Associate Professor of Health Care Management and Policy
TEACHING & ADMINISTRATION
Dr. Singer developed and teaches a Masters level course at the Harvard School of Public Health, entitled Health Care Organizations and Organizational Behavior: Leadership and Management for Learning, Innovation, and Performance Improvement. She also advises Doctoral and Masters-degree students at the School of Public Health.
My research in the field of health care management and policy addresses the role of organizational leadership and culture in efforts to implement health delivery innovations, integrate patient care, and improve performance of health care organizations. Specific areas of investigation include: (1) patient safety climate, culture, and leadership, (2) integrated patient care, (3) implementation of surgical safety checklists and other health delivery innovations, and (4) organizational learning.
A key feature of this research is the development of survey instruments that measure provider and patient perspectives on key interpersonal and organizational factors. These surveys generate novel information about critical features of organizational behavior, which I have used to conduct research that tests organizational theory and examines the effectiveness of delivery system innovations. In my work, I apply organizational theories and mixed quantitative and qualitative methods to demonstrate not only whether organizational interventions such as surgical checklists and patient-centered medical homes work, but also how and under what conditions they do so. One of my key capabilities is the collaborative design and leadership of multiple, interdisciplinary, action-oriented research projects, cutting across departments, schools, universities, and organizational partners.
I developed and teach a course at the Harvard School of Public Health, entitled Health Care Organizations and Organizational Behavior: Leadership and Management for Learning, Innovation, and Performance Improvement, which is offered twice a year. I also teach in the Harvard PhD in Health Policy core course on the subject of “Patient Safety, Safety Culture and Safety Leadership” and in the Masters in Health Care Management program on topics related to organizational culture, leadership and teamwork. In addition, I serve as advisor or dissertation committee member for Masters and Doctoral students at the School of Public Health and for junior faculty recipients of career development awards.
Previously I co-founded and served as Executive Director for the Center for Health Policy at Stanford, where I was also a Senior Research Scholar and Lecturer (1993-2003). I also served as Staff Director for the California Managed Care Improvement Task Force (1997-98), a Senior Legislative Assistant for Health Policy in the US House of Representative (1994), and Health Policy Analyst at the Office of Management and Budget (1992).
2007, Ph.D., Harvard University, Program in Health Policy/Management.
1993, M.B.A, Stanford University, Graduate School of Business.
1986, A.B., Princeton University, English and European Cultural Studies.
Singer SJ, Hartmann, CW, Hanchate A, Zhao S, Meterko M, Shokeen P, Lin S, Gaba D, Rosen AK, “Comparing safety climate between two populations of hospitals in the US.” Health Services Research; (Forthcoming).
Singer SJ, Falwell A, Gaba D, Meterko M, Rosen A, Hartmann C, Baker L. “Identifying Organizational Cultures that Promote Patient Safety.” Health Care Management Review; (Forthcoming).
Singer SJ, Falwell A, Lin S, Gaba G, Baker L. “Relationship of Safety Climate and Safety Performance in Hospitals,” Health Services Research, 2009; 44(2, Part 1):399-421.
Singer SJ, Gaba D, Falwell A, Lin S, Hayes J, Baker L. Patient Safety Climate in 92 US Hospitals: Differences by Work Area and Discipline. Medical Care. 2009 Jan; 47(1):23-31.
Singer SJ, Falwell A, Gaba G, Baker L. Patient Safety Climate in US Hospitals: Variation by Management Level. Medical Care. 2008 Nov; 46(11):1149-56.
Tucker A, Singer S, Hayes J, Falwell A. Front-line Staff Perspectives on Opportunities for Improving the Safety and Efficiency of Hospital Work Systems, Health Services Research, 2008 Oct; 43(5 Pt 2):1807-29.
Hartmann C, Rosen A, Meterko M, Shokeen P, Zhao S, Singer S, Falwell A, Gaba D. “An Overview of Patient Safety Climate in the VA,” Health Services Research, 2008 August; 43(4):1263-1284. [Role: conception and design; obtained funding; analyzed and interpreted data; critically reviewed manuscript; provided technical support; provided administrative support]
Rosen A, Gaba D, Meterko M, Singer S, Shokeen P, Zhao S, Labonte A, Falwell A. Recruitment of Hospitals for a Safety Climate Study: Facilitators and Barriers, Joint Commission Journal on Quality and Patient Safety, 2008; 34(5):275-84. [Role: design; obtained funding; analyzed and interpreted data; critically reviewed manuscript; provided technical support; provided administrative support]
Shortell S and Singer SJ. Improving Patient Safety by Taking Systems Seriously, JAMA, 2008; 299(4):445-447.
Singer SJ, Meterko M, Baker L, Gaba G, Falwell A, and Rosen A, “Workforce perceptions of hospital safety culture: Development and validation of the Patient Safety Climate in Healthcare Organizations survey,” Health Services Research, 2007 October, 42(5) 1999-2021.
Tucker A, Singer S, Hayes J, Falwell A, “Front-line Staff Perspectives on Opportunities for Improving the Safety and Efficiency of Hospital Work Systems,” Harvard Business School Working Paper No. 08-015.
