Alden Lai
Alden Lai
Scroll
Assistant Professor of Public Health Policy and Management
-
Professional overview
-
Alden Lai studies the quality of jobs and work environments (i.e., “work design”) of workers to achieve better employee outcomes and organizational performance in health care. He uses qualitative and mixed methods to examine workplace behaviors that have important implications for employees, patients, and organizations, such as proactive behavior among frontline workers. With an aim of enhancing worker wellbeing, his research has been published in both management and health care journals, including Academy of Management Discoveries, Health Care Management Review, Medical Care Research and Review, Journal of General Internal Medicine, and The Milbank Quarterly. He is an editorial board member for Health Care Management Review and Medical Care Research and Review, and has served as a national and international expert for the National Academies of Sciences, Engineering, and Medicine (NASEM) and Organisation for Economic Co-operation and Development (OECD) on workforce issues. He is an affiliated faculty member in the Department of Management and Organizations at NYU Stern.
Dr. Lai has received international recognition for his research, teaching, and contributions to his field. They include an Early Career Achievement Award, Outstanding Early Career Educator Award, and Outstanding Paper based on a Dissertation Award from the Academy of Management’s Health Care Management Division, and a Teaching Excellence Award from GPH.
At GPH, he teaches courses on management, leadership, and strategy in public health.
Dr. Lai has advised federal and state governments, health systems, international and non-profit organizations, corporations, and philanthropies internationally. His professional experiences include being a management consultant and social enterprise strategist. He is currently a board member for the Wellbeing for Planet Earth Foundation, whose mission is to foster a more globally inclusive understanding of wellbeing for research, practice, and policy.
-
Education
-
BA, Psychology, National University of Singapore, SingaporeMPH, Social & Behavioral Sciences, The University of Tokyo, JapanPhD, Health Policy & Management (Organizational Behavior), Johns Hopkins University, Baltimore, MD
-
Honors and awards
-
Outstanding Early Career Educator Award, Health Care Management Division, Academy of Management (2025)Early Career Teaching Excellence Award, NYU GPH (2025)Early Career Achievement Award, Health Care Management Division, Academy of Management (2024)“40 Under 40 in Public Health” Award, Boston Congress of Public Health (2023)Denny Gioia Award for Best Qualitative Paper, Managerial and Organizational Cognition Division, Academy of Management (2023)“Best Paper” (top 10%), Managerial and Organizational Cognition Division, Academy of Management (2023)Goddard Faculty Award, NYU GPH (2023)NYU GPH Leadership Development Award (2021)19 Washington Square North Faculty Fellowship (2021)Outstanding Paper based on a Dissertation Award, Division of Health Care Management, Academy of Management (2021)Show Chwan Scholar in Health Care Management (2018)Sir Arthur Newsholme Scholar (2015)The University of Tokyo President Award (2013)University of Copenhagen-International Alliance of Research Universities Scholar (2012)Government of Japan Monbukagakusho Scholar (2011)Sato-Yo International Foundation Scholar (2009)
-
Areas of research and study
-
Health Care ManagementHealth Care WorkforceKnowledge WorkersPrimary CareProactivity at WorkQualitative ResearchWell-Being at WorkWork Design
-
Consulting and Community Engagement
1199 Benefit and Pension Funds
Ajinomoto
Ando Foundation
Ashoka
Asian Venture Philanthropy Network
Australian Sports Commission
Carnegie UK Trust
Clinical Directors Network Inc.
Columbia University Department of East Asian Languages and Cultures
Columbia University School of International and Public Affairs
Diplomatic Courier
Earth Company
G1 Institute Japan
Gallup Inc.
