guidelines of this assignment will be posted on Latte.

Second Essay: This essay should reflect the skills you acquired through the second module in organization analysis by applying the tools we discussed to your internship organization. Each student will be required to submit a final essay analyzing the alignment of the strategic design, power and politics, and culture of his internship site to the site’s mission and vision.

The paper should be 8-10 pages, Times New Romans font-12, double space. Detailed guidelines of this assignment will be posted on Latte.

Internship Presentation:

This assignment provides you with an opportunity to reflect on your internship experience. You will prepare a brief presentation about the scope of your work, and an organizational component that impacted your work.

How to submit assignments 2 HSSP89a: Internship and Analysis | Brandeis University | Spring 2018 Wednesday: 3:30 PM–4:50 PM Olin-Sang Amer Civ Ctr112 All assignments should be submitted on Latte. Group assignments should have all names of group members, and be submitted on behalf of the group once on latte.

Late policy All forum assignments are due by 3:25p.m. on the dates noted on Latte. No late assignments will be accepted. Essays are due by 11:55p.m. on the dates noted on Latte. No late assignments will be accepted.

Feedback On essays, the course instructor will provide a verbal and written feedback.

Students with disabilities If you are a student who needs academic accommodations because of a documented disability, please contact the course instructor and present them with your letter of accommodation as soon as possible. If you have questions about documenting a disability or requesting academic accommodations, you should contact Beth Rodgers-Kay in Academic Services ([email protected]). Letters of accommodation should be presented at the start of the semester to ensure provision of accommodations. Accommodations cannot be granted retroactively.

Brandeis University’s statement on academic integrity Brandeis University’s 2014-2015 Rights and Responsibilities states:

Every member of the University community is expected to maintain the highest standards of academic integrity. A student shall not submit work that is falsified or is not the result of the student’s own effort. Infringement of academic honesty by a student subjects that student to serious penalties, which may include failure on the assignment, failure in the course, suspension from the University or other sanctions (see Section 20). A student who is in doubt regarding standards of academic honesty in a course or assignment should consult the faculty member responsible for that course or assignment before submitting the work.

DETAILED COURSE OUTLINE (Readings might be modified during the semester) WEEK 1 Introduction to the HSSP89a Recognize Your Strengths and Leadership Style In class Exercise: MBTI (Bring your laptops to the classroom)

MODULE (1) INFLUENCING ELEMENTS IN HEALTHCARE INDUSTRY WEEK 2 Innovation and Healthcare Delivery Case Study: Eli Lilly and Co.: Innovation in Diabetes Care Reading: Omachonu, Vincent K., and Norman G. Einspruch. "Innovation in healthcare delivery systems: a conceptual framework." The Innovation Journal: The Public-Sector Innovation Journal 15.1 (2010): 1-20. Reading: Herzlinger, Regina E. "Why innovation in health care is so hard." Harvard business review 84.5 (2006): 58. Optional reading: Hwang, Jason, and Clayton M. Christensen. "Disruptive Innovation in Health Care Delivery: A Framework For Business-Model Innovation." HEALTH AFFAIRS 27.5: 1329.

Assignment: Answer the online posted questions on latte due before class starts. According to Omachonu et. al what is the definition of disruptive innovation and non-disruptive innovation, which one does healthcare system need more of? Why? Do you agree with Omachonu et. al that shortage in healthcare providers is an urgent call for innovation? Please support your stand. Herzlinger mentioned a lot of barriers to innovation, from your perspective which one do you think is the most influential barrier?

Case questions

3 Updated: 五/十一/一八七:一七十一五/P 五 HSSP89a: Internship and Analysis | Brandeis University | Spring 2018 Wednesday: 3:30 PM–4:50 PM Olin-Sang Amer Civ Ctr112 (1) Going back in history, what mistakes did Lilly make in its product development efforts? (2) Why were those mistakes made? (3) As you analyze what lessons Lilly needs to have learned from its past experiences, apply those lessons to the innovation projects on Larry Ellingson’s current agenda. Is he pursuing the right opportunities? What should he do to ensure success of these efforts? WEEK 3 Information Technology in Healthcare Reading: Pharmacy Service Improvement at CVS (A) Reading: Kern, Steven E., and Dov Jaron. "Healthcare technology, economics, and policy: An evolving balance." IEEE engineering in medicine and biology magazine: the quarterly magazine of the Engineering in Medicine & Biology Society 22.1 (2003): 16-19. Reading: Okunadea, Albert A., and Vasudeva NR Murthyb. "Technology as a ‘major driver’of health care costs: a cointegration analysis of the Newhouse conjecture." Journal of Health Economics 21 (2002): 147-159. Reading: Yang, Yang, Atreyi Kankanhalli, and Sarada Chandran. "A stage model of information technology in healthcare." Health and Technology 5.1 (2015): 1-11. Reading: Bardhan, Indranil R., and Mark F. Thouin. "Health information technology and its impact on the quality and cost of healthcare delivery." Decision Support Systems 55.2 (2013): 438-449. Optional reading: Sheikh, Aziz, Harpreet S. Sood, and David W. Bates. "Leveraging health information technology to achieve the “triple aim” of healthcare reform." Journal of the American Medical Informatics Association 22.4 (2015): 849-856.

