Stanford Exec Research

FACULTY RESEARCH SPOTLIGHT Current Research and Insights from Stanford Graduate School of Business Professors

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EXPLORE THE RESEARCH-BASED THINKING THAT DRIVES STANFORD LEAD CERTIFICATE The opportunity to learn from and engage with renowned Stanford Graduate School of Business (GSB) faculty is integral to the Stanford LEAD Certificate experience. In this special collection of recently published articles, Stanford GSB professors present their current research and insights on a wide range of business topics and trends—a sampling of the innovative ideas and thought leadership that are the foundation of the Stanford LEAD Certificate: Corporate Innovation program.

TABLE OF CONTENTS

Page3

William P. Barnett Page 4

Business Leaders Should Not Avoid Competition Page 6

Margaret Ann Neale Page 7

Does Breaking Bread Help Make a Negotiation a Success?

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Jeffrey Pfeffer Page 10

Ten Tips for Building Stronger Networks in Work and Life Page 12

Stefanos Zenios Page 13

Health Care: The Benefits of Human-Centric Design

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WILLIAM P. BARNETT

WILLIAM P. BARNETT Thomas M. Siebel Professor of Business Leadership, Strategy, and Organizations; Codirector of the Executive Program in Strategy and Organization; Affiliated Faculty, Woods Institute for the Environment at Stanford William Barnett is the Thomas M. Siebel Professor of Business Leadership, Strategy, and Organizations at the Graduate School of Business, Stanford University. After receiving his PhD in Business Administration from the University of California, Berkeley, in 1988, Barnett was an Assistant Professor at the University of Wisconsin, Madison, School of Business. In 1991, Barnett came to the Stanford Business School as an Assistant Professor. He became an Associate Professor in 1994 and received tenure in 1996, and has been a full professor since 2001. Barnett has twice been a Fellow at the Center for Advanced Study in the Behavioral Sciences, and is an affiliated faculty member of the Woods Institute for the Environment at Stanford University. Barnett serves as a senior or associate editor for several academic journals.

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BUSINESS LEADERS SHOULD NOT AVOID COMPETITION Do you send your children to the least demanding school you can find? Of course not. What kind of parent are you? You know that they need to measure up to a high standard in school if they are to do well in life.

the Korean steel firm Posco came up with the “finex” process, this innovation raised the bar for any firms wanting to compete in the global steel business. Those steel firms that kept pace are still competing today. Similarly, when Qualcomm revolutionized digital wireless transmission by making CDMA technology workable, this put pressure on every other firm in that space to respond. Apple, Samsung, Nokia, Ericsson, LG, and many other firms engaged in that competition for years. Some still are competing but only by remaining innovative.

Yet every day I hear business leaders claim that they want to avoid competition. Are you one of these leaders? What kind of leader are you?

Of course, when organizations compete, they make it difficult for each other to perform well. But this fact has led to a great misunderstanding. Many business leaders, especially those trained in business schools, infer from this fact that they should avoid competition. That conclusion is wrong.

The result? Well, to the firms involved it can feel like they are running in the same place since each is evaluated relative to the others. But for the rest of us, we’ve seen clunky wireless phones transform into sleek mobile devices.

Pressure from competition causes people to search for ways to improve their company’s performance.

These improvements, in turn, make companies stronger competitors. So now these improved firms put more pressure on their rivals, who must also find a way to improve. Once those rivals improve, they now are stronger competitors, starting the whole cycle over again. So it is that competition causes organizations to learn, which in turn intensifies competition in a self-accelerating process known as the “Red Queen” effect. This term was coined by the evolutionary theorist Van Valen in reference to Lewis Carroll’s Alice who remarks to the Red Queen: “Well, in our country, you’d generally get to somewhere else—if you ran very fast for a long time, as we’ve been doing.” To this the Red Queen responds: “A slow sort of country!

Now, here, you see, it takes all the running you can do, to keep in the same place.” Van Valen noted that biological evolution features such change. In my book, I demonstrate that in an ecology of learning organizations, relatively stable performance masks absolute development.