Government of Australia, Treasury
Harvard University Human Flourishing Program
John Templeton Foundation
Katsuiku Foundation
Learned Society of Wales
National Healthcare Group
Nestle
New York City Department of Health and Mental Hygiene, Bureau of Equitable Health Systems
New York City Health + Hospitals
New York City Office of Labor Relations
New York City Department of Education, Office of School Health
Nikkei
OECD Center for Well-Being, Inclusion, Sustainability and Equal Opportunity
Otsuka Pharmaceutical
Oxford University Wellbeing Research Centre
Permanent Delegation of Japan to the OECD
PERSOL Holdings
Physician Affiliate Group of New York
Prime Minister’s Office, Iceland
Tecnologico de Monterrey, Human Flourishing Projects
Templeton World Charity Foundation
The Consumer Goods Forum
The Hastings Center
The HOW Institute for Society
The Leadership and Happiness Laboratory, Harvard Kennedy School
KRC Research and United Minds, The Weber Shandwick Collective
UNICEF Office of Global Insight and Policy
United Nations Human Development Report Office
United Nations Statistics Division
Unson Foundation
WHO Commission on Social Connection
Woodlands Health Campus
World Happiness Council-
Publications
Publications
Changes in hospital-supported substance use services across U.S. nonprofit hospitals, 2015-2021
AbstractLai, A. (n.d.).Publication year
2024Journal title
Health Affairs ScholarAbstract~Clinician Trust in Healthcare Organizations Expert Working Group, George Washington University Fitzhugh Mullan Institute for Health Workforce Equity, American Board of Internal Medicine, and The Hastings Center (2024)
AbstractLai, A. (n.d.).Publication year
2024Abstract~Expert consultant to OECD Report "An OECD survey of employee wellbeing: An instrument to measure employee wellbeing inside companies"
AbstractLai, A. (n.d.).Publication year
2024Abstract~Lai, A. Y. (2024, Feb 8). Uncertainty and Curiosity. Gallup Global Learning Day, Gallup Inc. Virtual.
AbstractLai, A. (n.d.).Publication year
2024Abstract~Lai, A. Y. (2024, Oct 2). Consequences of burnout and implications for equity. The Impact of Burnout on Gender Equity in Science, Engineering, and Medicine: A Workshop. Committee on Women in Science, Engineering, and Medicine. National Academies of Sciences, Engineering, and Medicine, Washington DC, USA.
AbstractLai, A. (n.d.).Publication year
2024Abstract~Lai, A. Y. (2025, Apr 2). Job burnout, employee wellbeing, and work design. Latin American Initiative for Health Management and Innovation Annual Summit 2025, INCAE Business School, La Garita, Costa Rica.
AbstractLai, A. (n.d.).Publication year
2024Abstract~Lai. A. Y. (2024, December 5). Discussion on Mapping human flourishing research in Mexico. International Seminar on Human Flourishing in Latin America, Tecnológico de Monterrey and the Templeton World Charity Foundation, Monterrey, Mexico.
AbstractLai, A. (n.d.).Publication year
2024Abstract~Love over gold and mind over matter? Identifying capabilities that preserve medical assistants' sustainable employability
AbstractFleuren, B. P., Lai, A., Larkin, J., Grunewald-Schmitz, L., & Yuan, C. T. (n.d.).Publication year
2024Journal title
Human Resources for HealthAbstract~Love over gold and mind over matter? Identifying capabilities that preserve medical assistants’ sustainable employability
AbstractFleuren, B. P., Lai, A., Gruenewald-Schmitz, L., Larkin, J., & Yuan, C. T. (n.d.).Publication year
2024Journal title
Human Resources for HealthVolume
22Issue
1AbstractBackground: Medical assistants (MAs) are crucial for affordable, high-quality primary care, but what motivates this low-wage occupational group to stay in their job remains underexplored. This paper identifies the work aspects that MAs value (“capabilities”), and how they affect sustainable employability, which refers to employees’ long-term ability to function and remain in their job. Methods: We used structural equation modelling to assess how capabilities relate to four outcomes among MAs: burnout, job satisfaction, intention to quit, and experiencing work as meaningful. Results: We find that earning a good income, developing knowledge and skills, and having meaningful relationships at work relate to the outcomes. Meaningful relationships represent a stronger predictor than salary for one’s intention to quit. Conclusions: Competitive salaries are necessary but not sufficient to motivate low-wage health care workers like MAs to stay in their job. Health care leaders and managers should also structure work so that MAs can foster meaningful relationships with others as well as develop competencies.Managing Surges in Demand : A Grounded Conceptual Framework of Surge Management Capability
AbstractLarson, J. D., Lai, A., DePuccio, M. J., & Hilligoss, B. (n.d.).Publication year
2024Journal title
