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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.

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”.

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:3 Entrepreneurship.

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.

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.

The case is particularly well suited to entrepreneurship, marketing, technology, innovation, or strategy courses.

This teaching case is aimed at postgraduate students in management or business programmes.

This case follows the Kenyan healthcare tech company Savannah Informatics as they contemplate how the company will continue to grow in a post-pandemic world. Savannah is the market leader in electronic claims validation solutions for the Kenyan healthcare system. Their flagship product, the digital platform Slade 360, allows health insurers, healthcare providers, and patients to share claims information for health services in real time, drastically reducing payment transfer times, incidents of fraud, and account errors. The Covid-19 pandemic and the subsequent lockdown mandates from the Kenyan government have reduced short-term revenues by driving down hospital visits for citizens overall, but they have also created a demand for telemedicine and more online healthcare solutions. CEO John Muthee and his co-founders are left to consider their options for growing Savannah Informatics: expanding into new markets, creating more solutions for their insurance and provider customers in Kenya, or diversifying.

Identify the key challenges facing Savannah

Analyse the organisation using the 5Cs model (company, customers, competitors, collaborators and context) and VRIO (value, rarity, imitability, and organisation) analysis

Assess the growth opportunities available to Savannah and make recommendations

Aster Retail (AR) is the retail pharmacy division of the Aster Dr Moopen's Healthcare (ADMH) Group. The group delivers healthcare services across the Middle East, India and the Far East, with a portfolio of hospitals, clinics, diagnostic centres and retail pharmacies. AR, under the leadership of Chief Executive Officer (CEO) Jobilal Vavachan, is well known for its people-centric approach, unique culture and innovative human resource (HR) practices. AR has won multiple awards for HR practices, service quality and business performance. In a recent corporate restructuring (2018), “Aster Primary Care” was carved out by combining the group's Clinics and Retail businesses. This case discusses the evolution of AR's HR journey and the challenges associated with integrating culturally diverse businesses without compromising the values of ADMH and its promise, “We'll Treat You Well.”

This case was designed not only for MBA and executive education but also undergraduate courses in human resources (HR), leadership development, HR metrics and change management. It is ideal for introducing the concepts of diversity, equity and inclusion (DE&I), the balanced scorecard and talent retention.

The case deals with initiating and integrating DE&I programs into a company. It highlights how and when to start, change management issues during roll-out and convincing senior leadership why a program such as the one the protagonist started adds value to an organization.

In early 2018, Kate McKinnon, AVP of HR for CareerStaff Unlimited (CSU), a temporary staffing company and division of Genesis HealthCare, reflected on the late 2016 decision to develop women for leadership roles at the company. With a rather unconventional implementation of the Women’s Leadership Group (WLG), Kate successfully developed fifteen female individual contributors, many of whom were promoted to leadership roles by early 2018. Kate was concerned about maintaining the momentum necessary to continue (and expand) the program of identifying, developing, promoting, and retaining women and other diverse employees across the company. She also wanted to measure a clear correlation between the WLG and CSU’s financial and customer outcomes. It was time to plan phase two of the program, including further improvement of the DE&I efforts at CSU.

The learning outcome of this paper are as follows: focused programs, led by courageous and committed leaders, improve gender equity. DE&I is a business imperative, as much as a legal/risk challenge. To be understood, approved and communicated, HR Initiatives must add value and be aligned with the company strategy along with financial and customer outcomes. People development and growth contribute to top talent retention.

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

Given the issues the USA is encountering after the George Floyd death and protests, this is a good way to demonstrate how courageous leadership can start to facilitate change in organizations.

CSS 6: Human Resources.

Marketing, Innovation, Strategy, Digital Marketing and E-Business.

Master's level and Executive Program.

MocDoc is a young Indian online health-care company that has achieved success in early years of establishment, and is looking forward to expand the customer base. The founder, Senthil Peelikkampatti, along with his friends decided to design a service that can bridge the gap between doctor and patients. However, initially, Senthil lost the trust in his idea due to the unacceptance of the idea by health-care experts. It took a little long for the team to gain visibility after launch of the service. Senthil and the team brainstormed to gain recognition online through different techniques of search engine optimization (SEO) and social media networking through Facebook Web site. MocDoc case is designed to stimulate discussion of a broad array of entrepreneurial issues related to online start-ups. In particular, it deals with strategy and marketing of service in the online arena. At the same time, it gives detailed overview of marketing techniques online as fuel to the business. The company is moving under strong leadership skills of CEO but fails to gain momentum in terms of gaining online customers. This case deals with decision-making capabilities to bring more number of registered customers in the online space.

