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Learning outcomes are as follows: students will discover the importance of process orientation in management; students will determine the root cause of the problem by applying root cause analysis technique; students will identify the failure modes, analyze their effect, score them on a scale and prioritize the corrective action to prevent the failures; students will analyze the processes and propose error-proof system/s; and students will analyze organizational culture and ethical issues.

Purpose: This case study is intended as a class-exercise, for students to discover the importance of process-orientation in management, analyze the ethical dilemma in health care and to apply quality management techniques, such as five-why, root cause analysis, failure mode and effect analysis (FMEA) and error-proofing, in the management of the health-care and service industry. Design/methodology/approach: A voluntary reporting of a case of “radiation overdose” in a hospital’s radio therapy treatment unit, which led to an ethical dilemma. Consequently, a study was conducted to establish the causes of the incident and to develop a fail-proof system, to avoid recurrence. Findings: After careful analysis of the process-flow and the root causes, 25 potential failure modes were detected and the team had assigned a risk priority number (RPN) for each potential incident, selected the top ten RPNs and developed an error-proofing system to prevent recurrence. Subsequently, the improvement process was carried out for all the 25 potential incidents and a new control mechanism was implemented. The question of ethical dilemma remained unresolved. Research limitations/implications: Ishikawa diagram, FMEA and Poka-Yoke techniques require a multi-disciplinary team with process knowledge in identifying the possible root causes for errors, potential risks and also the possible error-proofing method/s. Besides, these techniques need frank discussions and agreement among team members on the efforts for the development of action plan, implementation and control of the new processes. Practical implications: Students can take the case data to identify root cause analysis and the RPN (RPN = possibility of detection × probability of occurrence × severity), to redesign the protocols, through systematic identification of the deficiencies of the existing protocols. Further, they can recommend quality improvement projects. Faculty can navigate the case session orientation, emphasizing quality management or ethical practices, depending on the course for which the case is selected.

MBA or PG Diploma in Management – health-care management, hospital administration, operations management, services operations, total quality management (TQM) and ethics.

Teaching Notes are available for educators only.

CSS 9: Operations and Logistics.

Quality management among multiple business units of a large organization is often difficult if each unit is run independently in terms on their quality standards. In this case, participants will discuss how Bukhari Group of Companies should establish a common brand image through standardized quality. Participants should also understand that common brand image for diverse products does not mean identical level of rejection or customer complaints. It should be understood that different markets have different tolerance for product failures. The participants can chalk out the measures the protagonist of the case should be able to take to effectively steer the Bhukari Group to achieve profits and excellence.

By reading and understanding this case study, students are expected to: 1.Able to understand and review the impact of unethical practices from accounting perspective; 2.Able to make an analysis of how one unethical act triggers a series of forced unethical acts (ripple effect); 3.Identify the unfair practices as well as be proactive in preventing unfair practices in the business day to day affairs; 4.Able to relate the function of various ratios (current ratio, quick ration, debt to asset ratio, debt to equity ratio etc.) and its impact on the business performance; and 5.Able to apply various lean quality tools, doing the root cause analysis in identifying and solving problems.

T.M. Exports (TME) was an India-based privately owned and operated enterprise. The company had a brilliant employee named Sanjay, who was a 12-year veteran. TME’s Business Intelligence (BI) department at TME head office, Kanpur, India, ostensibly learned on April 8, 2019, from the rumors about a brand-new vehicle dished out to Sanjay by his friend who made fortune worth of millions from certain transactions. To add fuel to the fire, another incident surfaced concerning a warehouse keeper, Mohit, who was also involved in embezzlement in one of the sales offices. On May 16, 2019, BI reported these two incidents to the internal auditor who launched an internal investigation to get to root of this case. Consequently, the company owner, Tariq Mahmood got himself caught up in a dilemma to fire both Sanjay and Mohit only or restructure the organization for better transparency and integrative approach in future. Moreover, the newly appointed Chief Executive Officer had the dilemma of keeping high safety stock to maximize service level or keeping conservative safety stock and rely on-spot market-buying if demand spiked. He decided and instructed all the warehouses to keep higher inventories to meet the forecasted demand, considering unexpected spikes in demand witnessed historically. Thus, increase in inventory caused panic in the sales department as demand was sluggish. He, therefore, offered high discounted prices to liquidate the stock. This study integrated the theories of accounting/financial ratio metrics, accounts reconciliation, business ethics and lean tools. It was demonstrated in this case that the irregularities in sales accounting and their inability of reconciliation had a serious impact on business performance. The concept of total reward was also invoked to understand the disruptive and unscrupulous practices.

This case has been particularly focused on undergraduate and postgraduate early-stage-level students pursuing business or commerce program, particularly those specializing in accounting (sales accounting) and human resource management courses.

Teaching notes are available for educators only.

CSS 1: Accounting and Finance.