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The learning objectives have been prepared following Bloom’s taxonomy (Bloom et al., 1956). After completing the case study, the students will be able to identify and recall the prerequisites necessary for establishing a pathology laboratory. (knowledge); analyze the micro- and macroenvironmental factors considered by Mr Sabihul Haque in the development of the strategic plan for Healthcare Laboratories (HCL) (knowledge and application); explain the key components of the Porter’s value chain and their significance in the operation of HCL (comprehension and evaluation); use the TOWS analysis to map the internal strengths, weaknesses, opportunities and threats of HCL (application and synthesis); and analyze the challenges faced by protagonist in managing HCL and generate suggestions for addressing the challenges (analysis and synthesis).

HCL, an enterprise established in 2018 in Sahdeo Khap, Gaya, Bihar, India, aims to provide high-quality pathological diagnostic services in semi-urban and rural areas. This health-care initiative is pioneering, offering pathology services to make high-quality, low-cost diagnostic services accessible in rural India. In rural settings, numerous health-care hurdles make it challenging for individuals to access the care they need. Since its inception, HCL has expanded its reach to connect more areas, facilitating diagnostic services for people in remote regions. The establishment of laboratories in semi-urban areas aims to reduce patient travel time, costs and health risks by bringing services directly to their doorstep. Haque, the chief executive officer of the lab, grappled with multiple challenges, including selecting an appropriate location for the lab, recruiting and retaining skilled workforce, managing logistics supply, collaborating with local health-care providers, dispelling the stigma among the population that superior services are only available in cities and enhancing health literacy in rural communities. Following numerous meetings with Ms Ummati Naiyyer, head of operations, they worked collaboratively to address these challenges, developing a blueprint and future plan to operate services in rural areas. This case study provides insights into the obstacles faced by HCL striving for success in rural areas. It elucidates the beneficial application of the Porter’s value chain, along with an analysis of macro- and microenvironmental factors. Unique challenges such as societal stigma and mistrust are specifically emphasized. Students engaging with this case study will enhance their problem-solving skills through brainstorming and providing recommendations, contributing to potential solutions for HCL’s difficulties.

The teaching notes for the HCL case is designed to enhance the learning experience of undergraduate and graduate students within the context of the course. This case study serves as a valuable teaching tool, allowing students to apply theoretical knowledge to real-world scenarios in the health-care industry. The notes provide a framework for instructors to facilitate discussions, encourage critical thinking and promote a deeper understanding of key concepts related to establishing diagnostic laboratories in rural areas.

Teaching notes are available for educators only.

CSS3: Entrepreneurship.

The purpose of this case study is to illustrate how Dianne Savastano, founder and CEO of Healthassist, Inc., a US-based health-care advocacy firm, successfully led her clients and team through the COVID-19 pandemic of 2020. To gather the data for this case study, the authors interviewed the protagonists, the members of her team and two clients. The authors read Healthassist Newsletters and the firm’s documents; and in fact, they included one Newsletter and several documents in the Exhibits of the case study. The authors conducted a literature review for articles in newspapers and journals about the newly developing field of “health-care advocacy,” a field which Savastano helped to create.

The authors illustrate how Savastano, using the five practices of exemplary leadership by Kouzes and Posner, in The Leadership Challenge, led her team through the pandemic of 2020. This is a story of a woman leader, using traits such as warmth, empathy, analysis and decisiveness, keeps her small business afloat when so many other firms collapsed in 2020.

The authors conducted seven interviews and literature searches on the topics of health-care advocacy; women leaders; leading through a crisis; and COVID-19.

The case study illustrates how a woman founder and CEO can lead her firm through a crisis.

This is an example of how a woman leader managed through the 2020 pandemic.

