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Aston University: From Metformin to modern obesity therapies
Early beginnings: from herbal medicine to modern drug The origins of a modern diabetes therapy can be traced back to Galega officinalis (goat’s rue), a herb used in European folk medicine for centuries to treat excessive thirst and urination. Its active chemical, guanidine, was found to lower blood sugar in animals in 1918, inspiring the synthesis of a family of drugs known as biguanides. Among these new drugs was metformin, created in 1922 and introduced as a treatment for diabetes in Europe in the late 1950s. However, by the 1970s, metformin was largely disregarded because other biguanide medicines were being withdrawn due to their side-effect of lactic acidosis. Revival in the 1990s: Aston’s role in rediscovery In the early 1990s, research at Aston University provided a decisive turning point. Professor Cliff Bailey and his colleagues revealed that metformin’s primary action occurred in the intestine, where it promoted glucose metabolism and reduced blood sugar without causing weight gain. Their studies clarified that concerns about lactic acid were largely due to misuse, not inherent toxicity. These findings reignited global interest in metformin. Professor Bailey presented his work as an expert witness to the US Food and Drug Administration in 1994, a critical step in securing approval of the drug in the US. He also assisted the European Medicines Agency during periodic reassessments. “My research has always focused on understanding how type 2 diabetes develops and how best to treat it.” Professor Clifford Bailey, Aston University. Establishing global first-line therapy Momentum built through the late 1990s. The UK Prospective Diabetes Study (1998) demonstrated that metformin not only improved blood sugar but also reduced cardiovascular risk, strengthening the case for its wider adoption. By 2012, the American Diabetes Association and the European Association for the Study of Diabetes recommended metformin as the preferred first-line treatment for type 2 diabetes. “We discovered that metformin worked somewhat differently from what was previously thought. By showing how it could be used safely and effectively, we helped pave the way for its wider acceptance.” Today, metformin is the most prescribed diabetes drug worldwide. It is included in the World Health Organization’s Essential Medicines List and has been taken by hundreds of millions of patients, profoundly reshaping global diabetes care. New directions: dapagliflozin and the SGLT-2 inhibitors After the success of metformin, Aston played a central role in the next wave of diabetes medicines. In the 2000s, Professor Bailey was principal investigator in clinical trials for dapagliflozin, the first of the sodium-glucose co-transporter-2 (SGLT-2) inhibitors. Unlike older therapies, SGLT inhibitors lower blood sugar by blocking reabsorption of glucose in the kidneys, causing excess glucose to be excreted in urine. Large international trials demonstrated additional benefits, including weight reduction, lower blood pressure, and improved outcomes for patients with kidney and heart disease. Since its launch in 2012, dapagliflozin has become the most widely prescribed SGLT-2 inhibitor, with more than five million patients treated. It is now embedded in global treatment guidelines, expanding therapeutic options to improve the control of blood glucose and body weight. Foundations for modern obesity therapies The influence of Aston University’s research extends beyond metformin and dapagliflozin. The University’s diabetes research team also studied gut hormones such as GIP (glucose-dependent insulinotropic peptide), which play a central role in regulating insulin secretion and fat metabolism. These early discoveries helped lay the groundwork for today’s incretin-based therapies, including combined GIP/GLP-1 receptor agonists such as tirzepatide. Now widely known as 'anti-obesity injections', these medicines emerged as diabetes treatments and are now transforming care for overweight people with and without type 2 diabetes. Key findings from the research at Aston University Metformin is now being investigated for its anti-ageing and fertility benefits Dapagliflozin shows promise against heart and kidney diseases and gout Gut hormones such as GIP may hold the key to entirely new treatment strategies Why does this matter? The work by Professor Bailey and his colleagues at Aston University has contributed to metformin’s recognition as the primary treatment worldwide for type 2 diabetes. Today, at least half of all patients in Western countries are prescribed metformin — an incredibly cost-effective medicine that continues to save lives. “We identified early on that gut hormones such as GIP were central players in the control of blood glucose and body weight — long before they became the basis for today’s new generation of anti-obesity medicines.” This original research helped lay the scientific foundation for breakthrough treatments like tirzepatide, widely hailed as a game-changer in obesity and diabetes care. Aston University also contributed to the development of dapagliflozin, the first in a new class of drugs that lower blood sugar while also protecting the heart and kidneys. “Millions of people worldwide are living longer and healthier lives because of therapies that have been underpinned by research at Aston University.” Looking ahead Type 2 diabetes remains one of the world’s most pressing health challenges, affecting more than 500 million