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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.

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.

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

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.

For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

South Africa’s primary health outcomes do not correspond to the country’s spending on public health, with South Africa ranking among the worst globally in the incidence of tuberculosis, HIV prevalence, infant mortality and life expectancy. In part, this poor outcome can be explained by high inequality in access to healthcare, which reflects South Africa’s grossly skewed income and wealth distributions, with the bulk of the country’s population reliant upon an underfunded, inefficient and poorly managed public health system. This substandard service for the working poor in South Africa’s townships with high population densities offered a profitable entrepreneurial opportunity to provide affordable and effective primary care with vast gains in quality and outcomes improved dignity for patients. After receiving her MBA, physician and entrepreneur Dr Nthabiseng Legoete self-funded the launch of Quali Health in 2017. The business model set out to disrupt healthcare delivery for South Africa’s poorest citizens. Drawing patients from the working poor in Diepsloot, Quali Health’s inaugural site was cash flow positive within five months when the facility hit only 30% of installed service capacity. With quick success, Dr Legoete faced the strategic question of how fast to scale and finance the expansion. She also considered a new micro-insurance product for her clientele.

For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

Teaching notes are available for educators only.

CSS: 3 Entrepreneurship.

Dr. Juan Caicedo was educated in general medicine and surgery at Universidad Nacional de Colombia and practiced transplant medicine in Bogota. He determined that he would need to go to the United States to advance his training, and ultimately was awarded a fellowship in transplant surgery at Northwestern Memorial Hospital.

During his three years as a fellow, Caicedo was struck by the number of Hispanic patients on the kidney transplant waiting list. Not only were Hispanics the highest growth group on the transplant waiting list, they also waited longer for transplants and died while waiting at higher rates than non-Hispanic whites or African-Americans. Caicedo also was alarmed by Hispanic patients' lower utilization of living donors for transplantation they were underrepresented not only as live donor transplant patients, but also as donors.

As he neared the end of his fellowship in 2006, Caicedo wondered if the Hispanic population encountered unique barriers to transplantation and living donor usage, and began to think about creating a program to address these barriers.

In late 2012 Adeline Herzog Memorial Hospital in Castle Rock, Colorado, was facing a problem with patient satisfaction. The Press-Ganey scores for the third-floor nursing unit–the primary destination (70 percent) for patients admitted through the emergency department–were at the 15th percentile, and the key HCAHPS score for inpatients was well below the Colorado average. Over the past six months Jeri Tinsley, director of medical, surgical, and intensive care services, had made various changes to try to improve the patient satisfaction scores for her 32-bed unit, but the scores seemed stuck at an unacceptably low level.

Tinsley worried that if improvements were not made soon, patients would start “voting with their feet” and take their business to competing hospitals. As a registered nurse, Tinsley's expertise was helping people heal; it was not analyzing data. In particular, she was overwhelmed by the patient comments included in the surveys; she had no idea how to analyze them and could not decide which issues to address first.

After analyzing the case, students should be able to:

• Organize and analyze qualitative data using affinity diagrams

• Identify priorities using Pareto diagrams

• Identify which aspects of a problem are (1) within their control to solve, (2) within their influence to solve, or (3) outside their control to solve

Organize and analyze qualitative data using affinity diagrams

Identify priorities using Pareto diagrams

Identify which aspects of a problem are (1) within their control to solve, (2) within their influence to solve, or (3) outside their control to solve

First National Healthcare (FNH) runs a large network of hospitals and has worked to systematically reduce waiting times in its emergency departments. One of FNH's regional networks has run a successful marketing campaign promoting its low ED waiting times that other regions want to emulate. The corporate quality manager must now determine whether to allow these campaigns to be rolled out and, if so, which waiting time estimates to use. Are the numbers currently being reported accurate? Is there a more accurate way of estimating patient waiting time that can be easily understood by consumers?

This case provides an opportunity to identify and discuss issues in sustenance of an incumbent's strategy in the changing environment. The context is the practice of Nadi Nidan (pulse diagnosis) and treatment of disorders based on this according to Ayurveda, the ancient system of Indian medicine. It describes the functioning of Bharadwaj Aushadhalay, an Ayurveda clinic run by Vaidyaji since 1955 and presents the history of the clinic, the process by which Vaidyaji learnt the practice of Nadi Nidan, the profile of the patients, the mode of treatment, restrictions imposed by Vaidyaji on the patients, their response and competitive pressures on the system. The case also provides a brief sketch of Ayurveda, its principles, currents trends in the education and research in Ayurveda, and recent advances in diagnostic tools and techniques. The case can be used in courses of Strategic Management in the module on Strategies for Sustainable Competitive Advantage and Knowledge Management.

The case deals with a chain of hospitals, that has grown vary fast in last few years as a result of various acquisitions and new developments. The hospital chain is lagging behind in use of technology. The IT department is inward looking and the focus is more on provide support services rather than strategic orientation. A new CIO takes charge of the IT department and decides to transform IT from playing a support to strategic role. He identifies cloud computing as a tool to take the leap. The case provides an opportunity to discuss the type of service and deployment models of benefits of cloud technology. A rough data to do financial evaluation of cloud technology is presented. Evaluation parameters that may be used to decide on cloud versus in-house technology are also discussed.