Assignment: Answer the online posted questions on latte due before class starts. Apply the Nolan’s stage model to the US healthcare system. In each stage highlight the major differences between the Singaporean system and the US system. According to Bardhan, what is the impact of using HER on the quality of ambulatory care in the US? Do you agree with the author? please support your position. Ouknad et al used R&D as a proxy for change in healthcare technology cost. What do you think of this method? Do you agree with his findings? (1) What changes do you recommend to CVS’s existing pharmacy fulfillment process? What IT changes, if any, are required to implement your changes? (2) How can you be sure that the new process you propose will be an improvement over the existing one? How can you be sure that it won’t make things worse? (3) What groups, if any, are likely to have problems with your proposed solution? How will you deal with their objections? (4) How will you ensure that there is no backsliding that there won’t still be wooden boxes in use six months from now? How can technology be used to prevent or inhibit backsliding? (5) Does PSI represent a significant opportunity for CVS? Would improving customer services be of significant financial benefit to the company? (6) What percent of pharmacy defectors from CVS in 2000 were light versus heavy users? WEEK 4 Social Media in Healthcare (Group Presentation) There are some important topics that social media plays an important role in the healthcare system. In-class you will have 8 minutes to share the impact of utilizing social media in these areas and your proposed solution to mitigate risks if any. Each group should prepare a short power point. We will have 2 minutes for questions after each presentation. Reading: Moorhead, S. Anne, et al. "A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication." Journal of medical Internet research 15.4 (2013).

4 HSSP89a: Internship and Analysis | Brandeis University | Spring 2018 Wednesday: 3:30 PM–4:50 PM Olin-Sang Amer Civ Ctr112 Reading: Ventola, C. Lee. "Social media and health care professionals: benefits, risks, and best practices." Pharmacy and Therapeutics 39.7 (2014): 491. Reading: Gamache-OLeary, Valerie, and Gerald Grant. "Social media in healthcare." Proceedings of the 50th Hawaii International Conference on System Sciences. 2017.

WEEK 5 Political Landscape of Healthcare Reading: Allen, John. "The whereabouts of power: politics, government and space." Geografiska Annaler: Series B, Human Geography 86.1 (2004): 19-32. Reading: Bambra, Clare, Debbie Fox, and Alex Scott-Samuel. "Towards a politics of health." Health promotion international 20.2 (2005): 187-193. Reading: Navarro, Vicente, and Leiyu Shi. "The political context of social inequalities and health." Social science & medicine 52.3 (2001): 481-491. Reading: Coburn, David. "Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities." Social science & medicine 58.1 (2004): 41-56. Assignment: Answer the online posted questions on latte due before class starts Bambara et al. used health as an example to expose us to the relationship between capitalism and citizenship. He. Please explain his opinion and your own opinion on the matter. Bambara et al. “The dominance of the first conceptualization of politics, as the art of government and the activities of the state, influences which aspects of health are considered to be political”. Do you agree with his opinion? How does the political seen in the US influence health? Navarro and Shi expose us to the impact of the political traditions in the advanced OECD countries during the golden years of capitalism. They picked four outcome variables, please select a country of your choice and summarize his findings. While Navarro and Shi associate income inequalities to health outcomes, Coburn criticizes this approach. Which author do you agree with and why? Bernie Sanders wrote an article in the New York Times advocating for Medicare for all which is another way to state that health is a right not a luxurious good. The Main activity of this class is an open debate exercise. The class will be divided in two groups (groups are assigned randomly by me see below). Group will support “health is a right for all” and the other will support the opposite stand. You will conduct an open debate on the two stands. The debate time will be 20 minutes. Please conduct your own research, use statistics, and scholar opinions to support your debate team, and to highlight the social, economic, and political implications of each stand.

MODULE (2) LEADERSHIP AND ORGANIZATION STRUCTURE WEEK 6 Leadership in Healthcare Industry Case Study: Boldly Go: Character Drives Leadership at Providence Healthcare, Mary Weil; Chitra P. Reddin, 2015. Reading: Herd, Ann M., et al. "Finding What Works: Leadership Competencies for the Changing Healthcare Environment." Journal of Leadership Education 15.4 (2016). Reading: Savage, Grant T., et al. "Interprofessional academic health center leadership development: the case of the University of Alabama at Birmingham’s Healthcare Leadership Academy." Applied Nursing Research 27.2 (2014): 104-108.

Assignment: Answer the online posted questions on latte due before class starts. (1) Discuss and analyze the relative importance of competencies, commitment and character in effective leadership. (Think of any role model leader that you know in your life) (2) What are the potential professional and organizational ramifications of a business leader who has poor character? (3) What is your concept of the ideal 21st-century leader? Give reasons for your answer.

