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Organizational Development; Change Management; Leadership; Healthcare Management Operations; Supply Chain.

MBA; Masters in Healthcare Management; Post-graduate Diploma in Leadership; MPhil in Strategic Leadership.

On April 16, 2016, the CEO of Prince Mshiyeni Memorial hospital, Kwa-Zulu Natal, South Africa, Dr Sandile Tshabalala reflected as he drove through the winding hills of the Cato range. In recent years, the hospital had been a subject of negative publicity with horror stories about patients collapsing while waiting for their medication at one of Durban’s largest hospitals. The case features a number of stakeholders and their demands and even threats. Contextual leadership intelligence requires accurate identification of relevant stakeholders and then involvement in solutions. The case illustrates how these demands had been listened to and how the stakeholders had been involved in finding solutions. A remarkable solution was to realize that the bottleneck at the pharmacy was actually caused by a problem early on in the process, for example, the late start of administrative staff who had to submit patients. A further solution was to utilize the primary health care clinics and even churches for dispensing chronic medicine.

Gaining insight and foresight into the operations and supply chain dilemmas in public health care. Developing understanding of the impact of various stakeholders in the healthcare sector. Understanding buy-in when leading change. Acquiring contextual leadership intelligence in the public health environment.

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CSS 7: Management Science.

Corporate strategy and family business management.

The case is designed for usage in senior-level undergraduate courses of strategic management and managing family businesses.

This case study relates the story of the launch and development of Zayed Al Hussaini Group, a family business in the United Arab Emirates (UAE). The business had been established a year after the unionization of the different Emirates by the founder, Zayed Al Hussaini, in partnership with his brother. Following a series of strategic moves, such as acquisitions and divestures, and adverse family-related events, the Group was led solely by the founder himself. Over the years, Zayed Al Hussaini Group has grown to become a successful family business in various industries of its operation, but following the death of the founder's son, the company activities have been struck with chaos. Zayed's nephew, Ahmed, who had left the family business to continue his studies and work at McKinsey & Company in London, has been called back home after eight years to take the lead of the entire Group. However, he is faced with several challenges, such as dealing with the family gap he has developed over time and balancing family and business priorities. Will Ahmed be able to make the right decisions in the role and responsibilities that have been bestowed upon him?

To analyse the process of launching a family business and making strategic decisions for managing its development over time.

To assess the potential difficulties and challenges which are associated with managing a family-run organization.

To evaluate the effectiveness of decisions with regards to the company's growth and succession management planning.

To apply relevant theoretical concepts to the analysis of complex situations in the specific context of family businesses.

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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.

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CSS 9: Operations and Logistics.

This case study aims to stimulate the students’ thoughts about the introduction of sustainability and its importance in the travel and tourism industry and introduce the concept of resilience and building of dynamic capability of a venture from the perspective of an entrepreneur.

Established in 2009, India Someday was a fledgling travel company based in Mumbai, India. The team comprised passionate travellers who provided planning assistance for those willing to explore India independently. The company offered customised, personalised and tailor-made trips to create a memorable travel experience for travellers with differing budgets and age groups. Upon the launch of Asia Someday, an extension of the travel venture India Someday, Mr Asif Munshi shared a moment of relief as he shook hands with his co-founder, Mr Harsh Shirodkar. The pandemic significantly impacted the tourism industry, yet it fortified their entrepreneurial spirit and inspired them to bounce back with a dynamic and vigorous comeback and further strengthened the foundation of the endeavour. The expansion of their entrepreneurial venture marked the initiation of the second innings of their enterprise. Although the company had managed to stay afloat because of savings, it was soon depleted. But the withdrawal of the no-fly list and the gradual opening of borders brought a ray of hope for India Someday. Munshi was preoccupied with his thoughts about the future steps of his dream venture. With emails from his previous clients regarding travel plans to India, he could see that the prior impact of India Someday had not gone in vain. Although relieved with the commencement of people travelling, the future was uncertain and the founders knew that they had to be prepared to successfully operate their venture.

Tourism and hospitality courses/entrepreneur courses

Beginner

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CSS 12: Tourism and hospitality.

The area of focus is on organization strategies, specifically in developing appropriate strategies for business expansion in a situation of high economic uncertainties.

This case is designed for advanced undergraduate in the business and management programs and students in the MBA programs. It is suitable for courses of organizational management, organization theory and design, strategic management, and managerial economics.

