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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.

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 is a field-researched case about a nonprofit organization, the Accelerated Cure Project (ACP), dedicated to accelerating advances toward a cure for multiple sclerosis (MS). Inspired by the successful open source software development platform, ACP brings the strengths of that platform into the medical research and development environment. At the opening of the case, Robert McBurney, an Australian scientist with extensive experience in the biotech world, has been named CEO. McBurney and his team want to use ACP's bio-sample and data Repository to drive innovation in the search for the cure for MS by fostering collaborative research and development across research institutions, pharmaceutical and bio-tech companies. To encourage such collaboration ACP waives its rights to potentially lucrative Intellectual Property. This decision to foster collaboration at the expense of revenue sources appears problematic, since ACP does not have the staff or resources to undertake fundraising at the scale needed to fund current projects. ACP chooses to serve instead as an open access research accelerator making an impact on the field by functioning as an innovation driver rather than a profit maker. Is this an innovative recipe for success in finding a cure for MS or a recipe for financial disaster for ACP?

Interviews provided the primary source of data for this case. Four semi-structured interviews were conducted with the CEO of ACP, the Vice President of Scientific Operations, and a member of the organization's Board of Trustees, a collaborating university researcher, and the President of a bio-tech company working with ACP. Interview data was supplemented with additional information from ACP's web site, news reports, McBurney's comments at Suffolk University's Global Leadership in Innovation and Collaboration Award event, and follow-up conversations.

This case is intended for use in an undergraduate course examining strategic management issues midway through the term. The case discussion can center on issues relating to: first, the development of the business model; second, revenue resources and fundraising. Students are expected to spend two to three hours of outside preparation reviewing concepts of change leadership and the collaborative enterprise business model. They should read the case materials and brainstorm options for improved change leadership. The case can be taught in one two-hour class period.

The purpose of this case is to introduce students to the strategic management and funding challenges faced by an organization that is using a non-traditional business model in an increasingly complex environment. As a result of discussing this case, students should be able to: first, examine strategic organizational strengths, analyze opportunities created by business, market and environmental factors, and strategize to minimize weaknesses and to address threats identify an organization's strategic focus; recognize and recommend options at crucial decision making junctures in a business situation; second, assess an organization's revenue model; analyze how this model can be improved; third, analyze the functionality and sustainability of an organization's business model.

Small to medium-sized enterprises, SMEs, play a critical role in the global economy. They comprise 90% of the global firm population and employ more than 50% of the labor force in the private sector. This case study examines issues related to sustainable supply chain management and social entrepreneurship in the SME context. Being small does matter and the efficiencies of small to medium-sized companies struggling for competitive advantage in the global marketplace warrants consideration. Philosopher's Wool Co., located in Inverhuron, Ontario, Canada, is a woolen producer and woolens product manufacturer that partners with other Ontario wool producers and American wool processors and distributors. Its sustainable vertical supply chain system increased local woolen farmers' revenues contrary to the “conventional” price wisdom in the Canadian woolen industry and turned by-product cost into profitable end use. It also effected social change in its local business community and in global customer relations through resource efficiency and socially responsible employee and consumer policies. However, the struggle to maintain a foreign distribution network and remain competitive and profitable was problematic. Students are challenged to solve the problems of an SME operating in a global economy.