CSS 3: Entrepreneurship

This case series describes the startup of Farm to School of Park County, an emerging nonprofit organization in the US state of Montana. Case (A) describes the community, the need, and the origins of Farm to School in Livingston, Montana. The leaders of Farm to School face a budget crisis and need to evaluate four options to decide whether, when, and how it should become an independent organization. As Case (B) begins, Farm to School has decided to enter into a fiscal sponsorship agreement with the local community foundation. The next task for the organization's leaders is recruiting founding board members. They need to decide whom to ask and how to do it. In Case (C), the board develops a strategic plan and establishes committees. However, the board members and leaders start to feel fatigue in the face of the demands of a startup organization, leading to questions about what is truly strategic and how work will get done. The Farm to School organization in Case (D) has just issued its first annual report, filled with meaningful accomplishments. The leaders of the organization begin to plan to build an organization that will outlast them and the founding board members.

The learning objectives of using this case are as follows: to understand the concepts of organizational structure, organizational culture and organizational change; to expose students to the problems that may encounter organization when it intends to bring changes in culture; to stimulate students’ understanding of the necessity to build positive organizational culture; to advance students’ knowledge about oil and gas industry; to develop students’ understanding of using Levin’s model of cultural change; and to illustrate the challenges that an organization might face while changing its existing culture.

This case teaches about the importance of boosting positive organization culture to accept organizational change. Stardust was established in 2013 as Petronas Carigali Sdn Bhd’s subsidiary. The company was established to manage small and marginal field in Malaysia which was under the oil and gas field that had smaller reservoir and lasted for four to five years. On 2014, Stardust was given an opportunity to take over one of the fields to manage. However, during the process of handing over the facility and field from the parent to the new company, the tanker caught fire in one of its pump in the pump room. The fire resulted substantial damage to the pump room; two out of four pumps were totally damaged. It delayed the oil production for more than a month. Total estimated damage due to the fire incurred RM19m losses. Direct cost included replacing two new 400 kW pumps, repairing the damaged pump room with new manifolds and painting, and cost of shutdown production for 40 days. Investigation was initiated to identify the causes of the fire which revealed that human error, mostly peoples’ negligence was one of the major reasons along with location, equipment and procedure. The Health, Safety and Environment department of the company was given the task to create ‘Living Safety’ culture among the crew. Being the head of this department, Tarmizi found it very challenging to inculcate the culture ‘Action Today, Perfect Day Tomorrow’ and was thinking how to instill this culture with zero failure by the end of the calendar year which is December 2016. The time was running fast as the parent company emphasized to handle the situation urgently and to ensure that the similar incident will not happen in the future. If it re-occurs, it will jeopardize the trustworthiness of Stardust with the other parties involved and also the parent company might not allow the company to operate other facilities, which will put the company at stake to remain competitive in the oil and gas business.

This case is suitable to use in advanced undergraduate level, MBA and MSc to teach organizational behavior and organizational theory courses.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS 7: Management Science.

Key State Blue Cross and Blue Shield Plan (a disguised case of an actual BCBS Plan) is the merged product of three state plans. Initially burdened with a reputation of poor customer service, Key State's executives decided to invest heavily in service improvement, eventually achieving superior levels. Key State's high-quality customer service emerged as a true competitive advantage for its customers, who were primarily businesses and health benefits consultants who influenced corporate purchasers of health insurance. The Key State brand came to be synonymous with personal service, security, choice, and dependability. But the health care insurance market was changing under Key State's feet. Spiraling costs meant that high-quality service became less of a competitive advantage as employers were lured by low-cost, low-service providers. Many employers cut or dropped health care benefits entirely, swelling the ranks of the under- and uninsured, who in turn were extremely price-sensitive when shopping for health insurance on their own. Finally, the health care insurance market was being revolutionized by financial institutions willing to hold health benefit accounts and pay providers directly, thereby eliminating the need for Key State as a mediator. Key State executives were aware of these changes but were challenged by the mindset, culture, and organizational design custom-fit to their business accounts. The case asks the reader to consider whether Key State has the right number of target markets, whether it should have one brand or several for its different target markets, what it should do for the uninsured, and how it should improve its brand experience in light of the industry's changing landscape. All of these decisions will have significant implications for the organizational design of Key State.

