The start of a new year is a symbolic clean slate. It’s a chance to embrace fresh opportunities, set ambitious goals, and imagine what lies ahead.

It’s also a great time to pause for a moment of reflection. Before diving headfirst into the demands of work, school, or life’s daily rhythm, we can appreciate the journey we’ve traveled over the past year. It’s a chance to celebrate our achievements, reflect on the lessons learned and challenges faced, and carry forward the wisdom we’ve gained.

So, before we launch full steam ahead into the new year, let’s take a look back at some of the most compelling and memorable stories that defined 2024 on EmoryBusiness.com.

Welcoming Impressive Inaugural Classes to Two New Programs

Meet the Inaugural Cohort of Goizueta’s New Master in Management Program

One of Goizueta Business School’s newest additions is the Master in Management degree, a program for recent college graduates with liberal arts and science majors. Spanning 10 months, the program acts as a “fast track” option for students to gain business skills to complement their undergraduate work. Among the inaugural cohort, 38% graduated from an Emory University program, with a total of 84% of the class graduating from their undergraduate programs in 2024.

Meet the First Cohort of Goizueta’s New Master in Business for Veterans

Goizueta Business School launched a new graduate degree last year, and the first cohort of students started in May. The Master in Business for Veterans program is led by Retired U.S. Army Lieutenant General and Associate Dean for Leadership Ken Keen. The inaugural cohort of this working professional program includes 31 students. Among them are two Air Force, 19 Army, five Marines, and five Navy veterans and active duty service members. These men and women have decorated and accomplished backgrounds, including several careers of service to the United States.

Experiential Learning Opportunities Abound

MBA Students Explore Denmark’s Model for Work and Well-being

This summer, more than 25 MBA students from Goizueta Business School ventured out of the classroom and across the globe, traveling to Copenhagen, Denmark to explore how the Danes approach their short work week (standard 37 hours), while having some of the most productive companies in the world. The immersive experience is part of a new course at Goizueta, Life Design for the Modern MBA, focused on helping Goizueta students—who are passionate, ambitious, and often working in overdrive—to find meaning and fulfillment in both career and life.

Team Building with Taste: Lessons in Leadership from the Kitchen

At first, Yaqi Liu 26BBA wasn’t keen about getting up early on a Saturday to cook. But over the course of the day, Liu changed his mind. “It was a really good experience,” he says. That experience is called “Team Building with Taste.” It’s a cooking competition in the style of Bravo network’s “Top Chef,” except with the ultimate goal of improving team dynamics. The challenge is a part of the undergraduate BBA program’s Team Dynamics and Leadership class. Over multiple weekends this fall, student teams were given a $50 budget, a set time to plan and shop, and one hour to cook and plate their meals. The teams then presented their dishes to a panel of judges.

How HackATL Fosters Future Changemakers

A lot can happen in 48 hours. For Selina Kao 27BBA, that was the turnaround time afforded her team at this October’s HackATL competition. Their mission? Transform a fledgling business idea into an actionable plan. Hosted by The Roberto C. Goizueta Center for Entrepreneurship & Innovation of Emory University’s Goizueta Business School, this year’s event—powered by a dynamic collaboration between InnovATL, the City of Atlanta and the center—brought together more than 300 students from across the Southeast. After two days of frenetic brainstorming, building, and pitching transformative start-up initiatives to a panel of judges, the top teams took home over $13K in prizes.

Accomplished Alumni Create Meaningful Impact

Goizueta’s Veterans: Meet Matt Smith

In February 2025, Matt Smith 01MBA will retire as a two-star major general for the U.S. Army. His story is unique because of its many twists and turns. Smith joined the Army in college, before heading to the corporate world in Atlanta in the late 90s and enrolling in Goizueta Business School’s MBA program. However, it wasn’t long before Smith realized that the military was where he was meant to be. He resumed active duty for the Army in 2019, and in December 2022, he stepped into his current role as commander of the Joint Task Force – North. His team has helped federal agencies with interdepartmental coordination and assisted U.S. Border Patrol when they needed additional observation help. Smith says the skills he gained from earning an MBA have helped set him apart as a military leader. Now he’s he’s giving voice to Goizueta’s veterans as part of the advisory board for the new Master in Business for Veterans program.

Meet Marnie Harris: Building Hotels with Purpose

When Marnie Harris 20MBA was an undergraduate biomedical engineering student, she dreamed of building a more accessible world. Harris helped found The Excel Program at Georgia Tech, a certificate program for students with intellectual disabilities. When Harris graduated, she stayed on to welcome the first cohort of Excel students. But she soon came to believe that creating meaningful employment for this demographic must begin inside business, where the jobs are. So, Harris enrolled in Goizueta Business School’s MBA program, where she received the Woodruff Scholarship, Emory’s most prestigious named scholarship, awarded to Emory applicants who want to make a positive social impact. Now, Harris serves as the director of business and marketing strategy at Pavilion Development Company. There, she’s developing and franchising the Shepherd Hotels brand, which focuses on employing staff with intellectual disabilities.

Holistic Health Starts at Home: Meet Kyle Brown

After enrolling in the One-Year MBA program at Emory’s Goizueta Business School, Kyle Brown 20MBA became interested in holistic living and the various ways cannabidiol (CBD) could improve one’s health. Brown soon teamed up with his aunt, an expert gardener and advocate of natural medicine, who had long been growing her own herbs for healthful teas. The duo developed a series of CBD tea formulas, and ultimately launched their brick-and-mortar cannabis bar Bookstore Gallery. While its products assist in pain management on an individual level, Bookstore Gallery leads the charge of healing on a community level. Brown’s holistic healing mission comes to life through diverse events, including therapy-focused happy hours, game nights, tailgates, spoken word poetry, men’s mental health meetups, and creative outlets like “Puff and Paint.”

Groundbreaking Research from Goizueta’s Brightest Minds

Mitigating Bias in AI: Sharing the Burden of Bias When it Counts Most

From directions on Google Maps to job recommendations on LinkedIn, by now, we’ve all grown accustomed to AI systems’ integration in nearly every aspect of our daily lives. But are AI systems fair? The answer to this question, in short—not completely. Fortunately, some dedicated data scientists are working around the clock to tackle this big issue. One of those data scientists is Gareth James, who also serves as the Dean of Goizueta Business School as his day job. In a recent paper titled “A Burden Shared is a Burden Halved: A Fairness-Adjusted Approach to Classification” Dean James—along with coauthors Bradley Rava, Wenguang Sun, and Xin Tong—have proposed a new framework to help ensure AI decision-making is as fair as possible in high-stakes decisions where certain individuals—for example, racial minority groups and other protected groups—may be more prone to AI bias, even without our realizing it. 

