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The purpose of this study is to document the experience and impact of implementing lean thinking (LT) in an Indian healthcare institution.

A detailed review of literature documenting the experience of implementing LT in healthcare institutions is carried out. Review revealed that there is a dearth of documentation on implementation of LT in Indian healthcare institutions. To address this gap, the experience of implementing LT in an Indian case hospital is documented by adopting a single case study research methodology.

Lean practices adopted by the Indian case hospital are documented. Performance measures before and after implementation of lean practices in the case hospital are compared. Based on this experience, a framework for implementing LT is proposed for healthcare institutions.

The current study documents the experience of an Indian case hospital, which is only at its initial stages of LT implementation. Future studies can be undertaken to assess the long-term impact of implementing LT in a healthcare institution. Similarly, the proposed framework for implementing LT can be validated by using the same in different healthcare institutions.

Review of lean principles, practices and performance measures discussed in the literature on implementing LT in healthcare institutions can act as a ready reckoner for practitioners. Framework proposed based on the experience of the case hospital is expected to guide healthcare practitioners in their lean journey.

This study is unique, as it documents the experience of implementing LT in an Indian healthcare institution and proposes a framework for implementing LT for future validation.

Lean thinking (LT) has been implemented in various manufacturing and service sectors. But, only a few published research articles have developed a framework describing the procedure for implementing LT in an educational institute. The purpose of this paper is to develop and demonstrate a framework that can provide a structured procedure for the implementation of LT in an educational institute.

Various LT tools and techniques applicable in educational institute were identified by reviewing the relevant literature. By adopting an action research methodology (ARM) for a time period of 28 months, the processes in a case institute were studied; wastes in the process were identified and various solutions were proposed and implemented.

A comparison of the performance measures before (Batch 1) and after (Batch 2) implementation of solutions provided interesting insights into the effectiveness of LT. In both the batches, absenteeism in the class was found to increase across the terms. But the magnitude of increase was lesser in Batch 2. Results also showed that the number of unfilled seats (poor utilization) in an elective course in the second year of the program drastically reduced in Batch 2. Finally, a framework that can guide LT implementation in educational institutes was proposed.

The current study describes only the initial stages of implementation in an educational institute. Hence, some of the benefits discussed are expected in the long run which can be assessed by carrying out a longitudinal study. Future study can attempt to empirically validate the proposed framework in multiple educational institutes and theoretically explain the reasons behind the results obtained.

ARM can be used as a tool by practitioners to study the behavioral aspects of employees of educational institutes toward LT implementation. The proposed framework and its demonstration can assist employees in educational institutes to implement LT. Positive results obtained in this study can further motivate the educational institutes to consider LT as a potential tool for improving the processes.

This is the first study to develop and validate a framework for structured implementation of LT in the processes of an educational institute. The study is also unique in empirically capturing the impact of LT implementation of an educational institute by analyzing the archived data.

The learning outcomes have been prepared in accordance with Bloom’s Taxonomy (Bloom et al., 1956). After completing the case, the students shall be able to do the following: • describe the challenges faced by the not-for-profit, non-governmental and voluntary organizations operating at a local level in a conflict-ridden zone (knowledge). • Explain the key features, roles and typologies associated with non-governmental organizations (NGOs) (comprehension), apply such typologies to specific organizations (application) and differentiate between social enterprises and NGOs (analysis). • Analyse various scaling-up techniques and infer the technique(s) used or can be potentially used by a particular organization (analysis). • Synthesize different elements of the organizational environment and reflect on the potential influence of these elements on an organization (synthesis). • Develop frameworks by applying institutional theory and motivations for volunteerism to map challenges of organizational legitimacy and volunteer turnover, respectively, as well as make recommendations to tackle these challenges (synthesis and evaluation) • Develop recommendations for the problems faced by not-for-profit voluntary NGOs (evaluation).