Medical Care Research and ReviewAbstractSurge management is important to hospital operations, yet surge literature has mostly focused on the addition of resources (e.g., 25% more beds) during events like pandemics. Such views are limiting, as meeting surge demands requires hospitals to engage in practices tailored to a surge’s unique contingencies. We argue that a dynamic view of surge management should include surge management capability, which refers to how resources are deployed to respond to surge contingencies. To understand this capability, we qualitatively studied five hospital systems experiencing multiple surges due to COVID-19 between April 2020 and March 2022. We develop a framework showing that managing surges involves preserving capacity, expanding capacity, smoothing capacity demand, and enabling surge management. We contribute to surge literature by identifying practices hospitals can adopt to address surges and offering a better understanding of surge conditions (e.g., degree of novelty) that make some surge management practices more appropriate than others.Proactive behaviors and health care workers : A systematic review
AbstractLai, A., Wee, K. Z., & Frimpong, J. A. (n.d.).Publication year
2024Journal title
Health Care Management ReviewVolume
49Issue
3Page(s)
239-251AbstractBackground Proactive behaviors at work refer to discretionary actions among workers that are self-starting, change oriented, and future focused. Proactive behaviors reflect the idiosyncratic actions by individual workers that shape the delivery and experience of professional services, highlight a bottom-up perspective on workers' agency and motivation that can influence organizational practices, and are associated with a variety of employee and organizational outcomes. Purpose This systematic review aims to understand the various forms of proactive behaviors in health care workers that have been studied, and how these proactive behaviors are associated with employee-level outcomes and quality of care. Methods Systematic review of articles published to date on proactive behaviors in health care workers. Results Based on the identification of 40 articles, we find that job crafting, active problem solving, voice, extra-role behaviors, and idiosyncratic deals have been investigated as proactive behaviors among health care workers. Among these, job crafting is the most commonly studied (35% of articles), and it has been conceptualized and measured in the most consistent way, including as individual- and group-level phenomena, and as organizational interventions. Studies on active problem solving, which refers to workers accepting responsibility, exercising control, and taking action around anticipated or experienced problems at work, have not been consistently investigated as a form of proactive behavior but represent 25% of the articles identified in this review. Overall, this review finds that proactive behaviors in health care is a burgeoning area of research, with the majority of studies being cross-sectional in design and published after 2010, and focused on workers' job satisfaction as the outcome. Practice Implications Health care workers and managers should consider the distinct influences and contributions of proactive behaviors as ways to improve employee-level outcomes and quality of care.Rural-urban disparities in the availability of hospital-based screening, medications for opioid use disorder, and addiction consult services
AbstractFranz, B., Cronin, C. E., Lindenfeld, Z., Pagan, J. A., Lai, A., Krawczyk, N., Rivera, B. D., & Chang, J. E. (n.d.).Publication year
2024Journal title
Journal of Substance Use and Addiction TreatmentVolume
160AbstractIntroduction: Hospitals are an ideal setting to stage opioid-related interventions with patients who are hospitalized due to overdose or other substance use–related complications. Transitional opioid programs—which initiate care and provide linkages upon discharge, such as screening, initiation of medications for opioid use disorder, and addiction consult services—have become the gold standard, but implementation has been uneven. The purpose of this study was to assess disparities in the availability of hospital-based transitional opioid programs, across rural and urban hospital settings in the United States. Methods: Using hospital administrative data paired with county-level demographic data, we conducted bivariate and regression analyses to assess rural-urban differences in the availability of transitional opioid services including screening, addiction consult services, and MOUD in U.S general medical centers, controlling for hospital- and community-level factors. Our sample included 2846 general medical hospitals that completed the 2021 American Hospital Association (AHA) Annual Survey of Hospitals. Our primary outcomes were five self-reported measures: whether the hospital provided screening in the ED; provided screening in the inpatient setting; whether the hospital provided addiction consult services in the ED; provided addiction consult services in the inpatient setting; and whether the hospital provided medications for opioid use disorder. Results: Rural hospitals did not have lower odds of screening for OUD or other SUDs than urban hospitals, but both micropolitan rural counties and noncore