people globally. Its progressive nature demands a continual search for safer, more effective treatments. From helping rescue a nearly forgotten drug in the 1990s to shaping the next generation of therapies, Aston University’s research has left an enduring mark on clinical practice, regulation, and patient outcomes. The legacy of this work is clear: millions of people worldwide are living longer, healthier lives because of medicines that Aston helped bring to the forefront of modern diabetes and obesity care. About Cliff Bailey is Emeritus Professor of Clinical Science and Anniversary Professor at Aston University in Birmingham, England. He has served on medical and scientific committees of Diabetes UK (formerly the British Diabetic Association), Society for Endocrinology, and European Association for the Study of Diabetes. He has served as a diabetes expert for the approval of new medicines by regulatory agencies including the European Medicines Agency and NICE. His research is mainly directed towards the pathogenesis and treatment of diabetes, especially the development of new agents to improve insulin action and reduce obesity, and the therapeutic application of surrogate beta-cells. Dr Bailey has published over 400 research papers and reviews, and four books, and he is particularly known for research on metformin. References to Case Studies and Key Sources Bailey CJ et al. Metformin: Changing the Treatment Algorithm for Type 2 Diabetes. Aston University REF Impact Case Study, 2014. Bailey CJ. Metformin: Historical Overview. Diabetologia, 2017. Bailey CJ & Day C. Treatment of Type 2 Diabetes: Future Approaches. British Medical Bulletin, 2018.
With the opening of a new cardiology practice at its Wilmington campus, ChristianaCare is bringing life-saving treatment for peripheral artery disease (PAD) closer to home for people who live in and around the city of Wilmington. Peripheral artery disease happens when plaque builds up in the arteries and limits blood flow to the legs. This can cause pain, cramping and difficulty walking. If left untreated, it can lead to serious problems like limb loss, heart attack or stroke. “We’re on a mission to improve the heart and vascular health of our community, and one of the key ways we do that is to identify where people need access to care and ensure that it’s convenient, high-quality and accessible. ChristianaCare’s expansion of cardiology services to the Wilmington campus has made it easier for patients in Wilmington and the surrounding community to receive excellent heart and vascular care,” said Kirk Garratt, M.D., MSc, medical director of the Center for Heart and Vascular Health. “Importantly, it’s part of a multi-disciplinary effort to bring a focus on PAD that includes vascular surgery and interventional radiology. We’re expanding those services in the Wilmington community, too.” In Delaware, an estimated 45,000 to 50,000 people are living with PAD. The condition is more common among older adults and those with diabetes, high blood pressure or a history of smoking, all of which are widespread in the state. Because symptoms can be subtle, many people may not know they have it. That’s why awareness and early diagnosis are so important. Anyone who experiences leg pain, numbness or slow-healing sores should talk with their doctor. A simple test can measure blood flow, and with the right treatment or lifestyle changes, people can ease symptoms and lower their risk of serious complications. The new practice, located in the Gateway Building at Wilmington Hospital, 501 West 14th Street, 4th Floor, offers convenient access to diagnosis and treatment in the heart of the city. The practice is open on Wednesdays from 8 a.m. to 12 p.m., and hours will be adjusted based on patient demand. Meet the Cardiologist: Dr. Vikashsingh Rambhujun Board-certified interventional cardiologist Vikashsingh Rambhujun, MBBS, has cared for ChristianaCare patients for more than a decade and now sees patients at the Wilmington practice. Rambhujun earned his medical degree from SSR Medical College in Mauritius. He completed his residency in internal medicine at the NYU Grossman Long Island School in New York and did his fellowship in cardiovascular medicine and interventional cardiology at ChristianaCare. Rambhujun also spent a year doing interventional cardiology and endovascular medicine and interventions at Yale University Hospital in New Haven, Connecticut. His research has been published widely in medical journals. Rambhujun aims to help patients manage PAD before it becomes advanced. When appropriate, he can perform minimally invasive catheter-based procedures to open blockages in the arteries. “We have new patients with blockages that haven’t progressed to the point that they need a procedure, which is where we want to catch them,” Rambhujun said. “We can manage their cholesterol, blood pressure and other risk factors to prevent disease from progressing.” When Rambhujun began practicing in Wilmington, he made it a priority to speak at local community meetings, raising awareness about the warning signs of heart and vascular disease. His message is simple but urgent: don’t wait; seek treatment early. “We’re trying to help people keep their toes and feet,” he said. “When we treat blockages from peripheral artery disease, the difference can be dramatic,” he said. “Patients who once struggled to walk even a short distance because of pain can leave the hospital able to move freely again. Helping someone reclaim their basic freedoms to walk, stay active and enjoy life is incredibly rewarding.”
