a challenge for quality case study

Discussion Forum

Top Challenges for Case Study Programs

What gets in the way of case study adoption? The Case Studies Affinity Group, a consortium of Harvard-affiliated case programs, took up this question during its quarterly meeting on May 12. The Affinity Group welcomed as panelists Carolyn Wood, Assistant Academic Dean & Director of SLATE and the Case Program, Harvard Kennedy School; Lisa Rohrer, Executive Director of the Case Development Initiative at Harvard Law School; and Susan Madden, Associate Director, Case-Based Teaching and Learning Center, Harvard T.H. Chan School of Public Health. Together, the panelists identified key challenges facing case study programs at Harvard and beyond:

Poor visibility. A searchable index of all available case materials is a fundamental resource, but surprisingly challenging to achieve when instructors write case studies for their own courses. This index must be featured prominently in faculty onboarding or resource pages; ideally, faculty would receive formal pedagogical training or advising on available curricular resources. According to Wood, the Kennedy School of Government circulates an e-update three times per year to 80+ HKS faculty to highlight new cases and share high-level statistics and FAQs on case teaching and case usage. HKS also reaches out to instructors directly, suggesting a few new case studies specifically tailored to their course(s).
Few role models and mentors. The prevalence of poorly-facilitated case discussions can undermine support for case method teaching, but a skilled, energizing case teacher can transform student learning and inspire fellow faculty. Case study programs need respected opinion leaders on the faculty to act as champions; if such role models also direct or supervise case programs, the programs themselves can develop from this galvanizing leadership.
Incentive structure. Faculty members are typically promoted based primarily on research and scholarship, while teaching is thought to be weighted less. We need career incentives for faculty to stay on the cutting edge of pedagogy. In the interim, we can make the case development effort worthwhile for faculty by dovetailing case topics with faculty research interests, so that there is a greater return on investment for case research.
Lack of testing environments. Instructors need spaces to test new teaching styles outside of the classroom. Workshops where instructors test-teach short cases and see peer approaches would increase success, confidence, and ease for new case teachers.
The challenge of case teaching. Case teaching has been the dominant means of instruction in business schools across the globe for decades. It can seem intimidating for instructors in fields outside of business to adopt case method teaching when they lack a stock of tested cases in their field, robust training, and the pervasive culture of case teaching that is so prevalent in business schools. Public policy faculty often practice case teaching in a more heterogeneous manner than their business school colleagues. Wood muses, “Even the most skilled case teachers at HKS are often reluctant to call themselves case teachers, perhaps because they’re uncertain they meet the HBS definition of a true ‘case teacher.’ But in our context, there’s room for variation in how case method teaching is practiced so long as it’s done in a manner that advances active learning. It’s all about using authentic problems to push students to practice higher-order thinking skills (analysis, decision-making, advocacy) in a group context in class.” Susan Madden notes that Emory University addresses this barrierby hosting a global health case study competition , encouraging multidisciplinary teams.
Benefits of traditional materials . According to Wood, some HKS faculty report that students read less carefully in the digital age; it is hard for students to skim case studies and still contribute deeply to the discussion. Furthermore, in legal education casebooks and lectures provide a broad abundance of information; it is hard for instructors to cut a lot of material and replace it with one deep scenario. However, instructors have successfully paired traditional legal cases with case studies, so that students may extrapolate to other scenarios. To achieve breadth with a single case study, instructors can mine the text for lessons comparable to those in legal casebooks, and lead students to articulate enduring, transferable takeaways.

Nonetheless, case study adoption should be slow. Wood explains that it is better to have a small number of instructors who teach cases well than many who teach ineffectively. Relationships between case writers and faculty take time to build; quality cases take time to research and write. With a foundation of quality, case study programs can address their challenges without undercutting the main objective: more engaged, thoughtful teaching and learning.

About Elizabeth Moroney

Search for:

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive weekly notifications of new posts by email.

Email Address

Follow HLS Case Studies

Subscribe to our newsletter

Subscribe to our RSS feed

Et Seq., The Harvard Law School Library Blog
Harvard Negotiation and Mediation Clinical Program
HLS Berkman Center for Internet and Society
HLS Forum on Corporate Governance and Financial Regulation
HLS Program on the Legal Profession
Program on Negotiation

A Rose by Any Other Name: Supply Chains and Carbon Emissions in the Flower Industry

Headquartered in Kitengela, Kenya, Sian Flowers exports roses to Europe. Because cut flowers have a limited shelf life and consumers want them to retain their appearance for as long as possible, Sian and its distributors used international air cargo to transport them to Amsterdam, where they were sold at auction and trucked to markets across Europe. But when the Covid-19 pandemic caused huge increases in shipping costs, Sian launched experiments to ship roses by ocean using refrigerated containers. The company reduced its costs and cut its carbon emissions, but is a flower that travels halfway around the world truly a “low-carbon rose”? Harvard Business School professors Willy Shih and Mike Toffel debate these questions and more in their case, “Sian Flowers: Fresher by Sea?”

17 Sep 2019

How a New Leader Broke Through a Culture of Accuse, Blame, and Criticize

Children’s Hospital & Clinics COO Julie Morath sets out to change the culture by instituting a policy of blameless reporting, which encourages employees to report anything that goes wrong or seems substandard, without fear of reprisal. Professor Amy Edmondson discusses getting an organization into the “High Performance Zone.” Open for comment; 0 Comments.

27 Feb 2019
Research & Ideas

The Hidden Cost of a Product Recall

Product failures create managerial challenges for companies but market opportunities for competitors, says Ariel Dora Stern. The stakes have only grown higher. Open for comment; 0 Comments.

31 Mar 2018
Working Paper Summaries

Expected Stock Returns Worldwide: A Log-Linear Present-Value Approach

Over the last 20 years, shortcomings of classical asset-pricing models have motivated research in developing alternative methods for measuring ex ante expected stock returns. This study evaluates the main paradigms for deriving firm-level expected return proxies (ERPs) and proposes a new framework for estimating them.

26 Apr 2017

Assessing the Quality of Quality Assessment: The Role of Scheduling

Accurate inspections enable companies to assess the quality, safety, and environmental practices of their business partners, and enable regulators to protect consumers, workers, and the environment. This study finds that inspectors are less stringent later in their workday and after visiting workplaces with fewer problems. Managers and regulators can improve inspection accuracy by mitigating these biases and their consequences.

23 Sep 2013

Status: When and Why It Matters

Status plays a key role in everything from the things we buy to the partnerships we make. Professor Daniel Malter explores when status matters most. Closed for comment; 0 Comments.

16 May 2011

What Loyalty? High-End Customers are First to Flee

Companies offering top-drawer customer service might have a nasty surprise awaiting them when a new competitor comes to town. Their best customers might be the first to defect. Research by Harvard Business School's Ryan W. Buell, Dennis Campbell, and Frances X. Frei. Key concepts include: Companies that offer high levels of customer service can't expect too much loyalty if a new competitor offers even better service. High-end businesses must avoid complacency and continue to proactively increase relative service levels when they're faced with even the potential threat of increased service competition. Even though high-end customers can be fickle, a company that sustains a superior service position in its local market can attract and retain customers who are more valuable over time. Firms rated lower in service quality are more or less immune from the high-end challenger. Closed for comment; 0 Comments.

08 Dec 2008

Thinking Twice About Supply-Chain Layoffs

Cutting the wrong employees can be counterproductive for retailers, according to research from Zeynep Ton. One suggestion: Pay special attention to staff who handle mundane tasks such as stocking and labeling. Your customers do. Closed for comment; 0 Comments.

01 Dec 2006
What Do You Think?

How Important Is Quality of Labor? And How Is It Achieved?

A new book by Gregory Clark identifies "labor quality" as the major enticement for capital flows that lead to economic prosperity. By defining labor quality in terms of discipline and attitudes toward work, this argument minimizes the long-term threat of outsourcing to developed economies. By understanding labor quality, can we better confront anxieties about outsourcing and immigration? Closed for comment; 0 Comments.

20 Sep 2004

How Consumers Value Global Brands

What do consumers expect of global brands? Does it hurt to be an American brand? This Harvard Business Review excerpt co-written by HBS professor John A. Quelch identifies the three characteristics consumers look for to make purchase decisions. Closed for comment; 0 Comments.

Sign up for the newsletter

Digital editions.

Total quality management: three case studies from around the world

With organisations to run and big orders to fill, it’s easy to see how some ceos inadvertently sacrifice quality for quantity. by integrating a system of total quality management it’s possible to have both.