The expected learning outcomes are as follows: to animate online business environment and challenges faced by virtual enterprises in the cyber space; to illustrate opportunity for students to speculate the start-up business environment; to illustrate opportunity to introduce cloud computing as a viable business option for the health-care industry; to develop understanding among students for designing effective marketing strategy for online business; to identify business opportunities and gaining competitive edge by offering bouquet of services; and to stimulate business environment for understanding innovation and strategy building.

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

The assignment is to design a plan that aligns patient satisfaction scores with quality care metrics. The instructor’s manual (IM) introduces models for designing and implementing a strategic plan to approach the quality improvement process.

This is a field research case. The author(s) had access to the Chief Operating Officer (COO) and other members of the management team, meeting with them on numerous occasions. Cleveland Clinic Florida (CCF) provided the data included in the appendices. Additionally, relevant hospital data, also included in the appendices, is required to be made public on Centers for Medicare and Medicaid Services (CMS) databases. Accordingly, all data and information are provided by original sources.

Osmel “Ozzie” Delgado, MBA and COO of CCF was faced with a dilemma. Under the new CMS reimbursement formula, patient satisfaction survey scores directly impacted hospital reimbursement. However, the CCF patient satisfaction surveys revealed some very unhappy patients. Delgado pondered these results that really made no sense to him because CCF received the highest national and state rankings for its clinical quality at the same time. Clearly, patients were receiving the best medical care, but they were still unhappy. Leaning back in his chair, Delgado shook his head and wondered incredulously how one of the most famous hospitals in the world could deliver such great care but receive negative patient feedback on CMS surveys. What was going wrong and how was the hospital going to fix it?

This case is designed for graduate Master’s in Business Administration (MBA), Master’s in Health Sciences Administration (MHSA) and/or Public Health (PA) audiences. While a healthcare concentration is useful, the case raises the generic business problems of satisfying the customer to increase brand recognition in the marketplace and displacing competition to increase annual revenues. Indeed, the same analysis can be applied in other heavily regulated industries also suffering from a change in liquidity and growth occasioned by regulatory change.

Siemens Medical Solutions (SMS) offered innovative products and systems, clinical solutions, and services for medical professionals. Its latest project, transforming a hospital to digital records and processes, was experiencing serious delays that had damaged the relationship with the client. Management believed the underlying problem was that SMS was not using the correct approach to organization and processes for solutions marketing. The executives in charge of on-time completion and successful delivery of the project must now agree on a different recommendation.

Students will examine the infrastructure, customer offerings, and competitive landscape for Seimens Medical Solutions, as well as evaluate three potential organizational models (transient solutions, solutions streamlined enterprise, and adaptive solutions) to determine which represents the ideal structure for SMS. They will be able to identify the role of leadership in the organization, recommend how SMS should prepare for this change, and recommend how it would measure the transformation's success.

Hewlett-Packard (HP) had a long history of engaging in corporate citizenship, dating back to its founding. By 2009, however, under the leadership of its latest CEO, Mark Hurd, the company had lost its focus on corporate social responsibility (CSR). Hurd instead focused on undertaking a financial turnaround and overcoming other reputational challenges; he viewed CSR and philanthropic efforts as costs rather than as strategic levers. He instituted widespread cost-cutting measures to get HP back on track, including reducing CSR expenditure. The HP board, however, did not want to let CSR go by the wayside; in fact, it wanted HP to reorganize and restrategize its approach to corporate citizenship.

The case focuses on this strategic transformation from traditional, cost-center CSR to business-aligned social innovation. It outlines the details of the board's approval of the new strategy, and then discusses how HP employees worked to reorganize their CSR activity. The new team, the Office of Global Social Innovation (OGSI), had to devise a pilot project to demonstrate the new approach. The project under consideration was an engagement that would improve the early infant diagnosis process for testing infants for HIV in Kenya—an area virtually unknown to HP. The case asks students to assess the work of the OGSI team thus far, and to put themselves in the shoes of one team member who had to justify the project to HP's leadership.

The case is especially important for demonstrating the most recent shifts across some leading companies regarding how they position CSR, as well as how for-profit leaders can structure partnerships for impact.

After reading and analyzing the case, students will be able to: understand current shifts from traditional corporate social responsibility work to social innovation; understand the challenges facing leading companies as they seek to do well (enhance the company's bottom-line performance) by doing good (making social impact); identify best practices for developing partnerships for impact; articulate a project's social impact and how it aligns with a desirable business impact.