Balgran, a local not-for-profit non-governmental voluntary organization operating in the conflict-ridden state of Jammu and Kashmir (J&K), India was established in the year 1975 to empower destitute, orphans, abandoned and socially handicapped children. Since its inception, Balgran has expanded its services at a rapid pace including Bal Bharti public school, health care centre, vocational training and a computer centre. Mr A.K. Khajuria, President of Balgran, was concerned about the high turnover of the voluntary staff, mistrust among the potential donors concerning fund management of NGOs and inadequate funding. Mr Khajuria after a few failed attempts at resolving these issues, called for a meeting of the members of the governing body in February 2019 to decide the future plan of action to resolve these issues. Through this case, the students can understand the challenges faced by local NGOs in general and unique challenges (mistrust among potential donors) faced by NGOs operating in conflict-ridden areas such as J&K. The students will be able to enhance their skills in brainstorming and making recommendations while framing possible solutions to the challenges faced by Balgran. The case seeks to enable the students to comprehend the features and typologies associated with NGOs; the role played by local NGOs in community development; differences between social enterprises and NGOs; scaling-up techniques and paths with special reference to local NGOs and the environmental factors that can potentially influence the operation of NGOs.

This case is suitable for undergraduate and graduate-level students learning social entrepreneurship, social work and management of alternate organizations such as NGOs. This case could be used to discuss concepts related to not-for-profit organizations operating in voluntary settings.

Teaching Notes are available for educators only.

CSS 3: Entrepreneurship.

The subject areas are family-owned business, entrepreneurship and strategic management.

The target audiences for the case study are BBA and MBA students and management trainees who are interested in learning about family-owned business and the problems faced by them when generations change. This case can be used to teach concepts in family-owned business and strategic management courses in the context of emerging markets. The case also introduces the problems faced by a traditionally operating organization which has to change to survive in the market. The case can be used to teach senior management teams participating in executive education programs on how problems arise in family-owned business. To successfully work with this case study, students need to have the basic theoretical understanding of family-owned business.

Sree Subramania Ayurvedic Nursing home (SSANH), one of the most reputed Ayurvedic treatment centers in Kozhikode, Kerala in India, was converted into its present form in 1974 from Thekkayil Vaidyasala by Thekkayil Rajaratnam Vydiar. The latest addition to this family run nursing home is Dr Sananad Ratnam, who in continuity of his family tradition studied Ayurveda. Dr Sanand wanted to rethink the positioning of the 400-year-old family business system with an objective to increase the number of people served by SSANH. He is armed with ambitious plans to expand SSANH and increase the volume of patients served. Dr Sanand’s father, the second partner of SSANH, was not quite supportive of this idea. His father felt that the increase in scale without compromise in quality was impossible in Ayurveda. Dr Sanand felt handicapped with problems such as lack of marketing strategies, lack of standard managerial procedures, lack of innovation in processes and, more importantly, conflicting ideologies between father and son in the family-owned business. To address these problems, Dr Sanand has recently hired the services of a consulting firm. This case highlights how SSANH, in spite of being in an advantageous position, is unable to exploit its full potential. Further explaining the different ways in which different generations perceive business, this case invites the attention to the dilemma: Should the business proceed with its expansion plan? If it decides to expand, how it should convince the previous generation of the family that the expansion plan accommodates their concerns.

After completion of this case, students would be able to: gain a perspective on the problems faced by a family-owned business which has successfully survived for decades; understand how a family-owned business functions differently from other business models; evaluate different ways in which the organization can look to solve the dilemma by considering the different stakeholders in question; and apply the result of the literature on family-owned businesses to understand the dynamics of business of this specific setting, i.e. one that has a rich heritage, is in an emerging economy and is a family-owned business.

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CSS 3: Entrepreneurship.

After studying this case, students should be able to: understand the process of opportunity identification for forming social enterprises (knowledge), discuss various concepts related to social entrepreneurship and not-for-profit firms (comprehension), apply tools to differentiate between social and commercial enterprises (application), analyze the role of environmental factors like culture in influencing business (analysis) and develop decision-making skills by critically evaluating the options (evaluation).