Top 5 ways to manage the board during turbulent times Top 5 ways to create a family-friendly work culture Top 5 tips for a successful joint venture Top 5 ways managers can support ethnic minority workers Top 5 ways to encourage gender diversity in the workplace Top 5 ways CEOs can create an ethical company culture Top 5 tips for going into business with your spouse Top 5 ways to promote a healthy workforce Top 5 ways to survive a recession Top 5 tips for avoiding the ‘conference vortex’ Top 5 ways to maximise new parents’ work-life balance with technology Top 5 ways to build psychological safety in the workplace Top 5 ways to prepare your workforce for the AI revolution Top 5 ways to tackle innovation stress in the workplace Top 5 tips for recruiting Millennials

There are few boardrooms in the world whose inhabitants don’t salivate at the thought of engaging in a little aggressive expansion. After all, there’s little room in a contemporary, fast-paced business environment for any firm whose leaders don’t subscribe to ambitions of bigger factories, healthier accounts and stronger turnarounds. Yet too often such tales of excess go hand-in-hand with complaints of a severe drop in quality.

Food and entertainment markets are riddled with cautionary tales, but service sectors such as health and education aren’t immune to the disappointing by-products of unsustainable growth either. As always, the first steps in avoiding a catastrophic forsaking of quality begins with good management.

There are plenty of methods and models geared at managing the quality of a particular company’s goods or services. Yet very few of those models take into consideration the widely held belief that any company is only as strong as its weakest link. With that in mind, management consultant William Deming developed an entirely new set of methods with which to address quality.

Deming, whose managerial work revolutionised the titanic Japanese manufacturing industry, perceived quality management to be more of a philosophy than anything else. Top-to-bottom improvement, he reckoned, required uninterrupted participation of all key employees and stakeholders. Thus, the total quality management (TQM) approach was born.

All in Similar to the Six Sigma improvement process, TQM ensures long-term success by enforcing all-encompassing internal guidelines and process standards to reduce errors. By way of serious, in-depth auditing – as well as some well-orchestrated soul-searching – TQM ensures firms meet stakeholder needs and expectations efficiently and effectively, without forsaking ethical values.

By opting to reframe the way employees think about the company’s goals and processes, TQM allows CEOs to make sure certain things are done right from day one. According to Teresa Whitacre, of international consulting firm ASQ , proper quality management also boosts a company’s profitability.

“Total quality management allows the company to look at their management system as a whole entity — not just an output of the quality department,” she says. “Total quality means the organisation looks at all inputs, human resources, engineering, production, service, distribution, sales, finance, all functions, and their impact on the quality of all products or services of the organisation. TQM can improve a company’s processes and bottom line.”

Embracing the entire process sees companies strive to improve in several core areas, including: customer focus, total employee involvement, process-centred thinking, systematic approaches, good communication and leadership and integrated systems. Yet Whitacre is quick to point out that companies stand to gain very little from TQM unless they’re willing to go all-in.

“Companies need to consider the inputs of each department and determine which inputs relate to its governance system. Then, the company needs to look at the same inputs and determine if those inputs are yielding the desired results,” she says. “For example, ISO 9001 requires management reviews occur at least annually. Aside from minimum standard requirements, the company is free to review what they feel is best for them. While implementing TQM, they can add to their management review the most critical metrics for their business, such as customer complaints, returns, cost of products, and more.”

The customer knows best: AtlantiCare TQM isn’t an easy management strategy to introduce into a business; in fact, many attempts tend to fall flat. More often than not, it’s because firms maintain natural barriers to full involvement. Middle managers, for example, tend to complain their authority is being challenged when boots on the ground are encouraged to speak up in the early stages of TQM. Yet in a culture of constant quality enhancement, the views of any given workforce are invaluable.

AtlantiCare in numbers

5,000 Employees

$280m Profits before quality improvement strategy was implemented

$650m Profits after quality improvement strategy

One firm that’s proven the merit of TQM is New Jersey-based healthcare provider AtlantiCare . Managing 5,000 employees at 25 locations, AtlantiCare is a serious business that’s boasted a respectable turnaround for nearly two decades. Yet in order to increase that margin further still, managers wanted to implement improvements across the board. Because patient satisfaction is the single-most important aspect of the healthcare industry, engaging in a renewed campaign of TQM proved a natural fit. The firm chose to adopt a ‘plan-do-check-act’ cycle, revealing gaps in staff communication – which subsequently meant longer patient waiting times and more complaints. To tackle this, managers explored a sideways method of internal communications. Instead of information trickling down from top-to-bottom, all of the company’s employees were given freedom to provide vital feedback at each and every level.

AtlantiCare decided to ensure all new employees understood this quality culture from the onset. At orientation, staff now receive a crash course in the company’s performance excellence framework – a management system that organises the firm’s processes into five key areas: quality, customer service, people and workplace, growth and financial performance. As employees rise through the ranks, this emphasis on improvement follows, so managers can operate within the company’s tight-loose-tight process management style.

After creating benchmark goals for employees to achieve at all levels – including better engagement at the point of delivery, increasing clinical communication and identifying and prioritising service opportunities – AtlantiCare was able to thrive. The number of repeat customers at the firm tripled, and its market share hit a six-year high. Profits unsurprisingly followed. The firm’s revenues shot up from $280m to $650m after implementing the quality improvement strategies, and the number of patients being serviced dwarfed state numbers.

Hitting the right notes: Santa Cruz Guitar Co For companies further removed from the long-term satisfaction of customers, it’s easier to let quality control slide. Yet there are plenty of ways in which growing manufacturers can pursue both quality and sales volumes simultaneously. Artisan instrument makers the Santa Cruz Guitar Co (SCGC) prove a salient example. Although the California-based company is still a small-scale manufacturing operation, SCGC has grown in recent years from a basement operation to a serious business.

SCGC in numbers

14 Craftsmen employed by SCGC

800 Custom guitars produced each year

Owner Dan Roberts now employs 14 expert craftsmen, who create over 800 custom guitars each year. In order to ensure the continued quality of his instruments, Roberts has created an environment that improves with each sale. To keep things efficient (as TQM must), the shop floor is divided into six workstations in which guitars are partially assembled and then moved to the next station. Each bench is manned by a senior craftsman, and no guitar leaves that builder’s station until he is 100 percent happy with its quality. This product quality is akin to a traditional assembly line; however, unlike a traditional, top-to-bottom factory, Roberts is intimately involved in all phases of instrument construction.

Utilising this doting method of quality management, it’s difficult to see how customers wouldn’t be satisfied with the artists’ work. Yet even if there were issues, Roberts and other senior management also spend much of their days personally answering web queries about the instruments. According to the managers, customers tend to be pleasantly surprised to find the company’s senior leaders are the ones answering their technical questions and concerns. While Roberts has no intentions of taking his manufacturing company to industrial heights, the quality of his instruments and high levels of customer satisfaction speak for themselves; the company currently boasts one lengthy backlog of orders.

A quality education: Ramaiah Institute of Management Studies Although it may appear easier to find success with TQM at a boutique-sized endeavour, the philosophy’s principles hold true in virtually every sector. Educational institutions, for example, have utilised quality management in much the same way – albeit to tackle decidedly different problems.

The global financial crisis hit higher education harder than many might have expected, and nowhere have the odds stacked higher than in India. The nation plays home to one of the world’s fastest-growing markets for business education. Yet over recent years, the relevance of business education in India has come into question. A report by one recruiter recently asserted just one in four Indian MBAs were adequately prepared for the business world.

RIMS in numbers

9% Increase in test scores post total quality management strategy

22% Increase in number of recruiters hiring from the school

20,000 Increase in the salary offered to graduates

50,000 Rise in placement revenue

At the Ramaiah Institute of Management Studies (RIMS) in Bangalore, recruiters and accreditation bodies specifically called into question the quality of students’ educations. Although the relatively small school has always struggled to compete with India’s renowned Xavier Labour Research Institute, the faculty finally began to notice clear hindrances in the success of graduates. The RIMS board decided it was time for a serious reassessment of quality management.

The school nominated Chief Academic Advisor Dr Krishnamurthy to head a volunteer team that would audit, analyse and implement process changes that would improve quality throughout (all in a particularly academic fashion). The team was tasked with looking at three key dimensions: assurance of learning, research and productivity, and quality of placements. Each member underwent extensive training to learn about action plans, quality auditing skills and continuous improvement tools – such as the ‘plan-do-study-act’ cycle.

Once faculty members were trained, the team’s first task was to identify the school’s key stakeholders, processes and their importance at the institute. Unsurprisingly, the most vital processes were identified as student intake, research, knowledge dissemination, outcomes evaluation and recruiter acceptance. From there, Krishnamurthy’s team used a fishbone diagram to help identify potential root causes of the issues plaguing these vital processes. To illustrate just how bad things were at the school, the team selected control groups and administered domain-based knowledge tests.

The deficits were disappointing. A RIMS students’ knowledge base was rated at just 36 percent, while students at Harvard rated 95 percent. Likewise, students’ critical thinking abilities rated nine percent, versus 93 percent at MIT. Worse yet, the mean salaries of graduating students averaged $36,000, versus $150,000 for students from Kellogg. Krishnamurthy’s team had their work cut out.