5 Updated: 五/十一/一八七:一七十一五/P 五 HSSP89a: Internship and Analysis | Brandeis University | Spring 2018 Wednesday: 3:30 PM–4:50 PM Olin-Sang Amer Civ Ctr112 (4) What principles and practices need to be followed to ensure a communications strategy is successful in supporting and achieving change? (5) As a potential leader, describe and analyze three approaches you consider effective in building employee engagement during times of change. (6) As the CEO of Providence Healthcare, what are your plans and recommendations for sustaining the values of Transformation by Design and winning the continuing support of internal and external stakeholders?

WEEK 7 Strategic Design of Organizations: Congruence Model Reading: Marie Trellu-Kane at Unis-Cité: Establishing Youth Service in France, Julie Battilana; Michel Anteby; Anne-Claire Pache, 2015. Reading: Abernethy, Margaret A., and Anne M. Lillis. "Interdependencies in organization design: a test in hospitals." Journal of Management Accounting Research 13.1 (2001): 107-129.

Assignment: Answer the online posted questions on latte due before class starts. (1) According to Abernethy and Lillis, how does literature define organizational success? How do you rate your internship site in relation to this definition? (2) How did the fast-paced environment of healthcare market affect the strategic choices of management? (3) The author argues that with increased autonomy the level of accountability will rise, what is his argument and what do you think about it? (4) What is your assessment of Unis-Cite’s action to date? (5) What are the key challenges that Unis-Cite facing? (6) What should Trellu-Kane do following Chirac’s announcements? Please develop a specific action plan for the next three years WEEK 8 Power, Politics, and Strategic Decisions in Healthcare Case Study: Philip Chase: An Organizational Power Case Study: The Merger of UCSF Medical Center and Stanford Health Services Reading: Thomas, James B., Shawn M. Clark, and Dennis A. Gioia. "Strategic sense making and organizational performance: Linkages among scanning, interpretation, action, and outcomes." Academy of Management journal 36.2 (1993): 239-270. Reading: Van de Bovenkamp, Hester M., Margo J. Trappenburg, and Kor J. Grit. "Patient participation in collective healthcare decision making: the Dutch model." Health Expectations 13.1 (2010): 73-85. Reading: Porter, Michael E., and Michael E. Porter. "How competitive forces shape strategy." (1979): 21-38. Reading: Kotter, John P. "Leading change: Why transformation efforts fail." (1995): 59-67.

Assignment: Answer the online posted questions on latte due before class starts. Case 1 (1) How did Philip Chase get into this situation? (2) How should he manage the meeting with Judy Aiken, the HR director at Winterplain? Case 2 (1) Using the “Five Forces” framework, what environmental forces were UCSF and Stanford Health Services dealing with in the mid-1990s? (2) How well-positioned were the hospitals to desal with those forces? (3) What kind of value would you expect this merger to achieve and why?

6 HSSP89a: Internship and Analysis | Brandeis University | Spring 2018 Wednesday: 3:30 PM–4:50 PM Olin-Sang Amer Civ Ctr112 (4) Using your analysis form question 1 and 2, and the Knotter article’s as a guide, address the question: “was the merger a bad idea or a good idea badly executed?” WEEK 9 Organizational Culture and Healthcare Outcomes Case Study: Riot Games: Can Culture Survive Growth? Boris Groysberg; Michael Norris, 2016 Reading: Gershon, Robyn RM, et al. "Measurement of organizational culture and climate in healthcare." Journal of Nursing Administration 34.1 (2004): 33-40. Reading: Zazzali, James L., et al. "Organizational culture and physician satisfaction with dimensions of group practice." Health services research 42.3p1 (2007): 1150-1176. Reading: Meterko, Mark, David C. Mohr, and Gary J. Young. "Teamwork culture and patient satisfaction in hospitals." Medical care 42.5 (2004): 492-498.

Assignment: Answer the online posted questions on latte due before class starts. (1) Conduct a SOWT analysis to Riots.

(2) In your own words, how would you describe the culture of Riot? How important is culture to Riot? Is it scalable and sustainable? what are the tradeoffs associated with Riot’s culture and with the specific practices used to develop their culture?

(3) What are the elements of Riot’s talented management system that make it effectives? What is the role of organizational culture and structure in managing human capital at Riot?

(4) What are the challenges faced by the company?

(5) What should Brandon Beck and Marc Merrill do moving forward? If you were them, what would you do to ensure Riot could grow in a sustainable way? What are the steps should management take to further strengthen Riot’s culture and develop its people practices carrying out its ambitious growth plans? Please devise and action plan. please be specific

MODULE (3) REFLECTION ON INTERNSHIP WEEK 10 Internship Presentation

WEEK 11 Internship Presentation

WEEK 12 Get Ready for Your Career How to Write a Resume and a Cover Letter Job Interview

WEEK 13 Case Challenge

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