To better understand the challenges involved in a successful health insurance company to cope with a rapidly changing and unpredictable environment; to formulate a new strategy and a new organizational design to accomplish this adaptation.

This case was based on both primary and secondary data. In-depth semidirected interviews were conducted in 2021–2022 after receiving the institutional research board approval. The interviews took an approximate time ranging from 90 to 120 min. They were recorded and transcribed. A thematic analysis was undertaken to identify the most relevant themes for the case. The secondary sources used included various websites, scholarly and trade journals, as well as specific databases, such as Statista.

The case exposes students in multiple disciplines to the challenges created by the COVID-19 crisis at Yale School of Medicine (YSM). It describes its remarkable effects on organizational and community members as they struggled to reimagine more inclusive and supportive spaces. As one of the most severe crises humanity has ever witnessed, COVID-19 exacerbated the existing struggles of the underrepresented communities, creating a double pandemic. It has also amplified inequities among marginalized groups including black, indigenous and people of color; women; immigrants; lesbian, gay, bisexual, transgender, queer/questioning; people with different abilities; working parents; single parents; religious minorities; and people with low income. When COVID-19 hit in 2020, Yale University School of Medicine (YSM), like other pioneering schools in the field of health care, doubled their efforts to face both the public health crisis and the substantial social turmoil (racial tensions after the death of George Floyd, food insecurity, vaccine resistance, social inequalities, etc.). Professor Marietta Vazquez, MD, who was the first Latina to be named Associate Dean for Medical Students Diversity at YSM, launched with Dr Latimore (Chief Diversity Officer) and her other colleagues many strategic initiatives aiming at improving the diversity, equity and inclusion of organizational and community members.

The case is an invitation to graduate students and students in executive education programs to reflect on the grand challenges leaders faced at YSM as well as in other institutions across the nation and the globe. It is also a call to reimagine ways leaders can accelerate the pace of change in their organizational ecosystems.

This case was written for use in graduate-level courses, including executive education dealing with Diversity, Equity, Inclusion and Belonging, Leadership and Change, Health-Care Equity/Policy, Health Sciences, Human Resource Management, Organizational Behavior, Crisis Management, Sustainability, Business and Society, Social Issues in Management, Strategy, etc. Faculty members can easily adapt the case to fit the content of the course they teach, the students’ context as well as the specific learning outcomes to be achieved.

After studying this case, the students should be able to: explain the importance of employee engagement; illustrate the role of the participatory management style in an organizational context; discuss why managers may use engagement practices to operate effectively in businesses to lead change and innovation; identify the critical success factors, barriers and outcomes of employee involvement in driving high performance; and discuss the dilemma faced by the managers in the emerging economies while driving the momentum of excellence in the long run.

This is a real case about a leading health-care service company located in the Middle East. The health-care organization’s name is changed to NOVA for reasons of confidentiality. The NOVA is an independent, public joint stock company created to meet the curative needs of the public health-care system in Middle East. The company introduced the Employee Suggestion Scheme named Minara in 2011 in a Federal Government decree, introducing innovation as a major pillar of management in 2013 with intent to encourage organizations build innovative solutions and pioneer initiatives and apply it effectively in services, processes and programmes. Making the Minara programme work in line with the national health agenda, Ms. Fatima who headed the Excellence and Innovation Department took the initiative of accelerating the innovative Programme (Minara). The case data were collected based on both primary and secondary sources. Although the case is based on the real data, it has been ammonised. The case describes the transformation of the innovation process at NOVA through the employee engagement programme (Minara) in meeting the disruptive challenges. This case addresses the challenges faced by the Excellence and Innovation manager who used effective employee engagement practices through the Employee Suggestion Programme in a creative way to bring about innovation in the health-care sector. The case outlines the dilemma faced by the Excellence and Innovation manager in bringing about innovation through the Employee involvement programme in the emerging economic scenario. The case will focus on the analysis of the different aspects of the issues pertaining to employee engagement, employee motivation and the framing of empowerment strategies to bring about innovation and continuous improvement through an effective employee suggestion programme. The case is intended to give budding managers an insight into innovation and employee engagement practices that impact performance in the organization.