Singer SJ, Baker L, “Relationship of Safety Climate and Safety Performance in Hospitals,” Best Paper Proceedings 2007 Academy of Management, 2007 August.
Bundorf MK, Wagner TH, Singer SJ, Baker LC, “Who Searches the Internet for Health Information?” Health Services Research, 2006 June, 41(3) 819-836.
Wagner TH, Bundorf MK, Singer SJ, and Baker LC, “Free Internet Access, The Digital Divide and Health Information,” Medical Care, 2005 April, 43(4): 415-420.
Huang AJ, Gemperli MP, Bergthold L, Singer S, and Garber A, “Health Plans’ Coverage Determinations for Technology-based Interventions: The Case of Electrical Bone Growth Stimulation,” American Journal of Managed Care, 2004 Dec, 10(12): 957-962.
Wagner TH, Baker LC, Bundorf MK, and Singer SJ, “Use of the Internet for Health Information By the Chronically Ill, Preventing Chronic Disease: Public Health Research, Practice and Policy, 2004 Oct, 1(4): 1-13.
Bundorf MK, Singer SJ, Wagner TH, Baker LC, “Consumers’ Use of the Internet for Health Insurance,” American Journal of Managed Care, 2004 Sep, 10(9): 609-616.
Gaba D, Singer S, Sinaiko S, Bowen J, “Differences in Safety Climate Between Hospital Personnel and Navy Aviators,” Human Factors, 2003 Summer, 45(2): 173-185.
Baker LC, Wagner TH, Singer SJ, and Bundorf MK, “Use of the Internet and E-Mail for Health Care Information: Results from a National Survey,” JAMA, 2003 May 14, 289(18): 2400-2406.
Singer SJ, Gaba DM, Geppert JJ, Sinaiko AD, Howard SK, Park KC, “The Culture of Safety in California Hospitals,” Quality and Safety in Healthcare, 2003 Apr, 12:112-8.
Singer SJ and Bergthold L, “Prospects for Improved Decision Making About Medical Necessity,” Health Affairs, 2001 Jan-Feb, 20(1): 200-206.
Singer SJ and Enthoven AC, “Structural Problems in Managed Care in California and Some Options for Ameliorating Them,” California Management Review, 2000 Fall, 43(1): 50-65.
Bergthold L, Koebler S, and Singer S, “In Loco Parentis? The Purchaser Role in Managed Care,” California Management Review, 2000 Fall, 43(1): 34-49.
Enthoven AC and Singer SJ, “Unrealistic Expectations Born of Defective Institutions,” Journal of Health Politics, Policy and Law, 1999 Oct, 24(5): 931-940.
Enthoven AC and Singer SJ, “The Managed Care Backlash and the Task Force in California,” Health Affairs, 1998 Aug, 17(4): 95-110.
Enthoven AC and Singer SJ, “Markets and Collective Action in the Regulation of Managed Care,” Health Affairs, 1997 Nov-Dec, 16(6): 26-32.
Hunt KA, Singer SJ, Gable J, Liston D, and Enthoven AC, “Paying More Twice: When Employers Subsidize Higher Cost Health Plans,” Health Affairs, 1997 Nov-Dec, 16(6): 150-156.
Enthoven AC Singer SJ, “Managed Competition and the California Health Care Economy,” Health Affairs, 1996 Spring, 15(1): 39-57.
Enthoven AC and Singer SJ, “Increasing Cost-Consciousness for Managed Care: Reforming the Tax Treatment of Health Insurance Expenditures, Health Care Management, 1995 Oct, 2(1): 109-114.
Enthoven AC and Singer SJ, “Market-Based Reform: What to Regulate and By Whom,” Health Affairs, 1995 Spring, 14(1): 105-119; reprinted in Aaron HJ, ed., The Problem That Won’t Go Away: Reforming U.S. Health Care Financing (Washington, DC: The Brookings Institution) 1995, 185-206.
Enthoven AC and Singer SJ, “Choosing Among Health Plans,” Health Care Management, 1994 Aug, 1(1): 45-56.
Enthoven AC and Singer SJ, “Incentives for a Better Health Care System,” Journal of Health Care Benefits, 1994 Jul-Aug, 3(6): 4-7.
Enthoven AC and Singer SJ, “A Single Payer System in Jackson Hole Clothing,” Health Affairs, 1994 Spring, 13(1): 81-95.
Singer SJ, “Problems in Gaining Access to Hospital Information,” Health Affairs, 1991 Summer, 10(2): 148-151.
Singer SJ and Edmondson AC, “When Learning and Performance are at Odds: Confronting the Tension,” in Learning and Performance Matter, Kumar P and Ramsey P, eds., (New Jersey: World Scientific Books) 2008 (also available as HBS Working Paper No. 07-032).
Singer SJ, Enthoven AC, and Garber AM, “Healthcare Financing and Information Technology: A Historical Perspective,” in Biomedical Informatics: Computer Applications in Health Care and Biomedicine, Third Edition, Shortliffe EH, Cimino JJ, eds., (New York: Springer-Verlag) 2006, 791-828.
