Assistant Professor, Management Science and Engineering
Honors & Awards
Winner, Dissertation Proposal Competition, INFORMS/Organization Science (2012)
Outstanding Paper with Practical Implications, Academy of Management (2012)
Wyss Award for Excellence in Doctoral Research, Harvard Business School (2013)
Dissertation Award Finalist, Industry Studies Association (2013)
Susan Cohen Award for Doctoral Research, Center for Effective Organizations (2010)
Current Research and Scholarly Interests
Melissa Valentine is an Assistant Professor at Stanford University in the Management Science and Engineering Department, and a core faculty member of the Center for Work, Technology, and Organization. Her research focuses on organizational structures and designs that support collaboration and coordination in fast-paced highly dynamic work environments. She has conducted multi-method field research in a variety of organizational settings, including pharmaceutical R&D, software development, and emergency medical care. In these and other on-going research settings, Prof. Valentine studies how organizations can support people in effectively combining their expertise and efforts to produce high-impact results.
Prof. Valentine’s research has won several awards, including the Outstanding Paper with Practical Implications award from the Organizational Behavior division of the Academy of Management, and the Organization Science/INFORMS dissertation proposal competition. She received her PhD from Harvard University.
From striving to thriving: Systems thinking, strategy, and the performance of safety net hospitals
HEALTH CARE MANAGEMENT REVIEW
2013; 38 (3): 211-223
Safety net hospitals (SNH) have, on average, experienced declining financial margins and faced an elevated risk of closure over the past decade. Despite these challenges, not all SNHs are weakening and some are prospering. These higher-performing SNHs provide substantial care to safety net populations and produce sustainable financial returns.Drawing on the alternative structural positioning and resource-based views, we explore strategic management as a source of performance differences across SNHs.We employ a mixed-method design, blending quantitative and qualitative data and analysis. We measure financial performance using hospital operating margin and quantitatively evaluate its relationship with a limited set of well-defined structural positions. We further evaluate these structures and also explore the internal resources of SNHs based on nine in-depth case studies developed from site visits and extensive interviews.Quantitative results suggest that structural positions alone are not related to performance. Comparative case studies suggest that higher-performing SNH differ in four respects: (1) coordinating patient flow across the care continuum, (2) engaging in partnerships with other providers, (3) managing scope of services, and (4) investing in human capital. On the basis of these findings, we propose a model of strategic action related to systems thinking--the ability to see wholes and interrelationships rather than individual parts alone.Our exploratory findings suggest the need to move beyond generic strategies alone and acknowledge the importance of underlying managerial capabilities. Specifically, our findings suggest that effective strategy is a function of both the internal resources (e.g., managers' systems-thinking capability) and structural positions (e.g., partnerships) of organizations. From this perspective, framing resources and positioning as distinct alternatives misses the nuances of how strategic advantage is actually achieved.
View details for DOI 10.1097/HMR.0b013e31825ba9ab
View details for Web of Science ID 000320698400004
View details for PubMedID 22647851
- Measuring Teamwork in Health Care Settings: A Review of Survey Instruments. Medical Care 2013
Strained Local And State Government Finances Among Current Realities That Threaten Public Hospitals' Profitability
2012; 31 (8): 1680-1689
This study demonstrates that some safety-net hospitals--those that provide a large share of the care to low-income, uninsured, and Medicaid populations--survived and even thrived before the recent recession. We analyzed the financial performance and governance of 150 hospitals during 2003-07. We found, counterintuitively, that those directly governed by elected officials and in highly competitive markets were more profitable than other safety-net hospitals. They were financially healthy primarily because they obtained subsidies from state and local governments, such as property tax transfers or supplemental Medicaid payments, including disproportionate share payments. However, safety-net hospitals now face a new market reality. The economic downturn, slow recovery, and politics of deficit reduction have eroded the ability of local governments to support the safety net. Many safety-net hospitals have not focused on effective management, cost control, quality improvement, or services that attract insured patients. As a result, and coupled with new uncertainties regarding Medicaid expansion stemming from the recent Supreme Court decision on the Affordable Care Act, many are likely to face increasing financial and competitive pressures that may threaten their survival.
View details for DOI 10.1377/hlthaff.2011.1401
View details for Web of Science ID 000307498200005
View details for PubMedID 22869645
Hospital Performance, the Local Economy, and the Local Workforce: Findings from a US National Longitudinal Study
2010; 7 (6)
Pay-for-performance is an increasingly popular approach to improving health care quality, and the US government will soon implement pay-for-performance in hospitals nationwide. Yet hospital capacity to perform (and improve performance) likely depends on local resources. In this study, we quantify the association between hospital performance and local economic and human resources, and describe possible implications of pay-for-performance for socioeconomic equity.We applied county-level measures of local economic and workforce resources to a national sample of US hospitals (n = 2,705), during the period 2004-2007. We analyzed performance for two common cardiac conditions (acute myocardial infarction [AMI] and heart failure [HF]), using process-of-care measures from the Hospital Quality Alliance [HQA], and isolated temporal trends and the contributions of individual resource dimensions on performance, using multivariable mixed models. Performance scores were translated into net scores for hospitals using the Performance Assessment Model, which has been suggested as a basis for reimbursement under Medicare's "Value-Based Purchasing" program. Our analyses showed that hospital performance is substantially associated with local economic and workforce resources. For example, for HF in 2004, hospitals located in counties with longstanding poverty had mean HQA composite scores of 73.0, compared with a mean of 84.1 for hospitals in counties without longstanding poverty (p<0.001). Hospitals located in counties in the lowest quartile with respect to college graduates in the workforce had mean HQA composite scores of 76.7, compared with a mean of 86.2 for hospitals in the highest quartile (p<0.001). Performance on AMI measures showed similar patterns. Performance improved generally over the study period. Nevertheless, by 2007--4 years after public reporting began--hospitals in locationally disadvantaged areas still lagged behind their locationally advantaged counterparts. This lag translated into substantially lower net scores under the Performance Assessment Model for hospital reimbursement.Hospital performance on clinical process measures is associated with the quantity and quality of local economic and human resources. Medicare's hospital pay-for-performance program may exacerbate inequalities across regions, if implemented as currently proposed. Policymakers in the US and beyond may need to take into consideration the balance between greater efficiency through pay-for-performance and socioeconomic equity.
View details for DOI 10.1371/journal.pmed.1000297
View details for Web of Science ID 000279400000017
View details for PubMedID 20613863
Race/ethnicity and patient confidence to self-manage cardiovascular disease
2008; 46 (9): 924-929
Minority populations bear a disproportionate burden of chronic disease, due to higher disease prevalence and greater morbidity and mortality. Recent research has shown that several factors, including confidence to self-manage care, are associated with better health behaviors and outcomes among those with chronic disease.To examine the association between minority status and confidence to self-manage cardiovascular disease (CVD).Survey respondents admitted to 10 hospitals participating in the "Expecting Success" program, with a diagnosis of CVD, during January-September 2006 (n = 1107).Minority race/ethnicity was substantially associated with lower confidence to self-manage CVD, with 36.5% of Hispanic patients, 30.7% of Black patients, and 16.0% of white patients reporting low confidence (P < 0.001). However, in multivariate analysis controlling for socioeconomic status and clinical severity, minority status was not predictive of low confidence.Although there is an association between race/ethnicity and confidence to self-manage care, that relationship is explained by the association of race/ethnicity with socioeconomic status and clinical severity.
View details for Web of Science ID 000258945400006
View details for PubMedID 18725846