This simulation presents the challenge of integrating regional health system payments in a context where parties each operate independently and the social determinents of health are incompletly addressed. Set in New Hampshire, respoinding to a fedearal initiative, the simulation features five roles, each essential to the integraiton challenge. Ths case provides students with an experiential view on the challenge of breaking down silos in social impact service delivery.
The number of connecting passengers through Southwest Airlines' Baltimore station has grown 100% CAGR since 1997. Originally designed as a point-to-point network, this load of connecting passengers has been stressing Baltimore ground operations, resulting in an erosion of service quality and difficulties in achieving fast plane turnarounds--one of the key elements of Southwest's low-cost strategy. This case presents comparative data to illuminate the key elements of Southwest's operating strategy and provides detailed information about the activities and information flows required to turn around a plane, allowing for a meaningful analysis of the process--e.g., resource utilization, capacity, bottlenecks, and coordination mechanisms. A rewritten version of an earlier case.
In a roundtable discussion, top executives from Southwest Airlines reveal that relationships with the company's unions and frontline supervisors may actually be more important to its success than the operational focus for which it is so well known.
JetBlue Airways shows how an entrepreneurial venture is able to use human resource management, specifically a values-centered approach to managing people, as a source of competitive advantage. The major challenge faced by Ann Rhoades is to grow this people-centered organization at a rapid rate, while retaining high standards for employee selection and maintaining a small company culture.
This article describes the contrasting systems of coordination and control at American and Southwest Airlines. Contrary to popular belief, the best way to achieve coordination in high velocity settings like the airline industry is not to create a flat organization based on performance measurement and little supervision. Rather it is better to build an organization based on cross-functional accountability to diffuse blame, with adequate supervisory staffing to provide coaching and feedback. Coordination benefits from strengthening this role of supervisors while weakening the role of accountability and performance measurement.
External cost pressures are motivating the adoption of case management (CM) at Beth Israel Deaconess Medical Center (BIDMC), but several of the organization's key professional groups are working against it. President and CEO David Dolins must decide whether CM is needed, and whether it is compatible with the employee-and patient-centered culture upon which BIDMC has built its success. CM has been touted in the health-care industry as a way to coordinate the complex, multidisciplinary process of patient care, in hopes of controlling costs without reducing quality. CM creates a new role that stands above the established disciplines--physicians, nurses, and social workers--to coordinate their activities and oversee their performance. The case describes the threat posed by CM to the professional status of physicians, social workers, and nurses. It also explores the coordination mechanisms already in place--care paths, primary nursing, care-management teams, and information systems--and questions whether CM is needed.
Reading Rehab Hospital has experimented with a popular new concept in health care--patient-focused care--intended to increase quality and reduce costs by organizing care delivery around particular diagnoses or "service lines," rather than around the functions or disciplines of the care providers. It is equivalent to product rather than process focus. Rehabilitation involves multiple disciplines which must share information about their evaluations of the patient, about planned treatments, and about patient progress. The decisions and actions of one care provider depend on those of another. This case illustrates the effects of a problem fundamental to service operations--variable demand and the limitations of organizing production by service lines under conditions of uncertain demand, due to the loss of pooling. Finally, its methods, for achieving the coordination benefits of service lines under conditions where the level or stability of demand is insufficient to justify the use of service lines.
Transitional Infant Care Specialty Hospital (TIC) addresses the question of whether and how to maintain strategic focus in an industry that is calling increasingly for integrated service delivery. Despite providing high-quality, cost-effective care relative to competitors in its market, TIC is in trouble. Full-service hospitals in its market area are adopting some of its innovative practices and are beginning to provide similar services. Worse, the local health care system in Pittsburgh is shaping up into two large integrated delivery systems, in neither of which TIC is a strong player. TIC has neglected marketing and strategy issues in favor of "caring for babies." How can they position themselves in an increasingly integrated local health care delivery system, without losing the focus that has been the source of their operational and service excellence?