To tackle these issues, Krishnamurthy created an employability team, developed strategic architecture and designed pilot studies to improve the school’s curriculum and make it more competitive. In order to do so, he needed absolutely every employee and student on board – and there was some resistance at the onset. Yet the educator asserted it didn’t actually take long to convince the school’s stakeholders the changes were extremely beneficial.

“Once students started seeing the results, buy-in became complete and unconditional,” he says. Acceptance was also achieved by maintaining clearer levels of communication with stakeholders. The school actually started to provide shareholders with detailed plans and projections. Then, it proceeded with a variety of new methods, such as incorporating case studies into the curriculum, which increased general test scores by almost 10 percent. Administrators also introduced a mandate saying students must be certified in English by the British Council – increasing scores from 42 percent to 51 percent.

By improving those test scores, the perceived quality of RIMS skyrocketed. The number of top 100 businesses recruiting from the school shot up by 22 percent, while the average salary offers graduates were receiving increased by $20,000. Placement revenue rose by an impressive $50,000, and RIMS has since skyrocketed up domestic and international education tables.

No matter the business, total quality management can and will work. Yet this philosophical take on quality control will only impact firms that are in it for the long haul. Every employee must be in tune with the company’s ideologies and desires to improve, and customer satisfaction must reign supreme.

Contributors

Industry Outlook

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Publications
Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

Advanced Search
Journal List
BMJ Open Access

The contribution of case study research to knowledge of how to improve quality of care

Efforts to improve the implementation of effective practice and to speed up improvements in quality and patient safety continue to pose challenges for researchers and policy makers. Organisational research, and, in particular, case studies of quality improvement, offer methods to improve understanding of the role of organisational and microsystem contexts for improving care and the development of theories which might guide improvement strategies.

This paper reviews examples of such research and details the methodological issues in constructing and analysing case studies. Case study research typically collects a wide array of data from interviews, documents and other sources.

Advances in methods for coding and analysing these data are improving the quality of reports from these studies.

The gap between the knowledge of what works and the widespread adoption of those practices has become a major preoccupation of researchers and a challenge for funders and policy makers. 1–3 Recognition of this ‘quality chasm’ (the term that the US Institute of Medicine used to describe the distance ‘between the healthcare we have and the care we could have’ 4 ) has led to an increased focus on quality improvement and implementation science to advance understanding of how to promote evidence-based practice. In turn, the focus on implementation has led to the development of multiple theories and frameworks to guide implementation, 5–7 but no framework has demonstrated widespread results in practice.

There seems to be no immutable formula for successful implementation of innovations. While rational decision-makers would like the effectiveness of new technologies (including new work routines, devices and medications) to be the primary determinant of their adoption, research suggests otherwise. Healthcare systems are complex and variable. While some teams or organisations provide a ‘receptive context’ for innovation, 8 others resist, having limited interest or abilities to implement new ideas. Decades of research in organisational and social sciences suggest that the nature of the innovation and the organisational, professional and health system contexts into which they are introduced influence their adoption. 7 9–11 Thus, creating more effective, evidence-based care relies not just on developing and disseminating the evidence, but also on building knowledge of the ways in which innovations can be embedded into ongoing practice. Understanding the structures and processes of change is as critical as the knowledge of what works. In this paper, we outline how case study research can contribute a more detailed understanding of how to improve care. Case study methods are underutilised in quality improvement research, and given the growing calls to understand how innovation works in different contexts 12–14 these methods could be a valuable addition to current approaches. We begin by illustrating the insights from case study research, and then examine the contribution of case study research to theory. Next we discuss strategies for analysing case study data and the scientific soundness of such information, ending with a discussion of the need for case studies to enhance the scientific understanding of quality improvement.

Insights from case study research

Three examples of how qualitative organisational research informs our understanding of the adoption of healthcare innovations illustrate the value of this research. Denis and colleagues 15 studied the adoption of four innovations in several Quebec hospitals. They found that the strength of evidence of the innovation was not the only factor influencing adoption. Organisational arrangements, clinical skills and other more ambiguous elements that were open to interpretation and negotiation were also critical. In another study examining innovations in acute care and primary care settings in the UK, Ferlie 16 identified the critical role of boundaries between professional groups. Unlike some prior studies where high levels of professionalisation facilitated adoption of innovations, Ferlie's research found that the varying roles, social boundaries and distinctive cognitive styles of different professional groups can limit the adoption of new technologies. For example, the introduction of an anticoagulation service was slowed by disagreements between cardiologists, primary care physicians, nurses and IT system designers about the appropriate indications for treatment.

The adoption of minimally invasive cardiac surgery for coronary artery bypass graft or valve replacement surgery in 16 US hospitals provides a third example. Edmondson and colleagues 17 found that successful implementation depended on team learning processes rather than resources, academic status or innovation history. Innovative procedures like minimally invasive cardiac surgery disrupt established work routines. Establishing the necessary new routines for minimally invasive cardiac surgery depended on staff perceptions of psychological safety (the sense that ‘well-intentioned interpersonal risks will not be punished’), team stability and a collective learning process supported by leaders.

Each of these research projects used case study methods to identify the novel aspects of the process of implementing innovation. The research teams collected and analysed data from interviews, clinical data and documents. These research projects examined individuals or teams in context; they were embedded multiple case designs. 18 Although the researchers had detailed knowledge of potentially relevant factors, these were primarily exploratory studies, examining which aspects of the innovation, the individuals and teams and the larger organisations influenced the adoption of the innovation.

The case study methods used in these three studies offer valuable tools in exploring the effectiveness of quality improvement more broadly. While case study research is a well-established method in organisational research, it appears to be less common in organisational health services research. Case study research designs involve the collection of qualitative (and often quantitative) data from various sources to explore one or more organisations or parts of organisations and the characteristics of these contexts. 19 Some criticise case study research because they believe that the small sample size and lack of controls undermine the ability to generalise, 20 while others worry that the analysis of case study data is often unsystematic. 21 Yet case studies, because they detail specific experiences in particular contexts, offer the opportunity to learn more about the relationship of organisational processes and context to the success or failure of quality improvement efforts.

Contributions of case studies to theory

Case studies can inform the development of more robust theory that identifies the links between problem, intervention and outcome. Robert Yin, in his classic book, 22 notes that case study research is particularly helpful when researchers want to answer questions of how or why things work in real life contexts. Theory generated from cases may help to make sense of the complex relationships that underline healthcare practice and elucidate why efforts to improve care succeed in some circumstances, but not in others.

Christensen and Carlile 23 note that theory building (the creation of a ‘body of knowledge’ or understanding) occurs in two ways or stages; first there is a descriptive or inductive stage where researchers observe phenomena and describe and measure what they see (see figure 1 ). Based on these observations, researchers develop constructs that abstract the essence of what has been observed, classify or categorise these observations, and identify relationships between them. Through these activities, researchers develop theories or models which organise the aspects of the world they study. Second, in a deductive process, researchers test and improve these theories by exploring whether the same correlations exist in different data sets. This hypothesis testing allows the theory to be confirmed or rejected, and it also permits further specification of the theory to define the phenomena more precisely or specify the circumstances under which correlations hold. Where the goal of research is discovery or new explanations, case studies may offer a more powerful research design than experimental methods. 24 25

An external file that holds a picture, illustration, etc.
Object name is qhc46490fig1.jpg

Process of building theory.

Edmondson and McManus 26 add to Christensen and Carlile's outline of the process of theory building and testing by identifying the importance of ‘methodological fit’ between theory building and different research methods. They suggest the appropriateness of different types of data varies depending on the research questions posed, the current state of the literature and the contribution envisaged from the research. Qualitative data, including interviews, observation and document analysis, are most appropriate for research where theory is nascent, and the research questions are exploratory. On the other hand, where theory is mature, survey methods and statistical testing focused on confirmation of hypotheses are more appropriate.

Organisational case studies have been an effective way to build theory in organisational research. 18 Eisenhardt and Graebner 27 note that ‘[a] major reason for the popularity and relevance of theory building from case studies is that it is one of the best (if not the best) of the bridges from rich qualitative evidence to mainstream deductive research. Its emphasis on developing constructs, measures and testable theoretical propositions makes inductive case research consistent with the emphasis on testable theory within mainstream deductive research.’ Some authors 28 argue that single case studies provide more detail and offer ‘better stories’ which are helpful in describing phenomena. But others assert that multiple case studies provide a stronger base for theory building. 22 27 Multiple case studies are powerful, since they permit replication and extension among individual cases. Replication enables a researcher to perceive the patterns in the cases more easily and to separate out patterns from change occurrences. Different cases can emphasise varying aspects of a phenomenon and enable researchers to develop a fuller theory. Fitzgerald and Dopson 19 identify four common types of multiple case study designs, each based on a different logic. These include (1) matching or replication designs intended to explore or verify ideas; (2) comparison of differences, including cases selected for their different characteristics; (3) outliers, comparison of extremes to delineate key factors and the shape of a field; and (4) embedded case study designs where multiple units are examined to identify similarities and differences.

