Health systems are struggling to address the many shortcomings of health care delivery: rapidly growing costs, inconsistent quality, and inadequate and unequal access to primary and other types of care. However, if retailers and health systems were to form strong partnerships, they could play a major role in addressing these megachallenges. While some partnerships do exist, they are rare and have only scratched the surface of their potential. Rather than focusing on the direct-to-consumer model that retailers have largely employed, the partnerships should offer much broader care. Drawing on real-world examples, the authors outline four key actions that retailers and health systems should take: (1) They must move beyond convenience to offer comprehensive care. (2) They should move care from clinics into the home. (3) They should leverage data to improve clinical care and the customer experience. And (4) they should change how-and by whom-health care work is done. Implementing these four actions would generate improvements that would benefit not just patients but also the organizations that pay for their health care.

Pal's Sudden Service has developed a unique operating model and organizational culture in the quick service restaurant business. With a deep emphasis on process control and improvement, zero defects, extensive training, and a high level of employee engagement, Pal's has been able to achieve excellent operating and financial performance. The case examines the challenges it potentially faces as it contemplates growing the chain significantly from the 28 units it currently operates.

Boston-based fast-casual chain, b.good, was founded on the idea of healthy food, sourced locally, and prepared in-store. They'd worked to build a value-based business, and worked hard to cultivate a sense of family--among employees, customers and suppliers. In 2015, they had entered a period of substantial growth, with the company doubling in size over the past 12 months, and plans to double again over the coming twelve months. The management felt this purpose and sense of family had served them well, but were worried that growth would water down these key ingredients to their success. As they enter 2016, they are particularly focused on ensuring that they get the "people" systems right.

For any enterprise to be competitive, continuous learning and improvement are key--but not always easy to achieve. After a decade of research, the authors have concluded that four biases stand in the way: We focus too heavily on success, are too quick to act, try too hard to fit in, and rely too much on experts. Each of these biases raises challenges, but each can be curbed with particular strategies. A preoccupation with success, for example, leads to an unreasonable fear of failure, a mindset that inhibits risk taking, a focus on past performance rather than potential, and blindness to the role of luck in successes and failures. Managers therefore need to treat mistakes as learning opportunities, recognize and foster workers' capacity for growth, and conduct data-based project reviews. To counter the bias toward action--and the unthinking perpetual motion and exhaustion that ensue--leaders can schedule more work breaks and make time for reflection. They can redress the tendency to conform, which stifles innovation, by encouraging workers to cultivate their individual strengths and to speak up when they have ideas for improvements. And they can develop and empower their employees to solve problems instead of turning automatically to outside experts.

With 24,000 staff and over 300 stores, Belk Inc. sought to replace its entirely manual labor scheduling system with an automated software solution from Reflexis. Belk hoped the upgrade would simplify scheduling, reduce time employees spent in non-customer-facing roles, and result in improved allocation of resources through the use of big data, thereby increasing sales productivity. Like many other retailers, Belk expected the benefits from automated scheduling software to be significant. But unlike other retailers who took an iron hand approach to push compliance, Belk's implementation permitted store managers "edit" the system to "fix" the "bugs" in the automated schedules-seeking not to replace labor but rather inform it. Belk commenced piloting the solution in May of 2013 and subsequently expanded the number of stores running the software to 50 over the course of 2013. Despite signs of initial success with the stores running the scheduling solution, Bass quickly began to notice a significant issue with the implementation: over 70% of shifts generated by the system were receiving manual overrides ("edits") by the store managers. Store managers believed the edits were necessary to remain responsive to local needs-and were, indeed, productive. Senior executives were skeptical, concerned that edits indicated resistance to productive change, and unsure of why Belk had spent so much time and money on an automated system only to have the stores override it. Having deliberately allowed store managers and lead schedulers to override the system, SVP Eric Bass (a retail store veteran who worked his way up to corporate) now needed to understand how and why they were doing so, and make sure that those edits were being made in a constructive manner. In a disagreement between human and machine, Belk allowed humans to win by design by giving them the right to edit the 'optimized' schedules.

Valve, one of the world's top video game software companies, has also become an iconic example of an organization with virtually no hierarchy. A 400-person organization, Valve's unique organizational form (described in detail in the case and accompanying employee handbook) includes 100% self-allocated time, no managers (and therefore no managerial oversight), a structure so fluid that all desks have wheels to allow free movement between ""cabals"" (teams) on a regular basis (which happens frequently enough that Valve created a homegrown tracking app to allow peers to find each other), a unique hiring apparatus that supports recruitment of T-shaped individuals, and a purely peer-based performance review and stack ranking. As customer demand and market forces draw Valve into hardware in 2013, Valve questions whether their organizational model will need to change as it expands from software into hardware-and, if so, whether they should prioritize strategy over structure or structure over strategy. The case therefore presents students with a strategic and organizational challenge which tests students' understanding, and Valve's resolve, with regard to the congruence between their organizational model and strategic direction. Students should have read and discussed the (A) case, and Valve's options for entering hardware, prior to the (B) case being distributed. The (B) case provides significant detail on Valve's initial decisions but keeps the final outcome as a work-in-process.

Valve, one of the world's top video game software companies, has also become an iconic example of an organization with virtually no hierarchy. A 400-person organization, Valve's unique organizational form (described in detail in the case and accompanying employee handbook) includes 100% self-allocated time, no managers (and therefore no managerial oversight), a structure so fluid that all desks have wheels to allow free movement between "cabals" (teams) on a regular basis (which happens frequently enough that Valve created a homegrown tracking app to allow peers to find each other), a unique hiring apparatus that supports recruitment of T-shaped individuals, and a purely peer-based performance review and stack ranking. As customer demand and market forces draw Valve into hardware in 2013, Valve questions whether their organizational model will need to change as it expands from software into hardware-and, if so, whether they should prioritize strategy over structure or structure over strategy. The case, therefore, presents students with a strategic and organizational challenge that tests students' understanding, and Valve's resolve, with regard to the congruence between their organizational model and strategic direction.

