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Provides a detailed description of the way in which several improvements and innovations in clinical care were arrived at. Describes individual insights, how these were evaluated and validated, and how they were translated into improved medical practices. The changes in medical care include improvements in primary care, intensive care, and inpatient ward care. Detailed descriptions of each innovation are provided, along with a description of the processes of innovation, generation, and capture. It relates closely to Intermountain (A), which describes the organizational structure Intermountain has put in place to support these processes.

In 2000, Dr. Gary Kaplan became CEO of the Virginia Mason Medical Center in Seattle, Washington. The hospital was facing significant challenges: It was losing money for the first time in its history, staff morale had plummeted, and area hospitals presented ardent competition. Considerable change was imminent. Within his first few months, Kaplan had rallied the organization around a new strategic direction: to become the quality leader in health care. What Kaplan and his administrators lacked was an effective tool to execute their strategy. Soon thereafter, a series of serendipitous events led to the discovery of the Toyota production system, and the Virginia Mason Medical Center became entrenched in an overwhelming challenge: how to institute a production model in health care.

Describes the 16-day final mission of the space shuttle Columbia in January 2003 in which seven astronauts died. Includes background on NASA and the creation of the human space flight program, including the 1970 Apollo 13 crisis and 1986 Challenger disaster. Examines NASA's organizational culture, leadership, and the influences on the investigation of and response to foam shedding from the external fuel tank during shuttle launch.

This case looks at the turnaround at the Massachusetts Port Authority after the 9/11 terrorist attacks. It begins with the situation during the immediate aftermath of 9/11 and then describes how the new CEO restructures the public agency to operate much more like a business organization.

Supplements the (A) case.

Supplements the (A) case.

Describes the Colorado fire tragedy that resulted in 12 deaths. Examines leadership, decision making, and team dynamics in a high-stress, crisis situation.

Describes the 1949 firefighting tragedy in Montana that led to the deaths of 12 smoke jumpers. Explores the myriad of poor decisions by the firefighting crew and their foreman.