Hiring More Nurses Generates Revenue for Hospitals

Underfunding is driving an acute shortage of trained nurses in hospitals and care facilities in the United States. American nurses are quitting in droves, and that’s bad news for patient outcomes. For beleaguered administrators looking to sustain quality of care while minimizing costs (and maximizing profits), hiring and retaining nursing staff has arguably become something of a zero-sum game in the U.S. But could there be potential financial losses attached to nurse understaffing that administrators should factor into their hiring and remuneration decisions? Research by Goizueta Professors Diwas KC and Donald Lee, as well as recent Goizueta PhD graduates Hao Ding 24PhD (Auburn University) and Sokol Tushe 23PhD (Muma College of Business), would suggest there are.

Training Innovative AI to Provide Expert Guidance on Prescription Medications

A new wave of medications meant to treat Type II diabetes is grabbing headlines around the world for their ability to help people lose a significant amount of weight. The two big names that come to mind are Ozempic and Wegovy. However, both medications come with a host of side effects, and are not suitable for every patient. Many clinics and physicians—particularly in smaller communities—do not have immediate access to expert second opinions needed to make decisions about prescription medications such as these. That’s one of the reasons Karl Kuhnert is using artificial intelligence to capture the expertise of physicians like Caroline Collins MD through the Tacit Object Modeler, or TOM. By using TOM, Kuhnert and Collins can create her “decision-making digital twin.” Though there are a number of ways TOM could be useful to the healthcare industry when prescribing medications, not least among them is the potential to expand access to the expert opinions of medical specialists to rural areas experiencing significant health disparities.

Help keep the great Goizueta stories coming with a gift of support to Emory’s 2O36 campaign.

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American nurses are quitting in droves, thanks to low pay and burnout as understaffing increases individual workload. This is bad news for patient outcomes. Nurses are estimated to have eight times more routine contact with patients than physicians. They shoulder the bulk of all responsibility in terms of diagnostic data collection, treatment plans, and clinical reporting. As a result, understaffing is linked to a slew of serious problems, among them increased wait times for patients in care, post-operative infections, readmission rates, and patient mortality—all of which are on the rise across the U.S.

Tackling this crisis is challenging because of how nursing services are reimbursed. Most hospitals operate a payment system where services are paid for separately. Physician services are billed as separate line items, making them a revenue generator for the hospitals that employ them. But under Medicare, nursing services are charged as part of a fixed room and board fee, meaning that hospitals charge the same fee regardless of how many nurses are employed in the patient’s care. In this model, nurses end up on the other side of hospitals’ balance sheets: a labor expense rather than a source of income.

For beleaguered administrators looking to sustain quality of care while minimizing costs (and maximizing profits), hiring and retaining nursing staff has arguably become something of a zero-sum game in the U.S.

The Hidden Costs of Nurse Understaffing

But might the balance sheet in fact be skewed in some way? Could there be potential financial losses attached to nurse understaffing that administrators should factor into their hiring and remuneration decisions?

Research by Goizueta Professors Diwas KC and Donald Lee, as well as recent Goizueta PhD graduates Hao Ding 24PhD (Auburn University) and Sokol Tushe 23PhD (Muma College of Business), would suggest there are. Their new peer-reviewed publication* finds that increasing a single nurse’s workload by just one patient creates a 17% service slowdown for all other patients under that nurse’s care. Looking at the data another way, having one additional nurse on duty during the busiest shift (typically between 7am and 7pm) speeds up emergency department work and frees up capacity to treat more patients such that hospitals could be looking at a major increase in revenue. The researchers calculate that this productivity gain could equate to a net increase of $470,000 per 10,000 patient visits—and savings to the tune of $160,000 in lost earnings for the same number of patients as wait times are reduced.

“A lot of the debate around nursing in the U.S. has focused on the loss of quality in care, which is hugely important,” says Diwas KC.

But looking at the crisis through a productivity lens means we’re also able to understand the very real economic value that nurses bring too: the revenue increases that come with capacity gains.

Diwas KC, Goizueta Foundation Term Professor of Information Systems & Operations Management

“Our findings challenge the predominant thinking around nursing as a cost,” adds Lee. “What we see is that investing in nursing staff more than pays for itself in downstream financial benefits for hospitals. It is effectively a win-win-win for patients, nurses, and healthcare providers.”

Nurse Load: the Biggest Impact on Productivity

To get to these findings, the researchers analyzed a high-resolution dataset on patient flow through a large U.S. teaching hospital. They looked at the real-time workloads of physicians and nurses working in the emergency department between April 2018 and March 2019, factoring in variables such as patient demographics and severity of complaint or illness. Tracking patients from admission to triage and on to treatment, the researchers were able to tease out the impact that the number of nurses and physicians on duty had on patient throughput. Using a novel machine learning technique developed at Goizueta by Lee, they were able to identify the effect of increasing or reducing the workforce. The contrast between physicians and nursing staff is stark, says Tushe.

“When you have fewer nurses on duty, capacity and patient throughput drops by an order of magnitude—far, far more than when reducing the number of doctors. Our results show that for every additional patient the nurse is responsible for, service speed falls by 17%. That compares to just 1.4% if you add one patient to the workload of an attending physician. In other words, nurses’ impact on productivity in the emergency department is more than eight times greater.”

Boosting Revenue Through Reduced Wait Times

Adding an additional nurse to the workforce, on the other hand, increases capacity appreciably. And as more patients are treated faster, hospitals can expect a concomitant uptick in revenue, says KC.

“It’s well documented that cutting down wait time equates to more patients treated and more income. Previous research shows that reducing service time by 15 minutes per 30,000 patient visits translates to $1.4 million in extra revenue for a hospital.”

In our study, we calculate that staffing one additional nurse in the 7am to 7pm emergency department shift reduces wait time by 23 minutes, so hospitals could be looking at an increase of $2.33 million per year.

Diwas KC

This far eclipses the costs associated with hiring one additional nurse, says Lee.

“According to 2022 U.S. Bureau of Labor Statistics, the average nursing salary in the U.S. is $83,000. Fringe benefits account for an additional 50% of the base salary. The total cost of adding one nurse during the 7am to 7pm shift is $310,000 (for 2.5 full-time employees). When you do the math, it is clear. The net hospital gain is $2 million for the hospital in our study. Or $470,000 per 10,000 patient visits.”

Incontrovertible Benefits to Hiring More Nurses

These findings should provide compelling food for thought both to healthcare administrators and U.S. policymakers. For too long, the latter have fixated on the upstream costs, without exploring the downstream benefits of nursing services, say the researchers. Their study, the first to quantify the economic value of nurses in the U.S., asks “better questions,” argues Tushe; exploiting newly available data and analytics to reveal incontrovertible financial benefits that attach to hiring—and compensating—more nurses in American hospitals.