In the two years since Augusta University and Wellstar Health System formally signed an agreement on August 30, 2023, the historic partnership has continued to evolve into a truly collaborative alliance. At its heart, the mission hasn’t changed: improving the health and wellbeing of all Georgians while educating and preparing the next generation of health care providers through access to world-class training. That was the message shared by Augusta University President Russell T. Keen, Medical College of Georgia at Augusta University Dean David C. Hess, MD, and former Wellstar President and CEO Candice L. Saunders at the recent Health Connect South conference held at the Georgia Aquarium in Atlanta. During their panel “Advancing Healthcare Through Public-Private Partnerships,” the three leaders – each instrumental in helping to create, implement and mold the historic partnership – shared with close to 1,100 attendees their insight into what makes the partnership beneficial for all and how it can be a model for advancing health care and health care education in Georgia and beyond. The full panel discussion is available for viewing here: It was an important event, and a full article is attached below as well. And if you're interested in learning more about the partnership between Augusta University and Wellstar, or connect with Augusta's President Russell T. Keen - simply click on his icon now to arrange an interview today.
Some interesting areas that I’ve seen in the press: "Consumer Sentiment was measured at the 7th lowest point (55.1) since its inception in 1952, yet we’re not seeing a huge decrease in spending (CNN). Part of the argument is the spending is an average measure and really wealthy consumers are not feeling the pinch and spending like normal or moreso, while less financially-well-off-individuals are pulling back their spending (Spectrum Local News). Presumably, the shutdown doesn’t help that figure. In terms of consumer groups affected, let’s look at government workers first. An article by the BBC claimed roughly 750,000 “non-essential” federal workers could be furloughed without pay. This means that many to most of those are going to struggle with paying for the necessities and this becomes more and more of a strain the longer the shutdown wears on. Furloughed Workers: Most furloughed workers are required to be paid back pay when the shutdown is over by law. That could in some ways create more purchases in the future if they can’t be bought currently, but could also lead to things like more credit card debt as people can put charges on a credit card to pay back later. While from a consumer psychology standpoint that might make sense, but it’s a very risky practical strategy. Gov’t contractors don’t get the same guarantee. Businesses that rely heavily on such groups (e.g., in a town where many fall into those segments) might suffer or shutter. This means other consumers that frequent those establishments have their routines disrupted , and force them to find other providers. Essential Workers: Then we have the group of “essential” workers that must go to work and still not be paid, Air Traffic Controllers, The military, TSA Agents, certain law enforcement groups, etc. that all might draw back spending with no immediate income. That can cause major issues for retailers and producers, which could lead to more layoffs in the private sector, putting more consumers into financial straits. If you’re someone that likes to visit national parks or zoo’s like the National Zoo, or the Smithsonian Museums (which has claimed they’ll have funding at least through October 6th), you could be disappointed to have reduced accessibility or outright closures due to the shutdown, again according to the BBC. Healthcare: Healthcare could definitely be affected, particularly for those on Medicaid and medicare (i.e., the elderly and poor). So if you view medical services as consumer good, then there will be issues there as well (increased wait times, decreased satisfaction, etc.), which is likely to add apprehension and anxiety to many consumers. Travel: If you’re a traveler, staffing shortages in the TSA and Air Traffic Controllers could lead to significant travel delays, which could disrupt leisure or business plans, or force people to cancel plans altogether. If you’re traveling abroad getting your passport updated could take longer. All these things (and many more) may happen or not depending on the length of the shutdown and the severity of the furloughs. Those in better financial positions will suffer less, while those already in less desirable financial situations might find that delays in some of their normally federally funded services (e.g., SNAP, WIC, etc.) create even bigger issues."
