Case studies

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

Tom McKillop, CEO of AstraZeneca, faced the classic quandary of large pharmaceutical firms. The firm's patent for Prilosec (active ingredient omeprazole) was expiring. Severe cost-based competition from generic drug manufacturers was inevitable. Patent expirations were nothing new for the US$15.8 billion in revenues drug firm, but Prilosec was the firm's most successful drug franchise, with global sales of US$6.2 billion. How could the company innovate its way around the generic cost-based competition and avoid the drop in revenues associated with generic drug market entry? AstraZeneca had other follow-on drugs in the pipeline—namely Nexium, an improvement on the original Prilosec molecule. Additionally, the company had the opportunity to introduce its own version of generic omeprazole, hence becoming the first mover in the generic segment, and/or introduce an OTC version of omeprazole that might tap into other markets. Ideally, AstraZeneca would like to move brand-loyal Prilosec customers to Nexium. In this market, direct-to-consumer advertising has remarkable efficacy. Classical marketing challenges of pricing and promotion need to be resolved for the Nexium launch as well as possible product and place challenges for the generic or OTC opportunity. Which combination of marketing options will allow the firm to best sustain the value of the original omeprazole innovation?

The central objective of the case is to teach students how marketing variables can be used by first movers with diverse product portfolios to fend off severe price competition. These variables include pricing, promotion, product, and place (distribution) options as considered in the context of branded, generic, and OTC pharmaceutical market segments.

Bruce-Alfred Technologies (BAT) has built a successful business selling packaged software. Its marketing has long promised free technical support to all customers, a key point of differentiation from BAT's competitors. However, the call center providing tech support is now in crisis. Wait times for callers are unacceptably high, leading to low customer satisfaction and negative press. BAT managers are evaluating the Fast Track Proposal, which would create two classes of calls. Fast Track calls would be promised a one-minute wait but pay for service. Standard calls would still be free but be given lower priority and have no wait time guarantee. Considers both the operational impact of this change and the strategic considerations of backing away from free tech support.

To emphasize the impact of priorities and alternative ways of managing capacity, discuss different ways of pricing services--i.e., pay-per-transaction vs. subscription, and demonstrate the basics of the relation between utilization and delay.

How does a mature business develop new growth markets, assuming it already has new products? That was the challenge facing The Coca-Cola Company and its global system of bottlers in the 2000s when demand for its core line of carbonated soft drinks flattened. The Australian bottler, Amatil, pinned its hopes on energy drinks, a fast-growth, youth-oriented category that was capturing headlines and share away from traditional products. To wrest control from the upstart brands that originated them, Amatil was targeting the retail context where young people congregated and formed their preferences, in pubs, nightclubs, healthclubs, and sporting events. This international case explores the challenges encountered when a mature company with considerable distribution assets, well-honed systems, and entrenched operating procedures attempts to sell into an underserved retail channel with requirements quite unlike those of the company's mainstream buyers. How does it attract market interest? How does it develop new routes-to-market without undercutting the cost efficiencies and delivery value that have earned it dominant position elsewhere? How does it win over what could be its core customers of the future without alienating today's faithful? These are just some of the questions that Amatil management was determined to solve.

Understand issues related to retail channel strategy development in fast-changing international consumer markets, and the challenges of adapting legacy routes-to-market systems to changing consumer demands.

Colfax Corporation was a young, privately held collection of pump-manufacturing companies from the United States and Europe. Intending to go public, it was eager to find a story for investors of how it could grow at rates faster than its subsidiaries had historically grown in their home regions and core-customer industrial markets. This case describes a singular new-growth opportunity: selling Colfax solutions into state-owned petroleum enterprises in the Middle East at a time when these producers were straining to add capacity. Designing the optimal marketing system required Colfax to weigh a complex of issues, including global resource allocation and deployment, a process for customer-relationship building, and estimates for revenue streams versus investment outlays. The design process was, in short, far more than “sticking sales rep pins in the map.” Case readers are asked to think along with the Colfax global management team in deciding, “How much can we afford to risk our current income model in order to build new capacity in a new region in a new way?”

Understanding issues related to global B2B marketing channel strategy development, as well as complexities of entering unfamiliar new international markets such as Middle East oil and gas.