Despite growing numbers of studies on quality improvement in healthcare, there is limited growth in a more general theory about improvement. For example, there is a growing view that improvement interventions should be tailored to potential barriers. Yet, as Bosch notes, 29 in many cases it is difficult to assess whether such tailoring was done based on a priori barrier identification, and explicit use of theory to match the intervention to the identified barriers. Bosch adds that ‘the translation of identified barriers into tailor-made [quality improvement] interventions [and their] implementation is still a black box for both educational and organisational interventions’ (p. 161). Case studies might contribute useful information to develop relevant theory. More broadly, case study research provides methods to examine organisational processes over time, examining the interplay of interventions with team dynamics or leadership strategy. For example, studies by Baker 30 and Bate 31 of high-performing healthcare organisations illustrate the challenges of creating, spreading and sustaining effective practice in organisations. Some case study research has followed organisations over extended time periods repeating interviews with key informants (eg, Denis' work on strategic change 40 41 ). Unlike survey research and RCTs, case study research can analyse the process of implementation and unpack the dynamics of change.

Data collection and analysis

Organisational case studies can include a wide array of data, including interviews, documents, ethnography, survey data and observations. Although the case study is generally viewed as a qualitative method, it may include quantitative data. For example, Greenhalgh's study of the impact of ‘modernisation initiatives’ of the delivery of care in London 42 used a wide range of methods and data, including interviews, document analysis and ethnography. Other organisational case study research 17 32 40 43 has adopted a similar mix of data sources.

Case study research typically generates large quantities of data, which makes analysis critical, but complex. Moreover, the methods for aggregating data across projects are not well developed. Coffey and Atkinson note that the use of coding and sorting, and the identification of themes are ‘an important, even an indispensable, part of the qualitative research process.’ 44 Yet, there are challenges to such methods, since coding individual experiences can lead to ‘decontextualisation,’ fragmenting such meanings and making them difficult to identify. 45 These problems are accentuated in multiple cases where results may reflect differences between the methods used, or the interests and orientation of various researchers. Even within the same research project, different investigators may take the lead in different cases. Dopson adds several other considerations about chronology: ‘Were the studies synchronous? Were they prospective or retrospective? Were they longitudinal or cross-sectional? How variable were the political and organisational contexts?’ (p. 6). 32 Multiple case studies are difficult to report, given the space constraints for journal publication, 27 and the use of extensive tables risks mimicking the presentation of quantitative data, stripping the illustrative detail from the case presentations. 19

Synthesis across studies can help to build a more generalisable understanding of organisational strategies to support improvement. Yet views vary on whether we can synthesise research from multiple case studies undertaken independently. In their review of studies examining efforts to integrate evidence into clinical decision-making in UK healthcare, Dopson and colleagues 32 compared and synthesised their findings reanalysing the original studies to identify themes, recoding their reports and then assessing the outputs generated by the five researchers involved (see table 1 ). Such tables offer a bird's-eye view of the extent to which common themes inform different case studies, but such summaries are divorced from understanding how these issues are inter-related within each case.

Identifying research themes across studies of innovation diffusion 32

1, Theme is present; 2, strong evidence of theme; 3, very strong evidence of presence.

Methodological rigour

Efforts to create such syntheses raise issues about methodological rigour. For those researchers who adopt a positivist framework, the test of good case studies builds on four criteria used to assess the rigour of field research: internal validity, construct validity, external validity and reliability. 22 These criteria might be applied to case studies in the following ways (see table 2 ).

Framework for an investigation of the methodological rigour of case studies 40

Gibbert and colleagues 46 reviewed case studies published in the organisation/management literature between 1995 and 2000. They found research procedures enhancing external validity in 82 of 159 papers, and procedures supporting reliability in 27 of these papers. Few papers provided evidence of internal or construct validity. Yin proposes pattern matching; explanation building; addressing rival explanations and using logic models as strategies to address internal validity. 22 Eisenhardt offers a series of questions that reflect on the match between method and results: ‘Have the investigators followed a careful analytical procedure? Does the evidence support the theory? Have the investigators ruled out rival explanations?’ 18 (p. 548). Non-positivist researchers employ other methods to ensure the soundness of their findings; for example, see Lincoln and Guba. 47

An alternative measure of the rigour of case study research focuses on how good the theory is that emerges from this research. Pfeffer 48 suggests that good theory is parsimonious, testable and logically coherent. Good theory should also address critical issues of interest to organisations and interested parties. Insights from other disciplines and attempts to seek out anomalies in other authors' work that might inform research in different areas are other strategies that may enrich the quality of case study research, improving the theory that results. 48

Despite the need for more robust theory, why are there so few organisational case studies of quality improvement? Some candidate explanations might include: (1) the limited number of organisational scholars working in this area; (2) the dominance of alternative research paradigms that dismiss case study research; (3) difficulties in securing funding; (4) the lack of publication outlets; and (5) the absence of a clear understanding of the relationship of case study research to the development of theory, and the testing of theory using randomised control trials and other methods. Still, the emergence of several strong research groups in the UK, Canada and the USA, and growing numbers of high-quality publications offer hope. What is missing in quality improvement research is a clear understanding of how case study research could contribute to the broader research enterprise, enriching the qualitative understanding of the complex processes of improving healthcare delivery.

Conclusions

Comparative case study research provides useful methods for identifying the factors facilitating and impeding improvement. Although valuable in their own right, such methods also offer the opportunity to enrich more traditional approaches to assessing interventions, helping to explain why some interventions are unsuccessful, or why they seem to work effectively in some contexts but not in others. Efforts to improve patient safety and quality of care need to take into account the complexities of the systems in which these improvements are being introduced. Case study methods provide a robust means to guide implementation of effective practices.

Competing interests: None.

Provenance and peer review: Not commissioned; externally peer reviewed.

Evolution of quality assurance practices in enhancing the quality of open and distance education in a developing nation: a case study

Asian Association of Open Universities Journal

ISSN : 2414-6994

Article publication date: 18 August 2022

Issue publication date: 5 October 2022

The purpose of this study is to look at the challenges and successes that the case institution has had in implementing and maintaining quality assurance (QA) processes. The study also looks into the role of QA techniques in improving an institution's performance in a developing country.

Design/methodology/approach

The research is qualitative. Nine significant persons were interviewed, including the institution's top administration, faculty members and related staff. Data were gathered to learn more about the background, incremental changes and numerous internal and external elements that influenced how QA was approached over time.

The findings revealed the challenges and experiences of the evolution of QA practices in the case institution. The results show the changes in QA practices regarding three aspects, including people, place and program of case institutions under three phases. During phases I and II, the adoption and upgradation of QA practices were very slow; phase III showed significant improvement in all three aspects. In addition, the positive impact of QA practices is evident in improving the performance of students and teaching and nonteaching staff of the case institution.

Practical implications

The findings of this research could aid open and distance learning (ODL) providers in other developing nations in understanding the challenges of such a system. It may also make it easier for other ODL providers to comprehend the QA-led success in stakeholder confidence, employability and reputation.

Originality/value

The research will give insights into how QA procedures are used and valued in ODL in developing nations.

Quality assurance
Developing economies
Open and distance education
Bangladesh Open University
Performance

Ferdousi, F. , Ahmed, A. and Momen, M.A. (2022), "Evolution of quality assurance practices in enhancing the quality of open and distance education in a developing nation: a case study", Asian Association of Open Universities Journal , Vol. 17 No. 2, pp. 147-160. https://doi.org/10.1108/AAOUJ-02-2022-0025

Emerald Publishing Limited

Published in the Asian Association of Open Universities Journal . Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) license. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this license may be seen at http://creativecommons.org/licences/by/4.0/legalcode

1. Introduction

Higher education faces numerous interconnected challenges, including limited access to tertiary level institutions, insufficient funding, inadequate information communication technology (ICT) infrastructure and low research output ( Mannan, 2015 ). Particularly in developing countries, educational systems face a variety of challenges. It includes rising costs due to fiscal constraints, a lack of curriculum renewal, a lack of appropriate learning materials, a shortage of trained teachers, an insufficient level of systemic compatibility and inadequate teaching aids, all of which contribute to low-quality and ineffective education ( Dhawan, 2020 ). In addition, natural disasters such as COVID-19 have wreaked havoc on these countries' traditional face-to-face education infrastructures ( Churiyah et al. , 2020 ). Additionally, many groups, particularly the rural poor and disadvantaged, including women, have limited access to quality education. However, in these circumstances, the requirement for large numbers of people resulted in the concept of open and distance learning (ODL), which has developed into a critical component of higher education in both developed and developing countries ( Alhumaid et al. , 2020 ).