Aging in context: Why culture matters in discussions on menopause
How do we age? Why do we age? And why are experiences of menopause and midlife so different across cultures? These are the driving questions behind the work of Melissa Melby, a medical anthropologist and professor at the University of Delaware. For more than 25 years, Melby has been exploring how biology and culture intersect to shape the way people experience aging and menopause. Her new book, Reframing Aging: Insights from Biology and Culture of Midlife Japanese, introduces a biocultural framework that goes beyond the “what” of aging to ask both how (the immediate mechanisms) and why (the deeper evolutionary reasons) we age and experience menopause the way we do. By weaving together insights from evolutionary biology, anthropology, medicine and lived experience, Melby challenges what many consider to be the “normal” path of midlife. Her research highlights how cultural expectations, medical practices, social structures and lifestyle habits can profoundly influence not just how symptoms are treated – but how they are perceived in the first place. What may be pathologized in one society could be understood as a natural stage of life in another. As conversations around women’s health, longevity and healthy aging gain overdue attention, Melby’s cross-disciplinary expertise offers journalists a fresh lens for exploring some of the most universal – and misunderstood – aspects of human life. For stories that bridge science, culture and health, Melby provides a rare perspective: one that reframes aging and menopause not as fixed biological destinies, but as experiences shaped by the complex interplay of our bodies, histories, and communities. Reporters interested in speaking to Melby can email mediarelations@udel.edu.
ChristianaCare’s Virtual Primary Care practice at the Center for Virtual Health has earned full accreditation from the National Committee for Quality Assurance (NCQA), placing it among the first health systems in the nation to achieve this distinction. ChristianaCare was one of only 18 organizations invited to participate in NCQA’s inaugural pilot program in 2023 to develop the Virtual Care Accreditation. The recognition affirms ChristianaCare’s leadership role in shaping the future of health care and its commitment to delivering accessible, equitable and patient-centered care through innovative digital platforms. “This accreditation is a powerful validation of our vision to reimagine health care,” said Sarah Schenck, M.D., FACP, executive director of ChristianaCare’s Center for Virtual Health. “We’ve built a model that meets people where they are—at home, at work or on the go—with care that is personal, proactive and powered by love and excellence.” What Accreditation Means for Patients NCQA accreditation underscores that ChristianaCare’s Center for Virtual Health meets rigorous standards for: Clinical quality and safety: clear care protocols, escalation pathways and outcome monitoring. Access and equity: technology, language and disability-inclusive design that extends care to more people. Data privacy and security: strong safeguards to protect personal health information. ChristianaCare’s participation in NCQA’s pilot helped shape the benchmarks now used nationwide. The center delivers comprehensive virtual primary care through a multidisciplinary team that includes physicians, nurses, nurse practitioners, behavioral health specialists, pharmacists and patient digital ambassadors. Virtual Care by the Numbers In 2024, ChristianaCare’s Center for Virtual Health provided more than 7,500 patient visits, reflecting both rapid growth and strong demand for its virtual-first model. Services are offered at no copay to ChristianaCare caregivers and their dependents, while availability continues to expand across Delaware and the region “At ChristianaCare, we believe virtual care isn’t just a convenience, it’s a catalyst for better health outcomes,” said Brad Sandella, D.O., MBA, medical director, Ambulatory Care for the Center for Virtual Health. “This accreditation affirms our commitment to innovation and excellence. We’re proud to be among the pioneers defining what high-quality virtual care looks like in America.” Beginning in 2026, ChristianaCare will expand its Virtual Primary Care practice, giving a broader consumer audience convenient access to primary care. At that time, the service will be covered by most insurance carriers and continue to feature dedicated providers in areas such as behavioral health and neurology. ChristianaCare will also continue working with NCQA and other partners to advance best practices nationwide.
