This case addresses the challenges surrounding residential long-term care (LTC) in Ontario, Canada, through the lens of a fictional Chinese Canadian family coming to terms with placing their family member in a LTC home. The case protagonist is Henry Chan, a middle-aged health-care executive who is determined to ensure his mother, Kimberley (Kim), who has late-stage Alzheimer’s disease, is placed in a LTC home that is medically and culturally appropriate. The case follows Henry as he navigates Ontario’s complex LTC system with his father, Joshua, and Kim’s care coordinator, Omar, and addresses the important context of the LTC sector in Ontario, including the sector’s current state, its history, and the policy choices that have led to the challenges it faces today.
Rijul Jain, the operations supervisor at Grooves Distillery Records (Grooves), is trying to decide if and how to address capacity issues at this boutique vinyl record production facility after receiving a large contract that increased demand significantly. Based in Montreal, Quebec, Canada, the small business was started by Josephine “Fina” Leite and her wife, Theresa, to produce vinyl records of modern indie music for vinyl record enthusiasts. Jain must figure out where a bottleneck exists, balance Grooves' line of production workers, and increase production to meet demand.
In February 2022, an emergency registered nurse who worked a night shift in a Toronto, Ontario hospital was appalled at the overwhelming number of patients arriving at the emergency department with mental health issues. In recent times, the increase in the number of mental health patients arriving in the emergency department, especially with the novel COVID-19 pandemic exacerbating the rise in mental health disorders, made the registered nurse aware of the need for effective strategies to address this issue. The growing interest and changing attitudes about psychedelic-assisted therapy was a potential treatment for mental health, which has the potential to disrupt the health care industry. From the beginnings of psychedelics use and research, starting with the creation of lysergic acid diethylamide (commonly known as LSD) in 1938 and the experimentation with psychedelics during the Cold War, questions were raised about the use of psychedelics in therapy and the need for further research to fully understand their potential as a treatment option. Based on the growing interest and changing attitudes about psychedelics in psychotherapy, the potential benefits and challenges of this field raised important ethical considerations that needed to be discussed and examined.
In the rush to develop vaccines, many strains of viruses are used in laboratories in an effort to help humanity. However, the same samples used to develop life-saving vaccines could potentially be used to develop weapons of biological warfare. This case looks at the scenario from multiple perspectives in an effort to discuss the ethics of virus usage, storage and regulatory oversight given the differing economical situations and motivations of the actors.
Opened in January 2021, the medical centre of the Chinese University of Hong Kong (CUHK), CUHK Medical Centre (CUMC), was a non-profit teaching hospital wholly owned by the university. In December 2022, Professor Hong Fung, the executive director and chief executive officer, knew that the CUMC board of directors would soon be asking how he was going to ensure that the privately operated CUMC would remain financially sustainable while still achieving its mission and vision—offering quality healthcare services at affordable and transparent package prices—and returning all surpluses from healthcare services to the hospital to support its future development and the CUHK Faculty of Medicine’s research and teaching.
This case series focuses on Theranos Inc. (Theranos), a health care technology start-up founded by Elizabeth Holmes in 2003. Theranos focused on developing a revolutionary blood-testing technology that was supposed to be able to detect diseases using only a few drops of blood. Once valued at US$10 billion, the company never demonstrated its alleged technological breakthrough, and Holmes was eventually charged by the Securities and Exchange Commission for fraud and deceit. In 2018, Theranos was forced to shut down its operations, and in January 2022, Holmes was found guilty of three counts of wire fraud and one count of conspiracy to commit wire fraud. The case series explores Theranos’s history, as well as the role of overconfidence bias in Theranos’s downfall.
This case series focuses on Theranos Inc. (Theranos), a health care technology start-up founded by Elizabeth Holmes in 2003. Theranos focused on developing a revolutionary blood-testing technology that was supposed to be able to detect diseases using only a few drops of blood. Once valued at US$10 billion, the company never demonstrated its alleged technological breakthrough, and Holmes was eventually charged by the Securities and Exchange Commission for fraud and deceit. In 2018, Theranos was forced to shut down its operations, and in January 2022, Holmes was found guilty of three counts of wire fraud and one count of conspiracy to commit wire fraud. The case series explores Theranos’s history, as well as the role of overconfidence bias in Theranos’s downfall.
This case series focuses on Theranos Inc. (Theranos), a health care technology start-up founded by Elizabeth Holmes in 2003. Theranos focused on developing a revolutionary blood-testing technology that was supposed to be able to detect diseases using only a few drops of blood. Once valued at US$10 billion, the company never demonstrated its alleged technological breakthrough, and Holmes was eventually charged by the Securities and Exchange Commission for fraud and deceit. In 2018, Theranos was forced to shut down its operations, and in January 2022, Holmes was found guilty of three counts of wire fraud and one count of conspiracy to commit wire fraud. The case series explores Theranos’s history, as well as the role of overconfidence bias in Theranos’s downfall.