Sasta Bhojan Sewa (SBS) was one of the key projects of Parupkar Sewa Society. The social venture initiated by Jaswinder Singh, a young resident of Ambala (a small town in Haryana, India), got registered as a not-for-profit society in the year 2018. Mr. Singh initiated various social welfare projects since the year 2006 when he got inspired from the history of Sikh Gurus. As years passed, he was able to employ more and more people. This led to the development of a social venture, which had 33 employees at the end of the year 2019. The society was running seven major projects with the help of dasvandh (donations). Project SBS was about providing home-like hygienic meals to people at merely INR10. There were 11 canteens in Ambala city and cantonment, which were being run under that project. Around 1,500 people were eating daily in those canteens, out of which around 70–80 people were not able to pay even INR10. The project had employed 30 people. The salaries of the staff and other operating expenses like liquid petroleum gas (LPG) expense, transportation cost and electricity were met through dasvandh (donations) from the local households. When the project was initiated, the cost of preparing a meal was INR10, but by the end of 2019, the cost went up to INR12 per meal due to food inflation. The meal was still being sold at INR10 at a loss of INR2 per meal. On December 28, 2019, as founder of the society, Mr. Singh was thinking of raising the selling price to INR12 per meal, which had to be implemented on January 01, 2020 but he was doubtful in doing so. He thought increasing the price might defeat the purpose of starting SBS as he was reflecting on how poor people were and how each rupee mattered to them. He was also considering that it might affect the goodwill of the society that was known for selling food at an extremely low price. By using the example of SBS, we explain various concepts of not-for-profit social enterprises like opportunity identification, key drivers, business model canvas and environmental effects in this teaching note. The teaching note also provides cost–benefit analysis of the available options to facilitate effective decision-making.

Undergraduate and graduate-level business programs.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

Launch strategies, marketing techniques and data analytics procedure adopted by a firm before launching a new product.

Academic students and management trainees who want to learn the methodology adopted by firms with respect to strategic management and marketing for launching a new product in Indian market.

Launch plan for Roulette, a premium segment brandy manufactured by John Distilleries Private Limited, has to be designed for Karnataka, Pondicherry and Andhra Pradesh markets in India by the Brand Manager Mr Pundlik Kalburgi. Competitors and target market share needs to be identified for all the three markets. Potential outlets, target outlets, channel-wise sales contribution, depot-wise sales contribution and size of the packs to be produced need to be identified for Karnataka market. These identifications need to be submitted to the chairman of the company and other department heads to implement the launch.

Pareto rule (80/20 rule) application for cost-efficient launch strategy; segmentation and identification of competitors; procedure to identify potential of the launch product and market share that can be targeted; and understanding the complete functioning of alcoholic beverage industry in Indian markets (with special reference to Karnataka) and analysing the market data to build an entire launch plan; 4.1 Identifying channel-wise potential and target outlets for the launch product; 4.2 Identifying potential and target depots and number of outlets under each of the depots; 4.3 How pack size of launching product to be manufactured is decided upon.

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

After completing the case study, the students will be able to explore, create and capture the dilemmas of a platform strategy; compare, contrast and configure strategies for successful platform adoption; develop fitting configurations for marketplace design; and use temple framework to evaluate the dilemma of the element of time (do it sooner, delay for later or dismiss forever) in launching a new marketplace.

Shoppre was a parcel-forwarding firm established in 2017. In a short period, Shoppre turned out to be one of the best parcel forwarding and cross-border commerce companies in India, thanks to the first-mover advantage it enjoyed. Shoppre had offerings of shopping and shipping of cross-border e-commerce. As a new firm looking forward to increasing its market power, Shoppre faced the dilemma of whether to launch the marketplace, and if yes, whether to do it soon or delay it for the future. There was also confusion in the marketplace’s design and implementation. Nikkitha Shankar’s (she/her) worry was that if Shoppre did not decide quickly on this, there would be possible crises in managing the partners and their financial performance. Shankar was brainstorming the issues with the founding partner and was gauging the dimensions. This case study presented new marketplaces’ dilemmas along with managing sellers, customers, markets, finance, logistics and digital transformation.

The case study is suitable for undergraduate- and graduate-level students pursuing courses in business programmes and senior management professionals participating in executive education programmes. The case study will also fit well for courses such as the “Platform strategy: building and thriving in a vibrant ecosystem” course [1], digital business models [2] and digital business strategy [3].

Teaching notes are available for educators only.

CSS 11: Strategy.

The purpose of this paper is to critically review and explore how organizations knowledgeably respond to unfavorable institutional environments that exert institutional pressures and thereby limit their decision-making and eventually their actual behavior.