First in Delaware to Offer Breakthrough Tricuspid Valve Disease Treatments
For the first time in Delaware, patients with tricuspid valve disease have access to two new FDA-approved, minimally invasive procedures that can repair or replace a failing heart valve without the need for open-heart surgery. The tricuspid valve helps keep blood moving in the right direction through the heart. When it doesn’t close properly — a condition known as tricuspid valve regurgitation — blood leaks backward, forcing the heart to work harder. Over time, patients can experience fatigue, shortness of breath and swelling in the legs and ankles. ChristianaCare’s Center for Heart & Vascular Health is among the first in the nation and the first in the state to offer these advanced procedures, which can restore valve function and improve quality of life. “ChristianaCare continues to innovate in the area of non-surgical valve procedures,” said Kirk Garratt, M.D., MSc, medical director of the Center for Heart & Vascular Health. “We now offer every FDA-approved therapy for tricuspid valve disease, which means we can tailor treatment to each patient and choose the option that best fits their condition.” New Procedures Offer Hope for Patients ChristianaCare offers these minimally invasive procedures to treat tricuspid valve regurgitation: TriClip, which repairs a leaky tricuspid valve. A staple-like clip is attached to the flaps of the valve that don’t close properly, which stops the valve from leaking. EVOQUE, which replaces a faulty tricuspid valve. When the new valve is placed, it uses the patient’s own tricuspid valve as an anchoring system. The new valve takes over for the leaky valve, correcting the problem. “Most of our patients with tricuspid valve disease are older adults, and they really do not desire to travel to Philadelphia for treatment,” said Erin Fender, M.D., an interventional cardiologist at the Center for Heart & Vascular Health. ChristianaCare’s tricuspid valve disease program enables patients to stay in Delaware for treatment and receive this leading-edge care. Fender and interventional cardiologist James Hopkins, M.D., performed ChristianaCare’s first TriClip procedure in August. In September, they performed ChristianaCare’s first EVOQUE procedure. Minimally Invasive, Maximum Impact During both procedures, an IV catheter is inserted into a vein at the top of the leg. A hollow tube is threaded through the IV and into the heart, allowing the clip or replacement valve to access the tricuspid valve. The entire procedure is guided by echocardiogram and generally takes one to two hours. “Patients are usually up and walking later that evening or the next morning, depending on what time of day the procedure was done,” Fender said. “They’re typically discharged the following day.” In the past, open-heart surgery was the only treatment for tricuspid valve disease, but patients with severe symptoms usually weren’t good surgical candidates. “When I was a fellow, I did research focused on tricuspid regurgitation at a time when patients really had no therapeutic options,” Fender said. “Now, being able to offer people therapy that’s so safe and effective, with minimal downtime afterwards, is absolutely transformative to our patients. It’s delightful to see the evolution.” Expanding the Toolbox of Innovation The TriClip and EVOQUE are two of the most recent minimally invasive procedures performed at the Center for Heart & Vascular Health. Other recent innovative, minimally invasive heart and vascular procedures include: Pulsed field ablation for atrial fibrillation. A-fib arises when abnormal heart tissue mistakenly prompts electrical impulses, causing heart palpitations, chest pain and shortness of breath. Pulsed field ablation safely destroys the abnormal tissue quicker and more consistently than other treatments, such as freezing (cryoablation) or heating (radiofrequency ablation). Genicular artery embolization for mild to moderate knee pain. Osteoarthritis can cause inflammation and pain within the knee, which can limit a patient’s mobility. Genicular artery embolization pinpoints areas of inflammation within the knee, and tiny bead-like particles are placed within the blood vessels to block blood flow to those areas. The procedure reduces pain and improves mobility. National Recognition for Excellence ChristianaCare’s Center for Heart & Vascular Health continues to earn national recognition as one of the nation’s premier destinations for cardiovascular care. Most recently, the Center received the HeartCare National Distinction of Excellence award from the American College of Cardiology for the 6th consecutive year. This award honors hospitals that consistently deliver superior medical, surgical and radiologic care aligned with the most rigorous standards of the American College of Cardiology. The award reflects ChristianaCare’s commitment to ensuring patients receive the best, evidence-based care for every cardiovascular need. That excellence is further affirmed by U.S. News & World Report, which named ChristianaCare a High Performing hospital in its 2025—2026 Best Hospitals rankings for aortic valve surgery, heart bypass surgery and heart failure. The Center for Heart & Vascular Health is among the largest and most advanced programs on the East Coast, uniquely integrating cardiac surgery, vascular surgery, vascular interventional radiology, cardiology and interventional nephrology in one location. In 2024, its expert clinical teams performed nearly 200,000 patient procedures, underscoring the depth of experience and patient-centered care that set ChristianaCare apart.
Michael McClure, Ph.D., associate professor from the Department of Biomedical Engineering and affiliate faculty in the Department of Orthopaedic Surgery and in the Institute for Engineering and Medicine, has been named chair of the Orthopaedic Research Society’s (ORS) newly launched Skeletal Muscle Section. The section began in August 2025, building on research interest groups and symposia to create a dedicated home for skeletal muscle studies within ORS. Its mission is to advance collaboration, innovation, education and translation in this field. Skeletal muscle disorders cause disability, chronic pain and high health care costs. Severe injuries and degenerative diseases, such as muscular dystrophies, remain difficult to treat. The section will strengthen research in muscle development, aging, trauma, disuse and disease. This work will expand the basic understanding of and identify therapeutic targets to restore function. In its first year, the section will measure success through increased skeletal muscle abstracts at the 2027 ORS Annual Meeting, growth in ORS membership and active participation in section programs. “We are thrilled to launch the Skeletal Muscle Section,” McClure said. “This home for translational muscle research will build on ORS progress over the past 10 years, help recruit new members and foster an environment that connects multiple areas of orthopaedic science.” McClure’s commitment to this work is shaped by his family’s experience with neuromuscular diseases, witnessing the impact of war-related injuries on patients’ quality of life from the Richmond Veterans Affairs Medical Center, and the momentum of translational discovery. Learn more about the ORS Skeletal Muscle Section.