As a consumer, you probably think of this amazing record of innovation as something that was inevitable. But this development did not have to happen. Each innovation along the way was carried out by a firm as it attempted to do a better job, in turn raising the bar for others. So perhaps for a while your device could not map correctly, but by now the problem has been fixed. Competition still thrives in the wireless industry, so each manufacturer keeps pressuring its rivals to do a better job.

Yet according to many, firms are supposed to find a way to avoid competition—to gain positional advantage or locate in “blue oceans” where rivalry is weak. Had Qualcomm, Apple, LG, Samsung, and the others taken this advice, how different the wireless industry would be. (Indeed, many experts on the telecommunications industry argued just a few years ago that it was a natural monopoly, where competition would be ruinous!) Avoiding competition would be more comfortable, for sure.

But avoiding competition is just a way to shut down the engine that generates innovation.

The Red Queen is at work around us all the time, triggering progress on many fronts. When

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William Barnett, Stanford Graduate School of Business

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William Barnett, Stanford Graduate School of Business

But, you might say, surely competition is bad for an organization’s performance. Don’t monopolists outperform other firms? Isn’t that why so many companies are trying to dominate their markets?

Well, yes, in the short run a monopolist performs better than a firm facing rivalry (other things equal). But over time, that monopolist gets lazy.

Meanwhile, firms facing competition continue improving. If fact, I estimated the statistical effects of Red Queen competition on hundreds of firms over many, many years, and found a pattern.

Comparing inexperienced firms, the monopolist performs better. But over time experience makes the firms facing rivalry improve, eventually becoming better performers than had they found a way to be a monopolist. That is the Red Queen effect. As a firm competes, it becomes more capable, and so performs better. Even though its rivals also perform better, the net effect turns out to be beneficial in time. Highly competitive markets, over time, feature some of the world’s most capable and innovative companies.

Reflect on your role as a business leader. Is your job to shield your company from competition? Not if you want it to learn and improve. Shortsighted business leaders hide their companies from competition. Great leaders do just the opposite: They understand that competition teaches.

So what kind of leader are you?

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MARGARET ANN NEALE MARGARET ANN NEALE Adams Distinguished Professor of Management; Director of the Managing Teams for Innovation and Success Executive Program; Director of the Influence and Negotiation Strategies Executive Program; Codirector of the Executive Program for Women Leaders Margaret Neale is the Adams Distinguished Professor of Management. She was the Graduate School of Business John G. McCoy-Banc One Corporation Professor of Organizations and Dispute Resolution from 2000-2012, and Trust Faculty Fellow in 2011-2012 and in 2000-2001. From 19972000, she was the Academic Associate Dean of the Graduate School of Business at Stanford University. Prior to joining Stanford’s faculty in 1995, she was the J.L. and Helen Kellogg Distinguished Professor of Dispute Resolution and Organizations at the J.L. Kellogg Graduate School of Management at Northwestern University. She received her Bachelor’s degree in Pharmacy from Northeast Louisiana University, her Master’s degrees from the Medical College of Virginia and Virginia Commonwealth University, and her PhD in Business Administration from the University of Texas. She began her academic career as a member of the faculty at the Eller School of Management of the University of Arizona.

Professor Neale’s major research interests include bargaining and negotiation, distributed work groups, and team composition, learning, and performance. She is the author of over 70 articles on these topics and is a coauthor of three books: Organizational Behavior: A Management Challenge (third edition) (with L. Stroh and G. Northcraft) (Erlbaum Press, 2002); Cognition and Rationality in Negotiation (with M.H. Bazerman) (Free Press, 1991); Negotiating Rationally (with M.H. Bazerman) (Free Press, 1992); and one research series Research on Managing in Groups and Teams (with Elizabeth Mannix) (Emerald Press). She is or has served on the editorial boards of the Administrative Science Quarterly, Journal of Applied Psychology, Organizational Behavior and Human Decision Processes, International Journal of Conflict Management, and Human Resource Management Review.