At the end of 2009, Kumpulan Perubatan Johor Healthcare Group was the largest public-listed healthcare service provider in Malaysia, with revenues of RM1.5 billion (approximately USD0.5 billion) and a net profit after tax of RM115 million (approximately USD38 million). The country was experiencing economic downturn, which affected demands of the affluent as well as medical tourism segments, which were the targeted market of the company. Datin Paduka Siti Sa'diah Sheikh Bakir, the group's CEO and her management team realized that the company needed to seek a new growth strategy. The case stimulates a discussion on the future strategy of a high-growth healthcare company that aspired to be the leading healthcare player in the region.

Understanding the process of analyzing an industry, as well as formulating strategies, enables case analysts to extend the practice of making strategic decisions to many business situations.

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Innovation, information technology, e-marketing and sales, strategy and entrepreneurship.

The case is intended for use in advanced graduate and executive education level management and technical programs of study. The case is high inter-disciplinary appropriate for all courses dealing in use of innovation, information technology, entrepreneurship, marketing and sales and strategy.

Practo Technologies Pvt Ltd is a company established in 2008 by entrepreneurs Shashank, N.D. along with Abhinav Lal. At Practo Technologies engineers practice to create technology that supports healthcare industry. In India, there is not enough assistance given to the patients in terms of searching for appropriate doctors and fixing an appointment with them easily. The patient's data lie scattered in reports and the patient's medical history goes unrecorded. Practo provides a robust platform for doctors and patients to collaborate together under one umbrella. It provides patients with open basket of doctor profiles and special search based on doctor's specialty. The case showcases the journey of transformation healthcare sector in India has gone through. The change was resisted, it never came that easy! The case explores issues in implementing information technology for clinics and hospitals in India. This case illustrates interesting facts Indian healthcare and the preparation they need to equip with to manage global technology tide.

The case can be used for teaching service innovation. Managing innovative practices and low-cost online business models is illustrated. In particular, it deals with how the early start up employs innovation to set up new working ideas. The case is designed to stimulate discussions of broad array of issues regarding deployment of IT services specifically in the hospitals and clinics across India. Evaluate the advantages and liabilities of expanding globally at a very early start up stage. The case focuses on Practo early development with only concept in hand and transforming it into a profit generating business. Evaluate the advantages and challenges of innovation, technology development, deployment and training of manpower to use it. The case offers students opportunity to understand and take view of strategically building early start up and management of concerns with no prior experience. To identify business opportunities and explore various possibilities of expansion into IT healthcare business. The students are given base to explore sales and marketing strategies for online model. The students get overview of cutting edge business offerings and surviving the dynamic competition in the era of globalization.

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Need for preventive health care: To comprehend the contribution of preventive health care in improving the health quotient. Sri Sathya Sai Sanjeevani Hospital (SSSSH) and its initiative is an apt example of the wonder which preventive care can bring in the context of rural health. Community participation: The case can be instrumental in showing the pathway to encourage community involvement in mainstream health by promoting the holistic model of SSSSH that understands mothers and children's health profile and needs, especially in the unreached rural segments of an emerging economy like India. Importance of healthy childhood: World Health Organization (WHO) promotes the school health programme to prevent health risks among children by inculcating healthy behaviours during childhood. The successful SSSSH model proves that it is implementable by integrating comprehensive health education modules in the existing institutions for medical care.

The challenge of a healthy childhood is inadequate availability and accessibility of quality care. Non-awareness of the parents is also a significant reason for the children who miss the benefit of a happy childhood. While much is planned by the Government and some part of it being executed, this case highlights the effectiveness of the maternal and child health programme executed by the Sri Sathya Sai Sanjeevani Hospital (SSSSH). This initiative fulfills the dire need of ensuring the preventive healthcare component leading to safe motherhood and safe birth of healthy children. Further, the case is also the culmination of pin-pointed innovative awareness activities such as school health screening and the Divine Mother and Child Health Program (DMCHP). It opens up the discussion on the current model of health care followed by SSSSH, Raipur, and its impact in the local areas to decide on its expansion across the country for nationwide implementation.

Bachelors in Business Administration, MBA, Executive MBA, Post Graduate Diploma in Healthcare Management

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CSS 2: Built Environment.