We know that a lot of nurses are leaving the profession not just because of cuts and burnout, but also because of lower pay. We would say to administrators struggling to hire talented nurses to review current wage offers, because our analysis suggests that the economic surplus from hiring more nurses could be readily applied to retention pay rises also.

Sokol Tushe 23PhD, Muma College of Business

The Case for Mandated Ratios

For state-level decision makers, Lee has additional words of advice.

“In 2004, California mandated minimum nurse-to-patient ratios in hospitals. Since then, six more states have added some form of minimum ratio requirement. The evidence is that this has been beneficial to patient outcomes and nurse job satisfaction. Our research now adds an economic dimension to the list of benefits as well. Ipso facto, policymakers ought to consider wider adoption of minimum nurse-to-patient ratios.”

However, decision makers go about tackling the shortage of nurses in the U.S., they should go about it fast and soon, says KC.

“This is a healthcare crisis that is only set to become more acute in the near future. As our demographics shift and our population starts again out, demand for quality will increase. So too must the supply of care capacity. But what we are seeing is the nursing staffing situation in the U.S. moving in the opposite direction. All of this is manifesting in the emergency department. That’s where wait times are getting longer, mistakes are being made, and overworked nurses are quitting. It is creating a vicious cycle that needs to be broken.”

Goizueta faculty apply their expertise and knowledge to solving problems that society—and the world—face. Learn more about faculty research at Goizueta.

*Ding, Tushe, Kc, Lee: “Frontiers in Operations: Valuing nursing productivity in emergency departments.” Manufacturing & Service Operations Management 26:4:1323-1337 (2024)

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More than two million individuals in the US are experiencing Opioid Use Disorder (OUD). The CDC defines OUD as “a problematic pattern of opioid use that causes significant impairment or distress.”

Around 130 people die of opioid overdoses every day. Perhaps more startlingly, four million people over the age of 12 have reported using pain medication recreationally, including opioids. Prescription opioids are a highly-regulated class of drug. They interact with the opioid receptors on nerve cells throughout the body, as well as the brain, which reduces the intensity of pain signals to the body.

For many, they are a necessary prescription to get through the pain of surgery or injury, as the body heals itself. Unfortunately, the function of opioids in the body—releasing endorphins and boosting feelings of pleasure, as well as reducing pain—also make them highly addictive.

PDMP: A Successful Federal Mandate

The United States continues to see increases in deaths from opioid overdoses. So, federal and state governments have been working in enact policies that are designed to decrease those fatalities. One of the methods states are using to prevent common abuse patterns like “doctor shopping,” which is the pattern of visiting multiple physicians to obtain prescriptions, is the Prescription Drug Monitoring Program (PDMP), designed to be used in conjunction with Health Information Technology (HIT) programs. PDMP serve two purposes: identifying drug-seeking behaviors in patients, and identifying physicians with patterns of inappropriate prescribing.

Nearly all 50 states have enacted PDMPs of some degree. Some programs require physicians to check the PDMP before prescribing restricted pharmaceuticals, but in others it’s only suggested. Intrastate communication between PDMPs is not always possible, however.

The Unintended Consequences

The use of PDMPs has been shown to reduce the number of opioid prescriptions, the intended outcome of the program. Enter a recently published study by Diwas KC, Goizueta Foundation Term Professor of Information Systems & Operations Management. The research shows that during time the research was conducted, prescriptions for opioids declined by 6.1%.

However, the research also brought to light a very serious and unintended consequence of the implementation of PDMPs. The study concluded that while the implementation of PDMPs did reduce opioid prescriptions, it did not reduce overall numbers of prescription opioid deaths. In fact, it may have contributed to a 50% increase in heroin overdose fatalities.

“The heroin increase was definitely something we were not expecting, it was a total surprise,” says KC.

It was something that we had hypothesized. You’ve got a bunch of individuals who have used prescription opiates and had presumably been dependent. Now with the passage of this PDMP law, it has become more difficult to obtain prescription opiates. Therefore, some people might be forced to turn to the street version of it.

Diwas KC

“We didn’t expect the effect size it to be as significant as it is,” says KC.

Heroin and commonly prescribed opioids like oxycodone and hydrocodone are very similar on a biochemical level. What’s more, they generate a similar sensation in the body, according to KC. That’s why he and his team had the initial hypothesis that some addicted individuals, when unable to get prescription medication, might turn to street drugs, which are much more dangerous on many levels.

“There are many aspects to this. One has to do with the potency and the toxicity of the things you get on the streets. There are very little checks and balances on those. There’s no control in quality for sure,” KC says. He also notes the lack of checks and balances on the frequency of usage. “So the frequency of usage, the quality of the substances you’re putting inside your body, and possibly the circumstances of acquiring it might also be very risky too.”

A Dual Impact

The research concludes that mandating PDMP use is an example of a successful use of policy for intervention. It does, in fact, decrease the number of opioid prescriptions available to patients. That’s critical information for policy makers and physicians to take in. And it’s a solid reason to keep using and expanding PDMP usage, according to KC.

I should point out very clearly that the policy did have the intended effect of reducing prescriptions. So, it definitely benefited people who might otherwise have become addicted.

Diwas KC

“By reducing unnecessary prescriptions it might have limited the number of people who would have gotten hooked on the drugs in the first place. So there’s definitely the benefit of that,” says KC. “It’s just that when the policy was implemented, there was also this side effect because of people who were already using it. So, when those people were forced to look for alternatives, that’s when things got bad.”

Research papers like this one show an important side of using data to mark successes and failures of government policies. Taken on the surface, data can show a policy’s impact for the greater good. But a deeper dive into the surrounding data—like the increase in heroin use after the implementation of PDMPs—gives everyone a better idea of the full impact of this mandate.

Policies have intended as well as unintended consequences. In this case of PDMP it had the desired effect of reducing prescriptions. That probably helped a lot of people not get addicted to opiates in the first place.

Diwas KC

“But sometimes policies also have unintended consequences,” says KC. “Like in the case of people who were already addicted to painkillers suddenly stopping it, causing them to take drastic actions, and that’s what happened for some of the people in the study. Policies need to consider the possibility of unintended consequences and take actions to also mitigate those unintended consequences.”

Goizueta faculty apply their expertise and knowledge to solving problems that society—and the world—face. Learn more about faculty research at Goizueta.

The post Mandated Restrictions on Opioid Prescriptions Have Unintended—and Deadly—Consequences appeared first on EmoryBusiness.com.

“It’s an evolving process and a story of shifting bottlenecks,” explained Nikolay Osadchiy, associate professor, Information Systems & Operations Management, who has been paying close attention to the vaccine rollout. “Overall, from the vaccine development to the ongoing immunization, it’s been an incredible process with great progress.”

