Harkness Project Title: Strategies to Reduce Unwarranted Clinical Practice Variations in U.S. Hospitals
Mentors: Alan B. Cohen, Sc.D.; David Blumenthal, M.D.
Placement: Boston University Health Policy Institute
Biography at time of Harkness Fellowship: Robin Gauld, Ph.D., a 2008–09 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, is an associate professor of health policy at the University of Otago, where he had previously been lecturer and senior lecturer. Past positions also include several lecturer posts and research officer at the City University of Hong Kong. Gauld's current research interests include comparative health policy, primary care, and health information and technology. He has written and contributed to numerous books and over 40 peer-reviewed journal articles, which have been published in journals such as the Journal of Health Politics, Policy and Law, Medical Care, the British Medical Journal, Health Policy, and the New Zealand Medical Journal. In addition, Gauld's research on the impact of New Zealand's health restructurings has been cited by the Australian Health Minister, and he gave the keynote address on "The New Zealand e-government experience: political promise, practical perceptions and future prospects" at the CIO Conference in Auckland in 2007. Gauld holds a Ph.D. in public administration from the University of Hong Kong, and a master's degree with distinction from Victoria University, Wellington.
Project: Gauld’s project aimed to examine strategies employed by health care providers to reduce performance variations. The project had two components. First, Gauld conducted five in-depth case studies of high-performing Massachusetts hospitals, including interviews with management and clinical staff. Second, he undertook a survey of chief quality officers in all acute care hospitals in four states.
Career Activity Since Fellowship
- First Prize, Health and Social Care, British Medical Association Book Awards (for: The New Health Policy), 2010
- Director, Centre for Health Systems, Department of Preventive and Social Medicine, University of Otago Medical School
Current Positions: (updated 7/2017)
- Dean and Pro-Vice Chancellor, Department of Management, University of Otago
- Professor of Health Policy and Director of the Centre for Health Systems, Department of Preventive and Social Medicine, University of Otago Medical School
E-mail: [email protected]
Harkness-Related Publications
Gauld R, Horsburgh S. Healthcare professional perspectives on quality and safety in New Zealand public hospitals: findings from a national survey. Aust Health Rev. 2014 Feb;38(1):109-14.
Gauld R. Clinical governance development: learning from the New Zealand experience. Postgrad Med J. 2014 Jan;90(1059):43-7.
Penno E, Gauld R, Audas R. How are population-based funding formulae for healthcare composed? A comparative analysis of seven models. BMC Health Serv Res. 2013 Nov 8;13:470.
Gauld R. Questions about New Zealand's health system in 2013, its 75th anniversary year. N Z Med J. 2013 Aug 16;126(1380):68-74.
Laugesen M, Gauld R. “Democratic Governance & Health: Hospitals, Politics, and Health Policy in New Zealand.” Otago University Press. September 2012.
Gauld R, Burgers J, Dobrow M, Luxford K, Minhas R, Wendt C, Cohen AB. “Quality improvement, information technology and primary care can improve healthcare system performance. But are policy makers promoting them?” Int J Clin Pract. 2012 Sep;66(9):827-33.
Derrett S, Cousins K, Gauld R. “A messy reality: An analysis of New Zealand’s elective surgery scoring system via media sources, 2000-2006.” International Journal of Health Planning and Management. 2012.
Gauld R. “New Zealand’s post-2008 health system reforms: Toward re-centralization of organizational arrangements.” Health Policy. 12 April 2012.
Goodyear-Smith F, Gauld R, Cumming J, O'Keefe B, Pert H, McCormack P. “International Learning on Increasing the Value and Effectiveness of Primary Care (I LIVE PC) New Zealand.” J Am Board Fam Med. 2012 Mar;25 Suppl 1:S39-44
Gauld R, Blank R, Burgers J, Cohen AB, Dobrow M, Ikegami N, Kwon S, Luxford K, Millett C, Wendt C., “The World Health Report 2008: Primary Healthcare: How wide is the gap between its agenda and implementation in 12 High-Income Health Systems?” Healthcare Policy. 7(3). 2012.
Gauld R, et al., "Scorecards for Health System Performance Assessment: The New Zealand Example," Health Policy, published online July 4, 2011.
Gauld R, Dovey S, Tilyard M, Tomlin A. “How physicians can drive comparative-effectiveness research: lessons from New Zealand.” Am J Med. 2011 Feb;124(2):93-4.
Tomlin A, Dovey S, Gauld R, Tilyard M. “Better use of primary care laboratory services following interventions to 'market' clinical guidelines in New Zealand: a controlled before-and-after study.” BMJ Qual Saf. 2011 Mar;20(3):282-90.
Gauld R. “Big country, small country: how the United States debated health reform while New Zealand just got on with it.” Int J Clin Pract. 2010 Sep;64(10):1334-6.
Gauld R. “Are elected health boards an effective mechanism for public participation in health service governance?” Health Expect. 2010 Dec;13(4):369-78.
Gauld R, Horwitt J, Williams S, Cohen AB. “What strategies do US hospitals employ to reduce unwarranted clinical practice variations?” American Journal of Medical Quality 2010.