In addition to her teaching and research activities, Professor Neale has conducted executive seminars and management development programs in the United States, United Kingdom, Australia, Holland, Switzerland, Brazil, Thailand, France, Canada, Nicaragua, the People’s Republic of China, Hong Kong, United Arab Emirates, Mexico, Israel, and Jamaica for public agencies, city governments, health care and trade associations, universities, small businesses, and Fortune 500 corporations in the areas of negotiation skills, managerial decision making, managing teams, and workforce diversity. She is the faculty director of three executive programs at Stanford University: Influence and Negotiation Strategies, Managing Teams for Innovation and Success, and the Executive Program for Women Leaders.

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DOES BREAKING BREAD HELP MAKE A NEGOTIATION A SUCCESS? People negotiating a deal commonly have a meal or two together. Sharing a meal seems a gesture of goodwill—after all, who’s going to fight in one sentence and then say “pass the sushi” in the next?

You might suppose, then, that negotiating while eating can only help bring good deals to fruition.

Neale: In a competitive situation, you have that assessment that this is going to be really tough.

We are really at odds. In the laboratory we can tell folks: this is a very contentious negotiation.

How did you do the research?

Not so fast. While such thinking propels the lunchtime scenes everywhere from the Four Seasons in New York City to Chateau Marmont in Los Angeles, new research from Stanford Graduate School of Business calls it into question.

Belmi: We told participants they were negotiating in either a competitive or a cooperative situation, and then we asked them to negotiate while they ate food that was either shared or individually served during the interaction. At the end of the exercise, we measured their perception of the interaction and assessed value creation by examining the joint gain created by the two parties. We used apples and caramel sauce in one study, and then we used chips and salsa in another study. What we found is that when people were negotiating in a competitive situation, sharing the food—and by that we mean sharing, not just eating—they created significantly more value. On the other hand, people negotiating in a cooperative situation created less value.

Professor Margaret Neale and doctoral student Peter Belmi find that sharing food does help create more valuable deals in competitive negotiations.

But in situations that are cooperative, such as when the two parties are friends, meal sharing reduces the overall value of the deal.

What are the two or three lessons a negotiator could draw from this research?

Neale: Food sharing would be one of my tools in my tool kit. Having a meal where you share food would be a good strategy in a competitive situation where there is an adversarial relationship. If you’re going to a lawyer’s office, and it’s you negotiating with your soon-to-be ex-spouse, you might want to suggest a plate of cookies on the table. If you are negotiating to end a dispute with another company, plan a meal at a restaurant.

What’s your explanation for what’s going on?

Neale: When you have a competitive negotiation, the added presence of food makes folks uncertain about how to behave. It’s that juxtaposition of that social ritual, which is cooperative, and the negotiation, which is competitive. That disconnect gets people to pay more attention to each other.

They realize opportunities to create value that they wouldn’t otherwise.

Belmi: On the other hand, if you have a cooperative negotiation, food sharing may facilitate a quick resolution but not necessarily a good resolution. So it might not be a good idea in a cooperative negotiation.

What happens in the cooperative negotiation? Is everyone just more relaxed and not focused on the deal at hand?

How do you tell the difference between the two?

Belmi: In a cooperative negotiation, sharing food creates a comfortable and familiar environment, and people can become more concerned about maintaining that atmosphere rather than finding the best deal. So, food sharing in that situation could restrict important information exchange and

Belmi: In more competitive negotiations, people want to have the best possible deal for themselves, and typically, they see their counterpart as having adversarial or opposing motives. In cooperative negotiations, typically people are more concerned about reaching an agreement for all parties involved.

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Margaret Ann Neale Stanford Graduate School of Business

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Margaret Ann Neale Stanford Graduate School of Business

What’s different about food, then? The biology?

The ritual surrounding it?

distract negotiators from finding the best outcomes.

You’re also probably concerned about maintaining the relationship. The deal may be less important.

