WEEK 6 eCHN Case study Workshop

 Average for midterm: 78-79%

Objectives for Today

 Understand the value of SWOT analysis and case study approach in general

What is a case study

 Learning processes that students actively engage with the content which in turn creates more learning
 Fry(1999) outlines that case studies are complex examples that give insight into the context of a problem as well
as illustrating the main point
 Case are based on real situations

Focus of Case Study Approach

 Understand a number of issues in health admin

 Apply theories and concepts to close the gap between theory and practice
 Use of real life examples to illustrate theory and principles
 Active learning process

How they are written

 Just enough detail to give insight on the issues

 Space for creativity
 Problem you need to figure out
 Situation and intention of document being written in that way

Components of case study

 Overview
o What is the general environment in which the case takes place
 SWOT
o Strength, weakness, opportunity, threats
o Think line by line when reading the case
o Dissect what is going on
 Situational Analysis and Recommendations
o Evidence based recommendations
o Now understand what is happening in organization, make recommendations for moving the ORG forward

Case analysis step by step

 Overview
o What is case all about
o Describe organization with respect to
 Structure
 How is it organized
o Example: Niagara Health
 Multi-site organization
 Acute and post-acute care
 Speciality services at 1 of 5 sites
 Teaching relationship with mcmaster
 Mission/vision/values
  Rarely laid out for you in a case
 Use their website
 Goals/objectives
 May or may not be presented directly in the case
 2-3 key things organization says its focus is
 Tied into mission/vision/values
 Culture
 Challenging to discern just from reading a case
 Get a sense of people would feel in that ORG(inviting, energizing, punitive)
 Key stakeholders
 Who does ORG have connections to
 Who would be impacted by any changes made
 Challenge with overview
o Lots of info in a paragraph MUST be concise
o Sets stage for understanding the context of the case
 15 minutes in group of 6-8
o Structure
 Complex multi level organization to share information, medical records and research
 Toronto Ontario
 2 websites and a database
 2 main components:
 training purposes
 clinical purposes
 Works on a regional basis and communicates between hospitals
 Non-profit organization**
o CULTURE:
 Sick kids: get a feel for their organization
 Read thru situations(problems and challenges) is best articulating feel
 Think about brock: cannot pinpoint it
 Effort to describe organization with reflection will get credit
 Can make inferences based on mission/values/vision
 Job reviews could give sense of work environment
 Make an attempt(all shes looking for)
 Stakeholders
o IBM hospital for sick children
o St joes and a number of other organizations
o Patients and families
o Health care professional that would be accessing the services
o Ontario ministry of health
 Where money going in and out of organization
o Health administrative staff
o eCHN based out of sick kids hospital
o massive number of stakeholders
 Mission Statement
o Electronically link hospitals, local pediatricians, home agencies, and other org that provide child health
services in Ontario?
o Become best pediatric center
o Resource to ensure proper communication so care is integrated as it can be, no gaps in care
o Timely and integrated access
 o Health care community dedicated to improving the health of children” that would “provide the best in
family-centred, compassionate care, lead in scientific and clinical advancement, and prepare the next
generation of leaders in child health
 Goals
o 1: resource to the local, regional and international communities in managing highly specialized children’s
healthcare problems;
o (2) site for training of specialists and primary care providers;
o (3) site for clinical research.
o CHN: provide an integrated and consistent system of maternal, newborn and child health services that
would improve the health and quality of life for children independent of geographic location.
o eCHN’s goal was to “electronically link hospitals, local pediatricians, home care agencies and other
organizations that provide child health services in Ontario.”

SWOT: How do we figure out what to do?

 Situational analysis(type of analysis)

o Understand various factors and sorting in methodical way
o Applied to business, pubic health, education, strategic planning
 Valuable tool
o Purpose: demonstrate that you have clear understanding of the ORG and current situation in the case
 Identify areas that could inform subsequent solutions, to make recommendation about
strategies to be used
o 4 parts

Strengths and weakness

 Internal factors(controlled by ORG) that will identify the capabilities of the ORG to implement necessary changes
 What are the strengths of the ORG that give it an advantage over others? What can we capitalize on?
 What are the weaknesses that put the OrG at a disadvnatge over other ORGS? What do we need to minimize?
o Could view something as both strength and weakness based on perspective
 Consider these:
o Leadership and other personnel(experience or knowledge, qualifications, certifications)
 Skills in other areas leading an ORG
 Too many people/not enough
o Financial situation
 Surplus or deficit
o Reputation or image (e.g. positive public perception or challenges with image or perception)
 Favourable or not
o Quality of services (output of services)
o Capabilities (or gaps in capabilities) or ORG
 Track record of advancement?
 Stuck and hasn’t achieved strategic goals?
o Time frame and deadlines
 Ability to act quickly or an inability to do so.
 Success or failure
 Culture comes into play(can be negative culture as well)
 Multisite ORG(positive serve people in geographically different areas/weakness isolates teams
from broader ORG
o Success of failure of previous change efforts (eludes to org culture – success because culture allows for
it? Or inverse)
o Organizational culture
 o Organizational structure (e.g. depending on how we view, site may be good because we rep diff geo
perspectives or bad because we don’t know anything)
o Partnerships/strategic alliances
 Opportunities & Threats
o External (not controlled by the org) that will impact the org’s change strategy or ability to change
o What external factors in the enviro could the org exploit to their advantage?
o What could we invest in?
o What external factors could cause problems for the org? what needs to be identified as problematic?
o Factors to consider:
 Changing demographics/needs of patients
 Could be opportunity or threat
 Population changing(cant serve foreseeable demand)
 Changes in available resources (human, financial, material)
 Human example: hospital---external factor(number of new PSW trained in colleges)
o Not within control
 Financial:
o When thinking about dollars what is internal is how money is used
o In HC, we get funding from a budget given to us, we essentially don’t get to
decide what money is coming in
 Changes in technology
 Economic conditions (e.g. federal. provincial budgets)
 Political/legal changes
 Politics changes everyday and be positive or negative work on ORG
 New markets or services
 New partnerships/strategic alliances
 What other opportunities are available in their environment
 Industry trends
 SWOT practice:
o Make yourself a table and do headings
 Must justify why we think point is strength or weakness
 *Physicians are EXTERNAL TO THE ORGANIZATION as they do not work for hospitals
 Ultimate goal is to match S of org with enviro opp and to eliiate W to aoiv or manage the enviro threats to org

