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Harvard Case - Harvey Freishtat and Conversations about End-of-Life Care

"Harvey Freishtat and Conversations about End-of-Life Care" Harvard business case study is written by Rosabeth Moss Kanter, Ai-Ling Jamila Malone, Oludamilola Aladesanmi. It deals with the challenges in the field of Social Enterprise. The case study is 17 page(s) long and it was first published on : Mar 9, 2016

At Fern Fort University, we recommend Harvey Freishtat embrace a social entrepreneurship approach to address the growing need for compassionate end-of-life care. This involves establishing a hybrid organization that combines the mission-driven focus of a nonprofit with the operational efficiency and scalability of a for-profit entity. This model allows for the creation of a sustainable business model that can serve a broader population while adhering to ethical principles and prioritizing social impact.

2. Background

Harvey Freishtat, a retired physician, is deeply troubled by the lack of quality and compassionate end-of-life care available to many. He witnesses firsthand the emotional and practical challenges faced by patients and their families during this vulnerable period. Inspired by his experiences, Harvey seeks to create a new model for end-of-life care that prioritizes individual needs, fosters meaningful conversations, and provides support for both patients and their loved ones.

3. Analysis of the Case Study

This case study highlights the intersection of health care and treatment, social and global issues, and entrepreneurship. The current end-of-life care landscape is characterized by:

  • Limited access to quality care: Many individuals lack access to comprehensive and compassionate end-of-life care due to financial constraints, geographical limitations, or lack of awareness.
  • Overemphasis on medical interventions: The focus on prolonging life through aggressive medical treatments often overshadows the importance of emotional and spiritual support.
  • Lack of open communication: Conversations about end-of-life care are often avoided, leading to misunderstandings and emotional distress for both patients and families.

Harvey's desire to address these issues presents a unique opportunity to create a social enterprise that can deliver significant social value. By combining health and behavioral science with business principles, he can develop a model that:

  • Increases access to care: By leveraging a hybrid organizational structure, Harvey can reach a wider range of individuals, including those with limited financial resources.
  • Prioritizes holistic care: The model can integrate medical care with emotional, spiritual, and practical support, addressing the multifaceted needs of patients and their families.
  • Promotes open communication: By creating a safe and supportive environment, Harvey can encourage open conversations about end-of-life care, fostering informed decision-making and emotional well-being.

4. Recommendations

Harvey should consider the following recommendations:

  1. Establish a Hybrid Organization: Create a social enterprise that combines the mission-driven focus of a nonprofit with the operational efficiency and scalability of a for-profit entity. This allows for the generation of revenue to sustain operations while prioritizing social impact.
  2. Develop a Sustainable Business Model: Identify revenue streams that align with the organization's mission, such as:
    • Fee-for-service: Offer end-of-life care services at affordable rates, potentially utilizing a sliding scale based on income.
    • Partnerships: Collaborate with hospitals, hospices, and other healthcare providers to offer integrated care services.
    • Grants and donations: Secure funding from foundations, corporations, and individuals committed to supporting end-of-life care.
  3. Focus on Holistic Care: Offer a comprehensive suite of services that address the physical, emotional, spiritual, and practical needs of patients and their families. This includes:
    • Medical care: Provide access to qualified medical professionals who specialize in palliative care and end-of-life management.
    • Emotional support: Offer counseling, support groups, and other resources to help individuals cope with grief, loss, and anxiety.
    • Spiritual guidance: Provide access to spiritual advisors or chaplains who can offer comfort and support.
    • Practical assistance: Offer services such as advance care planning, legal assistance, and financial planning to help families navigate the complexities of end-of-life care.
  4. Promote Open Communication: Create a culture of open and honest communication about end-of-life care. This includes:
    • Education and outreach: Develop educational materials and workshops to raise awareness about end-of-life care options and encourage proactive planning.
    • Community engagement: Partner with community organizations to provide resources and support to families facing end-of-life decisions.
    • Training for healthcare professionals: Develop training programs to equip medical professionals with the skills and knowledge necessary to provide compassionate and supportive end-of-life care.

5. Basis of Recommendations

These recommendations are based on the following considerations:

  • Core competencies and consistency with mission: Harvey's expertise in medicine and his deep commitment to providing compassionate end-of-life care align perfectly with the proposed social enterprise model.
  • External customers and internal clients: The target customers are individuals and families facing end-of-life care needs. Internal clients include healthcare professionals, volunteers, and staff who are dedicated to providing high-quality care.
  • Competitors: The existing end-of-life care landscape includes hospices, palliative care units, and other organizations offering similar services. The proposed social enterprise can differentiate itself by focusing on holistic care, open communication, and affordability.
  • Attractiveness ' quantitative measures if applicable: The financial viability of the social enterprise will depend on the successful implementation of the sustainable business model, including revenue generation and cost management. The model should be designed to achieve financial sustainability while maximizing social impact.

6. Conclusion

By embracing a social entrepreneurship approach, Harvey Freishtat can create a transformative model for end-of-life care that addresses the unmet needs of individuals and families. The hybrid organizational structure, sustainable business model, and focus on holistic care will enable the social enterprise to achieve significant social impact while ensuring its long-term viability.

7. Discussion

Alternative approaches to address the challenges of end-of-life care include:

  • Traditional nonprofit model: This model relies heavily on donations and grants, which can be unpredictable and limit scalability.
  • For-profit model: This model prioritizes profit generation, potentially compromising the quality and accessibility of care for underserved populations.

The proposed hybrid model offers a more balanced approach, combining the mission-driven focus of a nonprofit with the operational efficiency and scalability of a for-profit entity.

Key assumptions:

  • Demand for services: The success of the social enterprise hinges on the demand for its services. Market research and community engagement are crucial to ensure the model meets the needs of the target population.
  • Financial sustainability: The ability to generate revenue and manage costs effectively is essential for the long-term viability of the social enterprise. A robust business plan and ongoing financial monitoring are critical.
  • Partnerships and collaborations: Successful implementation requires strong partnerships with healthcare providers, community organizations, and other stakeholders.

8. Next Steps

To implement the recommended approach, Harvey should take the following steps:

  • Develop a detailed business plan: Outline the organization's mission, vision, services, target market, revenue streams, cost structure, and financial projections.
  • Secure funding: Identify potential sources of funding, including grants, donations, and investments.
  • Recruit a team: Assemble a team of experienced healthcare professionals, business professionals, and social impact experts.
  • Develop marketing and outreach strategies: Raise awareness about the social enterprise and its services through targeted marketing campaigns and community engagement initiatives.
  • Establish partnerships: Form strategic alliances with hospitals, hospices, and other healthcare providers to ensure seamless access to care.
  • Monitor and evaluate performance: Track key performance indicators to measure the social impact and financial sustainability of the social enterprise.

By taking these steps, Harvey Freishtat can create a lasting legacy that provides compassionate and accessible end-of-life care to those in need.

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Case Description

Former law firm chairman/CEO Harvey Freishtat was actively involved in the formation of The Conversation Project, a national public engagement campaign to promote earlier end-of-life care discussions among loved ones and then with providers to ensure that end-of-life care wishes were both expressed and respected. The Conversation Project's media campaign and three-pronged strategy of targeting people where they live, work, and pray, was beginning to yield results. However, questions still remained. Would the health care industry create the mechanisms needed to follow people's end-of-life wishes? Was The Conversation Project taking the right steps to fulfill its mission of culture change?

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