Neale: Food sharing is cooperative and communal in a way that sharing a calculator is not. Sharing a calculator is slightly cooperative, but it doesn’t have the same kind of social overlay. With whom do we share food? Our families, people in our social circle. It’s the inconsistency between the competitive negotiation and the cooperative nature of sharing food that makes the difference.

The lesson here is that you’re really trying to generate a sense of uncertainty. That helps you pay closer attention to your counterpart, and that, in turn, allows you to find ways to create more value.

Does it matter what people eat?

Neale: It is the shared-ness of the food that’s important. In one of the studies, some participants were given their own plates of chips and salsa, and some were given a communal bowl. Those who ate from a communal bowl and were in a competitive negotiation created more value, and those who were in a cooperative situation created less value. It was the communal bowl that made the difference, not eating.

The suggestion might be: If you’re in a competitive negotiation, take someone to an Ethiopian restaurant!

Or, order appetizers. Did this research address the effect of sharing food in cultures outside California?

Neale: We did not look at different cultures specifically; however, the ritual of sharing food among humans is typically a cooperative one— and not just in California or the United States.

So, the specific answer to your question is no; however, we would not be surprised if sharing food has a similar effect on negotiators from other countries and other cultures.

Is there more research to be done?

Neale: One area to consider is what happens when people bring the food instead of being given it. Does that affect the status of the giver and the receiver?

Isn’t it possible that sharing anything—not just food—would create the same effect?

Belmi: It’s not the effect of sharing in general.

We had study participants share a calculator and didn’t see a similar difference in how our participants approached the negotiation.

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JEFFREY PFEFFER

JEFFREY PFEFFER Thomas D. Dee II Professor of Organizational Behavior Dr. Pfeffer received his BS and MS degrees from Carnegie-Mellon University and his PhD from Stanford.

He began his career at the business school at the University of Illinois and then taught at the University of California, Berkeley. Pfeffer has been a visiting professor at the Harvard Business School, Singapore Management University, London Business School, Copenhagen Business School, and for the past nine years a visitor at IESE in Barcelona.

From 2003-2007, Pfeffer wrote a monthly column, “The Human Factor,” for the 600,000-person circulation business magazine, Business 2.0 and from 20072010, he wrote a monthly column providing career advice for Capital, a leading business and economics magazine in Turkey. Pfeffer also was a regular blogger for the Corner Office section of BNET (CBS Interactive), and for the Harvard Business Review website, Bloomberg Business Week online, Inc., Time, the CEIBS Business Review (China), and for the “On Leadership” section of The Washington Post.

Pfeffer currently writes a bi-monthly column exclusively for Fortune and Fortune. com. Pfeffer has appeared in segments on CBS Sunday Morning, 60 Minutes, and CNBC as well as television and radio programs in Korea and Japan and has been quoted and featured in news articles from countries around the globe.

Pfeffer currently serves on the board of directors of the nonprofit Quantum Leap Healthcare. In the past he has served on the boards of Resumix, Unicru, and Workstream, all human capital software companies; Audible Magic, an internet company; SonoSite, a company designing and manufacturing portable ultrasound machines; and the San Francisco Playhouse, a nonprofit theater.

Pfeffer has presented seminars in 38 countries throughout the world as well as consulting and providing executive education for numerous companies, associations, and universities in the United States.

Jeffrey Pfeffer has won the Richard I. Irwin Award presented by the Academy of Management for scholarly contributions to management and numerous awards for his articles and books. He is listed in the top 25 management thinkers by Thinkers 50, and as one of the Most Influential HR International Thinkers by HR Magazine. In November, 2011, he was presented with an honorary doctorate degree from Tilburg University in The Netherlands.

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TEN TIPS FOR BUILDING STRONGER NETWORKS IN WORK AND LIFE Time Counts

Most people understand that to be successful, they need to network. But actually going out and doing it is another matter. People “are daunted by the task and believe it requires inauthentic, uncomfortable behavior and is an activity that is inconsistent with focusing on job performance,” says Jeffrey Pfeffer, a Stanford professor of organizational behavior, who covers the subject of networking as part of his Paths to Power elective course. Too often, he says, people view networking “as something that ‘is not them’ or that they could not see themselves doing.”

