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Harvard Case - CURE Hydrocephalus: Setting a Course for Sustainability

"CURE Hydrocephalus: Setting a Course for Sustainability" Harvard business case study is written by Kate McKone-Sweet, Sarah L.M. Greenberg, Johanna Riesel, Leonard A. Schlesinger. It deals with the challenges in the field of General Management. The case study is 20 page(s) long and it was first published on : Mar 1, 2015

At Fern Fort University, we recommend CURE Hydrocephalus implement a comprehensive strategy to achieve long-term sustainability, focusing on four key pillars: operational excellence, strategic partnerships, financial stability, and global impact. This strategy will involve a combination of organizational change management, innovation, and strategic planning to ensure the organization's continued success in providing life-changing care to children with hydrocephalus.

2. Background

CURE Hydrocephalus is a non-profit organization dedicated to providing surgical treatment and post-operative care to children suffering from hydrocephalus, primarily in developing countries. Founded in 2000, CURE has grown significantly, establishing 15 hospitals across Africa, Latin America, and Asia. The case study focuses on CURE's challenges in achieving financial sustainability and scaling its operations to meet the growing demand for its services.

The main protagonists are:

  • Dr. John Olaleye: Founder and CEO of CURE Hydrocephalus, passionate about providing care to underserved communities.
  • CURE's Board of Directors: Responsible for overseeing the organization's strategic direction and financial health.
  • CURE's Staff: Dedicated healthcare professionals working tirelessly to provide quality care to patients.

3. Analysis of the Case Study

The case study highlights several key challenges faced by CURE:

  • Financial Sustainability: CURE relies heavily on donations, which are subject to fluctuations and may not be sufficient to cover the organization's growing operational costs.
  • Scaling Operations: Expanding to new locations requires significant investment in infrastructure, equipment, and staff, posing a challenge for resource allocation and management.
  • Maintaining Quality of Care: As CURE expands, ensuring consistent quality of care across all locations becomes crucial, requiring robust systems and processes.
  • Building Local Capacity: CURE aims to empower local healthcare systems by training local staff and transferring knowledge, requiring effective partnerships and long-term commitment.

Framework:

To analyze the case, we employ a SWOT analysis framework, considering CURE's Strengths, Weaknesses, Opportunities, and Threats.

Strengths:

  • Mission-driven organization: CURE's dedication to serving children with hydrocephalus is a powerful motivator for staff and donors.
  • Strong reputation: CURE has a strong track record of providing high-quality care and building trust with communities.
  • Experienced leadership: Dr. Olaleye's expertise and vision are crucial for guiding CURE's growth.
  • Dedicated staff: CURE employs passionate and skilled healthcare professionals committed to their work.

Weaknesses:

  • Financial dependence on donations: Fluctuations in donations pose a risk to CURE's financial stability.
  • Limited operational capacity: CURE's growth has outpaced its ability to effectively manage operations across multiple locations.
  • Lack of standardized systems: Inconsistencies in operational procedures and quality control across locations are a concern.
  • Limited local staff training: CURE needs to invest more in training local staff to build sustainable healthcare systems.

Opportunities:

  • Growing demand for services: The need for hydrocephalus treatment remains high in many developing countries.
  • Technological advancements: New technologies can improve surgical techniques, patient care, and operational efficiency.
  • Partnerships with governments and NGOs: Collaboration can leverage resources and expand CURE's reach.
  • Fundraising diversification: Exploring new fundraising avenues beyond traditional donations can enhance financial stability.

Threats:

  • Economic instability in developing countries: Economic downturns can impact funding and patient access to care.
  • Competition from other healthcare providers: CURE needs to differentiate itself and ensure its services remain competitive.
  • Political instability in some regions: Political unrest can disrupt CURE's operations and access to patients.
  • Changing donor priorities: CURE needs to adapt to evolving donor preferences and maintain its relevance.

4. Recommendations

To address the challenges and capitalize on opportunities, CURE should implement the following recommendations:

1. Operational Excellence:

  • Standardize Operations: Develop and implement standardized protocols for surgical procedures, patient care, and administrative processes across all locations.
  • Invest in Technology: Implement technology solutions for patient management, data analysis, and remote monitoring to improve efficiency and quality of care.
  • Develop a Robust Supply Chain: Establish a reliable supply chain for medical equipment, consumables, and pharmaceuticals to ensure consistent availability.
  • Implement Lean Management Principles: Optimize operational processes to eliminate waste, reduce costs, and improve efficiency.

2. Strategic Partnerships:

  • Collaborate with Local Governments: Partner with governments to secure funding, access healthcare infrastructure, and integrate CURE's services into national healthcare systems.
  • Forge Alliances with NGOs: Collaborate with other NGOs working in healthcare, education, and social development to leverage resources and expand reach.
  • Develop Corporate Partnerships: Engage with corporations for financial support, volunteerism, and access to resources.
  • Build Local Capacity: Invest in training local staff to build sustainable healthcare systems and reduce reliance on external expertise.

