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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 learning outcomes are as follows: identify and evaluate the impact of risk factors for health-care organizations during crisis; evaluate the role of different organizational factors in building resilient health-care organizations; define organizational resilience in a health-care context; and apply the effect-strategy-impact resilience framework.

September 2022 found Ranjan Thakur, the Hospital Director at Manipal Hospital, Jaipur (MHJ) reflecting on MHJ’s resilience toward future health-care crises. MHJ was established in the capital city Jaipur of the Indian state of Rajasthan in 2014, as a 225-bed multispecialty unit of the nationally renowned Manipal Health Enterprises Ltd. As the Hospital Director, Thakur had been responsible for navigating his team and the hospital through the multiple health-care related challenges exacerbated by the multiple waves of the Covid-19 pandemic in a large Indian state with a sizable rural and semiurban population. Though Thakur and his team of doctors had worked through the vulnerabilities of their health-care ecosystem, mapping the risks and mitigating the same, Thakur asked himself if they had done enough. He wondered how a health-care institution such as theirs could sustain effective health-care delivery during future crises situations to deliver high-quality health care to the vulnerable communities. Had they effectively mapped MHJ’s vulnerabilities and built resilience into the hospital’s functioning? The backdrop of the case is public health in the state of Rajasthan (Jaipur), and the case is rich in detailing social factors such as behavior issues of patients, doctors and nurses; operational factors such as standardization of treatment and standard operating procedures, availability of resources, clinical concerns; leadership and management of the hospital through the pandemic. This case can be used by instructors to teach organizational resilience building in the health-care context.

Graduate- and executive-level courses in managing change during crisis in health-care context; health-care management/leadership.

Teaching notes are available for educators only.

CSS 7: Management Science.

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.

The learning outcomes are as follows: understanding the impact on company growth through identification and alignment of stakeholder priorities in a project for SME in an emerging market; analyzing the impact of stakeholder alignment and relationship management on the project outcome; and evaluating the importance of Stakeholder Management for effective Project Management.

The case of ‘Hospedia Medicare,’ a medical device manufacturing company based in India, was started by a family involved in the medical devices business for over two decades. The company began operations in a new avatar and focused on one medical device or product by 2013. The product was designed with quality features to solve customer problems, making the cost relatively high compared to other domestic peers. Creating new product lines or updating the existing product attributes was imperative for the company to attain its growth objectives. The protagonist was dealing with a dilemma involving managing various stakeholders, aligning the project scope to create a growth story for the company in line with its vision and managing the stakeholders by understanding and analyzing their needs, expectations and interest, thus influencing the project outcome. The case can be used by instructors to identify, understand and evaluate the importance of different stakeholders on project outcome or success. Furthermore, it can be used to analyze and critique the impact of stakeholders on project scope, which can affect the long-term sustainability of the company, as different stakeholders have different expectations and needs. The case also details how regular communication, collaboration and awareness became essential for the project's success. Lack of an effective engagement strategy at the project planning stage can have risks concerning cost and achieving the overall vision, which creates a positive outcome for all the stakeholders.

The case study can be introduced to graduate and undergraduate students to reflect on and critique the importance of Stakeholder Management in Project Management. It can be used for, entrepreneurship, project management, operations and strategy, particularly emphasizing for small and medium enterprises (SMEs).

Teaching notes are available for educators only.

CSS 9: Operations and Logistics.

After completion of the case study, students will be able to describe the crisis types and the various phases in mapping a crisis and outline appropriate actions during each phase; identify stakeholders in the context of change management initiatives and map them through their power, influence and interest needs; identify the needs and resistance present in change management initiatives through the systems-thinking perspective; recognize the leadership competencies for an effective crisis management approach; and identify the way to conduct challenging conversations with important stakeholders whose support and influence are required.

Stella Fernandez, the vice president of human resources management in a family-managed business organization, was disturbed by the media reports on rising number of cases of COVID-19 infection in India during the first week of March 2020. She thought that a continued rise in the number of infection cases could affect the business continuity as well as the safety of the employees. In her opinion, a faster introduction of a work-from-home policy could help to reduce the impact of the potential crisis. Fernandez understood that without the senior management team’s consent, she could not drive the information technology team to implement the work-from-home measure. However, she felt that there could be challenges in convincing the senior management team, who did not treat this outbreak to be of grave importance. Anticipating the unfavourable reaction, Fernandez planned her approach carefully by identifying and convincing influential members to support this change management initiative; nevertheless, to her dismay, her meticulous plan failed to convince the powerful members of the team, who continued to resist the change proposed by her. Disappointed and surprised by their reaction, Fernandez wondered what she could have done to make the senior management team to accept her proposal.

This case study is designed for use in undergraduate- or graduate-level programmes.

Teaching notes are available for educators only.

CSS 6: Human resource management.