Singer SJ, Dunham KM, Bowen JD, Geppert JJ, Gaba DM, McDonald KM and Baker LC, “Lessons in Safety Climate and Safety Practices from a California Hospital Consortium,” in: Henriksen K, Battles JB, Lewin DI, Marks E, eds., Advances in patient safety: From research to implementation. (Rockville, MD: Agency for Healthcare Research and Quality) 2005 May, 3:411-423.
Geppert JJ, Singer SJ, Buechner J, Ranbom L, Suarez W, Xu W, “State Race and Ethnicity Data Collection,” in Melnick D and Perrin E, eds., Improving Racial and Ethnic Data on Health: Report of a Workshop (Washington, DC: National Academies Press), 2003.
Singer SJ, Garber AM, Enthoven AC, “Near-Universal Coverage Through Health Plan Competition: An Insurance Exchange Approach,” in Covering America: Real Remedies for the Uninsured, JA Meyer and EK Wicks, eds. (Washington, DC: Economic and Social Research Institute) 2001 Jun, 155-172.
Singer SJ, Enthoven AC, and Garber AM, “Health Care and Information Technology: Growing Up Together,” in Medical Informatics, Computer Application in Health Care, Second Edition, Shortliffe EH, Perreault LE, Wiederhold G, Fagan LM, eds., (New York: Springer-Verlag) 2000, 663-696.
Singer SJ and Enthoven AC, “California’s Struggle with Regulation,” in Regulating Managed Care: Theory, Practice, and Future Options, Altman S, Reinhardt U, and Schactman D, eds., (Menlo Park: Jossey-Bass) 1999, 312-330.
SELECTED OPINION PIECES
Gaba D, Singer SJ, Rosen A, “Safety culture: Is the ‘unit’ the right ‘unit of analysis’?” Critical Care Medicine, 2007 January, 35(1) 314-315.
Hoops A and Singer S, “Benefits Administration Requires Creativity in Consumer-Center Plans,” Managed Healthcare Executive, 2003 Mar, 13(3): 30-31.
Singer SJ and Bergthold L, “Cosmetic versus Reconstructive Surgery for Cleft Palate: A Window into the Medical Necessity Debate,” JAMA, 2001 Nov 7, 296(37): 6.
Singer SJ, “What’s Not to Like About HMOs,” Health Affairs, 2000 Jul-Aug, 19(4): 206-209.
Singer SJ, “Bundle of Joy Brings HMO Headaches,” Los Angeles Times, July 17, 2000, S1.
Enthoven AC and Singer SJ, “Managed Care Can Be Made to Work Better,” Los Angeles Times, February 6, 1998, B9.
Enthoven AC and Singer SJ, “Medicare Reform Needed Now,” Los Angeles Times, March 12, 1997, B9.
Enthoven AC and Singer SJ, “Danger Ahead on Medicare,” The New York Times, August 16, 1995, A25.
Enthoven AC and Singer SJ, “Nix Insurance with a Tax Break,” Los Angeles Times, April 7, 1995, B7.
Enthoven AC and Singer SJ, “Let’s Try Aspirin Before We Amputate,” Los Angeles Times, September 19, 1994, B7.
Enthoven AC and Singer SJ, “Bad Old Ways Beset National Health-Care Proposals,” Los Angeles Times, May 9, 1994, B7.
Enthoven AC and Singer SJ, “Good Profits Can Mean Good Care,” Los Angeles Times, April 21, 1994, B7.
Enthoven AC and Singer SJ, “Innovation: Medicine’s Best Cost-Cutter,” The New York Times, March 20, 1994, F13.
Enthoven AC and Singer SJ, “The One Huge Flaw of ‘Single Payer,” Los Angeles Times, March 8, 1994, B7.
Enthoven AC and Singer SJ, “Raise Quality by Lowering Costs,” Los Angeles Times, January 17, 1994, B7.
Enthoven AC and Singer SJ, “A Good Health Care Idea Gone Bad,” The Wall Street Journal, Thursday, October 7, 1993.
Enthoven AC and Singer SJ, “Health Plan: Who Will Watch Costs?” The New York Times, Sunday, October 3, 1993, 102.
Enthoven AC and Singer SJ, “Did Clinton Spell Relief? Proposal Has Strengths, Deficiencies,” Los Angeles Daily News. September 26, 1993.
Enthoven AC and Singer SJ, “Health Reform: Let’s Do It Right,” Fortune, September 1, 1993.
Enthoven AC and Singer SJ, “Health Care Is Healing Itself,” The New York Times, August 17, 1993, A17.
STATE & FEDERAL CONGRESSIONAL TESTIMONY
Singer SJ, “A Promising Path Toward Universal Health Insurance Coverage,” Testimony Before the Committee on Ways and Means, Health Subcommittee U.S. House of Representatives, Hearing on The Nation’s Uninsured, Washington, DC, April 4, 2001.
Singer SJ, “A Wrong Step: Limits on Administrative Costs and Profits of Health Plans,” Testimony Before the Assembly Committee on Health of the California Legislature, Sacramento, CA, April 19, 1994.
Singer SJ, “The Cooper Bill,” Testimony Before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, Washington, DC, February 2, 1994.