In late February, the Food and Drug Administration gave Johnson & Johnson the thumbs up for its coronavirus vaccine, paving the way for the company to join forces with the Moderna and Pfzier-BioNTech coronavirus vaccines, both of which were approved by the FDA in late 2020. “It’s good to see that these companies are working preemptively to keep [a manufacturing] bottleneck from happening,” Osadchiy added. According to Bloomberg.com, with the addition of the Johnson & Johnson vaccine, the U.S. should have enough doses to fully vaccinate 130 million Americans by late March.

Contract Manufacturing’s Role in Ramping Up Production

To meet the demand for their coronavirus vaccines, both Moderna and Pfizer-BioNTech have outsourced various aspects of their vaccine production to contract manufacturers. In January, Novartis signed a deal with Pfizer-BioNTech to receive bulk mRNA from the drug maker and fill the active ingredient into vials at its state of the art “aseptic” manufacturing plant in Stein, Switzerland, before shipping the vials back to Pfizer-BioNTech for distribution around the world. According to ContractPharma.com, Novartis is in talks with several other companies to provide similar manufacturing capabilities.

Likewise, Moderna has teamed up with Lonza, a global pharmaceutical contract manufacturer, to use its production capacity in the U.S. and Switzerland. In early March, the White House announced that pharmaceutical company Merck would help produce the Johnson & Johnson vaccine. Utilizing contract manufacturers to increase capacity comes at a premium. Osadchiy has talked with several major industry players and noted, “It’s a good time to be in the contract manufacturing business, as prices for their services have increased by up to 400%.”

To pay for increased vaccine administration capacity, states and local health systems have used financial resources earmarked for vaccine distribution via the stimulus bills passed by Congress. There is more money budgeted for vaccination efforts in the $1.9 trillion stimulus bill making its way through Congress now. “Money helps,” added Osadchiy.

Simplifying the Supply Chain with the Johnson & Johnson Vaccine

While the Johnson & Johnson vaccine may have different efficacy than the Moderna and Pfizer-BioNTech in preventing COVID-19 (it has a 66 percent rate of preventing moderate cases of COVID-19 while the other vaccines both exceed 90 percent), the Johnson & Johnson vaccine does boast 100 percent effectiveness against severe infection and death from COVID-19. It is also a single dose vaccine that requires nothing more than regular refrigeration. “Johnson & Johnson’s one dose vaccine does have appealing points,” explained Osadchiy. “We can prevent deaths with this vaccine, roll out vaccination more broadly, and get to herd immunity sooner.”

Coronavirus Variants Create Challenges

Dr. Anthony Fauci, chief medical advisor to President Joe Biden, believes that the coronavirus has undergone thousands of mutations since first being detected in humans. As a result, it’s likely that the coronavirus epidemic will become an endemic disease, one that is always present in the population and where booster shots are a constant necessity. That’s the bad news.

The good news? “These companies are already working on booster shots,” Osadchiy said.

The Effect of “No Shows” on Patient Behavior

Key to the effectiveness of the mass vaccination process is people’s behavior, noted Osadchiy. Even though vaccine manufacturing is on the increase, demand for vaccines exceeds available doses. As a result, people often look at multiple sites for inoculation appointments. If they book multiple appointments and show up for the first available, that can be a problem. When a patient forgets to cancel those unnecessary appointments, “capacity is wasted,” said Osadchiy.

In a 2016 research paper, “Are Patients Patient? The Role of Time to Appointment on Patient Flow,” Osadchiy teamed up with Diwas KC, professor of Information Systems & Operations Management, to study the effect of no shows on outpatient healthcare delivery. “We need to be proactive about how to manage no shows or multiple bookings,” Osadchiy said, suggesting that healthcare systems and vaccination sites utilize a “centralized queue” for appointments. “When people know they have a place in the queue, they are less likely to shop around,” Osadchiy explained. “Systems where slots for vaccines are released periodically and at somewhat unpredictable times create anxiety. So, people check multiple providers and schedule appointments with multiple providers. It’s important to avoid that.”

More controversial, noted Osadchiy, is deliberate overbooking for vaccinations to avoid wasting capacity due to no shows. “If done right, overbooking shouldn’t be noticed by patients,” said Osadchiy. “You’ll need to overbook very carefully and still provide vaccines to everyone on the same day you said you’d provide it. Otherwise, there will be a snowballing effect.”

Another potential roadblock is logistical coordination between the first and second shots for the two-dose vaccines, which need to be delivered 21 to 28 days apart, depending on which brand of vaccine a patient receives. “Luckily we have three to four weeks of lead time,” said Osadchiy. “There have been some reports of patients getting bumped from their second dose appointments, but in my opinion, this is totally preventable with planning—and barring a natural disaster.”

Ramping up Production of Vaccine-Adjacent Supplies

Products like syringes, glass vials, and the personal protective equipment necessary to distribute the vaccine are in high demand, but Osadchiy expects supply to keep pace with demand. “Free markets work well,” he explained. “Prices are at a premium. Manufacturers have a natural incentive to shift their capacity in those directions.”

“Give credit where credit is due.”

According to John Hopkins University of Medicine, vaccine development, on average, takes 5-10 years or more. That the coronavirus vaccine rollout is likely, at least in the U.S., to lead to herd immunity within two years of the virus’s appearance within the U.S. “is a very big achievement,” said Osadchiy. “From science, from manufacturing, from supply chain—all of it.” While there has been—and continues to be—a learning curve, “We need to give credit where credit is due,” Osadchiy added. ”Things are looking up. I am optimistic.”

Learn more about Goizueta’s faculty and research for Information Systems & Operations Management.

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Medical bodies, policy makers, and scholars alike question the ethics and efficacy of using (constrained) budgets to promote hospitals to patients. Diwas KC, professor of information systems & operations management at Emory University’s Goizueta Business School, and Tongil Kim, an assistant professor of management at Naveen Jindal School of Management in Texas, conducted a large-scale study of hospitals and patients in the state of Massachusetts to better understand the impact of hospital advertising.

What they found is striking: Not only does television advertising work, it significantly drives demand, attracting patients living far from the hospital and beyond its regular area. And that’s not all. KC and Kim discovered that limiting hospital advertising or imposing an outright ban, as some groups have called for, might actually have serious negative effects on patient healthcare.

“There has been a lot of discussion about banning advertising over recent years because of uncertainties around wasting money and resources,” KC said.

In the paper “Impact of hospital advertising on patient demand and outcomes,” KC shows that there is a correlation between the amount spent on TV advertising and the quality of the hospital in question. Healthcare facilities that invest more in advertising tend to be “better” hospitals, he adds; they offer higher caliber care and services and, as such, they see much lower patient readmission rates—a key quality metric in healthcare.