This case study is best suited for courses in career management, stress management, work–life management or science of well-being in organization behavior (OB) or human resources management (HRM). This case study is targeted at the MBA or executive development programs. The learning outcomes of this case study are as follows: to analyze the challenges in balancing Suraj Kumar’s (the protagonist) work–life balance situation and identifying the main causes of such a conflict. What are some strategies that could be used to address these issues? To develop a plan to balance work responsibilities with family and personal life. What specific actions could he take to achieve this balance? To design a training program for employees that addresses work–life balance issues. What topics would you cover in the training, and what methods would you use to deliver the content? To create a proposal for a flexible work arrangement program that an organization could offer to its employees. What would be the benefits of this program, and how would it be implemented and managed? To develop a business case for why an organization should prioritize work–life balance for its employees. What are the potential benefits of doing so, and how can the organization measure the impact of its efforts?

This case study discusses conflicts due to competitive priorities that people face in balancing the pressures, roles and responsibilities between their professional life (careers) and their personal life, and the trade-offs that they make across these multiple aspects of their lives. This case study revolves around Suraj Kumar, a successful consultant, who was offered a promotion as the executive director for the social sector. This promotion would require extensive travel and time away from his family. Kumar was struggling to balance his work responsibilities with his family life and his involvement with the Smile and Shine Foundation, which supports the education of children from economically weaker sections of society. He was reflecting on his past and present and trying to figure out how to prioritize his commitments while also achieving his personal and professional goals.

This research has shown that a case discussion and role-play can be effective for a less experienced audience. Instructors can provide multiple perspectives to stimulate reflection and debate. For executive MBA or executive development programs, a self-reflection exercise is recommended. Participants in these programs may have personal experience dealing with or may know others who have dealt with work–life balance issues, making self-reflection a valuable tool.

Teaching notes are available for educators only.

CSS 6: Human resource management.

This case study has been developed based on the primary data obtained through a series of interviews held with the senior management of Cargills, and the secondary data obtained from the company’s corporate website www.cargillsceylon.com/,annual reports and publicly available sources of information such as newspaper articles.

This case study focuses on the strategic responses employed by Cargills (Ceylon) PLC – a leading business conglomerate in Sri Lanka – in response to the challenges posed by the COVID-19 pandemic. The duration of this case study is from January 2020 to September 2021. The case study particularly examines the key business sectors of Cargills (Ceylon) PLC – retail, food manufacturing and quick service restaurants – which elaborate on the change management practices and strategies deployed by the company in each of these sectors during this challenging period. This study is based on the primary data gathered from the interviews held with the Cargills (Ceylon) PLC team, and the secondary data obtained from the corporate website of Cargills (Ceylon) PLC. This case study is most suitable to be taught in academic courses related to strategic change management.

The case is most suited to be discussed with undergraduates (3rd year and 4th year) following business and management studies related disciplines. While the pivotal area around which the case has been developed is strategic change management, covering environmental analysis, strategic analysis and process of change management, the case could also be used in strategic management classes, to discuss environmental analysis, strategic planning approaches and business and corporate level strategies.

CSS 11: Strategy.

This case study would enable students to understand the concept, process and advantages of mergers and acquisitions as a growth strategy with respect to 1mg. Also, the students would be able to use the threats, opportunities, weaknesses and strengths matrix to map 1mg’s strengths, weaknesses, opportunities and threats.

This case study analyses the transformation journey of 1mg to Tata 1mg, one of the most trusted internet pharmacies in India. This case describes a small start-up that was launched in 2013 and had made many acquisitions since then. This case revolves around Tata Digital’s purchase of 1mg. The case starts out by explaining 1mg’s financial situation and why the company was acquired. This case study focuses on how the integration helped Tata Digital and 1mg realize their respective missions. Furthermore, the case study illustrates the benefits and difficulties of this integration.

This case study is basically aimed at postgraduate management students; it can be used in strategic management and health-care courses. Students can understand the concept of diversification and acquisition with the help of this case study. Students can also gain an insight into the organic and inorganic diversification as a growth strategy.

Teaching notes are available for educators only.

CSS 11: Strategy.

This case was developed from the author’s personal experience as a participant in one of the health taskforce subcommittees. The author also sought the inputs of the Vice President of Health and Medical Education, the Dean of the Health Sciences College, the Student Affairs Assistant Dean of the Pharmacy College and the previous Vice President of Health and Medical Education. Moreover, secondary data were obtained from the office of the Vice President of Health and Medical Education at Qatar University (QU).

The government of Qatar has consistently provided generous funding for QU over the years. However, recent economic challenges, such as drops in oil prices, have had a negative impact on the country’s GDP and export revenue. In response, QU began to implement a new organizational structure. Specifically, the university proposed merging the three health-related colleges (health sciences, medicine and pharmacy) into a single cluster called the health education cluster. This decision was supported by a broad benchmark of approximately 40 universities worldwide, as well as input from various stakeholders within the university. Forming a cluster was expected to benefit the organization as a whole. However, the decision faced resistance and challenges that required investigation by top management. Would the new organizational structure be accepted by all? Was it feasible to have a single cluster that encompassed three distinct departments within the organization? These are examples of the questions that this case study addresses.

This compact case is suitable for a case study in basic undergraduate, postgraduate and advanced courses in Strategic Management at a business school. The case highlights the need to restructure an organization and the use of strategy formulation and implementation in the framework of management.

The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation.

Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy.

The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care.

Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation.

This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework.

The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.