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It was mid-March 2014, and GE's John F. Welch Technology Centre in Bangalore, India was brimming with activity. GE had developed an advanced, scalable positron emission tomography-computed tomography (PET/CT) scanner as part of its global Healthymagination initiative to provide better healthcare for more people at a lower cost. Munesh Makhija, Managing Director, GE India Technology Centre and Chief Technology Officer (CTO), GE South Asia, was thumbing through a report prepared by the PET/CT product development team and GE's healthcare market research team. In another office, Suresh Kumar R.(Kumar), General Manager of the Essential PET Segment, was putting the finishing touches on a presentation outlining a commercialisation strategy for the new PET/CT product, Discovery IQ (Exhibit 1).

Discovery IQ was a revolutionary product that would be useful for staging, treatment planning and post-treatment planning assessment. Early reviews from nuclear physicians had been positive. However, the product was still too costly for the bottom of the pyramid (BoP) market. Kumar and his team were scheduled to meet with Makhija the following morning to discuss a “go-to-market strategy”. Kumar knew that Makhija would want to talk about their segmentation strategy and the underlying needs of various customer types. He also expected Makhija to focus on return on investment (ROI) projections because diagnostic centres in India first looked at various financial return measures before investing in any new equipment. Kumar wanted to present a commercialisation strategy for Discovery IQ, which required a significant commitment of resources to tackle supply and distribution challenges across tier II and tier III cities^a in India.

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.

The subject areas are business communication, human resource management and health care.

The case was designed for use in a first-year MBA-level course in business communication but would serve well in a course for executives or for advanced undergraduates. It might also be assigned in general management courses to evoke discussion on communication skills required in sensitive and critical situations; human resource courses; and course on health care.

Palliative care is a specialized medical care focussing on improving the quality of life of patients suffering from life-threatening illnesses. It addresses symptom management and psychosocial and spiritual concerns of the patient and its caregivers. With the intent to alleviate the sufferings of terminally ill patients, Rajbala Foundation, a non-government organization (NGO), works at the psychosocial and spiritual levels. While training their volunteers in effective palliative care communication, it often encounters challenges such as socio-cultural variations, organizational challenges, appropriate verbal and nonverbal communication, etc. This teaching case focuses on the communication challenges faced by the volunteers of Rajbala Foundation. It would lead to a broader discussion on communicating empathically during critical situations. The case has a focus on NGOs, and non-profit organizations, public sector management, health-care management and human resources management. There is significant literature on communication skills for medical practitioners in palliative care. As an increasing number of NGOs step in to provide the second level of care to critically ill patients in non-physical domains, there is a need to understand the role of effective communication for such care providers. This case deals with non-medical care providers in palliative care; the issues of communication they face as they interact with patients; and the skills they require to address the emotional and spiritual needs of patients and their families.

The aim of this case is to raise awareness of the complexities involved in the communication process during an emotional and sensitive interaction. It aims to encourage volunteers involved in palliative care to reflect on good communication practices when communicating with patients and family members. After reading this case, the students should be able to discuss the complexities involved in the communication process when communicating in situations with high emotional involvement; understand the core elements of emotional interactions for effective practice; and emphasize the need for the development of communication skills within palliative care.

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 6: Human Resource Management

Describes Myriad Genetics and its struggle to develop a genetic testing service while facing challenges from competitors and activist organizations. After Myriad's discovery of the BRCA gene, capable of genetic testing for breast cancer in women, Myriad needed to choose a strategy to provide this service to the public. With several major competitors offering similar services, intense media scrutiny, and a charged activist and political climate, a poor Myriad decision could have major repercussions.

Non-profit management and corporate strategy.

The case is appropriate for teaching undergraduate students, executive MBAs and graduate students. The case is useful for an overview of hospice and palliative care in the developed and developing world, and for class room discussions of external analysis of non-profit organizations' ecosystems, funding needs and industry analysis.

Hospice care in the developed parts of the world is well established but in most developing countries, there are no organized hospice care facilities. This case focuses on a charitable organization, Brthya – Add Value to Life (Brthya – AVTL), that established and operates hospice care in Chennai, India. The Indian context for hospice care, and the ecosystem needed to sustain ongoing operations, are described along with a summary of four different models of hospice care used in other parts of the world.

The case will help students to understand: what hospice care is and its various forms; management issues related to funding and operating hospice care in particular and a non-profit in general; ecosystems that make non-profits sustainable in emerging economies; and managing expansion and growth in non-profit organizations, in emerging economies and globally.

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

GE Healthcare was on a continuous lookout for investing into new and innovative super value products for the Bottom of the Pyramid markets in India. After launching its first successful super value ECG machine Mac 400, GE had recently launched its twenty-fifth super value product a PET CT machine. Serving the BOP markets has its own unique challenges that may be different for each product that is placed in the market. However, GE has so far successfully sailed through all the challenges and developed a steep learning curve about BOP markets. However, it is now facing the challenge of ensuring sustainability of product pipeline. The company is also keen to exploit the opportunities for reverse innovation that super value products have provided. The company also wants to assess the disruptive impact of these products in domestic medical device markets as well as markets outside India.

Innovation Strategy/Entrepreneurship.

The case can be used in an MBA/postgraduate management program for a course on Innovations Strategy with a focus on disruptive innovation, specifically in relation to disruption in the value chain with the adoption of new technologies or for a course on Entrepreneurship focusing on the opportunities created by the Internet-based technologies for start-up businesses. Alternatively, it can be used in a course on e-commerce strategies, particularly to demonstrate the efficiency of online distribution vis-à-vis physical channels.

The case illustrates how Medknow Publications created a profitable e-commerce model out of a struggling conventional business, namely, the learned society journal publishing. It also provides a useful ground to discuss the challenges faced by the conventional scholarly journal publishing models, the current crisis in scholarly journal publishing and how Medknow, a disruptive business model innovation, would address these issues. Besides, the case illustrates how Medknow created a sustainable “for-profit” alternative to the prevailing not-for-profit models of open access publishing.

After the analysis and discussion of this case, students will be able to: appreciate how technological innovation can disrupt existing business models; understand how digitization helps improve the efficiency of value chain in the content industry, particularly the scholarly journal publishing industry; and appreciate that the flexibility of digitized content and the global reach of the Internet have the potential to transform the scholarly journal publishing industry for good.

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