This case will be suitable to be used in Human Resource Management and Management of Change and Innovation course at undergraduate and Master’s level.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS 1: Accounting and Finance

The reading and discussion on case will enable participants to appreciate importance of reward management in performance management system for both employee and organizational good; to develop insight on the effect of perceived discrimination on the motivation of employees; to internalize the effect of perceived unjust, subjective, non-communicative, non-transparent policies on the behavior and productivity of employees and overall organizational culture and climate; and to comprehend the importance of HR and OB issues with respect to performance management system for the benefit of employee morale, motivation and organizational culture.

The effectiveness of an employee is the key factor for the employer. All the profit that the company or the organization makes depends on the employees’ productiveness. The case needs to be understood in the overall context of performance management system (Ferreiraa and Otley, 2009) with focus on elements of appraisal and compensation via rewards and recognition as per objective standards. Performance management systems (PMSs) is a more general descriptor if the intention is to capture a holistic picture of the management and control of organizational performance. Performance management policies and practices refer to the processes of setting, communicating and monitoring performance targets and rewarding results with the aim of enhancing organizational effectiveness (Fee, McGrath-Champ and Yang, 2011). PMS includes both the formal mechanisms, processes, systems and networks used by organizations, and also the more subtle, yet important, informal controls that are used (Chenhall, 2003; Malmi and Brown, 2008). Otley (1999) proposed a framework which highlights five central issues which need to be considered as part of the process of developing a coherent structure for performance management systems. The five areas addressed by this framework include identification of the key organizational objectives and the processes and methods involved in assessing the level of achievement under each of these objectives, formulating and implementing strategies and plans, as well as the performance measurement and evaluation processes, process of setting performance targets and the levels at which such targets are set, rewards systems used by organizations and the implications of achieving or failing to achieve performance targets and types of information flows required to provide adequate monitoring of performance. While the case touches upon all the aspects of the PMS framework, it revolves round the reward episode and elaborates on the way it affects all stakeholders, those who got the benefit, those who felt discriminated and those were mere observers to the episode. Objective performance appraisals are needed to ensure that every employee produces the best performance and that the work performed is rewarded with reasonable increases in pay scales or special additional allowances or incentives. This system carries crucial importance as it helps managers to decide which rewards should be handed out, by what amount and to whom. Additionally, performance appraisals may increase an employee’s commitment and satisfaction (Wiese and Buckley, 1998) The case readers need to notice that when organizations fail to follow objective appraisal or reward standards, the same rewards become a cause of contention. The reward which was handed over to the employees in this case was in addition to the annual appraisal. Though the role of rewards has been well-recognized in motivating the employees to continue performing at high level and encourage others to strive for better performance, what needs to be recognized that rewards’ per say does not serve purpose. They need to be dealt within the context of performance management system. Using rewards to favor or discriminate a few employees by using subjective standards backfires and does no good as the person who is favored cannot take pride in it and is not motivated to perform better or equally well as he/she also knows that the work has no relation to the reward, it is personal favor, on the other hand, the one who is discriminated feel discouraged and demotivated to perform. Rewards have the potential to both help and harm the organization if dealt in a callous and careless manner. Use of rewards to favor or discriminate certain people due to subjective preference can be suicidal for the organization and irreparably damage the trust of the employees in the management. It has been well stated that fairness and objectivity are the core principles using an assessment of the nature and size of the job each is employed to carry out (Torrington et al., 2005). If any organization decides to include rewards as a motivating mechanism, it needs to cull out unambiguous and transparent criteria for rewarding. If employees perceive procedural or distributive injustice from the management, it is not only detrimental for the employee’ relations and teamwork, it also tarnishes the reputation of the organization and jeopardizes the culture of the organization. Reward management needs to be closely related to performance appraisals, job evaluations and overall performance management systems. The current case elaborates on one such instance where unjustified inequity in reward system not only disturbed the employees concerned but it had bred a negative image of the organization among other employees too, organizational citizenship was replaced with contempt and feeling of apathy.