Research by University of Chicago professor Ronald Burt shows that “being even one step removed from the person within the network almost completely reduces the benefits to you,” the authors wrote. “Simply put, networking is not something that can, or should, be outsourced.”

Find a Mutual Connection “People are the name of the game—you must understand how to read people quickly and find what you have in common,” says Walker. “With so much public information out there, this is easier to do today.” You are more likely to get a response from someone if you have already found a shared interest or acquaintance in advance of introducing yourself.

But in a new e-book coauthored with Ross Walker, a 2005 graduate of Stanford’s MBA program, they argue that networking ability is not just important for career success—“it is also crucial for getting things accomplished and making change inside organizations in both the public and private sector.”

Create a Robust Network Walker was initially interested in working in the hospitality business, and through his research learned that alumnus Chip Conley had founded the boutique hotel chain Joie de Vivre Hospitality while he was still in his mid-20s. When Walker finally reached out to Conley, the 1984 Stanford GSB graduate had already heard of him. “I got hit by three different people simultaneously saying ‘you have to meet Ross Walker,’” Conley recalled, according to the case study. “All of a sudden, you have him on your radar in a big way.”

The authors draw on Walker’s experience, which was shaped by an “ability to build relationships and an efficient and effective social network,” they write. Walker became one of the youngest members to serve on the Stanford Board of Trustees; found a career in his chosen field of real estate, where he has a successful real estate investment fund; has equity in Hollywood nightclubs; and has a small ownership stake in the Oakland Athletics Major League Baseball team.

Be Specific

While at Stanford, Walker had a reputation for being a big-tent person. He planned events and themed parties that not only were entertaining but also brought people together. These events naturally led to networks that would last beyond his time at Stanford, but Walker’s ability to make connections did not stop there, says Pfeffer, who was so impressed that he wrote a case study charting Walker’s networking efforts.

CEOs are busy people and therefore are unlikely to respond to vague requests or take on the burden of finding ways to help you. Help them to help you by making a specific request. For instance, when Walker met Conley, he submitted a brief one-page proposal to Conley in which he asked for an internship and offered to work for the summer without compensation. The reason: “Walker believed that you could not let highprofile executives think for you. … [It is] better to give them something tangible to consider, because once you’ve left their presence, they are not going to spend more time thinking about you.”

They teamed up to write People Are the Name of the Game: How to Be More Successful in Your Career—and Life. Here are some tips from the book.

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Jeffrey Pfeffer, Stanford Graduate School of Business

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Jeffrey Pfeffer, Stanford Graduate School of Business

Be Diverse

subject line. I try to write something there that reflects a connection. For example, if you are a student and you are contacting an alumnus, I might write ‘Current Stanford GSB Student Inquiry,’ as I know that most alumni enjoy hearing from current students for a number of reasons.”

Clearly, it is important to link up to the influencers in your intended field. But do not underestimate the importance of “weak ties.” It is important to create a diverse network—diverse people, diverse industries, and diverse locations—even though these connections may seem remote to your present career or contemplated future. Diversity can also help when seeking funding for a startup.

Stay in Touch and Give Back An easy way to keep in touch with those in your network is to send them emails now and then, introducing them to people who will be helpful additions to their networks. And, like Walker does, respond when others seek to add you to their circles.

Do What You Say You Will “Do not overpromise and underdeliver, but instead, maintain credibility by doing the followup work to always meet your commitments,” the authors write. “In financial parlance, it is easier to exceed expectations if those expectations are not completely over the top or in your face.” By keeping your promises, your reputation spreads throughout your network. “The action of ‘moving things from A to B’ or following through as promised builds a surprisingly rare reputation that can be leveraged in a number of ways as it builds the confidence of others,” write Pfeffer and Walker.

Be Genuine The coauthors say that the more you pursue your passion, the more compelling your story will be when you share it with someone either by email or in person.

Think Long-Term When Walker sought investors for a real estate fund he was creating, his connections led him to a billionaire CEO in Silicon Valley, who asked Walker how much he wanted him to invest.