The concept of ODL focuses on open access to education and training to make the learners free from the constraints of time and place and offer flexible learning opportunities to individuals and groups of learners. However, the central purpose of ODL is to provide education to those who lack the opportunity to obtain formal education. In open education, there are no formal classroom practices and students focus on independent study. In addition, learning content, including lectures, is disseminated by correspondence, broadcast using electronic media or provided through a learning management system here. Distance education (DE) is seen as a cost-effective and efficient means of increasing access to education. While DE with its utilization of advanced communication technology is a unique tool to enhance the quality of education in various groups and areas of the country ( Arthur-Nyarko et al ., 2020 ), contemporary communication technologies also facilitate the reach of education to a large number of people who can learn in their place, pace and time ( Tomasik et al. , 2021 ).

ODL was initially criticized for its poor quality, its lower standards of students who enroll and being detrimental to higher education planning in the country ( Stella and Gnanam, 2004 ). Even after introducing several changes in course materials, curriculum and teaching methods, there is considerable controversy throughout academia and among employers about what constitutes quality in ODL and how to ensure it ( Devkota, 2021 ). Assuring the quality of education is a fundamental aspect of gaining and maintaining credibility for programs, institutions and national higher-education systems worldwide. Despite a long and generally successful track record, ODL is still required to prove that the quality of student learning is at least equivalent to face-to-face teaching ( Arkorful and Abaidoo, 2015 ). A robust quality assurance (QA) system can assist in accomplishing this. However, the interest of stakeholders in ODL has increased interest in QA. While some argue that ODL QA practices are comparable to those used in traditional education, others argue that ODL tests conventional assumptions and thus that current QA mechanisms are insufficient to ensure the quality of ODL ( Palvia et al. , 2018 ). On the other hand, QA is not an attempt to create quality but a systematic and comprehensive effort to improve it. QA aims to demonstrate and improve the quality of an institution's methods, educational products and outcomes. It includes developing and producing instructional materials, academic programs, services, support and student learning standards in ODL ( Margaryan et al. , 2015 ).

While there are a large number of studies ( Hoecht, 2006 ; Ryan, 2015 ; Kahveci et al. , 2012 ) that have focused on the practices of QA in the traditional education system, some studies have looked into the same from ODL ( Perraton, 2012 ; Darojat et al. , 2015 ; Kihwelo, 2013 ; Scull et al ., 2011 ; Stella and Gnanam, 2004 ). However, while some studies have concentrated on the nature and importance of ODL, some other studies ( Darojat et al. , 2015 ; Kihwelo, 2013 ; Scull et al ., 2011 ; Stella and Gnanam, 2004 ) have shown the use of QA in the context of ODL. In this respect, while previous studies ( Stella and Gnanam, 2004 ) are mostly based on developed countries, only a few studies ( Darojat et al. , 2015 ; Belawati and Zuhairi, 2007 ) have examined the use of QA in ODL from a developing country's perspective. Available evidence indicates that the acceptance of ODL differs from country to country. In some developed countries, including the USA, Australia and the UK, stakeholders recognize the off-campus degrees considerably ( Stella and Gnanam, 2004 ), while the situation is different in some European countries where ODL promoters are struggling to gain acceptance of ODL. While the open university was introduced as an Apex Body in a developing country like India, Bangladesh is still concerned about the broader acceptance of ODL despite some positive changes being apparent in recent times during COVID-19 ( Churiyah et al. , 2020 ).

However, the focus on a developing country like Bangladesh is necessary due to its unique environment. It differs from developed countries in terms of opportunities, facilities, technological advancement, etc. ( Dhawan, 2020 ). Accordingly, a specific QA strategy is not universally adaptable because the DE “outfit” differs widely from institution to institution and from one country to another. This warrants that the pace of development and process of maintenance of QA in ODL be flexible ( Arthur-Nyarko et al ., 2020 ). This study, therefore, explores the experiences of incorporating QA practices in the Bangladesh Open University (BOU), the only open and distance education (ODE) provider in Bangladesh. In addition, this study further contributes to the literature by addressing the following research question:

What are the experiences of BOU in adopting and maintaining QA practices?

To explore the experiences of BOU in adopting QA practices;

To explore the experiences of BOU in maintaining QA practices;

To explore the impact of QA practices in enhancing the performance of BOU.

2. Context of QA practices in ODL and Bangladesh Open University (BOU)

While quality involves satisfying a defined standard in higher education, the quality of the inputs (e.g. staff, libraries, laboratory equipment and facilities) is generally assumed to determine the quality of its output (i.e. graduates and research).

However, recent studies argue that the quality inputs do not necessarily guarantee quality outputs; instead, it is critical to evaluate the outcome of the education, which is measured by students' learning achievement. A critical educational goal in higher education is to achieve high-quality teaching and learning or pedagogical techniques that result in student learning outcomes. Achieving high-quality teaching and learning requires a multidimensional approach that includes curriculum and course design, learning contexts, feedback, learning outcomes assessment, learning environments and student support services. In an ODL system, a comprehensive and integrated online student support system is mandatory to maintain the quality of ODL. ODL requires more endeavors in logistics, supply chain management and supporting activities, such as laboratories to support effective teaching and learning of science online at a distance. QA in the context of ODL requires a detailed examination of those characteristics that can give credibility to the various programs and products of ODL ( Tomasik et al. , 2021 ). With the increasing acceptance of ODL as widening access to education, it has become increasingly necessary that the QA process be developed and maintained if the ODL provision is relevant and more functional than the products recognized in the conventional higher learning in the emerging open learning environment ( Amin and Jumani, 2022 ).

Nevertheless, QA in ODL institutions has gained serious attention from institutions and stakeholders over a couple of decades. Accordingly, institutions began to redefine and revise their institutional missions, strategies and visions that address quality issues. While some studies have concentrated on exchanging ideas and experiences regarding the “best practices of QA implementation” in ODL contexts from around the world ( Tait, 1997 ), other studies examining the use of QA in Asian ODL have revealed significant variation in the level of QA practices ( Devkota, 2021 ). Therefore, considering the socioeconomic differences, this study focuses on exploring the experiences of BOU in adopting and maintaining the QA practices since its inception.

However, as students' backgrounds and needs diversify, BOU faces increasing pressure to accommodate the students' requests for flexibility. In this context, this institution has implemented QA practices as a cost-effective method and tool for addressing the ODL quality challenge. As in ODL, it is required to keep the quality concept in mind while developing and implementing systems, processes and procedures. In BOU, implementing QA principles in ODL was a monumental task as it required a great deal of effort, patience, socialization and training to ensure that innovation is a productive effort. However, BOU did not formulate a QA policy during its establishment, but the QA evolved along with its maturity. The formulation of the QA policy occurs at a later stage of its establishment based on the learners and institutional experience.

BOU was chosen as a case as it is the only university that provides both open and distance education (ODE) in Bangladesh and has experienced many challenges and changes from its inception. The institution was contacted via the registrar (hereafter “organization contact”). In examining the implementation of QA in BOU, 17 interviews were conducted over eight months with the university's key personnel ( Table 1 ) to explore the experiences in adopting and maintaining QA practices since its inception. Interviewees were selected based on their knowledge regarding the implementation of QA, and accordingly, two participants from top-level management, five administrative staff members, nine faculty members and one faculty member associated with the Institutional Quality Assurance Cell (IQAC) were interviewed. Interviewees were required to have had involvement with QA activities in the BOU, to have a minimum of five years' experience with the institution and to be willing to participate in the study. The case institution contact provided his support to find relevant respondents from different departments who met the aforementioned criteria.

A qualitative approach was used to better understand the experiences from the inception to date and the impact of using QA practices in enhancing the performance of the BOU. Using an interview schedule (open-ended questions), data were collected to obtain information concerning the context, gradual changes and various internal and external factors that brought such changes. The researchers collected data.

Meetings were held on the BOU campus using an interview guide. In order to gain an insight into the implementation process of QA, BOU's internal documents covering the last 10 years were also analyzed. The documents included BOU's meeting minutes, brochures and quality manuals. Prior consent was taken from the interviewees. Participants were offered the opportunity to interview in Bangla. Three participants chose to have the interviews conducted in Bangla, and the remaining participants chose the interviews to be conducted in English.

While participants were allowed to be interviewed in both Bangla and English, many respondents responded in English, and only a few respondents gave their responses in Bangla. Accordingly, the Bangla interviews were transcribed and translated. Data were analyzed using NVivo software (NVivo is a software program used for qualitative research, and it facilitates the analysis of text, audio, video and image data, including interviews, focus groups, surveys, social media and journal articles). While at the early stage of data analysis, the data were grouped into many codes. Finally, these codes were specifically categorized into different time phases such as phase I, phase II and phase III. The documents used included meeting minutes, bulletins and institutions' websites.