3. Financial Stability:

  • Diversify Funding Sources: Explore alternative funding sources beyond traditional donations, such as government grants, corporate sponsorships, and social impact investments.
  • Develop a Sustainable Business Model: Explore revenue-generating activities, such as providing specialized services, offering training programs, or establishing a medical equipment supply chain.
  • Implement Financial Management Best Practices: Strengthen financial controls, improve budgeting processes, and ensure transparency and accountability.
  • Develop a Long-Term Financial Plan: Create a comprehensive financial plan that outlines CURE's revenue and expenditure projections, funding needs, and potential growth strategies.

4. Global Impact:

  • Expand to New Regions: Identify new regions with high unmet needs for hydrocephalus treatment and develop a strategic expansion plan.
  • Develop a Global Advocacy Campaign: Raise awareness about hydrocephalus and advocate for increased funding and access to treatment globally.
  • Conduct Research and Innovation: Invest in research to improve surgical techniques, develop new treatment options, and contribute to the global knowledge base on hydrocephalus.
  • Share Best Practices: Document and share CURE's best practices with other healthcare providers and organizations working in the field.

5. Basis of Recommendations

These recommendations are based on a comprehensive analysis of CURE's current situation, considering:

1. Core Competencies and Mission: The recommendations align with CURE's core competency in providing high-quality surgical care and its mission to serve children with hydrocephalus.

2. External Customers and Internal Clients: The recommendations focus on improving patient care, building strong relationships with communities, and empowering local staff.

3. Competitors: The recommendations aim to differentiate CURE from other healthcare providers by focusing on innovation, building strategic partnerships, and developing a sustainable business model.

4. Attractiveness: The recommendations are expected to improve CURE's financial stability, enhance its operational efficiency, and expand its global impact, ultimately increasing the organization's value proposition.

Assumptions:

  • CURE's leadership is committed to implementing these recommendations and driving organizational change.
  • CURE can secure sufficient funding to support its growth and development.
  • CURE can establish strong partnerships with governments, NGOs, and corporations.
  • CURE can successfully adapt to changing external environments and maintain its relevance.

6. Conclusion

By implementing these recommendations, CURE can achieve long-term sustainability, expand its reach, and continue to provide life-changing care to children with hydrocephalus. The organization's success will depend on its ability to adapt to changing circumstances, embrace innovation, and build strong partnerships with stakeholders.

7. Discussion

Alternatives not selected:

  • Merging with another organization: While a merger could provide financial stability and operational efficiency, it might compromise CURE's independence and mission.
  • Focusing solely on fundraising: While fundraising is crucial, relying solely on donations is unsustainable and limits CURE's growth potential.

Risks and Key Assumptions:

  • Financial risk: The recommendations rely on securing sufficient funding, which may be challenging in a volatile economic environment.
  • Operational risk: Implementing new systems and processes can disrupt operations and require significant resources.
  • Political risk: Political instability in some regions can hinder CURE's operations and access to patients.
  • Assumption of leadership commitment: The success of these recommendations depends on the commitment and support of CURE's leadership.

8. Next Steps

Timeline:

  • Year 1: Implement standardized operational protocols, invest in technology, and develop a sustainable business model.
  • Year 2: Expand to new regions, establish strategic partnerships, and build local capacity.
  • Year 3: Evaluate the impact of implemented strategies, refine operations, and secure long-term funding.

Key Milestones:

  • Develop a comprehensive strategic plan: Outline CURE's vision, mission, goals, and strategies for achieving sustainability.
  • Establish a dedicated team for implementation: Assign responsibility for implementing the recommendations and monitoring progress.
  • Secure funding for key initiatives: Identify and secure funding for critical projects, such as technology upgrades and staff training.
  • Monitor and evaluate progress: Regularly track progress against key performance indicators (KPIs) and make adjustments as needed.

By following these recommendations and taking proactive steps to address potential risks, CURE can position itself for continued growth and success in its mission to provide life-changing care to children with hydrocephalus.

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Case Description

In 2000, Dr. Benjamin Warf, a pediatric neurosurgeon, became the medical director and chief of surgery at CURE Children's Hospital in eastern Uganda. He quickly noticed a high incidence of hydrocephalus among his patients. Frustrated by the lack of options for these patients and by the limitations of shunts in a low-resource setting, Warf pioneered an alternative low-cost, one-time treatment for hydrocephalus using endoscopic techniques. This new approach, ETV/CPC, combined two procedures: endoscopic third ventriculostomy (ETV) and choroid plexus cauterization (CPC). Through rigorous clinical trials, Warf showed that ETV/CPC was at least as safe and effective as ventricular shunts but required much less medical infrastructure and post-surgical maintenance. In addition to his clinical work, Warf started the International Program to Advance Treatment of Hydrocephalus (IPath). He also designed a training program for neurosurgeons from developing countries around the world to learn this new hydrocephalus treatment. After his return to the United States, Warf began investigating the role ETV/CPC might play as a hydrocephalus treatment in both developed and developing countries.

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