To get to these insights, KC and Kim looked at more than 220,000 individual patient visits to hospitals in the state of Massachusetts over a 24-month period. Among the data they collected were things like hospital type, location, and dollars spent on advertising. Patients were documented in terms of medical conditions, insurance, zip codes (to determine residence), and median household income.

They were able to contrast those hospitals that invested in television advertising and those that did not. With the former, they uncovered a significant uptick in patient visits, with people coming from far further afield. This was particularly true of wealthier patients.

Then there’s the question of patient outcomes.

Here the data showed unequivocally that it’s the high-quality, low-readmission hospitals that advertise more—something that KC attributes to the natural tendency to get “more bang for the advertising buck when the quality of your product or service is better.”

As for banning advertising, this would negatively impact these hospitals, he argues, limiting their ability to attract patients. It could also lead to an increase in population-level readmission rates.

“Patient readmission rates are one of the key metrics along with mortality rates that tell us how well a healthcare facility is working,” said KC. “If a patient gets discharged but has to come back to a hospital in, say, 30 days, unless it’s a chronic condition or ongoing treatment, it’s a good indication that the patient didn’t get the level of care they should have the first time.”

Indeed, “when we looked at all of the data, we found that the hospitals where there were fewest revisit rates were those that advertised more,” he said.

KC finds that a blanket ban on hospital advertising could lead to an extra 1.2 readmissions for every 100 patients discharged.

It’s a significant and “surprising” finding. And one that should inform the debate around healthcare advertising spend in the U.S.

“There’s also the idea that this is a zero-sum game because if a patient doesn’t go to hospital A, they’re just going to go to hospital B—the one that advertises more—splitting the pie in different ways but not increasing that pie,” KC said.

“What our study finds is that yes, advertising does draw patients away from one facility and towards another, but that the latter generally delivers better patient outcomes,” he said. “So, there is a social welfare benefit right there that suggests that you should not ban hospital advertising. There are real health benefits in allowing [advertising] to happen.”

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Healthcare delivery is a relatively untapped area in terms of academic investigation. This is perhaps a little surprising given the breadth of dimensions it offers researchers. From resource and capacity management to quality control, from productivity to decision-making under uncertainty, healthcare is a uniquely complex and rich space to explore, with the added potential to deliver substantive, real-world value in doing so.

So says Diwas KC, professor of information systems & operations management at Emory’s Goizueta Business School and a global authority on healthcare management.

For the last two decades, KC has explored many of the most pressing operational issues that healthcare systems face in the context of patient outcomes and spiraling costs. His research findings challenge basic assumptions about the way that modern hospitals should be managed, from the causal ties between sub-optimal triage frameworks and costly patient re-admittance to worker under-productivity and quality of care.

Balancing these operational challenges with the primary purpose of caregiving means that healthcare faces some of the most acute socio-economic issues of our time, noted KC, both in terms of complexity and scale. Rich pickings indeed for researchers.

“There are so many dimensions to healthcare delivery to investigate, and it’s a field that at the same time gives researchers a chance to make significant potential impact in care delivery,” KC said. “One of my research focuses is capacity management. Providers constantly have to figure out who to admit and who to discharge, and these are complex decisions characterized by trade-offs and uncertainty. And there are lots of insights, frameworks and tools from operations management that can be brought to bear both here and across all kinds of capacity allocation settings that define operational flow in hospitals.”

Since 2005, KC’s research has shed light on how to tackle the bottlenecks in patient flow through healthcare systems that tend to cluster around intensive care units — the most expensive resource in hospitals and, consequently, the most over-utilized.

Recently he has been interested in exploring the impact of policy and regulation in healthcare management and patient outcomes.

One of KC’s latest papers looks at another dimension of healthcare that has come under particular scrutiny from policy makers in recent times: advertising.

“In the U.S., some hospitals allocate a significant amount of budget on advertising, but until now it has been unclear whether this is effective in drawing in patients — and crucially, whether this kind of spending is wasteful given that it doesn’t directly impact caregiving.”

He finds that while advertising is successful in attracting patients from further afield and generating greater demand, it does not negatively impact patient outcomes. And it’s likely because the hospitals that spend money on ads also tend to be higher quality — so the more patients they draw in, the better the overall outcomes are in general.

It’s an insight, says KC, that can genuinely inform decision-making at the policy level — part of his goal of having real impact and finding real-world solutions to real-world problems.

Currently he is collaborating with Emory Healthcare, looking at potential ICU capacity shortages should there be successive outbreaks of COVID-19 in the U.S.

So, is he optimistic that American hospitals will have the resources and the wherewithal to overcome these unprecedented challenges?

“There is so much uncertainty about infection rates and a possible vaccine, and so many things that we still don’t know about this novel disease,” he said. “Something that does give me cause for optimism, however, is that we know more about the virus and how to more effectively mobilize our resources to treat it now than we did when it first emerged. But more than that, I have great belief in the capacity of the human spirit to prevail.”

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Do we dismiss bad news because we know better?

No one likes getting bad news. But grim tidings can, at least, inform our decisions and help us make better choices, right? Not necessarily, says Diwas KC, associate professor of information systems & operations management. Together with colleagues from UNC and Harvard, KC tested the hypothesis that we sometimes stick to pre-existing ideas even when bad news should reshape our perceptions. They looked at responses from 147,000 cardiologists to a 2016 announcement by the Food and Drug Administration criticizing a type of artery stent. While the doctors were generally less likely to use the stent following the news, it turns out that their views on it were also significantly influenced by their own experience and that of their peers. Not only that, but the more experienced they were, the faster they discounted the bad news over time. The study sheds new light on how we respond to bad news, and how perception and experience drive behavioral bias. Management Science (2019)

Calibration committees lead to better performance assessment

Most employees are dissatisfied with their company’s performance evaluation processes. This is one of the key findings of a new large-scale study conducted by Goizueta’s Karen Sedatole, interim dean and Goizueta Advisory Board Term Professor, in collaboration with the WorldatWork association. That said, there is one evaluation practice that consistently garners favor: calibration committees, which consist of peer supervisors or higher-level managers who assess performance ratings and adjust them to drive greater consistency across the organization. Surveying more than 250 WorldatWork members, Sedatole and colleagues found that 43 percent of organizations had been using calibration committees in recent years. Some 78 percent of the survey respondents reported that calibration committees were effective at reducing bias, while 82 percent said that they boosted consistency. These findings build on Sedatole’s previous research into calibration committees and their potential to attenuate the issues surrounding subjective performance evaluation. “Pay equity and even-handedness remain some of the most critical issues facing organizations,” she says. WorldatWork (2019)