#Expert Research: Incentives Speed Up Operating Room Turnover Procedures
The operating room (OR) is the economic hub of most healthcare systems in the United States today, generating up to 70% of hospital revenue. Ensuring these financial powerhouses run efficiently is a major priority for healthcare providers. But there’s a challenge. Turnovers—cleaning, preparing, and setting up the OR between surgeries—are necessary and unavoidable processes. OR turnovers can incur significant costs in staff time and resources, but at the same time, do not generate revenue. For surgeons, the lag between wheels out and wheels in is idle time. For incoming patients, who may have spent hours fasting in preparation for a procedure, it is also a potential source of frustration and anxiety. Reducing OR turnover time is a priority for many US healthcare providers, but it’s far from simple. For one thing, cutting corners in pursuit of efficiency risks patient safety. Then there’s the makeup of OR teams themselves. As a rule, well-established or stable teams work fastest and best, their efficiency fueled by familiarity and well-oiled interpersonal dynamics. But in hospital settings, staff work in shifts and according to different schedules, which creates a certain fluidity in the way turnover teams amalgamate. These team members may not know each other or have any prior experience working together. For hospital administrators this represents a quandary. How do you cut OR turnover time without compromising patient care or hiring in more staff to build more stable teams? To put that another way: how do you motivate OR workers to maintain standards and drive efficiency—irrespective of the team they work with at any given time? One novel approach instituted by Georgia’s Phoebe Putney Health System is the focus of new research by Asa Griggs Candler Professor of Accounting, Karen Sedatole PhD. Under the stewardship of perioperative medical director and anesthesiologist, Jason Williams MD 02MR 20MBA, and with support from Sedatole and co-authors, Ewelina Forker 23PhD of the University of Wisconsin and Harvard Business School’s Susanna Gallini PhD, staff at Phoebe ran a field experiment incentivizing individual OR workers to ramp up their own performance in turnover processes. What they have found is a simple and cost-effective intervention that reduces the lag between procedures by an average of 6.4 percent. Homing in on the Individual Williams and his team at Phoebe kicked off efforts to reduce OR turnover times by first establishing a benchmark to calculate how long it should take to prepare for different types of procedure or surgery. This can vary significantly, says Williams: while a gallbladder removal should take less than 30 minutes, open-heart surgery might take an hour or longer to prepare. “There’s a lot of variation in predicting how long it should take to get things set up for different procedures. We got there by analyzing three years of data to create a baseline, and from there, having really homed in on that data, we were able to create a set of predictions and then compare those with what we were seeing in our operating rooms—and track discrepancies, over-, and underachievement.” Williams, a Goizueta MBA graduate who also completed his anesthesiology residency at Emory University’s School of Medicine, then enlisted the support of Sedatole and her colleagues to put together a data analysis system that would capture the impact of two distinct mechanisms, both designed to incentivize individual staff members to work faster during turnovers. The first was a set of electronic dashboards programmed to record and display the average OR turnover performance for teams on a weekly basis, and segment these into averages unique to individuals working in each of the core roles within any given OR turnover team. The dashboard displayed weekly scores and ranked them from best to worst on large TV monitors with interactive capabilities—users could filter the data for types of surgery and other dimensions. Broadcasting metrics this way afforded Williams and his team a means of identifying and then publicly recognizing top-performing staff, but that’s not all. The dashboards also provided a mechanism with which to filter out team dynamics, and home in on individual efforts. “If you are put in a room with one team, and they are slower than others, then you are going to be penalized. Your efforts will not shine. Now, say you are put in with a bigger or faster team, your day’s numbers are going to be much higher. So, we had to find a way to accommodate and allow for the team effect, to observe individual effort. The dashboards meant we could do this. Over the period of a week or a month, the effect of other people in the team is washed out. You begin to see the key individuals pop up again and again over time, and you can see those who are far above their peers versus those who, for whatever reason, are not so efficient.” Sharing “relative performance” information has been shown to be highly motivating in many settings. The hope was that it would here, too. Three core roles: Who’s who in the Operating Room turnover team? OR turnover teams consist of three roles: circulating nurse, scrub tech, and anesthetist. While other surgery staff might be present during a turnover, depending on the needs of consecutive procedures, these are the three core roles in the team, and they are not interchangeable in any way: each individual assumes the same responsibilities in