Furthermore, evidence was also collected from other records, including the University Grants Commission's (UGC's) instructions. The triangulation method was incorporated where the responses of the interviews and the documents collected from various sources and observations were compared ( McKinnon et al ., 2000 ). Using multiple data sources reduces the risk of a validity issue because it relates to different research contexts or information about the same comparable research. The reliability was ensured through the use of archival documents.

4. Case study

A case study is a standard research tool in the social sciences. Case studies are investigations into the causes of underlying concepts that focus on a specific person, organization or event. A case study is a detailed and in-depth examination of a person, group or event in contrast to a single vision of an individual obtained from a survey response or an interview; case studies capture a variety of viewpoints. The case study method allows for a better grasp of the subject at hand ( Bennett, 2004 ). It also reduces the possibility of prejudice by diluting the agenda of a single individual. The case study method is always preferable in education research for revealing a complex grasp of underlying phenomena ( Yazan, 2015 ). The research employs the case study technique for the study at hand, based on the preceding explanation. Here, for the underlying objective, the research works with BOU.

4.1 About the Bangladesh Open University

In 1992, BOU was the first and only university established to provide ODE in Bangladesh. As a public university initially, the BOU started with a minimal number of students and staff members, which eventually increased to 29,700 academic staff members and 574,000 students (website). This university uses a flexible mode of education delivery in providing education and training from anywhere at its own pace.

The focus of this university is to promote education through multimedia instruction at all levels of education in science, agriculture, humanities, social science, etc. It offers 56 formal academic programs, along with 19 nonformal programs (environmental protection, basic science, elementary mathematics, agriculture, bank service, marketing management, health nutrition, population and gender issues) where ICTs are the core to provide education. With a blended learning approach, the university's instructional system comprises mainly the development of instructional materials in modular form, delivery of the printed materials to the learners, face-to-face tutoring of students at selected tutorial centers (called study centers), online tutoring (for both national and international students) and delivery of learning materials through ICTs.

4.2 Phases of changes in QA practices in the BOU

4.2.1 phase i (embryonic): period from 1992 to 1995.

The first phase was the “embryonic” phase for the case institution [1] . From the inception to 1995, this period is considered as the phase I of BOU when QA practices were relatively weak compared to any other period (participant 1). This phase mostly emphasized the initial development of infrastructure including regional centers (RCs) [2] and subregional centers (SRCs) [3] in different parts of the country; study centers as well as administrative and academic building in the main campus. However, BOU faced numerous challenges in hiring desired academic and administrative staff (participant 1). Participants' views reveal that the low acceptance of ODL and lack of expertise in the management of the ODL system were the key challenges and impeding factors in ensuring quality at this phase. Moreover, initially, the tools, techniques and facilities to support every activity were in their infancy.

4.2.2 Phase II (evolution): initial QA framework of BOU (1996–2013)

While there was no QA framework found until the early stage of phase II, some extent of QA practices received attention at the later stage of this phase. However, during the second quarter of this phase, BOU adopted an “internal QA framework”. In this respect, BOU used to have a “needs analysis framework” to identify the needs and gaps regarding three components, that is, (1) people, (2) programs and (3) place. This framework aimed to identify the desired quality requirements and then analyze the gap between the expectation and reality. As mentioned by participant 1, the “needs analysis framework” includes identifying the QA practices needed for the people (academic staff, administrative staff and students); program (curriculum, module, teaching, learning other processes and procedures) and place (space and facilities).

… The critical challenge in quality improvement emerged from people with diverse backgrounds. The lack of adequate training to develop the required skill within the staff and academics also challenged the success of the ODL system.

…. classroom delivery is a crucial skill for a faculty member to enrich his[her] knowledge … …till 2013, the faculty members were more involved in preparing modules and undertaking exams and other duties only. It was a significant drawback in enhancing the faculty knowledge and skills.

… the previous selection process failed to ensure quality of staff, ……however, in many cases, staff were found inappropriate for the selected positions.

In addition, the diverse background of students with no admission test also led BOU to produce low-performing graduates. Participants believed that there was a lack of interactive communication between the students and tutors, which is considered one of the critical inhibiting factors against BOU's success (participant 9). However, until this phase, the “study centers” used to facilitate direct interaction between tutors and students only every week. Moreover, with respect to the people aspect, participants viewed that while there was a little arrangement for the development and incentive programs for the faculty members and staff (participants 1 and 8), phase II took a few initiatives, including faculty and staff development through allocating funds for both local and foreign training.

… though the development of a faculty member largely depends on research and training, these were received less priority.

Participants' views also suggest that the lack of research culture was a key to the demotivation of faculty involvement in research. Moreover, the easy promotion was also viewed as an inhibiting factor in this regard.

Moreover, some underminers operate in the shadows to demoralize QA issue processes by creating or exaggerating destructive features of the BOU-implemented change. Other teachers, particularly those who lack a firm understanding of the topic or the willpower to resist, may be readily persuaded to join the negative debate. The BOU's upper management takes the issue of challenging employees seriously. They discuss this conduct in private or public, as appropriate, and determine the underlying causes. Regarding QA practices, BOU established a tone and a standard of conduct. Peer pressures shape it so that tough people become accustomed to it (participants 5 and 9).

Nevertheless, along with the “program” aspect, the “place” also appears to have received moderate attention even though most participants recognized it as a key operational area that must be given attention in improving quality. As the participants viewed, while there were many “study centers” all over Bangladesh with inadequate facilities, the lack of a proper monitoring system was central to the quality problem. In addition, the “RCs” also received less attention from the authority. However, over time, the increased awareness regarding the necessity of physical facilities in increasing the quality of staff members, faculty members and students led the authority to improve the facilities of “RCs,” “subregional centers,” “study centers” and the main campus.

4.2.3 Phase III (matured): QA practices from the end of 2013 to present

… although the new selection and promotion processes were highly debated, these proved necessary for improving the quality of academic and administrative staff.

… the research grant was found as a motivating tool in increasing faculty involvement in research. The fund also motivated external researchers in conducting collaborative research.

Additionally, participants 9 and 16 emphasize the role of ranking in developing the institution's QA practices, notably in the growth of its people and processes. University rankings are growing increasingly popular and have extended globally. According to some scholars, rankings can help ensure that schools and universities are of high quality ( Pham, 2018 ). However, because the assessment tools are not as effective as they could be, mainstream university rankings do not increase the quality of higher education as much as anticipated ( Liu, 2020 ).

In addition, phase III showed significant attention in respect to “program” aspects. Participants' views expressed that while updating the curriculum did not get much priority in phase II, phase III brought remarkable changes. Participants revealed that the curriculum review received key priority where a committee comprising members from different departments used to discuss and thoroughly examine the curriculum for any change and improvements, including the content editing, the mode editing, the language editing, etc. The changes in the curriculum took place from 2014 to 2019 (participant 1) in different academic programs. Moreover, e-learning materials that are very popular with the learners were prepared to complement the self-learning material to enrich the learners' knowledge further. Participants' views suggest that the top management was inclined to continuously update the materials supplied to the distance learners, whether in print or electronic form. Participants' views also expressed that phase III shows considerable interest in equipping learners with better learning tools including high-speed internet, micro-SD cards containing video and audio programs inserted into mobile sets of students, which assist students even when they are off-line. The university also uses YouTube ( www.youtube.com/user/bdopenuniversity ) and BouTube ( www.boutube.com ) to help students by providing all necessary textbooks/modules.

Moreover, along with the previous system, a few more technology-based systems and application software programs were introduced to ensure smooth administrative services and provide better online services to students. In addition, at this phase, the expansion of academic programs has also been prioritized. At this stage, study centers in foreign countries received attention. As revealed from participant 3, centers were established in South Korea, four centers in Qatar and more are under consideration in the Middle East.

In addition, participant 7 brings up the issue of massive open online courses (MOOCs) as the key to accelerating the success of BOU's ongoing QA practices. MOOCs can give students access to the knowledge they might not have otherwise. They can also help people who cannot afford college ( Al-Rahmi et al. , 2019 ). MOOCs are an excellent way to get a nontraditional education online, and they can work well with traditional university education.

However, suitable and attractive infrastructure at phase III also got critical attention. Although the importance of the “place” aspect in the QA framework sparked various debates, BOU emphasized the development of good infrastructure and facilities to comply with the desired quality requirements. In line with that, BOU focused more on increasing the facilities of “study centers,” “RCs” and the main campus. However, in order to comply with the requirements of the government, during the later part of this phase, BOU established an IQAC with the financial and technical assistance from the UGC's Higher Education Quality Enhancement Project (see Figure 2 ).

The objective of IQAC is to promote a quality culture following national QA guidelines and international practices. Moreover, the focus was to ensure that the university's QA procedures were designed following the Quality Assurance Unit guidelines and national requirements. Additionally, the establishment of this cell focuses on developing, sustaining and enhancing the quality of education and public perception of the university through consistent QA practices and performance. It contributes to the development of the university's image in the eyes of stakeholders by ensuring transparency, accountability and sound management practices in all areas of administration and preparing the university to meet external QA and accreditation requirements. The cell also includes setting development goals and indicators of improvement in the educational and administrative functions of the organization. The cell develops the plan to achieve the government's desired goals, including identifying the problems by evaluating the overall features of the university's degree programs, curriculum, methods of teaching, teacher training, research activities and administrative activities. Based on these, BOU emphasized the following QA activities.