The first three years of operation of the West Kendall Baptist Hospital (WKBH) in Miami, Florida provided a “poster child” for efficient and cost effective healthcare delivery to the West Kendall community that it served. The hospital leadership and management team exemplified a quality-oriented staff that moved as a cohesive and dedicated organization. WKBH exceeded every budget prediction and showed a profit in year 3, well before expected. Then came the winds of regulatory change. With the passage of the Affordable Care Act (ACA) and the attendant imposition of new reimbursement metrics, the picture at WKBH changed almost overnight. By the first quarter of 2016, WKBH started to lose money in excess of budget predictions despite its increased patient admissions, careful financial planning, expense reductions, quality service, and excellence in patient care delivery. A serious financial crisis was looming with little relief in sight. The hospital management team began to search for solutions.

The research methodology includes collecting quantitative data: original financial statements and financial data from WKBH, as well as qualitative data: interviews of hospital administrators and historical information.

Graduate capstone course in a finance course; masters in health administration; and/or the MBA program.

While it is clear that the ACA was designed with all good intentions, it has created substantial and perhaps, unanticipated financial burdens for caregivers. These issues are not only faced by WKBH. Most hospitals could relate to one or more of the four questions examined as part of this learning process. Graduate MBA students worked with the hospital to identify, define, focus, and resolve difficult quantitative and qualitative issues faced by the hospital as a result of major changes in the regulatory environment with the passage of the ACA. This case focuses upon the current reimbursement environment that has only recently emerged as a result of the implementation of the ACA.

This paper aims to highlight the implications of financial planning for public procurement process for medicine purchase. The purpose of this case is also to understand how the choice of contract type in public procurement impacts medicine inventory levels and availability. It finally highlights the appropriate configuration of framework procurement contract for procurement of discrete goods in the context of public sector procurement.

Primary and Secondary Healthcare Department (P&SHD), Government of the Punjab provides free public health-care services in the Punjab province. Public health-care services of P&SHD are organised in a tiered manner with almost 3,000 primary and secondary medical facilities dispersed throughout the Punjab province. P&SHD maintains inventories of approximately 300 medicines to support medical service provision.

This case can be taught in procurement and inventory management module of MBA level operations management course. It can also be used in executive course on public sector procurement management. The case aims to highlight the interrelation between inventory planning and procurement management process. Hence, it should be used after participants have understood inventory models, procurement process and procurement contract types. Standard readings or cases on inventory and procurement management that cover topics such economic order quantity, procurement process steps and procurement contracts can be used to develop this understanding.

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CSS 9: Operations and logistics.

The subject area is entrepreneurship.

Graduate and executive education level in leadership, entrepreneurship and strategic management are used to discuss leadership, entrepreneurship and strategy in health services.

This case talks about the passionate journey of a pediatrician practicing in the Mumbai city of India, who as an individual private practitioner is contributing to the fulfilment of the global health agenda and the fourth Millennium Development Goal (MDG) – “reduce child mortality”. His vision is to make quality and affordable expert pediatric care accessible to all the individuals, right from pre-birth to adulthood. Surya Mother and Child Care Hospital (SMCH) is being strengthened as a nation-wide network of mother and child hospital offering patient/consumer-centric integrated collaborative quality care, and it needs to be seen how this model can be made sustainable as it enlarges in scale for the future.

The case is structured to achieve the following learning outcomes: to understand about effectuation as a logic for entrepreneurial success through the lens of Dr Avasthi and his venture SMCH; To understand and apply Porter’s Principles of value transformation that essentially focus on outcome-driven cost-efficient work practices in a collaborative integrative fashion, where transformation must come from within (some practices suggested can be applied to the Indian Healthcare Services Delivery systems); to critically analyze the overall strategic position of SMCH as an organization and its competitive environment; to discuss the factors influencing health-care delivery capacity build up, given the MDGs 2015, Every Newborn Action Plan and Indian Newborn Action Plan framework, as applicable to India; and to discuss and analyze mechanisms for future sustainable service delivery options for SMCH. Although each of these principles is important, possibly, the instructor could emphasize and encourage more discussions on potential models of shared partnerships that can help quality health-care services reach the unreached and the incorporation of technology in achieving this. The learning process can also facilitate discussions about leadership qualities in the creation of health-care entrepreneurs, for the “Change That They Would Want To See”.

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CSS:3 Entrepreneurship.