every team they join. Typically, turnover tasks will include removing instruments and equipment from the previous surgery and setting up for the next: restocking supplies and restoring the sterile environment. Turnover tasks and activities will vary according to the type of procedure coming next, but these tasks are always performed by the same three roles: nurse, scrub tech, and anesthetist, working within their own area of expertise and specialty. OR turnover teams are assembled based on staff schedules and availability, making them highly fluid. Different nurses will work with different scrub techs and different anesthetists depending on who is free and available at any given time. With dashboards on display across the hospital’s surgery department, Williams decided to trial a second motivational mechanism; this time something more tangible. “We decided to offer a simple $40 Dollar Store gift card to each week’s top performing anesthetist, nurse, or scrub technician to see if it would incentivize people even more. And to keep things interesting, and sustain motivation, we made sure that anyone who’d won the contest two weeks in a row would be ineligible to win the gift card the following week,” says Williams. “It was a bit of a shot in the dark, and we didn’t know if it would work.” Altogether, the dashboards remained in situ over a period of about 33 months while the gift card promotion ran for 73 weeks. It was important to stress the foundational importance of safety and then allow individuals to come up with their own ways to tighten procedures. This was a bottom-up, grassroots experience where the people doing the work came up with their own ways to make their times better, without cutting corners, without cutting quality, and without cutting any safety measures. Jason Williams MD 02MR 20MBA Incentives: Make it Something Special and Unique Crunching all of this data, Sedatole and her colleagues could isolate the effect of each mechanism on performance and turnover times at Phoebe. While the dashboards had “negligible” effect on productivity, the addition of the store gift cards had immediate, significant, and sustained impact on individuals’ efforts. Differences in the effectiveness of the two incentives—the relative performance dashboard and the gift cards—are attributable to team fluidity, says Sedatole. “It’s all down to familiarity. Dashboards are effective if you care about your reputation and your standing with peers. And in fluid team settings, where people don’t really know each other, reputation seems to matter less because these individuals may never work together again. They simply care less about rankings because they are effectively strangers.” Tangible rewards, on the other hand, have what Sedatole calls a “hedonic” value: they can feel more special and unique to the recipient, even if they carry relatively little monetary value. Something like a $40 gift card to Target can be more motivating to individuals even than the same amount in cash. There’s something hedonic about a prize that differentiates it from cash—after all, you will just end up spending that $40 on the electricity bill. Asa Griggs Candler Professor of Accounting, Karen Sedatole “A tangible reward is something special because of its hedonic nature and the way that human beings do mental accounting,” says Sedatole. “It occupies a different place in the brain, so we treat it differently.” In fact, analyzing the results, Sedatole and her colleagues find that the introduction of gift cards at Phoebe equates to an average incremental improvement of 6.4% in OR turnover performance; a finding that does not vary over the 73-week timeframe, she adds. To get the same result by employing more staff to build more stable teams, Sedatole calculates that the hospital would have to increase peer familiarity to the 98th percentile: a very significant financial outlay and a lot of excess capacity if those additional team members are not working 100% of the time. These are key findings for healthcare systems and for administrators and decision-makers in any setting or sector where fluid teams are the norm, says Sedatole: from consultancy to software development to airline ground crews. Wherever diverse professionals come together briefly or sporadically to perform tasks and then disperse, individual motivation can be optimized by simple mechanisms—cost-effective tangible rewards—that give team members a fresh opportunity to earn the incentive in different settings on different occasions—a recurring chance to succeed that keeps the incentive systems engaging and effective over time. For healthcare in particular, this is a win-win-win, says Williams. “In the United States we are faced with lower reimbursements and higher costs, so we have to look for areas where we can gain efficiencies and minimize costs. In the healthcare value model, time and costs are denominators, and quality and service are numerators. Any way we can save on costs and improve efficiencies allows us to take care of more patients, and to be able to do that effectively. “We made some incredible improvements here. We went from just average to best in class, right to the frontier of operative efficiency. And there is so much more opportunity out there to pull more levers and reach new levels, which is truly encouraging.” Looking to know more or connect with Asa Griggs Candler Professor of Accounting, Karen Sedatole? Simply click on her icon now to arrange an interview or time to talk today.