rural counties had significantly lower odds of having addiction consult services in either the ED (OR: 0.74, 95 % CI: 0.58, 0.95; OR: 0.68, 95 % CI: 0.50, 0.91) or inpatient setting (OR: 0.76, 95 % CI: 0.59, 0.97; OR: 0.68, 95 % CI: 0.50, 0.93), respectively, or of offering MOUD (OR: 0.69, 95 % CI: 0.52, 0.90; OR: 0.52, 95 % CI: 0.37, 0.74). Conclusions: Our study suggests that evidence-based interventions, such as medications for opioid use disorder and addiction consult services, are less often available in rural hospitals, which may contribute to rural-urban disparities in health outcomes secondary to OUD. A priority for population health improvement should be developing implementation strategies to support rural hospital adoption of transitional opioid programs.Building student competencies to address healthcare’s grand challenges: Lessons from an international collaboration
AbstractSullivan, E. E., DePuccio, M. J., Stephenson, A. L., Raj, M., Lai, A., Tietschert, M. V., Fleuren, B. P., Thomas, S. C., & McAlearney, A. S. (n.d.).Publication year
2023Journal title
Journal of Health Administration EducationVolume
39Issue
4Page(s)
615-630Abstract~Complexifying Individualism Versus Collectivism and West Versus East : Exploring Global Diversity in Perspectives on Self and Other in the Gallup World Poll
AbstractLomas, T., Diego-Rosell, P., Shiba, K., Standridge, P., Lee, M. T., Case, B., Lai, A., & VanderWeele, T. J. (n.d.).Publication year
2023Journal title
Journal of Cross-Cultural PsychologyVolume
54Issue
1Page(s)
61-89AbstractA wealth of research has suggested the West tends toward individualism and the East toward collectivism. We explored this topic on an unprecedented scale through two new items in the 2020 Gallup World Poll, involving 121,207 participants in 116 countries. The first tapped into orientations toward self-care versus other-care (“Do you think people should focus more on taking care of themselves or on taking care of others?”). The second enquired into self-orientation versus other-orientation (“Which of the following is closest to your main purpose in life? Being good at what you do in your daily life, Caring for family and close friends, or Helping other people who need help?”). We anticipated that self-care and self-orientation would index individualism (hence be higher in the West), while other-care and other-orientation would index collectivism (hence be higher in the East). However, contrary to expectation, there was greater self-care in the East (45.82%) than in the West (41.58%). As predicted though, there was greater self-orientation in the West (30.20%) than in the East (23.08.%). Greater self-care in the East invites one of two interpretations. Either these items: (a) index individualism and collectivism as anticipated, so in some ways the East is more individualistic and the West less individualistic than assumed; or (b) do not index individualism and collectivism as anticipated, so the concepts are more complex than often realized (e.g., collectivism may involve prioritizing self-care over other-care). Either way, the findings help complexify these concepts, challenging common cross-cultural generalizations in this area.Delivering High-Quality Primary Care Requires Work That Is Worthwhile for Medical Assistants
AbstractLai, A., Fleuren, B. P., Yuan, C. T., Sullivan, E. E., & Mark McNeill, S. (n.d.).Publication year
2023Journal title
Journal of the American Board of Family MedicineVolume
36Issue
1Page(s)
193-199AbstractMedical assistants are core members of the primary care team, but health care organizations struggle to hire and retain them amid the ongoing exodus of health care workers as part of the “Great Resignation.” To sustain a stable and engaged workforce of medical assistants, we argue that efforts to hire and retain them should focus on making their work worthwhile. Work that is worthwhile includes adequate pay, benefits, and job security, but additionally enables employees to experience a sense of contribution, growth, social connectedness, and autonomy. We highlight opportunities during team huddles, the rooming of patients, and career development where the work of medical assistants can be made worthwhile. We also connect these components to the work design literature to show how clinic managers and supervising clinicians can promote worthwhile work through decision-making and organizational climate. Going beyond financial compensation, these components target the latent occupational needs of medical assistants and are likely to forge employee-employer relationships that are mutually valued and sustained over time.MODES OF ADJUSTMENT : THERE IS MORE THAN ONE WAY TO ORGANIZE FOR RESILIENCE
AbstractHilligoss, B., Larson, J. D., Lai, A., Depuccio, M. J., & Wong, E. M. (n.d.).Publication year
2023Journal title
Academy of Management Annual Meeting ProceedingsVolume
2023Issue
