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This case describes the innovations of a medical practitioner over six decades of practice. It provides an opportunity to the participants to analyse the motivation, processes, constraints and outcomes or innovating efforts of individuals as opposed to corporates. During his career Dr. Shah has experimented with novel methods of treatment, applications of known solutions and new product formulations. At the fag end of his career Dr. Shah is wondering whether the innovating efforts were worth their white.

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.

The case has the following learning objectives:

1. understand the various types of comparisons that are possible between groups over time and across space;

2. evaluate a policy intervention using relevant data and different methods; and

3. understand the meaning of the phrase “controlling for other relevant factors” in regression and non-regression contexts.

The difference-in-differences (DID) approach is a useful tool for making meaningful comparisons. This case tries to provide a non-technical introduction to the approach using a basic comparison of crime rates among districts in Punjab (Pakistan's largest province). Being the most populous region of the country, Punjab faces many governance challenges, and street crime is one of them. (Exhibit 5 provides additional information about the geographical and administrative setting used in this case study.) In 2016, Chief Minister Shahbaz Sharif established the Dolphin (police) Force in different locations to improve urban patrolling and reduce street crime. There were debates about the effectiveness of the Dolphin Force (DF).

Those who are skeptical of DF point to various situations that were handled incorrectly by DF personnel, as well as other administrative and operational problems in the initiative. Optimists believe it is beneficial and want it to be expanded to other districts and regions. The threat of street crime claims many lives and, according to optimists, necessitates the formation of a special force. Whether the huge resources invested in the DF worth their lot or not can be known through sound statistical analysis that can identify the difference in the rate of crime because of the DF. In this instance, the case provides information to answer the following question:

Is there a significant difference in crime rates between areas where the DF is operating and districts where it has not yet been installed?

In quantitative/statistical analysis classes, the case can be used to teach the DID technique to MBA/MS Applied Statistics/Applied Data Analysis students. It can also be used in undergraduate Econometrics classes.

Teaching notes are available for educators only.

CSS 7: Management Science.

It is January 2017, and Nikki Tyler, market access advisor at the U.S. Agency for International Development's Center for Accelerating Innovation and Impact, must recommend an actionable strategy for how to use the $10 million contributed by global donors and foundations to scale up the use of chlorhexidine in Nigeria. It was clear that chlorhexidine, a substance applied to newborns' umbilical cord stumps to prevent infection, could reduce infant mortality significantly. However, changing behavior would be an enormous challenge. This case gives students an appreciation for the importance and complexity of global health issues, along with an understanding of key analytic techniques for approaching a complex market situation. Students quickly learn that there are no easy answers to encouraging chlorhexidine's greater use. To develop a plan, it is essential to complete detailed analyses, study insights and motivations, and ultimately compare different possible solutions, considering efficiency and efficacy.

The cofounder of Compass Records, a small, independent music-recording company, must decide whether to “produce and own” the next album of an up-and-coming folk musician or simply “license” her finished recording. This case presents information sufficient to build cash-flow forecasts for either investment alternative. Discounted cash flow (DCF) analysis reveals that licensing will be the more attractive alternative unless the student assesses the value of the options for follow-on albums included in the “produce-and-own” contract.

This case looks at an important business task: forecasting a new product. The case can be used to teach finance, marketing (new product introduction), and healthcare strategy. The product is one of Amgen's most important new products: denosumab. On the surface, the case is fairly easy; students simply have to do some simple mathematical calculations. However, the challenges of forecasting quickly become apparent; every forecast depends on some critical assumptions, and the answer can vary dramatically.

Highlight the importance of forecasting as a business task. Give students the opportunity to create a forecast, using logical assumptions to generate an answer. Illustrate how dramatically forecasts can vary. Demonstrate why sensitivity analysis and customer understanding are both critical when trying to forecast a new product launch.

Learning outcomes are as follows: students will discover the importance of process orientation in management; students will determine the root cause of the problem by applying root cause analysis technique; students will identify the failure modes, analyze their effect, score them on a scale and prioritize the corrective action to prevent the failures; students will analyze the processes and propose error-proof system/s; and students will analyze organizational culture and ethical issues.

Purpose: This case study is intended as a class-exercise, for students to discover the importance of process-orientation in management, analyze the ethical dilemma in health care and to apply quality management techniques, such as five-why, root cause analysis, failure mode and effect analysis (FMEA) and error-proofing, in the management of the health-care and service industry. Design/methodology/approach: A voluntary reporting of a case of “radiation overdose” in a hospital’s radio therapy treatment unit, which led to an ethical dilemma. Consequently, a study was conducted to establish the causes of the incident and to develop a fail-proof system, to avoid recurrence. Findings: After careful analysis of the process-flow and the root causes, 25 potential failure modes were detected and the team had assigned a risk priority number (RPN) for each potential incident, selected the top ten RPNs and developed an error-proofing system to prevent recurrence. Subsequently, the improvement process was carried out for all the 25 potential incidents and a new control mechanism was implemented. The question of ethical dilemma remained unresolved. Research limitations/implications: Ishikawa diagram, FMEA and Poka-Yoke techniques require a multi-disciplinary team with process knowledge in identifying the possible root causes for errors, potential risks and also the possible error-proofing method/s. Besides, these techniques need frank discussions and agreement among team members on the efforts for the development of action plan, implementation and control of the new processes. Practical implications: Students can take the case data to identify root cause analysis and the RPN (RPN = possibility of detection × probability of occurrence × severity), to redesign the protocols, through systematic identification of the deficiencies of the existing protocols. Further, they can recommend quality improvement projects. Faculty can navigate the case session orientation, emphasizing quality management or ethical practices, depending on the course for which the case is selected.

MBA or PG Diploma in Management – health-care management, hospital administration, operations management, services operations, total quality management (TQM) and ethics.

Teaching Notes are available for educators only.

CSS 9: Operations and Logistics.

In the 1960s thalidomide, a popular new drug considered to be safe and effective, was revealed to cause severe nerve damage and birth defects in newborn infants, prompting health officials to ban the use of the drug and tighten overall restrictions on new drugs and drug use. Twenty years later, after recognizing the positive effects of thalidomide when treating patients with leprosy and its potential role in the treatment of certain types of cancer and cases of HIV/AIDS, the Celgene corporation would be forced to contend with stringent FDA regulations, liability concerns, public skepticism, and poor mass media portrayal in order to secure the drug's approval.

To illustrate how regulators are subject to political pressure, which companies much recognize and consider when making business decisions.

In January 2013, small biotechnology firm Orexigen was in the final stages of testing Contrave, a promising new pharmaceutical product for the treatment of obesity. At the time, Orexigen had no products in the market, so all its hopes of financial success rested on this new treatment. Contrave had proven to be highly effective in clinical trials, and Orexigen executives were confident it would receive FDA approval.

At the same time, a much larger pharmaceutical company was considering acquiring Orexigen. Because the decision to acquire would ultimately be a financial one, the project team from the large company had to complete a valuation for Orexigen's only significant product in its pipeline, Contrave. What was the new product actually worth?

In March 2015, Amgen is preparing for the launch of Repatha, a new molecule that has demonstrated a remarkable ability to treat high cholesterol. Through a series of clinical trials, Amgen has proven that the molecule is both safe and effective for patients with high cholesterol. It also is effective for patients with familial hypercholesterolemia, a difficult-to-treat population that has exceptionally high levels of cholesterol. Amgen expects the FDA to approve the molecule before the end of the year. Now, the Repatha team has to develop a revenue forecast.