… the continuous QA practices may help BOU increase the ODL program's acceptance to a greater extent.

However, participants indicate that QA practices increased stakeholders' satisfaction, including the students, employers and regulatory bodies. Participants' views also mentioned that increased recognition is one of the critical indicators of the positive consequences of QA practices (see Figure 3 ).

5. Conclusion, implications and limitations of the study

This study aimed to analyze the experiences of implementing and maintaining the QA practices by BOU. Moreover, the study analyzes the impact of QA practices in enhancing BOU effectiveness. The findings show the importance of the role played by QA in increasing the effectiveness of the institution. The study contributes to two strands of literature: QM studies within the management literature and developing countries. It provides practical evidence on the challenges and experiences and how the emphasis on QA practices changed over time. Specifically, the findings provide an insight into the change that was made to the practices of BOU.

The analysis revealed that the changes in QA practices of the case institution mainly focused on three components, comprising people, program and place under three phases, including phase I, phase II and phase III. The result shows that the nature of ODL is different from that of traditional education, which causes unique challenges for BOU to manage quality. The QA practices in ODL and the traditional system are different in many ways, in terms of the qualification of academic and administrative staff, students' background, mode of education, teaching-learning methods, space and facilities, etc. However, the result reveals that there were no such QA practices during phase I; instead, this phase concentrated more on developing basic infrastructures. The emphasis was more on introducing the new model of the education system – the ODL approach to many students. The key challenges were attracting and recruiting desired candidates for the academic and administrative positions, the low acceptance of ODL and the lack of expertise in the management of the ODL system. The finding has also been supported by the scholars Kihwelo (2013) .

The study demonstrated that while the first stage of phase II was found to have no attention to QA practices, the later stage of phase II shows little to moderate attention to various aspects of QA practices. In this phase, a “needs analysis framework” was developed to identify the requirements of QA practices in terms of people (academic staff members, administrative staff members and students); program (curriculum, module, teaching, learning and other processes and procedures) and place (space and facilities). This framework helped the case institution in identifying the challenges, such as inexperienced academic and staff positions, diverse backgrounds of students with no admission test, lack of face-to-face interaction between teachers and students and rigorous recruitment and promotion process, which inhibit the desired quality.

Regarding the programming aspect, findings reveal that while the experienced faculty members from reputed universities were involved in preparing the modules, there was a lack of an initiative in regularly reviewing the curriculum and modules. However, the result shows that while there was little attention with respect to faculty training and research, a moderate level of improvement was mentioned at the later stage of this phase. Moreover, this phase pays moderate attention in increasing the facilities of its regional and study centers.

However, compared to phase I and phase II, phase III showed significant changes in QA practices in terms of all three aspects, including people, process and programs. The participants mentioned changes in terms of faculty recruitment and promotion; review of curriculum and modules; inclusion of modern tools and techniques in the mode of learning and teaching; rigorous training for faculty and staff development and availability of research grants. Finding suggests that following the aforementioned developments, a continuous improvement mechanism is developed after establishing IQAC. The IQAC led BOU in ensuring QA practices according to the national requirements. The analysis suggests that in an effort to enhance the acceptability of ODL to the stakeholders, BOU is preparing to apply for the accreditations. The findings indicate that any improvement is the result of awareness and intention of the top management. When top management understands the need and benefits of assuring quality, they can create a milestone. Therefore, it is imperative for the top management to create a systematic process to adopt QA practices and monitor the outcome on a regular basis.

The study extends the existing literature by exploring the experiences of implementing and maintaining the QA practices and the impact on the effectiveness of ODE in a developing country like Bangladesh. In particular, the analysis incorporates a qualitative approach to exploring the research objectives. In doing so, the findings assist the regulators and authorities of ODL providers in developing countries in understanding how to enhance the use and effectiveness of QA practices. The focus on a developing country was considered important as the use and effectiveness of QA in developing countries are different from those in developed countries due to the political, social and cultural environment. Moreover, while QA practices are prevalent in developed countries, institutions within developing economies experience difficulties incorporating such practices due to scant facilities, resistance and negligible investment in technologies. Similar results are observed in other developing nations, such as India. Even though institutions in underdeveloped nations endeavor to provide excellent education, each institution has its own contextual goals, norms and laws, budgetary constraints, security concerns and technical legacies ( Patra et al. , 2022 ). Consequently, the measures must consider the specific environment of the concerned institution. In addition, developing nations' governments must identify the issues that impede the institution's application of QA procedures and then develop the required measures to overcome these obstacles.

The study also extends the literature by providing an insight into the effectiveness of QA, in terms of increased recognition, employability and satisfaction of stakeholders. This implies that institutions should endeavor to make greater use of QA practices to provide better services, thereby enhancing the institution's image. This finding supports the previous studies by Tsekouras et al. (2003) .

However, the findings imply that QA is a never-ending process. If institutions simultaneously focus on improving three aspects, including people, processes and programs, it is possible to enhance the effectiveness of the institutions. Therefore, the institutions should endeavor to use QA practices to provide better services, thereby enhancing the institution's image, which also highlights the critical role of QA practices in enhancing performance.

The study has limitations. While the case study aimed to explore the changes in QA practices through a retrospective analysis of organizational participants' views of the changes, there is a possible risk of missing valuable information due to the inability of respondents to recall events. While such concerns were minimized by using multiple data sources, future research may extend the current study by investigating the findings in different research sites.

Internal needs analysis/gap analysis framework of BOU

QA framework during phase III

IQAC-induced QA practices

List of participants

The time period of each phase is on the basis of the discussion of the participants.

Regional centers (RCs) usually organize the admission tests and maintain linkage with study centers including local school, colleges and universities.

Here, the “people” refers to the internal and external stakeholders including governing council members, management team members, senior academic and students who are part of QA activities. The “program” refers to the processes, procedures and activities including curricular design, teaching and learning, governance systems, professional development of staff, research, student assessment, staff recruitment, student admission, institutional ceremonies and student support services. “Place” refers to the space and facilities which are required to support every activity.

Al-Rahmi , W. , Aldraiweesh , A. , Yahaya , N. , Kamin , Y.B. and Zeki , A.M. ( 2019 ), “ Massive open online courses (MOOCs): data on higher education ”, Data in Brief , Vol. 22 , pp. 118 - 125 .

Alhumaid , K. , Ali , S. , Waheed , A. , Zahid , E. and Habes , M. ( 2020 ), “ COVID-19 and e-learning: perceptions and attitudes of teachers towards e-learning acceptance in the developing countries ”, Multicultural Education , Vol. 6 No. 2 , pp. 100 - 115 .

Amin , S. and Jumani , Z. ( 2022 ), “ Analysis of existing policies and practices in distance education: empowering women education ”, International Research Journal of Education and Social Sciences , Vol. 1 No. 1 , pp. 60 - 67 .

Arkorful , V. and Abaidoo , N. ( 2015 ), “ The role of e-learning, advantages and disadvantages of its adoption in higher education ”, International Journal of Instructional Technology and Distance Learning , Vol. 12 No. 1 , pp. 29 - 42 .

Arthur-Nyarko , E. , Agyei , D.D. and Armah , J.K. ( 2020 ), “ Digitizing distance learning materials: measuring students' readiness and intended challenges ”, Education and Information Technologies , Vol. 25 No. 4 , pp. 2987 - 3002 .

Belawati , T. and Zuhairi , A. ( 2007 ), “ The practice of a quality assurance system in open and distance learning: a case study at Universitas Terbuka Indonesia ”, International Review of Research in Open and Distance Learning , The Indonesia Open University , Vol. 8 No. 1 , p. 340 .

Bennett , A. ( 2004 ), “ Case study methods: design, use, and comparative advantages ”, Models, Numbers, and Cases: Methods for Studying International Relations , Vol. 2 No. 1 , pp. 19 - 55 .

Churiyah , M. , Sholikhan , S. , Filianti , F. and Sakdiyyah , D.A. ( 2020 ), “ Indonesia education readiness conducting distance learning in Covid-19 pandemic situation ”, International Journal of Multicultural and Multireligious Understanding , Vol. 7 No. 6 , pp. 491 - 507 .

Darojat , O. , Nilson , M. and Kaufman , D. ( 2015 ), “ Quality assurance in Asian open and distance learning: policies and implementation ”, Journal of Learning for Development (JL4D) .

Devkota , K.R. ( 2021 ), “ Inequalities reinforced through online and distance education in the age of COVID-19: the case of higher education in Nepal ”, International Review of Education , Vol. 67 No. 1 , pp. 145 - 165 .