Post graduate students and working professionals can benefit from this study.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Human resource management.

The present case study would help readers to understand paternalistic leadership behavior with its underlying theory. Readers would be able to appreciate the nature of experiences employees may have while working with a paternalistic leader high on authoritarianism. This case study would motivate readers to work out appropriate strategies for working under paternalistic bosses. The teaching note sensitizes readers about the complicated relationship between paternalistic leadership and culture.

Pyramid Globe Management Institute (PGMI) is struggling to generate revenue. PGMI founder, Tugmanshu Lakhani, has to find out new sources of revenue to keep the institute functioning. He constitutes a team of three professors for starting a new academic program with a foreign university. The initial success of the team brings favor from the founder but jealousy from the colleagues reeling under job threat. High authoritarianism and interference of the founder create a problematic situation for the three professors. When the new program starts showing promising results, the founder gets apprehensive about whether the new course may hurt the enrolment in the flagship program of the institute. The authoritarian and erratic behavior of the founder had a demotivating effect on the team working for the new program. Some team members resign under pressure while three professors stay to ensure the launch of the program. The professors have to resolve the conflict between their commitment toward PGMI in a troubled time and a career uncertainty if they continue working for it. Anticipating no change in the behavior of the founder and an uncertain future with PGMI, three professors quit after the start of the new program. The founder may continue losing committed employees if he is unable to balance his authoritarianism with benevolence and moral behavior. It will create more problems for PGMI in the future.

This case can be used in organizational behavior, leadership and team-building courses in the regular Master of Business Administration (MBA) programs. The case can further be used in the executive development program, especially for analyzing the leadership problem in higher education organizations.

Teaching notes are available for educators only.

CSS 7: Management science.

The subject areas are strategy, general management, health-care management, change management and inclusive growth model and application of technology to manage health care.

The case can be used to teach challenges in managing change in a health-care facility.

Tata Memorial Centre (TMC) is dedicated to provide best health-care services in the field of cancer cure. TMC established its credentials for service, education and research, which contributed to it being rated among the ten best hospitals year on year. Starting from humble moorings, TMC has grown to an institution of high repute from an 80-bed hospital to a 700-bed hospital. TMC held a number of pioneering efforts, which included bone marrow transplantation, external beam radiotherapy (linear accelerator), tumor tissue bank and bio-imaging to name a few. The management team of TMC had ensured that the growth had been orderly and appropriate to the changing needs of the community. Managing a hospital with disparate skill sets in the face of ever-increasing demand for services had always been a challenge in itself. As a government-run facility and well funded by the trust, TMC offered excellent services and post-operative care to the patients. So, it became imperative for the hospital to adopt technology to improve its hospital services and maintain transparency. Patients came to the hospital from different states in India and across the globe. TMC registered international and national patients online. Online medical reports were checked before the patients visited the hospital. TMC has developed an e-system that will allow patients around the world to send their tissue samples that are suspected to be cancerous for medical advice to the hospital. This case study is developed to provide insights into the transformation of TMC into an e-health-care service and explains the process of change management.

They are to provide insights into the challenges in health-care management, to illustrate the challenges faced by organization in implementing information and communication technology- managing change and to bring about best practices in the case organization and find solutions to the following questions: What are challenges faced by health-care officials in providing health care using new technological innovations? How can hospitals equip themselves with new technology? With the advent of improved and modern communication methods, medical practices and cases are more easily shared. Cases are discussed, recorded and, in many cases, put up for general public viewing through the electronic media. How can hospitals manage change? How can hospital administrators manage speed of delivery, quality healthcare, innovation and brand image?

Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS:11 Strategy.