1AbstractDespite growing concerns that unexpected events have become regular features of environments, we know little about organizing for resilience—the process by which leaders attempt to positively adjust operations to adversity. To address this gap, we conducted longitudinal case studies of eight U.S. health care organizations adjusting operations through successive phases of the COVID-19 pandemic. We discovered these adjustments demonstrated considerable variety during different phases of the pandemic, even when made by the same leaders in similar situations. We explain this variety through an inductively derived process model of organizing for resilience that traces how the enactment of different adverse situations leads to alternative modes of adjustment that target different resilience outcomes. In contrast to definitions that imply resilience entails both absorbing strain and preserving functioning, our study shows these, along with a third resilience outcome of anticipating and preparing for immanent threat, exist in three-way tension. Leaders must trade off one in pursuit of others. How leaders perceive the relative adversity of conditions and the alignment of organizational capabilities with those conditions shapes this trade-off and modes of adjustment made in pursuit of one, or at most a mix of two, of these three resilience outcomes.Rural-urban disparities in the availability of hospital-based screening, medications for opioid use disorder, and addiction consult services
AbstractLai, A., Franz, B., Cronin, C. E., Lindenfeld, Z., Pagan, J. A., Lai, A. Y., Krawczyk, N., Rivera, B. D., & Chang, J. E. (n.d.).Publication year
2023Journal title
Journal of substance use and addiction treatmentVolume
160Page(s)
209280AbstractHospitals are an ideal setting to stage opioid-related interventions with patients who are hospitalized due to overdose or other substance use-related complications. Transitional opioid programs-which initiate care and provide linkages upon discharge, such as screening, initiation of medications for opioid use disorder, and addiction consult services-have become the gold standard, but implementation has been uneven. The purpose of this study was to assess disparities in the availability of hospital-based transitional opioid programs, across rural and urban hospital settings in the United States.Starting from scratch : New work design to enact entrance screening during the COVID-19 pandemic
AbstractLai, A., Larson, J. D., Depuccio, M. J., & Hilligoss, B. (n.d.).Publication year
2023Journal title
Health Care Management ReviewVolume
48Issue
3Page(s)
260-273AbstractBackground Health care organizations are constantly creating new work to achieve evolving goals such as digitalization, equity, value, or well-being. However, scholars have paid less attention to how such work becomes "work"in the first place, despite implications for the design, quality, and experience of work and, consequently, employee and organizational outcomes. Purpose The aim of this study was to investigate how new work becomes enacted in health care organizations. Methodology A longitudinal, qualitative case study on the enactment of entrance screening - a new operation in response to COVID-19 - in a multihospital academic medical center was performed. Results Entrance screening comprised four tasks, whose design was initially influenced by institutional guidelines (e.g., Centers for Disease Control and Prevention recommendations) and clinical experts. Organizational-level influences (e.g., resource availability) then became more prominent, necessitating multiple feedback-response loops to calibrate the performance of entrance screening. Finally, entrance screening was integrated into existing operations of the organization to ensure operational sustainability. The treatment of entrance screening as an operation changed over time - initially seen as infection control work, it eventually bifurcated into patient care and clerical work. Conclusion The enactment of new work is constrained by the fit between resources and its intended output. Furthermore, the schema of work influences how and when organizational actors calibrate this fit. Practice Implications Health care leaders and managers should continuously update their schemas of work so that they can develop more sufficient and accurate representations of the employee capabilities that are required for the performance of new work.The world prefers a calm life, but not everyone gets to have one : global trends in valuing and experiencing calmness in the Gallup World Poll
AbstractLomas, T., Diego-Rosell, P., Shiba, K., Standridge, P., Lee, M. T., & Lai, A. (n.d.).Publication year
2023Journal title
