In June of 2023, the U.S. Census Bureau announced the release of new data on hospital management practices. The data, collected through a partnership with Raffaella Sadun, PhD, MSc, the Charles Edward Wilson Professor of Business Administration at Harvard Business School (HBS), provides an important look into how the quality of hospital management practices affects efforts to improve clinical outcomes.
The data release is the latest step in work that began in 2018 with a Spark Grant awarded to Dr. Sadun and Alex Haynes, MD, MPH, titled “Measuring Management Practices at Scale.” Spurred by the question of why implementation of the WHO Surgical Safety Checklist was successful in some health care settings, but not in others, the team set out to understand the mechanisms within organizations that enabled or hindered implementation of quality improvement efforts. They drew on previous research conducted by Sadun in the context of the World Management Survey, insurance claims, and management practice data to analyze the relationship between basic management practices and Checklist implementation. At the conclusion of the grant, Dr. Sadun continued and expanded on the work with funding through HBS.
“The preliminary work completed with the Spark Grant was crucial to the evolution of this project. With the grant, we were able to build a foundational framework for sampling the data and test the survey questions that formed the basis of our data collection,” said Sadun.
Meghan Long, MHA, Assistant Director of the Ariadne Labs Innovation Platform, which oversees the Spark Grant program, said “The goal of the Spark Grant program has always been to kickstart innovative new ideas to close gaps in health care and improve how care is delivered. We’re thrilled to see the growth of this work and the impact it can have on quality of care.”
The new data set will play an important role in helping hospitals understand how management quality is linked to clinical outcomes and assess their own management quality.
“When we think about improving clinical quality, we often assume that outcomes depend on providers changing something about how they practice, and that hospital managers have the ability to influence those changes,” said Dr. Sadun. “But hospital managers can vary tremendously in their ability to manage change, and it’s not always easy to assess how they’re performing. This data helps to address that gap.”
The project provides the first at-scale measurement of managerial quality across US hospitals and is an important step in examining the role of hospital management in quality improvement efforts.