Based on a thorough structuration and analysis of the literature in management and related fields, the authors present a comprehensive synthesis of organizational knowledgeable responses to institutional pressures.

Based on the review, the authors categorize organizational knowledgeable responses into three major types – passively responding to avoid non-conformity, reactively mitigating institutional pressures and proactively developing institutional environments toward less interfering setups.

The authors discuss the enabling conditions for the categorized organizational knowledgeable responses as well as limitations to their application. They identify research gaps and formulate research questions to offer promising avenues for future work. The authors expect this detailed synthesis to lay the framework for investigating how the knowledge-based view of the organization influences its knowledgeable response to institutional pressure.

The authors elaborate on distinct passive, reactive and proactive strategies, which firms can apply to cope with institutional pressures. The contribution of this study will be of relevance to practitioners managing organizations in the face of unfavorable institutional setups, as well as to policymakers engaged in the development of institutions and interacting with affected organizations.

This study provides a valuable overview on developments in institutional theory, particularly on contributions to the “nascent literature” that examines heterogeneous organizational knowledgeable responses to institutional pressures.

The purpose of this paper is to describe a leanness assessment methodology that takes into account the interaction between lean elements for computing the systemic leanness and for assisting continuous improvement of lean implementation.

Key elements determining the leanness level were identified by reviewing the relevant literature and were structured as a framework. Graph-theoretic approach (GTA) was used as the assessment methodology for its ability to evaluate the interaction between the elements in the developed framework.

Interactions between the lean elements were configured. Application of the proposed GTA for assessing systemic leanness was demonstrated. Scenario analysis was performed and a scale was developed to assist firms in comparing their systemic leanness index.

This paper is unique in developing an assessment approach for measuring the systemic leanness. In addition, this study explains how the implementation of lean thinking (LT) in a value stream can be continuously improved by proposing a systemic leanness index that can be benchmarked. The proposed approach to measure systemic leanness can be tested across different value streams in future for extending its generalizability.

Proposed framework and leanness assessment approach presents an innovative tool for practitioners to capture the systemic aspect of LT. Proposed assessment approach supports practitioners in achieving continuous improvement in lean implementation by revealing the lean elements that need to be focused in future.

Study introduces a new perspective for LT by studying the importance of interactions between the lean elements and by incorporating them to assess the systemic leanness.

This case draws upon the literature on appropriate leadership behaviors that Yahoo’s Founders or CEOs could have adopted. It discusses the process of environmental analysis that would have an impact on Yahoo!’s strategy. It discusses and depicts the levels of environmental analyzes that Yahoo! as a firm ought to have undertaken in mapping its competitive environment. Further, this case discusses transformational leadership factors and those behavioral traits that exemplify each of these factors. Finally, the four elements of aspiration in discussing future firm direction are identified. These include an appropriate vision translated into a clarifying mission reflected in specific objectives grounded in explicit value statements.

This case is based on secondary data sources that include official company records, online reports and commentary, newspaper reports, public interviews and books. All such information has been appropriately referenced.

Yahoo!, in its 22 years of existence, has demonstrated remarkable tumult. It has witnessed a succession of six CEOs, exhibited a roller coaster trajectory in its stock price and, for the most part of its existence, played “catch-up” with its strategic competitors. It has also struggled to define its core purpose, its industry category and its very essence of being. In early 2016, CEO Marissa Mayer announced that Yahoo! would be willing to sell its core internet business and that its board would “engage on qualified strategic proposals.” However, the board also reiterated that turning around Yahoo! to prosperity continued to remain a top priority. What went wrong, so terribly wrong, with Yahoo! in an otherwise lucrative industry? Does Yahoo! suffer from a fundamental, essential malaise which, if addressed, could restore it to wealth and vibrancy? This case focuses on the period 1994, the inception of Yahoo!, to early 2016. The acquisition of Yahoo! by Verizon, completed in 2017, is not to be considered for purposes of this case study.

This case is particularly suited to be taught in a capstone strategic management course for MBA/Master’s level business students, after they have been exposed to core courses in Marketing, Business Law, Accounting, Supply Chain, Corporate Finance. It may also be taught in an advanced strategy course for undergraduate business students, typically in their final year of study. Finally, this case can be used to teach senior management in executive management programs.