Journal of Positive PsychologyAbstractPsychology has paid relatively little attention to low arousal positive states like calmness. To remedy this lacuna, this study draws on the most globally comprehensive study to date on calmness (121,207 participants in 116 countries in the 2020 Gallup World Poll), featuring two items asking whether people: (a) prefer a calm life or an exciting life; and (b) experienced calmness yesterday. By intersecting these, we could categorise people in four categories of calmness: satisfied (both prefer and experience it); unwanted (experience calmness but prefer excitement); longed-for (prefer calmness but don’t experience it); and unmissed (neither prefer nor experience it). The results reveal a nuanced picture that challenges certain stereotypes (e.g. calmness had no particular association here with Eastern cultures), and shed new light on this overlooked topic (e.g. poorer people and countries are more likely to prefer calmness yet are less likely to actually experience it).A double-edged sword : The effects of social network ties on job satisfaction in primary care organizations
AbstractYuan, C. T., Lai, A., Benishek, L. E., Marsteller, J. A., Mahabare, D., Kharrazi, H., & Dy, S. M. (n.d.).Publication year
2022Journal title
Health Care Management ReviewVolume
47Issue
3Page(s)
180-187AbstractBACKGROUND: Social ties between health care workers may be an important driver of job satisfaction; however, research on this topic is limited.PURPOSE: We used social network methods to collect data describing two types of social ties, (a) instrumental ties (i.e., exchange of advice that enables work) and (b) expressive ties (i.e., exchange of social support), and related those ties to workers' job satisfaction.METHODOLOGY: We surveyed 456 clinicians and staff at 23 primary care practices about their social networks and workplace attitudes. We used multivariable linear regression to estimate the relationship between an individual's job satisfaction and two network properties: (a) eigenvector centrality (a measure of the importance of an individual in a network) and (b) ego network density (a measure of the cohesiveness of an individual's network). We examined this relationship for both instrumental and expressive ties.RESULTS: Individuals who were more central in the expressive network were less satisfied in their job, b = -0.40 (0.19), p < .05, whereas individuals who had denser instrumental networks were more satisfied in their job, b = 0.49 (0.21), p < .05.CONCLUSION: Workplace relationships affect worker well-being. Centrality in an expressive network may require greater emotional labor, increasing workers' risk for job dissatisfaction. On the other hand, a dense instrumental network may promote job satisfaction by strengthening workers' access to full information, supporting competence and confidence.PRACTICE IMPLICATIONS: Efforts to increase job satisfaction should consider both the positive and negative effects of social networks on workers' sense of well-being.Association of Implementation and Social Network Factors With Patient Safety Culture in Medical Homes : A Coincidence Analysis
AbstractDy, S. M., Acton, R. M., Yuan, C. T., Hsu, Y. J., Lai, A., Marsteller, J., Ye, F. C., McGee, N., Kharrazi, H., Mahabare, D., Kim, J., Gurses, A. P., Bittle, M., & Scholle, S. H. (n.d.).Publication year
2022Journal title
Journal of Patient SafetyVolume
18Issue
1Page(s)
E249-E256AbstractObjectives: The patient-centered medical home (PCMH) may provide a key model for ambulatory patient safety. Our objective was to explore which PCMH and patient safety implementation and social network factors may be necessary or sufficient for higher patient safety culture. Methods: This was a cross-case analysis study in 25 diverse U.S. PCMHs. Data sources included interviews of a clinician and an administrator in each PCMH, surveys of clinicians and staff, and existing data on the PCMHs' characteristics. We used coincidence analysis, a novel method based on set theory and Boolean logic, to evaluate relationships between factors and the implementation outcome of patient safety culture. Results: The coincidence analysis identified 5 equally parsimonious solutions (4 factors), accounting for all practices with higher safety culture. Three solutions contained the same core minimally sufficient condition: the implementation factor leadership priority for patient safety and the social network factor reciprocity in advice-seeking network ties (advice-seeking relationships). This minimally sufficient condition had the highest coverage (5/7 practices scoring higher on the outcome) and best performance across solutions; all included leadership priority for patient safety. Other key factors included self-efficacy and job satisfaction and quality improvement climate. The most common factor whose absence was associated with the outcome was a well-functioning process for behavioral health. Conclusions: Our findings suggest that PCMH safety culture is higher when clinicians and staff perceive that leadership prioritizes patient safety and when high reciprocity among staff exists. Interventions to improve patient safety should consider measuring and addressing these key factors.Balance and harmony in the Gallup World Poll : The development of the Global Wellbeing Initiative module
AbstractLomas, T., Ishikawa, Y., Diego-Rosell, P., Daly, J., English, C., Harter, J., Standridge, P., Clouet, B., Diener, E., & Lai, A. (n.d.).Publication year
2022Journal title
International Journal of WellbeingVolume
12Issue
4Page(s)
