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With a focus on daily operations, this piece shows students viable alternatives to "command control" management styles. Accompanied by thorough teaching notes, this four page case provides important lessons in the politics of the administration of small integrated practices and creating accountability for production through local tracking systems.

In the rush to integrate physician practices into PHO-like structure, accountability for physician productivity is frequently ignored.

The hospital must cut costs, and shift from a primary nursing model of patient care to an integrated practice model. This case explores working with a grant to reorganize, and to implement new programs with an interdisciplinary approach.

The case takes place in Beth Israel Hospital, an institution with highly progressive top management, and details a hospital's transition from the primary nursing model of patient care to an integra

This case can be used in a graduate level public management and leadership course to allow students to consider different approaches for Vice Minister Quesada in implementing major organizational change and how he handles the pressures upon him as a person and leader. This case can also be used in a leadership and organizational performance course to evaluate Quesada’s restructuring approach in managing rural health implementation and how to monitor and focus attention. Finally, this case could be used in a management course related to international development in the health sector to analyze the complex environment public manager’s face in implementing sweeping organizational changes in the developing world as well as his tactics for dealing with institutional opposition.

The case narrator is doing research on the health sector in Portobello—an alias for a Central American country—and follows Vice Health Minister Jose Manuel Quesada as he implements several major po

A newly hired program manager in a county health and human services department faces the challenge of turning a policy decision into a successful program, taking it from the developmental stage to actual implementation.

This is an excellent case to illustrate the use of training as a leverage point to reform a service delivery system.