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This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players.

To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs.

Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests.

This case study is basically aimed at postgraduate courses and executive management courses.

Teaching notes are available for educators only.

CSS11: Strategy.

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 analysis will make the audience aware of the sudden nature of the crisis, specifically the transboundary crisis. They will be introduced to the concepts of participative leadership and situational leadership. Majorly the audience would learn to remain composed in times of crisis and comprehend how a circumstance can transform a participatory leadership style into a situational leadership style. The case will allow the audience to brainstorm how to take innovative decisions to manage a crisis situation. The primary objectives of the case are as follows: ■ to understand a transboundary crisis and its characteristics to deal with it; ■ to visualise the application of participative and situational leadership and evaluate and analyse the most suitable leadership style during an unknown crisis; ■ to make the students aware of how to remain composed in times of crisis and, for instance, implementing the change of leadership styles per the situation's requirement; and ■ to make students learn to design innovative decision-making strategies to develop a crisis management plan for managing future crises.

The case highlights the successful management of the crises faced by a multi-specialty hospital named “Shukan-Caring Lives”, established in 2017 in Vadodara city of Gujarat, India. The case revolves around the Chief Operating Officer, his executive management body and the paramedical and medical staff of the hospital, who dealt with the grave Corona crisis. This case shows how the change in leadership style from participative to situational leadership style could manage the situation by taking brilliant initiatives and providing insightful solutions with a lot of dedication, showing how situational leadership can deal with the transboundary crisis.

The case is an excellent example of a transboundary crisis for any organisation and demonstrates a novel idea of transforming the participative leadership style into a situational leadership style as and when the need arises. The topics of transboundary crisis and management crisis can be taught in strategic management. At the same time, leadership styles and transformation of leadership style can be covered in organisation behaviour. Management development programmes can also include such kinds of cases to give exposure to crisis and its management. The target audience would be PG management students, management executives and senior-level managers in various courses.

Teaching notes are available for educators only.

CSS 11: Strategy.

This case is based on a project carried out in a tertiary care hospital of the Northeastern region of India for a period of eight months and is written by Dr Ankit Singh, Dr Meenal Kulkarni and Mr Avinash Poojari. The case was developed with the help of the hospital’s management team, disguised on request as Mr Raghugopal Ramalinga (Chief Hospital Administrator), Mr Suresh Kumar (Chief Engineer), Ms Linney Krubah (Chief Nursing Superintendent), Dr Premanand Ale (Chief Medical Superintendent) and Mr Srikrishna Shukla (Chief Finance Officer).

This case is about Trident Hospital, which faces issues pertaining to oxygen supply. Oxygen supply at Trident Hospitals is through three options as highlighted in the case, but due to the lack of preventive maintenance and no risk assessment done for the crucial medical oxygen, interruptions and additional work for the staff became a common phenomenon. The existing situation can lead to patient harm or death and can attract medico-negligence suit against the hospital, threatening the overall existence of the hospital. The hospital administrator is currently viewing the problem from only the cost perspective, which is a high-risk and a short-term approach.

Students pursuing full time/part time/diploma programme in health-care management, hospital administration/hospital operations; and undergraduate and post-graduate level students.

This case builds on Regency Hospital Limited (A), which describes the struggles that the founder Dr. Atul Kapoor went through in setting up the hospital and the challenges he and his team faced. Regency Hospital Limited, a multi-specialty hospital in Kanpur, India, was founded in 1995. Case (B) examines the development and progress made at the hospital, and the way various issues that the hospital faced were dealt with. It also highlights what made the hospital successful. In the process, the case highlights issues on leadership, entrepreneurship, organizational culture, and management of change.

The teaching objectives of the case study will enable the students as follows: to recognise the challenges of information technology (IT) implementation in the health-care sector associated with employee resistance, to apply the technology acceptance model for analysing the degree of employee resistance, to relate the utilisation of Kotter’s 8-step change management approach in successful IT implementation in the health-care sector and maintenance of employee productivity and to classify the leadership traits reflected by the leaders in training the 600 diverse employee population of Al-Ain hospital.

The case highlighted the predicament the government-owned Al-Ain City Hospital, United Arab Emirates, faced following the surge in the incidences of COVID-19 in the country in March 2020. The hospital management decided to initiate the work-from-home arrangement as a non-pharmaceutical intervention of handling the spread of the disease amongst its employees. Fatima Almur, the Information Technology Director in Al-Ain Hospital, asked the Application Support Manager, Aysha Shahwan, to deploy some IT tools significant for remote support to patient care within two weeks. Shahwan faced significant challenges in deploying the IT tools in two weeks given the diverse workforce, with the majority of them having limited knowledge in operating the tools, and hence, their apprehension in the usefulness of the tools. Besides, Shahwan had to deploy some advanced tools for easy and secured access to the electronic health record, telemedicine and telecommuting using mobile phones, tablets or PCs. The deployment of these advanced tools would be jeopardised by employee acceptance and consequent dwindling productivity. Considering the issue of employee acceptance of the change and their limited knowledge, Shahwan had, therefore, to develop training frameworks to boost the former’s perceived usefulness and ease-of-use of the IT tools. Will Shahwan successfully deploy the advanced IT tools to enable the hospital staff, including medical staff and departments, to ensure efficient patient care from a remote location? Will she be able to train the 600 employees across genders, ages and knowledge, use the IT tools and safeguard them from common software threats like email phishing and ransomware? Will the hospital be able to sustain its vision of quality patient care using advanced technologies through this new arrangement of remote support amidst the pandemic when patients are more?

Undergraduate business management.

Teaching Notes are available for educators only.

CSS 10: Public sector management.

Bottom of the Pyramid (BOP); social innovation and business modeling.

Undergraduate and graduate level management/business school students. It can be taught in marketing management and entrepreneurship/innovation courses.

LifeSpring Hospitals Pvt. Ltd is an expanding chain of hospitals that provide high quality health care to lower-income women and children across Andhra Pradesh. It is a 50-50 equity partnership between Hindustan Latex Ltd and the Acumen Fund. LifeSpring has demonstrated exceptional management principles, some of them being the most innovative and attractive ones. The entire focus of LifeSpring is on one particular niche: maternal care. Some argue about its strategy of not adopting diversification, but LifeSpring has proved its point by actually turning out to be a profitable business. The strategy of focusing on one niche has led to reduction in cost in terms of specialized doctors and the range of equipment needed to serve. Adding to the strategic strength of LifeSpring, its operations (management) is perfectly aligned with the organization's vision and quality is achieved via highly standardized procedures for maternal care service.

This case will cover two important aspects of BOP and social innovation. MBA students will investigate an innovative business model and apply their analytical skills to analyse the sustainability of the model.

Teaching notes and exercise for class-based discussion.

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.

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.

Regency Hospital Limited, a multi-specialty hospital in Kanpur, India was founded by Dr. Atul Kapoor in 1995. The hospital had grown over the years. However, there were a number of issues that were yet to be dealt with. The case describes the struggles that the founder went through in setting up this hospital. It presents the challenges from the perspective of the founder as well as the staff and doctors of the hospital. In the process, the case highlights issues on leadership, entrepreneurship, organizational culture, and management of change.