In March 2020, a physician in southwestern Ontario, Canada began working on the development of an innovative digital application called the Pandemic Population Health Navigator, designed to help mitigate the pressure on Ontario’s health care system due to the rapid increase and spread of COVID-19 infections. The founder worked quickly to engage local health system partners, trusted advisors, the provincial government, and a digital health vendor to support the development of his innovation, which was intended to act as a COVID-19 triage tool. The project garnered widespread support and benefited from unprecedented quick approval times by the provincial government, which was undergoing a provincial transformation to a new health care system. Six months later, however, unexpected issues and risks began to surface. A key stakeholder was threatening to terminate the project’s agreement due to increasingly complex customization demands from users of the Pandemic Population Health Navigator. The physician realized that he quickly needed to find a way to alleviate these complexities and associated risks, while maintaining the trust of his health care collaborators.
In 2019, the clinical director of the South East Grey Community Health Centre was conflicted about whether to proceed with presenting the chief executive officer with a proposal to expand the health centre's primary services to a satellite location in the neighbouring community of Port Elgin. The clinical director recalled the challenges she and her colleagues had faced in 2018, during the satellite expansion to Dundalk. As a nurse practitioner, she understood the pressing need for services and the moral imperative to put the patient's needs first. However, as a key member of the Centre's management team, she also knew what this proposal would entail operationally, and what internal pressures and risks were involved. The clinical director wondered how, in an environment of static or declining budgets, the Centre could build on its successes and challenges to date to address the emerging demand for further growth. Should she present the proposal to expand to another neighbouring community during a time of fiscal constraints?
In 2016, the chair of McMaster Family Health Team faced challenges related to differences in operational culture that had emerged at its two clinic sites—Stonechurch Family Health Centre and McMaster Family Practice. The two sites, which had operated independently with relative autonomy for over 30 years, were merged in 2015, in response to a government initiative, a new funding model intended to increase access to primary health care for all Ontarians. The original goal was to operate the two sites under one model, one set of standard operating procedures, and one common governance framework. Over time, however, two distinct team operating cultures evolved organically at the two sites. The identity of both sites was consistent, but they differed in functionality. The chair's goal was to continue growing the clinics, but he needed to decide how best to proceed. Should he allow the two sites to continue operating with different functional cultures, and possibly allow other future sites to also organically develop their own identities and cultures? Or should he proactively influence a standardization plan?
In June 2017, the chief executive officer (CEO) of Kindred Home Care, a home care company in the Canadian province of New Brunswick, bordering the United States, was grappling with three options for scaling up operations—take the familiar acquisition route, move toward the untested franchising route, or cross the border to the larger US market. The company has limited physical assets, and therefore the CEO cannot tap external capital to finance growth; however, he could access internally accrued funds of CA$2 million.
In 2016, the chief operating officer (COO) of InteraXon Inc., a Toronto-based technology start-up in the health and wellness sector, needed to put together a revised supply chain that was consistent with the company’s new strategic plan. InteraXon’s flagship product was a lightweight headband called Muse, aimed at measuring the wearer’s brain activity. The COO needed to keep in mind two major requirements of the new plan: a) the company would be relocating the production of Muse from China to the United States and b) it needed to quickly scale up its manufacturing and marketing operations. What plan of action should the COO develop?
Saint Elizabeth, a leading Canadian health-care enterprise, had been managing innovation through what it called the Innovation Tripod. This had three components—Ideas (which involved generating innovative ideas from among employees), Solutions (involving outside ventures in innovation), and Impact (consisting of ways in which results were measured). The chief executive officer (CEO) was facing a dilemma with each element of the tripod. How could staff engagement be improved? What was a better way of managing external partners? How could the prevailing metrics of innovation be fine-tuned? What was the way forward for the CEO?
HSBC is one of the largest and most global financial institutions in the world. The company has identified Bital, Mexico's fourth largest bank, as a potential acquisition target. Negotiations have come down to the wire, and the controlling Mexican shareholders are trying to get HSBC to raise its offer. Is it worth it? HSBC must decide on both strategic and short-term financial criteria under some degree of uncertainty as illuminated by a due diligence process. The HSBC executive who has handled the acquisition at a local level, and would be chief executive officer of HSBC Mexico should the deal go ahead, is assessing the pros and cons of the acquisition and must also identify the priorities which he and his team would have to address, including culture change issues, re-branding Bital as HSBC Mexico, personnel issues and maintaining the continuity of the business.
Bombardier Transportation, one of the world's largest manufacturers of passenger rail cars, has successfully negotiated the purchase of Adtranz, a large European manufacturer of rail equipment. The newly appointed chief executive officer has been brought in to manage the acquisition. The new CEO faces many challenges including decisions about the pace of integration, location of headquarters, organization structure, personnel retention and personal management style. Students may use this case to discuss post-acquisition strategy and how fast companies should move to integrate acquisitions.