1-19AbstractOver recent decades, scholarship on wellbeing has flourished. However, this has been critiqued as Western-centric, firstly in terms of the location of research participants and scholars, and moreover in terms of the very ideas and values through which wellbeing is understood. In response to such issues, the Global Wellbeing Initiative – a partnership between Gallup and the Wellbeing for Planet Earth foundation – was created to look at wellbeing from a more global perspective. The centrepiece of this initiative is a survey module in the Gallup World Poll. This paper charts the evolution of this module to date, from its initial incarnation in the 2020 poll (featuring items on various aspects of wellbeing) to a finalized 2022 iteration (which focuses specifically on balance and harmony). With the 2022 version now intended to stay consistent longitudinally, this paper establishes a valuable baseline for this important project which will contribute to a more inclusive and comprehensive understanding of wellbeing.Balance and harmony in the Gallup World Poll: The development of the Global Wellbeing Initiative module
AbstractLomas, T., Ishikawa, Y., Diego-Rosell, P., Daly, J., English, C., Harter, J., Standridge, P., Diener, E., Clouet, B., & Lai, A. (n.d.).Publication year
2022Journal title
International Journal of WellbeingVolume
12Issue
4Page(s)
1-19Abstract~Being "low on the totem pole" : What makes work worthwhile for medical assistants in an era of primary care transformation
AbstractLai, A., Fleuren, B. P., Larkin, J., Gruenewald-Schmitz, L., & Yuan, C. T. (n.d.).Publication year
2022Journal title
Health Care Management ReviewVolume
47Issue
4Page(s)
340-349AbstractBACKGROUND: Primary care is undergoing a transformation to become increasingly team-based and multidisciplinary. The medical assistant (MA) is considered a core occupation in the primary care workforce, yet existing studies suggest problematic rates and costs of MA turnover.PURPOSE: We investigated what MAs perceive their occupation to be like and what they value in it to understand how to promote sustainable employability, a concept that is concerned with an employee's ability to function and remain in their job in the long term.APPROACH: We used a case of a large, integrated health system in the United States that practices team-based care and has an MA career development program. We conducted semistructured interviews with 16 MAs in this system and performed an inductive analysis of themes.RESULTS: Our analysis revealed four themes on what MAs value at work: (a) using clinical competence, (b) being a multiskilled resource for clinic operations, (c) building meaningful relationships with patients and coworkers, and (d) being recognized for occupational contributions. MAs perceived scope-of-practice regulations as limiting their use of clinical competence. They also perceived task similarity with nurses in the primary care setting and expressed a relative lack of performance recognition.CONCLUSION: Some of the practice changes that enable primary care transformation may hinder MAs' ability to attain their work values. Extant views on sustainable employability assume a high bar for intrinsic values but are limited when applied to low-wage health care workers in team-based environments.PRACTICE IMPLICATIONS: Efforts to effectively employ and retain MAs should consider proactive communications on scope-of-practice regulations, work redesign to emphasize clinical competence, and the establishment of greater recognition and respect among MAs and nurses.Challenges and Strategies for Patient Safety in Primary Care : A Qualitative Study
AbstractYuan, C. T., Lai, A., Dy, S. M., Oberlander, T., Hannum, S. M., Lasser, E. C., Heughan, J.-A., Dukhanin, V., Kharrazi, H., Kim, J. M., Gurses, A. P., Bittle, M., Scholle, S. H., & Marsteller, J. A. (n.d.).Publication year
2022Journal title
American Journal of Medical QualityVolume
37Issue
5Page(s)
379-387AbstractAlthough most health care occurs in the ambulatory setting, limited research examines how providers and patients think about and enact ambulatory patient safety. This multimethod qualitative study seeks to identify perceived challenges and strategies to improve ambulatory safety from the perspectives of clinicians, staff, and patients. Data included interviews (N = 101), focus groups (N = 65), and observations of safety processes (N = 79) collected from 10 patient-centered medical homes. Key safety issues included the lack of interoperability among health information systems, clinician-patient communication failures, and challenges with medication reconciliation. Commonly cited safety strategies leveraged health information systems or involved dedicated resources (eg, providing access to social workers). Patients also identified strategies not mentioned by clinicians, emphasizing the need for their involvement in developing safety solutions. This work provides insight into safety issues of greatest concern to clinicians, staff, and patients and strategies to improve safety in the ambulatory setting.