Walker suggested he contribute whatever amount he was comfortable with. “Walker saw this first fund as building a track record and, in the process, cementing relationships with people who would be ‘with him for a lifetime’ once they had seen what he could accomplish and gotten comfortable investing together,” Pfeffer noted.

Consider Your Approach “Crafting emails can be an art sometimes,” Walker notes. “I always take time to think of the

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STEFANOS ZENIOS STEFANOS ZENIOS Charles A. Holloway Professor of Operations, Information and Technology; Director, Center for Entrepreneurial Studies Stefanos Zenios is the Charles Holloway Professor at the GSB and the faculty director of its Center for Entrepreneurial Studies. An innovative teacher and researcher, Zenios is the main architect of Startup Garage, a popular GSB course that each year helps hundreds of Stanford GSB students and executives learn and apply the innovation processes that are at the center of the Silicon Valley ecosystem. He also oversees the Stanford GSB Venture Studio: a vibrant learning facility for Stanford graduate students across all disciplines who want to learn about designing and creating sustainable, high-impact ventures by testing what they are learning in the classroom. He previously designed and co-taught Biodesign Innovation, a project-based course on designing and launching new medical devices, and is one of the senior authors of a textbook with the same name.

His research interests fall in two broad categories: innovation and health care. He examines how innovation can be described as a process with discrete steps and specific outcomes, and how the process varies with the industry sector, customer segment, technology, and source of innovation (startup vs large organization). He also pioneered the application of data and advanced modeling to improve health care delivery and treatment decisions and is the recipient of numerous best paper awards in his field of Operations Research. In the intersection between health care and innovation, he examines what attributes of health care startups are associated with successful exits (either financial, generating returns for the investors, or clinical, securing FDA approval).

He currently serves as the Editor-in-Chief for Operations Research, the seminal academic journal in his field.

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HEALTH CARE: THE BENEFITS OF HUMAN-CENTRIC DESIGN At a time when “medical innovation” often is associated with dramatic pharmaceutical advances, complex imaging equipment, and other high-tech wonders, students at Stanford are also looking for innovation at the other end of the spectrum: relatively simple, low-cost modifications to existing health care processes that would reduce costs while improving outcomes.

electrical engineering, materials science, and other fields. Here are three representative projects from the most recent lab: Follow-Up Colonoscopy The Population Senior citizens, mainly native Chinese and Russian speakers, being served at the Ocean Park Health Center, run by the San Francisco Department of Public Health in the city’s Sunset District.

One example is the Design for Service Innovation lab (also known as the D-Lab), which for the last two academic years has been jointly offered by Stanford’s business, medical, and design schools.

The lab emphasizes a “bottom-up” approach to innovation, with students working closely with patients, caregivers, and others, understanding their needs and, in some cases, getting ideas for their innovations directly from the interested parties.

The Problem Getting them to show up, fully prepared, for a colonoscopy.

Patients at the clinic who are 55 or older have annual stool screenings. In a very small percentage of the patients—less than 1%—the results of the test trigger the need for a follow-up colonoscopy.

But notifying patients, and then preparing them for the procedure, is a lengthy, complicated process.

Patients drop out at each stage, especially when they learn about some of the unpleasant prescreening preparation requirements.

“We are strong believers in human-centric design,” said James M. Patell, the Herbert Hoover Professor of Public and Private Management at Stanford GSB, who co-led the most recent lab, along with Stefanos Zenios, the Charles A. Holloway Professor of Operations, Information and Technology. “It’s crucial for our students to gain empathy for the real patients, doctors, nurses, and families.”

The problem is compounded when language difficulties are added to the mix. The staff at the Ocean Park Health Center faced challenges in its colonoscopy-related education efforts, even when aided by “patient navigators” fluent in the patients’ native language. Explanations, delivered either in person or on the phone, often were quickly forgotten. Professionally prepared educational materials, especially brochures, often were set aside, unread.