Using customer data to value non-subscription firms

Deciding whether to buy or sell a company has historically boiled down to two things: sales growth and profits. Recently though, customer-based corporate valuation has been gaining traction on Wall Street and elsewhere. For “contractual” firms that operate a customer subscription system, tracking customer loyalty and engagement is relatively straightforward. But most businesses are non-contractual, making it harder to assess customer-based valuation. A new paper by Goizueta’s Dan McCarthy, assistant professor of marketing, addresses this. McCarthy and Peter S. Fader (Wharton) have developed a methodology that overcomes challenges such as unobservable customer churn and highly aggregated data—things that make customer-based valuation hard to assess. Their model crunches publicly available data like latent attrition, repeat purchasing and time-varying spend-per-purchase patterns to give new depths of insight into overall firm valuation. Not only that, says McCarthy, it also “permits external stake-holders to get beneath surface-level metrics like revenues, and to therefore better understand the underlying unit economics of these kinds of businesses.” Journal of Marketing Research (2018)

Racial stigmatization, employee performance and the tie to lower pay for all

Research shows that there is a tie between compensation and diversity: the more black, minority or female workers there are in a team or company, the more likely it is that salaries for everyone in that team or company will be lower. But new research by Erika Hall, assistant professor of organization & management, suggests that other factors like performance can make matters even worse than previously thought. Hall and colleagues ran two industry studies and a field experiment to determine whether performance can exacerbate or alleviate stigmatization. With poor-performing teams, they found that the presence of black coworkers drives even greater stigmatization and, as a consequence, lower salaries for everyone. This is likely because managers penalize a team under the guise of “poor performance,” but in reality are discriminating against a team with black teammates. When the team performed well, employers no longer had a plausible reason for discrimination, so compensation did not suffer. Hall warns that poor performance can mask racial discrimination within organizations’ culture. Moreover, the amplifying effect of poor performance on stigmatization extends to non-black employees: a lose-lose scenario that can lead to white employees distancing themselves from black colleagues to avoid stigmatization by association. Journal of Applied Psychology (2019)

Employees with families are more absorbed in work than single, childless peers

The ideal employee is single and childless—unencumbered by family responsibility and free to focus more on work. It’s a common perception across many sectors, and for people who are married or have children, the negative connotations can impact career advancement. But new research by Jill Perry-Smith, professor of organization & management, turns this idea on its head. Together with Tracy L. Dumas (Ohio State), Perry-Smith has found that employees who have a spouse or children are actually more absorbed in their work than their single, childless colleagues. Surveying 2,000 business school alumni and analyzing employee diaries, they found that family structures and associated after-work activities have a direct tie to how absorbed people actually feel in their work. “We discover that anticipating family chores or responsibilities after work actually reinforces the work mindset rather than distract from it,” says Perry-Smith. “It keeps employees more psychologically immersed in their roles.” The onus is now on organizations to “work harder to understand the diversity of employees’ nonwork lives,” she says. Academy of Management Journal (2018)

Is effective community action a case of going back to school?

Civic action can be hugely effective. From neighborhood watch to youth projects to traffic safety initiatives, civic engagement has the potential to make meaningful differences in communities. But what happens when communities become more diverse over time? Research by Goizueta organization & management faculty Wes Longhofer, Giacomo Negro and Peter Roberts looks at 30 years’ worth of data from UNICEF’s “Trick or Treat” campaign to find out.

They discovered that counties with greater racial or economic heterogeneity experienced declining fundraising performance, likely because of the fragmentation of shared interests and less interaction between diverse groups. Interestingly, they also found that among the different kinds of community organizations involved in sponsoring civic activities, schools significantly outperformed churches and clubs.

As such, schools could be better equipped not only to bring young people from diverse backgrounds together, but also to mobilize their families around a common goal. In light of this, Longhofer, Negro and Roberts urge the research community to adopt
a more general and systemic focus on schools as critical community organizers. Administrative Science Quarterly (2019)

Are recommendation systems skewing consumer choices?

Personalized recommendation systems can take the work out of deciding what to buy in the densely crowded online marketplace. In theory, they’re good for business too—driving loyalty and sales. But it’s not all win-win, according to new research by Associate Professor of Information Systems & Operations Management Jesse Bockstedt. And that’s because computerized recommendation system don’t just reflect consumers’ tastes—they can actually mold them. Bockstedt and colleagues from Carlson (U of Minnesota) and Kelley (Indiana U) ran a series of experiments, assigning random and erroneous recommendation ratings to downloadable songs. For each 1 star increase in ratings, participants were willing to pay up to 17 percent more for the song. And that’s problematic, says Bockstedt. If recommendation engines can manipulate choices this way, there’s the potential for consumers to buy products that are ultimately disappointing or to ignore products they may otherwise have purchased. Not only that, these anomalies can compound over time, as consumer feedback influences future personalized recommendations, creating a vicious cycle that further compromises prediction accuracy. A case of caveat venditor? Information Systems Research (2018)

Incumbents versus new players—the role of “legitimacy” in customer perceptions

What happens to incumbents when new players enter the market? Goizueta’s Özgecan Koçak, associate professor of organization & management, and colleagues have leveraged the recent legalization of recreational cannabis to investigate this. In 2012, Colorado became the first state to green-light cannabis for non-medical use, creating a domino effect across the country. The researchers used data from Weedmaps, a website, to look at how incumbent dispensaries (re)positioned themselves relative to the newcomers. In counties which had not voted for the legalization of recreational cannabis, they found a “sharpening” of identity among medical dispensaries, with customers typically referred to as “patients.” Conversely, in states where voters were in support of legalizing cannabis for non-medical use, the researchers found a “blurring” of medical and recreational identity in response to increasing competition from new dispensaries with recreational licenses. The study provides a useful framework that integrates local communities’ beliefs about the legitimacy of products to show how producers can (re)connect with current and potential customers. Organization Science (2018)

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Provost Dwight A. McBride convened the inaugural faculty pop-up, noting that it was “an opportunity to sample the incredible breadth of work going on at Emory.” Approximately 60 attendees were treated to presentations by George Easton, associate professor of information systems & operations management, who uses data analysis and statistics to tackle real-world problems; Diwas KC, associate professor of information systems & operations management, who focuses on understanding and improving the performance of service systems, with an emphasis on healthcare delivery; and Donald Lee, associate professor of information systems & operations management, whose research deals with statistical machine learning to build decision tools for complex systems, such as those in healthcare. Amy Chen, associate professor of otolaryngology and head and neck surgery at Winship Cancer Institute and Emory School of Medicine, also spoke about her research on collaborative decisionmaking within multi-disciplinary oncology conferences, coauthored with Jill Perry-Smith, Goizueta Foundation Term professor of organization & management, and Kate Yeager, assistant professor of nursing, Neil Hodgson Woodruff School of Nursing.