Georgia Southern biology professor named 2025-26 Fulbright U.S. Scholar to Vietnam
Stephen Greiman, Ph.D., associate professor of biology in Georgia Southern University’s College of Science and Mathematics, has been awarded a 2025-26 Fulbright U.S. Scholar award to Vietnam where he will lead a teaching and research project focused on parasite diversity in bats. “Dr. Greiman is further proof that Georgia Southern faculty are among the best in their fields,” said Avinandan (Avi) Mukherjee, Ph.D., provost and executive vice president for Academic Affairs. “We are incredibly proud of this achievement and all the hard work that goes into such a celebrated milestone paying off.” Greiman’s Fulbright work will build on more than a decade of collaboration with Vietnamese scientists. During graduate school, he began working with parasitologists in Vietnam and participated in field expeditions in 2013 and 2014. That early partnership has since blossomed into multiple co-authored publications and enduring collegial friendships. Vietnam, Greiman explained, is a natural fit for this project. “Its exceptional biodiversity and the significant burden of parasitic infections across humans, domestic animals and wildlife make it a particularly relevant and meaningful host country for my research,” he said. “Our shared goal is to advance awareness and understanding of parasite diversity among students and the public.” During his grant period, Greiman will teach a parasitology course at Hai Duong Medical Technical University. He will also conduct field and laboratory research in partnership with the Vietnam Academy of Science and Technology’s Institute of Ecology and Biological Resources and the Department of Parasitology. His research will involve sampling and analyzing the parasites and microbiomes of Vietnamese bats—a project designed to engage both undergraduate and graduate students in hands-on scientific inquiry. “International collaborations often yield more impactful research than national projects alone,” Greiman noted. “This award not only strengthens our scientific goals but offers my family a chance to immerse ourselves in a new culture. It’s an experience we’re incredibly grateful for.” Beyond fieldwork, Greiman hopes the Fulbright project will open doors for new exchange programs between Georgia Southern and Vietnamese institutions. He envisions Georgia Southern students spending semesters abroad and returning with global perspectives that enrich their academic and personal growth. “The data and experiences I bring back will directly inform my courses, including parasitology and biology of microorganisms,” Greiman said. “I’ll also use our findings to support undergraduate and graduate research projects, pursue new grant opportunities and publish in high-impact journals.” He credits the Fulbright program with not only enabling his research abroad but also cultivating cultural exchange, particularly by allowing families to travel with awardees. His wife, who has a background in the arts, is excited to explore Vietnam’s artistic traditions, while their two young children will experience a culture far different from their own. “Vietnam is rich in natural and cultural history,” he said. “We’re looking forward to embracing it fully, both in the field and in everyday life.” Greiman’s selection is both a professional milestone and a personal journey—one shaped by long-standing collaborations, a deep commitment to global science, and the mentorship of Georgia Southern Vice President for Research and Economic Development David Weindorf, Ph.D. “Although I was initially hesitant to apply due to the program’s competitiveness, I was inspired by Dr. Weindorf’s own transformative experiences as a Fulbright Scholar and Specialist,” Greiman said. “His guidance and support helped me see the incredible potential of this opportunity—not just for my research, but for my family and our students.” That encouragement reflects a strong professional relationship rooted in mutual respect and a shared commitment to international collaboration. “I am so proud of Dr. Greiman’s selection as a Fulbright Scholar,” said Weindorf. “The benefits of the exchange will truly be lifelong, with new friends, colleagues and connections formed and cultivated. We look forward to celebrating the lives Dr. Greiman touches, both through his teaching and research, as a meritorious ambassador of Georgia Southern University.” For Greiman, the Fulbright award marks just the beginning of a broader vision. “This experience will generate foundational data for future National Science Foundation and National Institutes of Health proposals and deepen our international partnerships,” he said. “Being selected as a Fulbright Scholar is an extraordinary honor and a chance to contribute meaningfully to a global legacy of scholarship, cultural exchange and scientific discovery.” He encourages fellow faculty members considering the program to apply. “Go for it,” he said. “Your chances are zero if you don’t try. The Fulbright is one of the few opportunities that blends extended research, cultural immersion and family inclusion. It’s life-changing—and absolutely worth it.” If you're interested in knowing more about Stephen Greiman's work or more about his Fullbright award - simply contact Georgia Southern's Director of Communications Jennifer Wise at jwise@georgiasouthern.edu to arrange an interview today.