Strength(internal):

 Alliance and partnerships reduce geographic barriers

 Reputation is good so good quality service
 Novel and has benefits in terms of efficiency quality
 Andrew part of many ORGS and good track record

Weaknesses(internal)

 Compliance is external
 150,000 fee to register limited in scope
 Past struggle of system(past failures to adopt change)

Opportunities(external)

 Interim positions for students, more efficient

o Capitalizing on existing gov programs
 Economically friendly by following green tech

Threat(external)
  Using public scrutiny on program
o Context of ORG operation impact work being done
 Political pressure health service restructuring commission(waste of funds)

***Suggestion for final case: read it this week and put away and think about it

--come back to it and annotate down the page(SWOT)

--start to get in mindset
--do with others as other brains help the process

Link to the Evidence

o Some things will be straight forward and rely on the case
o Others will be based on evidence
o Make sure to reference where needed
o i.e. if you are talking about wait times (find reference)
o if you are linking in something around staffing requirements(find a reference)
 Each point requires proof from the case and or research to justify its classification as a strength, weakness,
opportunity, or threat and explain why relevant to the situation
o Having a leader with sense of history of success is a strength because…..(find reference)
SWOT Continued
 Ultimate goal of a SWOT analysis is to match the strengths of the ORG with the environmental opportunities and
to eliminate/minimize weaknesses to avoid or manage the environmental threats to the ORG
 A SWOT analysis is more than just a list, each point requires proof from the case and/or research articles, as well
as an explanation as to why the point is relevant to the current situation
o Will only need 2-3 from SWOT table, edit will occur to take stuff out and be concise

IN CLASS ACTIVITY SWOT(will be appendix in project) (tell why it is SWOT)

(Strength)
 Alliances and partnerships reduce geographic
barriers
 Good resource for a number of key stakeholders
 Andrew, the leader, has experience in various
difference sectors
 Organized, and efficient with no papers
 More accessible for patients and a variety of
physicians
 Uniform interface for users
(Opportunity)
 External sources of money coming in to be
managed
 Greater ability to connect to other organizations
and other technologies
 Able to seek other sources of funding for
innovated project
(Weakness)
 Cost of membership fees (this is internal because
the organization sets the cost)
 Compliance and maintaining an updated database
 Perhaps not user friendly?
 Previous lack of success
(Threat)
 Parents don’t feel they have the capacity to use or
providers are not able to maintain
 Or physicians do not comply
 Perhaps no access to internet
 If another database is competing
 Getting hacked
 Environmental disaster that impacts
 ability to function

Connecting the dots

 Purpose is to critically appraise the changes that need to be made within the org to make improvement
 Use SWOT and create recommendations to help more the org forward based on theories
When making recommendations:
 o Match strengths with weaknesses
-shouldn’t be isolated
-must back up rationale from case with evidence
-primarily research evidence(readings will likely present a good starting point)
o Try to eliminate weaknesses or manage environmental threats
o Research evidence must be used to support your recommendations
o E.g. what can we do to prevent hacking?
Strategic Analysis: Connect the Dots
 Based on SWOT points
 Evidence
 Your creative spin
 1 recommendation
o Try a pilot project on a small scale:
 Try in one primary care setting if successfully implemented than scale up by 5X until satisfactory
results are seen if errors or issues arise conduct PDSA cycles to determine where and how to
improve the program before scaling up services.
 Eliminate base user fee to entice organizations to participate (less risk for patients or loss of
funding)
o Reduction of user fee to small settings
o Implementing an incentive structure for participating providers

Recommendations – what to capitalize on or what threats to minimize

 1) Analyze the changes proposed within the case:
o a. Summarize the proposed changes outlines in the case (your recommendations must be different from
the plan identified in the case)
 somewhere in the case they make own suggestion of how to move forward
 acknowledging their plan
o b. Offer a brief assessment of whether the proposed plan is likely to be successful
 these are my recommendation as based on what the ORG is doing
 2) Create your own recommendations (4) to move the organization in the desired direction
o a. Offer four recommendations that have evidence to support their implementation
 need to be based in evidence
o b. Relate your recommendations to your SWOT (i.e. each recommendation should match a point
highlighted in your SWOT)
 i. Do proposed strategies align with the organizations strengths and improve weaknesses?
 ii. Do proposed strategies capitalize upon opportunities and minimize threats?
SAKAI

 USE SUBTITLES
 ½ page for overview
 2-3 pages for SWOT
o 3-4 points Strength and weakness
o 3-4 Opportunities and threats
 3-4 pages for strategic analysis
o What can we do
o This is their suggestion these are my recommendation based on my knowledge
o Minimum of 10 references

Parting Thoughts

 Challenging assignment so START early

 Welcome to talk and work through with prof
 Will use guided questions to accomplish goals
 NOT JUST WRITING AN ESSAY