Seven years of research into how teams work shows just how great the benefits are when team members have lots of experience working with one another. Five steps can help managers take advantage of team familiarity, a surprisingly underutilized tool.

Morning Star, a collection of affiliated companies, had grown steadily since 1970 when Chris Rufer, president and founder, started the business hauling tomatoes to processing plants in a truck. The company's main products continued to be tomato-based, including a 40% share in the tomato paste and diced tomato market in 2013. Different from traditional manufacturing companies, Morning Star relied on self-management to execute the work in any part of the organization. The company was built on individual freedom, with the expectation that employees would take responsibility for holding their peers accountable and address performance failures directly. The case explores how the company can establish a compensation model that fairly compensates employees for their performance and provides a broad incentive to hold others accountable, while being consistent with self-management. This case includes color exhibits.

This is an MIT Sloan Management Review article.

What's the best way to lift people out of poverty? The social entrepreneurs in the new "impact sourcing" industry believe the answer is providing work, not aid. Their organizations hire people at the bottom of the pyramid to perform digital tasks such as transcribing audio files and editing product databases. Essentially, they do business process outsourcing that also boosts economic development. Samasource, a San Francisco-based nonprofit, is one of the leaders in this new field. It has developed a model that addresses the challenges that impact sourcing faces: inexperienced workers; customers who make decisions on price, not social impact; and the cost of building the necessary IT infrastructure. One way Samasource overcomes hurdles is by teaming up with local entrepreneurs. The local partners run the service centers and cover the $25,000 needed to set each one up, and Samasource helps them win customers like LinkedIn and Google, prep and scope projects, hire and train staff, and measure success. Samasource's model is especially attractive because it has achieved big results with a small staff. Though it has only 30 employees, the nonprofit has created 16 centers that have paid more than $2 million to 3,000-plus employees.

Samasource sought to use work, not aid, for economic development. The company secured contracts for digital services from large companies in the United States and Europe, divided the work up into small pieces (called microwork) and then sent it to delivery centers in developing regions of the world for completion through a web-based interface. Different from traditional business process outsourcing companies, Samasource relied on a marginalized population of workers to execute the work. The case explores how the company can grow its capability to help individuals around the globe through the provision of digital work. This case includes color exhibits.

Many manufacturing companies and some service firms have reaped considerable benefits by applying variations of the Toyota Production System, a method for making operations "lean" through relentless efforts to increase quality and efficiency and eliminate waste. But conventional wisdom holds that lean principles don't lend themselves to knowledge work, which involves judgment and expertise, not the sorts of repetitive, easily specified tasks found on an assembly line. The authors' research, including multiyear studies of some 1,800 projects at the Indian IT services giant Wipro, challenges this thinking. Knowledge work can be made lean, Staats and Upton argue, if managers draw on six principles: 1) Continuously root out all waste; 2) Strive to make tacit knowledge explicit; 3) Specify how workers should communicate; 4) Use the scientific method to solve problems quickly; 5) Recognize that a lean system will always be a work in progress; and 6) Have leaders blaze the trail. Applying these principles demands sustained investment and a grassroots reinvention of how work is performed. But the benefits are considerable: ever-increasing productivity and job satisfaction, and a system that will be hard for competitors to replicate.

This case explores project management in a large organization through the eyes of a young project manager, Mike Morris. Morris is tasked with leading a project within the overall merger integration effort at Bank of America. Morris encounters difficulties with managing stakeholders, setting requirements, and reporting progress.

Examines a struggling IT outsourcing project from the perspective of the customer--Tegan. It should be used in conjunction with Hrad Technika (9-609-039), which illustrates the supplier's point of view. When Tegan, a Welsh toy distributor, outsources the development of a new accounts payable system to Hrad Technika, a growing outsourcing firm from the Czech Republic, Tegan believes they are getting a problem off their hands. Unfortunately the project goes poorly, and Tegan is left with the decision of how to prevent a failure in accounts payable from halting the entire company's operations. The case allows the examination of how to manage an outsourcing project and permits a general discussion about IT outsourcing.

Examines a struggling IT outsourcing project from the perspective of the IT services provider--Hrad Technika. When used in conjunction with Tegan c.c.c. (9-609-038), it provides an opportunity to see both sides of the issue. When Hrad enters into a contract to create a new accounts payable system for Welsh toy distributor, Tegan, the outsourcing firm from the Czech Republic views the project as another step in its progression towards delivering higher value services. Unfortunately the project goes poorly, and Hrad is left with the decision of how to rescue the relationship and avoid a similar problem in the future. The case allows the examination of how to manage an outsourcing project and permits a general discussion about IT outsourcing.

Tata Consultancy Services (TCS), a leading outsourced software services provider based in India, must decide whether to bid on a high-profile government project within India. The project, if completed successfully, would mark another step in TCS' progression from a provider of low-cost technical resources to their goal of becoming an end-to-end technology enabled services provider. However, the project was not only complex but also presented considerable hazards to the firm. The case permits the exploration of how and when companies in developing countries can leverage their domestic markets to build capabilities to serve global customers, by using their home market as a base for learning. The case is also designed to examine strategies (more generally) for such organizations to climb the value chain, and access higher-margin businesses with powerful incumbents.