Case analysis provides the student of health care an exciting opportunity to act in the role of a key decision-maker. From hospitals to community blood centres to physicians' offices, students have the chance to learn about a variety of health and medical organizations and to practice decision-making skills through analyzing cases.
The decisions required to “solve” cases represent a wide range of complexity so that no two cases are addressed in exactly the same manner. However, the strategic thinking maps presented in this text provide frameworks to aid in strategically thinking about case issues. The fundamental task of the case analyst is to make decisions that will serve as a map to guide the organization into the future. Therefore, most case instructors will expect a comprehensive plan for the organization that addresses relevant current issues and provides a viable and reasonably complete strategy for the future. In order to achieve this goal, the case analyst typically should:
•surface and summarize the key issues,
•analyze the situation,
•develop an organizational strategy,
•develop an implementation plan, and
•set some benchmarks to measure success.
These categories represent the major elements of strategy development and make appropriate section headings for a case analysis written report or presentation. First, using the strategic thinking map presented in Chapter 1 (Exhibit 1–1), it is important to do some serious strategic thinking about the external environment of the organization–the political/legal, economic, social/cultural, technological, and competitive situations faced by the case characters. After gaining knowledge of the issues in the general and industry environments, the service area competitors should be assessed. Next, it is important to relate the resources, competencies, and capabilities of the organization to the external environment, which will require a thorough and objective analysis of the competitively relevant strengths and weaknesses. The value chain provides a useful tool for uncovering these strengths and weaknesses. These strengths and weakness must be evaluated as to their potential to create competitive advantages or disadvantages for the organization. External issues and the organization's competitive advantages and disadvantages provide the basis for strategy formulation. In addition, to create the strategy for a health care organization it is necessary to understand its unique mission, vision, values, and strategic goals (directional strategies).
Once the situational analysis is complete, strategic alternatives can be generated as possible solutions to the issues identified in the case. Consideration must be given to the possible adaptive strategies, market entry strategies, and competitive strategies that provide the means for achieving the organization's mission and goals and lead to the accomplishment of its vision. The effectiveness of the chosen alternative for each type of strategy must be evaluated. In addition, at least some thought must be given to the likely outcomes resulting from the different choices. After the evaluation, a recommendation needs to be made from among the alternatives.
Nothing will happen, of course, unless the strategy can be implemented. Therefore, the case analyst must address how the strategy will be carried out. The development of a feasible implementation plan should include specific service delivery and support strategies and, where possible, action plans. These areas are important because they create value for the organization and translate strategy into organizational and individual actions–the work to be done.
Finally, the case analyst should consider how the success of the proposed strategy should be measured. Returning to the mission, vision, values, and goals will provide an initial measure of success. Other measures will include fit with the changing environment, internal changes (development of competitive advantages and lessening of competitive disadvantages), and other more specific measures such as financial measures, market share, growth, and so on.
Although the approach outlined here is logical, it is important to remember that a case should be approached and appreciated as a unique opportunity for problem solving. Cases that everyone agrees have only one solution are not good decision-making aids. Moreover, managers in health care organizations rarely face problems where the solution is obvious to everyone. This does not mean that there are no good and bad answers or solutions in case analysis; some are better than others on the basis of the logic presented. Sometimes the issues presented in a case are not even problems (defined as a negative occurrence that needs to be addressed). Often the greatest challenge facing an organization is recognizing and acting on an opportunity rather than solving a problem. The evaluation of a case analysis is often based more on the approach and logic employed than the precise recommendation offered.
Cases, Strategic Management, and Health Care OrganizationsCases add realism that is impossible to achieve in traditional lecture classes. Realism results from the essential nature of cases, although students may complain that cases fail to provide all the information necessary for decision making. The complaint is valid because cases rarely provide everything that is needed. However, decision makers in health care organizations rarely have all the information they want or need when they face decisions. Risks must be taken in case analysis just as in actual decision making.
Risk Taking in Case AnalysisAny decision about the future involves uncertainty. Decision making under conditions of uncertainty requires that means be devised for dealing with the risks faced by leaders. Cases are valuable aids in this area because they allow the analysts to practice making decisions in low-risk environments. Decisions in a poor case analysis may be embarrassing, but at least they will not result in the closure of a hospital or medical practice. At the same time, the lessons learned by solving cases and participating in discussions will begin to build problem-solving skills.