In 2007 Conseco's CEO, C. James Prieur, faced a complicated set of problems with his company's long-term care (LTC) insurance subsidiary, Conseco Senior Health Insurance (CSHI). CSHI faced the threat of congressional hearings and an investigation by the U.S. Government Accountability Office, triggered by an unflattering New York Times article alleging that CSHI had an unusually large number of customer complaints and was denying legitimate claims. This threat came in addition to broader systemic problems, including the fact that the entire LTC industry was barely profitable. What little profitability existed was dependent on the goodwill of state insurance regulators, to whom the industry was highly beholden for approvals of rate increases to keep it afloat. Furthermore, CSHI had unique strategic challenges that could not be ignored: First, the expense of administering CSHI's uniquely heterogeneous set of policies put it at a disadvantage relative to the rest of the industry and made rate increases especially necessary. Second, state regulators were negatively predisposed toward Conseco because of its notorious reputation and thus were often unwilling to grant rate increases. Finally, CSHI was dependent on capital infusions totaling more than $1 billion from its parent company, Conseco, for which Conseco had received no dividends in return. Faced with pressure from Conseco shareholders and the looming congressional investigations, what should Prieur do? Students will discuss the available options in the context of a long-term relationship between Conseco and state insurance regulators. Prieur's solution to this problem proved to be innovative for the industry and to have far-reaching consequences for CSHI's corporate structure.

After reading and analyzing this case, students will be able to: evaluate the impact of a regulatory environment on business strategy; and assess the pros and cons of various market strategies as well as recommend important non-market strategies for a firm in crisis in a highly regulated industry.

This case examines a company that rents and leases computers. The primary objective of the case is to provide a scenario where students can see the link between operational flow measures such as inventory, throughput, and flow time and financial flows. The case presents a scenario where a firm sees financial performance worsen even though sales increase. A link between the operational measures and financial flows allows students to understand the causes.

To provide a scenario that shows the link between operational flow measures such as inventory, throughput, and flow time and financial flows.

Looks at the introduction of statistical process control (SPC) into a distribution center servicing a department store chain. Focuses on the receiving process in the distribution center and describes the introduction of SPC methodology. Discusses run charts, pareto diagrams, and control limits.

To introduce statistical process control.

Fiserv, a pioneer in electronic payments, would like to increase the number of consumers who receive bills electronically. Currently, adoption is relatively low. To help guide their efforts, Fiserv managers have done extensive customer research and have segmented the market based on customer perceptions of e-billing. Students must recommend which segments to target and why. To support their recommendations, students must calculate the likely financial costs and benefits of adoption, estimate the likely returns for targeting different segments, and make targeting and positioning recommendations based on these calculations. Because Fiserv's direct customers are billers (such as utilities and credit card companies) and its end users are individual consumers, the case allows a focus on both B2B and B2C issues.

This case gives students the opportunity to estimate the relative profitability of different segments and to make targeting and positioning recommendations based on these calculations. It highlights the importance of assessing segments based on both quantitative and qualitative considerations. It also emphasizes the potential difficulties associated with targeting multiple segments at once.

Roger Osayende, a former management consultant, must advise the Ministry of Health of Ektu, a fictional country in Central Africa, on how to implement a new point-of-care diagnostic test for infants with HIV. In Ektu, mothers often transmitted HIV infection to infants during pregnancy, delivery, or breastfeeding due to inadequate resources to invest in prevention efforts. The existing procedure to diagnose infants with HIV required collecting dried blood samples at more than two hundred healthcare facilities around the country and transporting them to a central laboratory in the capital for testing. This process was characterized by significant delays due to long transportation times, batching of samples in transportation and processing in the lab, and concomitant congestion in the lab. This delay resulted in loss to follow-up, that is, lost patients due to mothers not collecting their infants' results. A new point-of-care device was about to be introduced, which would obviate the need for this centralized processing and the resulting diagnostic delay. The key decision under consideration is where to place the devices to maximize their effectiveness.

Understand the importance of making public health decisions based on a data-driven, logical framework   Uncover the link between operational performance of the healthcare system and health outcomes at the population level   Appreciate the relevance of operational decisions in enhancing or diminishing the effectiveness of a medical technology   Use process analysis concepts to characterize various components of delays