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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.

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

Andreas Stihl AG is the world's leading manufacturer of chain saws and other outdoor handheld power equipment. Based on marketing challenges in its high-volume retail channel—mass merchants such as The Home Depot and Lowe's—Stihl's U.S. unit has narrowed its distribution system to a single channel: independent retail dealers specializing in yard maintenance equipment. This risky and highly publicized decision has proved extremely successful, raising profits, attracting more dealers into exclusive relationships with Stihl, and strengthening the brand's top-quality positioning. But Stihl management are concerned that this channel system may not fit tomorrow's demographics, dominated by homeowners from the so-called Generation X and Generation Y. The case outlines Stihl's business and channel systems and customer needs, then poses a series of questions that management believes must be answered to determine whether to maintain or move away from reliance on its specialty retailers and how to adapt its system.

To understand issues related to retail channel strategy development in fast-changing consumer markets, as well as the challenges of adapting legacy routes-to-market systems to changing consumer service output demands.

Executives at biotechnology firm Genzyme are debating funding a clinical trial for a new version of a medical device called Synvisc. The trial is expensive and the odds of success are not high, but the upside is substantial. The case presents a common business question: invest or not? The case forces students to think about customer insights, wrestle with a number of complex issues, and evaluate the financials of the decision.

The case is ideal for teaching financial analysis and decision making. It can also be used to teach marketing, new product strategy, and healthcare industry management.

The purpose of this case study is to illustrate how Dianne Savastano, founder and CEO of Healthassist, Inc., a US-based health-care advocacy firm, successfully led her clients and team through the COVID-19 pandemic of 2020. To gather the data for this case study, the authors interviewed the protagonists, the members of her team and two clients. The authors read Healthassist Newsletters and the firm’s documents; and in fact, they included one Newsletter and several documents in the Exhibits of the case study. The authors conducted a literature review for articles in newspapers and journals about the newly developing field of “health-care advocacy,” a field which Savastano helped to create.

The authors illustrate how Savastano, using the five practices of exemplary leadership by Kouzes and Posner, in The Leadership Challenge, led her team through the pandemic of 2020. This is a story of a woman leader, using traits such as warmth, empathy, analysis and decisiveness, keeps her small business afloat when so many other firms collapsed in 2020.

The authors conducted seven interviews and literature searches on the topics of health-care advocacy; women leaders; leading through a crisis; and COVID-19.

The case study illustrates how a woman founder and CEO can lead her firm through a crisis.

This is an example of how a woman leader managed through the 2020 pandemic.

CSS 3: Entrepreneurship

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.

Addresses how flow times and capacity calculations can be made for a service process such as the Bariatric Surgery Center at a clinic. Highlights how these calculations can be made for a service process just as in any manufacturing setting. Discusses the notions of critical paths and bottlenecks and what factors affect both time and capacity. Also, discusses the relative profitability of two types of bariatric surgery, the goal being to link product profitability to the process.

Operations and human resourcing.

This case study is intended for use in graduate, executive level management and doctoral programs. The case study illustrates a combined IT and HR driven participative management control system in a flexible organization structure. It is intended for a class discussion rather than to illustrate either effective or ineffective handling of an administrative situation.

The case describes the situation of managing unskilled workforces (≥14,000 workers) during the construction phase of the 4 × 250MW power plants both for purposes of turnout as well as due compensation, in the event of an accident. The approved labour forces appointed for 45 × 8 h. Man-days after a rigorous fitness test and approvals of the safety officer are allocated housing and other necessary amenities and a commensurate compensation system.

These include: illustrating typical organizational responsibility structure at a construction site of a large power plant; illustrating the planning and administrative control mechanism in implementing strategy at a construction site of a large power plant; offering students the opportunity to understand and view a typical operational (project) structure; allowing students to speculate adaptations in the wake of an ever-changing business and company environment; and providing an opportunity to introduce a power scenario in India, Indian labour laws and radio frequency identification technology and to relate this to the case in context.

Teaching notes are available; please consult your librarian for access.

Developing and communicating a positioning strategy covering issues on market positioning, product lifecycle, product differentiation strategies and developing the marketing mix strategies in order to compete with competitors.

Advanced undergraduate and MBA student, taking courses of marketing management, strategic marketing, and brand management.

GranuLab is a private limited company based in Shah Alam, about 30 km from Malaysia's capital city of Kuala Lumpur; it was a producer of synthetic bone graft substitute GranuMaS. GranuMaS was launched in the Malaysian market in late 2010. At that time, the company aimed to capture 50-70 percent of the Malaysian bone graft substitute market by the end of 2015. However, by the end of 2012, GranuLab was experiencing low sales and the company had suffered a two-year loss due to manufacturing at low capacity. GranuLab also faced stiff competition from multinational competitors that had penetrated the Malaysian market earlier with competitive product offerings. The pressure to increase the sale ofGranuMaS was mounting for Mr Romli Ishak, the Managing Director of GranuLab, Mr Fadil Dalal, the new General Manager of Marketing, and GranuLab's management team. This is especially so since the company's contract to supply GranuMaS to government hospitals under the Ministry of Health (MOH) program would end soon. These situations forced the company to make a quick decision. In December 2012, Mr Romli and his team pondered upon the best strategy that the company should pursue to achieve its objective of being a dominant player in the Malaysian bone graft substitute industry. This teaching case is designed to stimulate case analysts' thinking on positioning a medical device product in a market which was already conquered by established multinational companies.

Understanding of the concept of product positioning, product lifecycle, marketing mix strategies, and social exchange theory, enables case analysts to extend the concepts to analyzing many other products and services in organizational settings.

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 contribution of the present case lies in the critical view that every business actor should exercise – be it general manager, middle management, supervisor or executive – when building a strong organizational culture in corrupt political environments.

The purpose of this case study is to explore the dilemma in which Marcelo Odebrecht, once CEO of Odebrecht, found/determined whether to continue with the business model established by the founders of Odebrecht or take a new path for the organization. After exploring the corrupt acts of Odebrecht and the scope of Operation Lava Jato, the reader can reflect on the importance of organizational culture (according to the three levels proposed by Schein) in the face of the emergence of corruption. By generating discussions about organizational culture, business ethics, political culture and corruption, the organizational culture of Odebrecht is problematized in relation to its real behavior.

Students of administration, business and international business undergraduates and graduates, as well as members of senior management in companies in the infrastructure sector. Also, given the plurality of possible readings, it is recommended that the case also be used in courses or specializations in organizational psychology, organizational sociology or organizational anthropology.

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 5: International Business.