“The course doesn’t start by trying to think up some cool new technology. It starts by trying to understand a real need—a weakness in the system, or an instance in which the system is failing its constituents. Then, we do whatever it takes to fix it,” noted Patell.

The 30 students enrolled in the class during the 2012 winter semester were placed in 4- or 5-person teams. Each team was assigned a realworld health care problem at a clinic in the Bay Area, many of which were associated with a medically underserved population.

The Proposal Personalized letters from the health center team provided to patients at key points in the screening process. In talking with patients and staff, the Stanford students realized that patients considered a personalized letter written on professional stationary and delivered via first-class mail to be a serious matter that required their utmost attention.

The students were from a wide sampling of the Stanford population: the business, medical, design, and law schools, along with graduate students in

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Stefanos Zenios, Stanford Graduate School of Business

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Stefanos Zenios, Stanford Graduate School of Business

The Proposal

The proposal calls for every patient requiring the procedure to receive such letters, hand-signed by a caregiver at the clinic. The letters would be in their native language, and would carefully explain everything they needed to know to prepare for the procedure. While the letters would duplicate most of what would be contained in a brochure, the quasi-legal, personalized nature of the communications resulted in patients taking them more seriously. Tests suggested that patients would keep the letters in a safe place, and share them with their children or other family members, as befitting an important communication.

A transition specialist assigned to patients, while still in their mid-teens, to help them prepare.

The specialist, working with each individual, would be responsible for developing and then implementing a master plan to help young people take this crucial step. He or she might, for example, engage in role-playing activities with the young patients, teaching them the assertiveness they will need to communicate their medical needs when their parents no longer are accompanying them through the process. The specialist also might help patients prepare a one-page “resume,” which would serve to introduce themselves to new caregivers, bringing them up to speed on current medical conditions, without patients having to answer the same sets of questions they’ve answered dozens of times in the past. And special attention would be paid to explaining some of the most opaque aspects of the adult health care system, notably insurance.

Students Jia Chang, Hayley Chan, Anya Greenberg, and Elena Kaye.

Transition Into Adult Care The Population Adolescent patients at hospitals with strong pediatric programs, such as the Lucile Packard Children’s Hospital.

Students Jacqueline Jacobs, Brian Kidd, Cammie Lee, and Alisa Mueller.

The Problem There is a large population of pediatric patients who have been receiving intensive medical care for most of their lives. Babies born prematurely or with clear health challenges often develop close personal relationships with their care providers as they grow older, due to the frequency with which they need to seek care. This sort of pediatric medicine usually is extremely personal, because of the deep emotional bonds that develop over the years between care providers, patients, and their families.

Fire Station Health Portal The Population Residents of Oakland, with the potential to expand across Alameda County.

The Problem What are the best locations for drop-in health clinics, designed for medically underserved residents? Are fire stations reasonable candidates?

Fire stations are dispersed throughout the community, and their staffs already have considerable experience in matters of emergency care. Because the buildings are county-owned, adding space to them to accommodate a clinic would be easier than starting from scratch with a new structure.

As pediatric patients reach adulthood, however, they are required to enter the traditional adult health care system. This transition often is a shock, as young people suddenly must fend for themselves after a lifetime of being at the center of a nurturing and supportive network.

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Stefanos Zenios, Stanford Graduate School of Business

The Solution The students came to appreciate early on that it would not be practical to expect a busy urban fire station to also function as a drop-in health clinic, although a clinic conceivably might be built next to a fire station. But in the process, the students realized that just as important as deciding where to place a clinic is figuring out exactly what services the clinic ought to provide. Because different communities have differentiated needs, no single scope of services would be appropriate for everyone. The team designed a decision-making tool that could help communities determine the scope of services they ought to offer in each local clinic. The Java-based program helps rank the community’s needs, while also systematically taking into account the severity of the diseases treated, cost of treatment, legal risk, number of emergency department visits that potentially could be averted, and other important factors.

Students Spring Sun, Ian Connolly, Maura Aranguren, Mira Wijayanti, and Curtis Chow.

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