“Let’s be clear: Health care has many wonderful people delivering wonderful care for millions of patients. It also has a lot of problems,” says Wharton health-care management professor Ingrid Nembhard. What’s not so obvious is how to fix all the well-known issues that have long plagued the system.
To help students effect change, Nembhard has structured her MBA course, Leading Health Care Organizations, to address organizational, managerial, and strategic issues that they’re likely to encounter in any part of the industry. “Health care is not just visits to providers. It’s an ecosystem with many subsectors aimed at increasing high-quality, cost-effective care for consumers,” she says. Among the subsectors that students express interest in are health-care delivery, pharmaceuticals, biotechnology, insurance, and private equity. “What I enjoy most about my students is the perspectives they bring from different parts of the industry and their curiosity about how those areas may complement each other,” she says. A sample of course materials illustrates the frameworks and skills she hopes students will take with them no matter where they land.
Crossing the Quality Chasm: A New Health System for the 21st Century
“There’s a big gulf between what care could be and what it actually is in the United States,” says Nembhard. This book from the National Academy of Medicine introduces six timeless aims to guide the industry — namely, that health care should be safe, timely, effective, efficient, equitable, and patient-centered.
“Making Health Care Better”
Stressing the importance of evidence-based care and the need for organizational learning to deliver it, this piece from the New York Times Magazine highlights a gold standard exemplified by Intermountain Healthcare and doctor Brent James. “Those who work in health care are constantly facing the challenge of bringing new knowledge, ideas, and practices into their organization effectively and efficiently,” says Nembhard. Published in 2009, the article details James’s efforts to gather data on patient outcomes to improve guidelines for care at Intermountain’s hospitals and clinics.
“How Do We Heal Medicine?”
Even with better protocols in place, care can go awry if practices simply aren’t followed. Atul Gawande HON22 offers a seemingly obvious yet unexpected solution: checklists. With thousands of conditions, treatments, and drugs these days, doctors “can’t know it all,” he says in this TED talk. Using checklists during surgeries reduced complication rates by 35 percent and death rates by 47 percent at eight hospitals around the world where Gawande and his team implemented them for a project with the World Health Organization.
“Social Spending to Improve Population Health — Does the United States Spend as Wisely as Other Countries?”
This article and audio interview published by the New England Journal of Medicine makes the case that the U.S. can boost its citizens’ health by better distributing social spending. Specifically, the U.S. spends more than other countries on older people and less on children and working people, write authors Roosa Tikkanen and Eric Schneider. “If we’re not spending enough on early childhood factors and working-age support,” Tikkanen says in the interview, “we are essentially risking perpetuating negative health effects that start early in life and may potentially accumulate.” Nembhard wants her students to think about where they focus their efforts and to realize that improving health care requires attention to social services and health policy, too.
“One Medical’s Innovation Chief on Amazon, Medicaid and More”
Nembhard supplements case studies, readings, and class discussions with guest speakers. “Having somebody walk into the classroom who just before was dealing with the issues we cover is very clarifying and illuminating,” she says. This article from Healthcare Dive introduces students to guest Rushika Fernandopulle RES95, whose Iora Health was acquired in 2021 by One Medical, the Amazon-owned primary-care company where he is now chief innovation officer.
“Leading Change: Why Transformation Efforts Fail”
None of the best practices that Nembhard shares with students are useful if organizations are unwilling to implement them. Nembhard includes this Harvard Business Review piece toward the end of the course to help students increase the chances that their efforts to inspire change will take hold within their organizations. Among the article’s reasons for transformation failure are a lack of urgency, not getting the right people on board, and neglecting to create interim wins on the way to the ultimate goal.
Published as “On the Path to Better Care” in the Spring/Summer 2023 issue of Wharton Magazine.