—MAT

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Goizueta’s Diwas KC is committed to finding solutions for hospital operations that could translate into real improvements in terms of cost management. Here are some highlights from a 10-year career in healthcare research that could leave hospitals and health centers in considerably better shape.

It’s a costly business. And it’s more complex than most. The healthcare industry in the United States faces the dilemma of constantly juggling cost and efficiency with patient care. The challenges are unique. Surprising, perhaps, is that academic research hasn’t prioritized the sector, particularly when it comes to business, operations, and the never-ending search for solutions to meet spiraling needs.

With the cost of keeping Americans healthy just south of 18 percent of GDP, the stakes are high.

But it’s not just about the money.

The healthcare system has a lot to balance: productivity, efficiency, capacity management and cost control. Add to that patient outcomes, and you get a prescription for complexity unlike anything facing other business sectors.

And the prognosis is complicated. Changing reimbursement schemes, the Affordable Care Act, and an aging population force hospitals to improve in multiple areas (and with fewer resources). Management science and operational theory can help. But the academic community has been relatively late in coming to the table.

While management science and behavioral theory could take up some of the slack in terms of exploring and framing solutions to needs and challenges, it’s only recently researchers have begun to look with acuity at how hospitals operate; and at what can be done to improve productivity, cost management and patient outcomes.

Diwas KC, Associate Professor of Information Systems & Operations Management, finds all of this a bit perplexing.

A pioneer in healthcare research, KC believes hospitals offer a particularly fertile environment for operations management research. His research challenges basic assumptions about the way hospitals can—and should—be managed. Since 2005, he has examined the unique operational issues hospitals face when addressing the continuing costcare dilemmas. He has found, for example, intensive care units that discharge patients without proper triage frameworks contribute greatly to the high-cost of re-admittance. Problems such as these are golden opportunities to explore how policy can improve patients’ choices.

The confluence of operational challenges balanced against the primary purpose of caregiving is such that the healthcare industry faces what KC describes as “some of the most pressing socioeconomic issues of our time – both in complexity and in scale.” A challenge, then, for academics to pursue research that has “real impact,” he says.

KC has spent the last 10 years exploring the unique operational issues hospitals face in addressing the on-going cost-care dilemma.

His work teases out the link between worker productivity and quality of care. And his findings, he says, have tended to be “surprising.”

Repurposing downtime

Spend a day in an average hospital and you’ll likely come away with the impression they are busy places: medical staff at maximum capacity and multitasking the norm.

In his paper Does Multi-Tasking Improve Performance? Evidence from the Emergency Department, KC challenges assumptions about the negative impact of multitasking on staff productivity. He finds that there is an optimal level – a kind of multitasking sweet spot – that can actually boost efficiency exponentially.

“Take the ER setting,” he says. “There is actually a considerable amount of downtime for doctors and nurses in this context, when they are waiting for lab work or X-rays for example. This is when they can perform routine tasks, or see other patients.”

Behavioral science sheds light on motivation and performance, says KC, meaning that there is an opportunity to reframe challenges and improve patient outcomes.

“Physicians typically falter when they feel bombarded with work,” he says. “But when things are presented as a ‘bit of a challenge’ they actually seem to thrive.”

Avoiding the bounce backs

Managing capacity is a major issue for hospitals – and nowhere more so in intensive care units. Cost is also a key factor.

KC’s research into capacity management in cardiac intensive care units, An Econometric Analysis of Patient Flows in the Cardiac ICU, reveals a critical link between how hospitals approach capacity and cost management and the potential for improved patient outcomes.

Current practice is such that a hospital will discharge a patient from the ICU to make room for intakes from the Operating Room – the principle criterion being capacity building. However when those patients are re-admitted, capacity remains an issue, costs increase and bottlenecking becomes a problem.

KC’s research finds that a triage approach to determine less severe conditions, combined with what he calls “step down” facilities offering less intensive care would significantly reduce the pressure on ICUs; reducing cost, improving patient care and mitigating the bounce back effect of readmission.   

Improving choices 

KC’s research also delves into the impact of policy and regulation on healthcare quality and patient care. As part of his on-going research, he has tracked the behavior of patients who had taken out health insurance in the wake of the Massachusetts Healthcare Act.

He has, so far, determined two effects of this kind of policy change.

The so-called “safety-net” hospitals that had provided care to uninsured patients prior to the reform have lost market share. But this is offset by an improvement in care for newly insured patients who are now able to pinpoint the hospital that best meets their short-, mid- and long-term needs. 

“I want to research a field where the work you do can have real impact – to break down the noise and find real-world solutions to real-world problems,” he says. “In healthcare, there are multiple players and multiple decisions that aren’t made in isolation. So it’s difficult to make changes. But the magnitude of the problem and the need for quality and cost-effective care make this a field of study that is as compelling as it is vital for the health of the U.S.”

About the Expert

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Managing style and product design

Mobile phones look very different now than they did ten years ago. With access to all of the design patents available from the US Patent & Trademark Office (including ones from products in the telecommunications industry), Tian Heong Chan, assistant professor of information systems & operations management, and coauthors Jürgen Mihm (INSEAD) and Manuel E. Sosa (INSEAD) show how one can cluster them according to their visual similarities. The process results in an evolutionary timeline charting the successive styles of mobile phones from “clamshell” to “touchscreen slate” and everything in between. This approach creates a novel data platform from which researchers can start testing hypotheses about how product forms evolve. With the data, the authors show that there is increasing turbulence (or unpredictability in the change in product forms) across all product categories. In other words, it is much harder now than in the past to predict what the next hot style will be based on current trends. This is especially salient in non-tech categories, such as furniture and fashion. The authors conclude that companies with the capability to manage this increasing uncertainty will have a significant competitive advantage in the future. Management Science (2017)

Relational signaling and gift giving

Prior research indicates that gift givers are motivated by competing goals. Often, they will simply select an item of the recipient’s choosing. However, gift givers are also likely to select an item on their own to help show knowledge of the recipient and further define and maintain a personal connection. Morgan Ward, assistant professor of marketing, and coauthor Susan Broniarczyk (U Texas) take the research a step further by analyzing how the closeness of a relationship further impacts the gift-giving decision when a gift registry is readily available. The duo employed five separate studies with human subjects presented with various gift-giving scenarios. The paper notes, “We find that despite their stated primary intention to please recipients, close (vs. distant) givers ultimately are more likely to ignore recipients’ explicit registry preferences in favor of freely chosen gifts.” Ward and Broniarczyk conclude that divergence from the registry was not necessarily about finding a better gift. Instead, it occurred only when givers specifically received attribution for their selection. The closeness of the personal connection resulted in a “perceptual distortion of the gift options in favor of relational-signaling gifts.” Distant givers were much more likely to pick an item from the registry, selecting gifts closely aligned with recipients’ preferences. Journal of Marketing Research (2016)

