Vogus' research on healthcare informs his classes on leadership and negotiation

This article was written by Randy Horick.

Professor Tim Vogus didn’t necessarily start out to research healthcare organizations. While pursuing his Ph.D. at the University of Michigan’s Ross School of Business, Vogus originally examined how HR practices affect organizational performance. “What I was really interested in,” he explained in his office on a “casual day” (shorts, t-shirt, no classroom lecture), “was figuring out what behavioral mechanisms produced particular outcomes. But I needed to collect my own data.”

As it happened, a 1999 report from the Institute of Medicine — which found that up to 100,000 preventable deaths occurred each year in the U.S. due to preventable medical error — offered both a promising direction for Vogus’ research and a fertile setting for data collection. “The study was a blockbuster,” he said. “It allowed a Ph.D. student to focus on a big problem.”

He hasn’t looked back. He approached the topic “somewhat opportunistically” at first, “but I stayed with it because I got caught up in the issue of making things more reliable,” he said. Now, he’s best known for his research into reducing medical errors and improving the performance of healthcare organizations.

Since then, Vogus has written extensively about how healthcare providers can emulate the practices of “high reliability” organizations such as aircraft carriers and air traffic control operations. His research examines numerous dimensions of the issue, from emotional exhaustion in nursing units to navigating care transitions to how a culture of compassion improves hospital quality rankings.

In the middle of his doctoral program, Vogus’ interest also became personal. His son was born with a rare genetic disorder for which autism was part of the diagnosis. “I saw the need we would have to interact frequently with the healthcare system, which brought home to me the importance of the system’s reliability,” he said. At Vanderbilt, Vogus was part of the founding team that established the Initiative for Autism, Innovation, and the Workforce, a trans-institutional program that helps match the needs of employers with the needs of adults on the autism spectrum.

In the course of his work, Vogus has identified concepts with implications beyond healthcare, such as the “underappreciated role of habit” in helping organizations standardize demonstrably effective practices. He’s written about “mindful organizing” that enables organizations to anticipate problems, quickly detect errors and respond adaptively. And he has examined how organizations can sustain mindful organizing behaviors through being “other-oriented” as a team and by fostering a mindset that balances hope and doubt, which Vogus calls “emotional ambivalence.”

Applying those ideas, Vogus helped develop a standard hospital safety score. More broadly, his research examined “safety cultures” in areas ranging from the Tennessee child welfare system to offshore oil and gas drilling and wildland firefighting.

Though Vogus doesn’t teach courses at Vanderbilt directly related to healthcare management, the ideas from his research inform his approach (not to mention his students) in his popular Leading Teams and Organizations class and in Negotiations (which he teaches in both the full-time and Executive MBA programs).

In Leading Teams, Vogus draws on his work with safety cultures and how “mindful, compassionate environments” promote high reliability and the case study of a famous eye hospital in India.

Successful negotiation, too, depends on compassion and mindfulness, Vogus says. “An essential element is empathy. You put yourself in the position of the other person,” he explained. “In negotiations, people feel vulnerable. They fear getting rolled. So you prepare mindfully to address their fears, manage your own feelings of vulnerability and share information in ways that helps people make better decisions and better deals.”

But these ideas also inform the process of teaching itself. Vogus works to create a classroom environment, he says, “that is safe for interactive learning, so people can share their ideas and experiences,” which is essential for creating the environment upon which effective teams and organizations depend. It makes sense when you think about it. As Vogus might tell you with one of his ready smiles, mindful organizing isn’t simply a management strategy; it’s a skill for life.