The link between corporate alliances and returns

Strategic alliances are agreements between two or more firms to pursue a set of agreed upon objectives while remaining independent organizations. Alliances are formed for a number of reasons, including licensing, marketing or distribution, development or research, technology transfer or systems integration, or some combination of the above. Tarun Chordia, R. Howard Dobbs professor of finance, and coauthors Jie Cao (Chinese U of Hong Kong) and Chen Lin (U Hong Kong) find evidence of return predictability across alliance partners. If the alliance partner or partners have high (or low) returns this month, then the firm has high (or low) returns over the next two months. Using a sample of alliances over the period 1985 to 2012, the authors find that a long-short portfolio sorted on lagged one-month returns of strategic alliance partners provides a return of over 85 basis points per month. This long-short portfolio return is robust to a number of specifications, including different adjustments for risk, controlling for different proxies for cross-autocorrelations, and excluding partnerships with customer-supplier relationships, as well as controls for industry returns. They theorize, “If investors are fully aware of the impact of strategic alliances on returns and pay attention to the firm-partner links, then the stock price of a firm should quickly adjust to price changes of its partners’ stocks.” The evidence suggests that investor inattention may be the source of a firm’s underreaction to its partners’ returns. Journal of Financial and Quantitative Analysis (2016)

Understanding the influence of mobile promotions

Michelle Andrews, assistant professor of marketing, and coauthors Jody Goehring (RetailMeNot), Sam Hui (U Houston), Joseph Pancras (U Conn), and Lance Thornswood (JCPenney) cull together divergent streams of research to provide a framework to better understand how mobile promotions influence the in-store shopping behavior of consumers. Online promotions allow merchants to reach shoppers easier and faster, enabling traditional stores to text out online discounts or highlight specific products. Merchants can also use geolocation on mobile phones to text and target shoppers once inside of their store to feature merchandise or advertise a special offer. The authors identify a number of key areas for additional research to “enable long-term, value enhancing relationships between consumers and marketers.” For instance, they note the need for a better understanding of the role of privacy concerns on personal data collection via mobile devices. Andrews and coauthors also find that a deeper investigation of such things as return on investment, loyalty programs, upselling, proximity to purchase, and global promotions are required to get a true sense of the effectiveness of mobile promotions. Journal of Interactive Marketing (2016)

Significance of pricing and product-line strategies

In new research, Ramnath Chellappa, associate professor of information systems & operations management, and coauthor Amit Mehra (U Texas) investigate the business practice of IT “versioning,” whereby a company creates different models of a product in order to charge varying prices for each one. Much research takes into account economies of scale and a company’s marginal costs—the price of making an additional unit of a product. However, Chellappa and Mehra note that companies also need to consider consumer usage costs when they decide to create various versions of the same IT product. But for IT products and services, the “costs” are not monetary. The pair note the “time commitment and physical effort” to use IT products or services. They use the example of mobile devices: “One cannot enjoy these information goods without them consuming resources such as memory and processing power.” They determine that “this consumption-related disutility” is critical to feature bundling and consumer segmentation. The researchers create a model to test the consumer cost impact, using a “digital goods firm with a unique production cost structure and agents—consumers who face resource constraints in consuming these goods.” Given the usage costs, they determine that individuals may not necessarily prefer products with more features to lower-quality items. The pair concludes “marginal cost and consumers’ usage costs have the same impact on versioning strategy.” Management Science (2017)

The impact of behavioral bias on decision-making

For business leaders, the ability to make critical decisions in a dynamic work and industry environment is essential to the success of an organization. However, Diwas KC, associate professor of information systems & operations management, and coauthors Francesca Gino (Harvard U) and Bradley R. Staats (UNC) note that behavioral traits can sometimes impact the ability to weigh new information and make a logical decision, even in the face of negative news. KC, Gino, and Staats analyze 147,000 choices made by cardiologists during a six-year period when they were presented with negative news from the FDA about drug-eluting stents used in angioplasty. The experienced cardiologists were more likely to continue using the questionable stents than their less-experienced peers, even after being informed of the problem. The role of influence also played a factor in the decision-making. They add, “Given that those who feel they are expert are less likely to react to negative news, those around them show the same tendency, thus making worse decisions than those in groups with less perceived expertise.” The seasoned cardiologists were better able to “generate counterexamples to the negative news and thus be susceptible to confirmation bias.” The authors note managers should be aware that more experience and the perception of expertise may bias decision-making. Management Science (2017)

The process behind auditor judgement

Auditors are required to use considerable judgment in their job, assessing information from a number of sources to create financial reports, critique accounting estimates, and assess a company’s internal controls over financial reporting. But an auditor’s decision-making process is not well understood. In their paper, Kathryn Kadous, professor of accounting, and coauthors Emily E. Griffith (U Wisconsin) and Donald Young 13PhD (Goizueta, Indiana U) provide a framework for researchers to better evaluate the judgment of auditors and, in turn, improve audit quality. Prior research in this area presumes that “decision makers typically engage deliberate, analytical processes to solve problems (i.e., pursue goals) that they have specifically chosen, that they limit their decision inputs to items they view as relevant, and that they have access to the details of their own cognitive processing.” The trio notes that “nonconscious goals” and “intuitive processes” are also influential in the decision-making process and in the factors driving these processes. Kadous, Griffith, and Young conclude that their framework indicates researchers approach their investigation by taking into account “conscious and nonconscious goals” and “decision makers with conflicting incentives, as well as differing capabilities.” Auditing: A Journal of Practice & Theory (2016)

The role of the economy on individualism

Past work has shown that as countries become wealthier, people often become more individualistic. In new research, Emily Bianchi, assistant professor of organization & management, takes the investigation a step further and finds that even subtle fluctuations in the economy are associated with changes in individualism. She finds that during good economic times, Americans are more likely to seek out ways to signal their uniqueness and individuality. For instance, during boom times, Americans tend to give their children more uncommon names and are more likely to prize autonomy and independence in child-rearing. They are also more likely to favor music featuring self-oriented lyrics. Conversely, during recessions, Americans tend to focus more on fitting in and tend to give their children more common names, listen to more relationally oriented music, and encourage their children to get along with others. Additionally, Bianchi discovered that recessions engender uncertainty, which, in turn, decreases individualism and encourages interdependence. The study results indicated that the “link between wealth and individualism is driven not only by differences in how people live, work, and learn but also by their sense of the predictability, orderliness, and certainty of the surrounding environment.” Journal of Personality and Social Psychology (2016)

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