Dhawan , S. ( 2020 ), “ Online learning: a panacea in the time of COVID-19 crisis ”, Journal of Educational Technology Systems , Vol. 49 No. 1 , pp. 5 - 22 .

Hoecht , A. ( 2006 ), “ Quality assurance in UK higher education: issues of Trust, control, professional autonomy and accountability ”, High Education , Vol. 51 , pp. 541 - 563 .

Kahveci , T.C. , Uygun , Ö. , Yurtsever , U. and Ilyas , S. ( 2012 ), “ Quality assurance in higher education institutions using strategic information systems ”, Procedia – Social and Behavioral Sciences , Vol. 55 , pp. 161 - 167 .

Kihwelo , P.F. ( 2013 ), “ Quality assurance system in open and distance learning for normative judgment ”, HURIA , Vol. 4 No. 1 , pp. 1 - 21 .

Liu , S. ( 2020 ), “ Can ranking contribute to the quality assurance of higher education? An examination of the Chinese disciplinary ranking ”, Cambridge Journal of Education , Vol. 51 , pp. 1 - 19 , doi: 10.1080/0305764X.2020.1829548 .

Mannan , A. ( 2015 ), “ Higher Education: no crisis but problem ”, True and Impartial Daily Sun , available at: https://www.daily-sun.com/post/45817/Higher-Education:No-crisis-but-problem .

Margaryan , A. , Bianco , M. and Littlejohn , A. ( 2015 ), “ Instructional quality of massive open online courses (MOOCs) ”, Computers and Education , Vol. 80 , pp. 77 - 83 .

McKinnon , K.R. , Walker , S.H. and Davis , D. ( 2000 ), Benchmarking: A Manual for Australian Universities , Department of Education, Training and Youth Affairs , Canberra, ACT .

Palvia , S. , Aeron , P. , Gupta , P. , Mahapatra , D. , Parida , R. , Rosner , R. and Sindhi , S. ( 2018 ), “ Online education: worldwide status, challenges, trends, and implications ”, Journal of Global Information Technology Management , Vol. 21 No. 4 , pp. 233 - 241 .

Patra , A. , Asghar , A. , Chaudhary , P. and Ravi , K.S. ( 2022 ), “ Integration of innovative educational technologies in anatomy teaching: new normal in anatomy education ”, Surgical and Radiologic Anatomy , Vol. 44 No. 1 , pp. 25 - 32 .

Perraton , H. ( 2012 ), Open and Distance Learning in the Developing World , 2nd ed. , Routledge, Taylor and Francis Group , London and New York .

Pham , H.T. ( 2018 ), “ Impacts of higher education quality accreditation: a case study in Vietnam ”, Quality in Higher Education , Vol. 24 No. 2 , pp. 168 - 185 .

Ryan , T. ( 2015 ), “ Quality assurance in higher education: a review of literature ”, Higher Learning Research Communications , Vol. 5 No. 4 .

Scull , W.R. , Kendrick , D. , Shearer , R. and Offerman , D. ( 2011 ), “ The landscape of quality assurance in distance education ”, Continuing Higher Education Review , Vol. 75 , pp. 138 - 149 .

Stella , A. and Gnanam , A. ( 2004 ), “ Quality assurance in distance education: the challenges to be addressed ”, Higher Education , Vol. 47 No. 2 .

Tait , A. ( 1997 ), Quality Assurance in Higher Education: Selected Case Studies , The Commonwealth of Learning , Vancouver, British Columbia.

Tomasik , M.J. , Helbling , L.A. and Moser , U. ( 2021 ), “ Educational gains of in-person vs. distance learning in primary and secondary schools: a natural experiment during the COVID-19 pandemic school closures in Switzerland ”, International Journal of Psychology , Vol. 56 No. 4 , pp. 566 - 576 .

Tsekouras , J. , Stamboulis , M. and Litsardakis , M. ( 2003 ), The Financing of Vocational Education and Training in Greece , Panorama Series, 78 .

Yazan , B. ( 2015 ), “ Three approaches to case study methods in education: Yin, Merriam, and Stake ”, The Qualitative Report , Vol. 20 No. 2 , pp. 134 - 152 .

Corresponding author

Related articles, we’re listening — tell us what you think, something didn’t work….

Report bugs here

All feedback is valuable

Please share your general feedback

Join us on our journey

Platform update page.

Visit emeraldpublishing.com/platformupdate to discover the latest news and updates

Questions & More Information

Answers to the most commonly asked questions here

How to write a case study — examples, templates, and tools

It’s a marketer’s job to communicate the effectiveness of a product or service to potential and current customers to convince them to buy and keep business moving. One of the best methods for doing this is to share success stories that are relatable to prospects and customers based on their pain points, experiences, and overall needs.

That’s where case studies come in. Case studies are an essential part of a content marketing plan. These in-depth stories of customer experiences are some of the most effective at demonstrating the value of a product or service. Yet many marketers don’t use them, whether because of their regimented formats or the process of customer involvement and approval.

A case study is a powerful tool for showcasing your hard work and the success your customer achieved. But writing a great case study can be difficult if you’ve never done it before or if it’s been a while. This guide will show you how to write an effective case study and provide real-world examples and templates that will keep readers engaged and support your business.

In this article, you’ll learn:

What is a case study?

How to write a case study, case study templates, case study examples, case study tools.

A case study is the detailed story of a customer’s experience with a product or service that demonstrates their success and often includes measurable outcomes. Case studies are used in a range of fields and for various reasons, from business to academic research. They’re especially impactful in marketing as brands work to convince and convert consumers with relatable, real-world stories of actual customer experiences.

The best case studies tell the story of a customer’s success, including the steps they took, the results they achieved, and the support they received from a brand along the way. To write a great case study, you need to:

Celebrate the customer and make them — not a product or service — the star of the story.
Craft the story with specific audiences or target segments in mind so that the story of one customer will be viewed as relatable and actionable for another customer.
Write copy that is easy to read and engaging so that readers will gain the insights and messages intended.
Follow a standardized format that includes all of the essentials a potential customer would find interesting and useful.
Support all of the claims for success made in the story with data in the forms of hard numbers and customer statements.

Case studies are a type of review but more in depth, aiming to show — rather than just tell — the positive experiences that customers have with a brand. Notably, 89% of consumers read reviews before deciding to buy, and 79% view case study content as part of their purchasing process. When it comes to B2B sales, 52% of buyers rank case studies as an important part of their evaluation process.

Telling a brand story through the experience of a tried-and-true customer matters. The story is relatable to potential new customers as they imagine themselves in the shoes of the company or individual featured in the case study. Showcasing previous customers can help new ones see themselves engaging with your brand in the ways that are most meaningful to them.

Besides sharing the perspective of another customer, case studies stand out from other content marketing forms because they are based on evidence. Whether pulling from client testimonials or data-driven results, case studies tend to have more impact on new business because the story contains information that is both objective (data) and subjective (customer experience) — and the brand doesn’t sound too self-promotional.

89% of consumers read reviews before buying, 79% view case studies, and 52% of B2B buyers prioritize case studies in the evaluation process.

Case studies are unique in that there’s a fairly standardized format for telling a customer’s story. But that doesn’t mean there isn’t room for creativity. It’s all about making sure that teams are clear on the goals for the case study — along with strategies for supporting content and channels — and understanding how the story fits within the framework of the company’s overall marketing goals.

Here are the basic steps to writing a good case study.

1. Identify your goal

Start by defining exactly who your case study will be designed to help. Case studies are about specific instances where a company works with a customer to achieve a goal. Identify which customers are likely to have these goals, as well as other needs the story should cover to appeal to them.

The answer is often found in one of the buyer personas that have been constructed as part of your larger marketing strategy. This can include anything from new leads generated by the marketing team to long-term customers that are being pressed for cross-sell opportunities. In all of these cases, demonstrating value through a relatable customer success story can be part of the solution to conversion.

2. Choose your client or subject

Who you highlight matters. Case studies tie brands together that might otherwise not cross paths. A writer will want to ensure that the highlighted customer aligns with their own company’s brand identity and offerings. Look for a customer with positive name recognition who has had great success with a product or service and is willing to be an advocate.

The client should also match up with the identified target audience. Whichever company or individual is selected should be a reflection of other potential customers who can see themselves in similar circumstances, having the same problems and possible solutions.

Some of the most compelling case studies feature customers who:

Switch from one product or service to another while naming competitors that missed the mark.
Experience measurable results that are relatable to others in a specific industry.
Represent well-known brands and recognizable names that are likely to compel action.
Advocate for a product or service as a champion and are well-versed in its advantages.

Whoever or whatever customer is selected, marketers must ensure they have the permission of the company involved before getting started. Some brands have strict review and approval procedures for any official marketing or promotional materials that include their name. Acquiring those approvals in advance will prevent any miscommunication or wasted effort if there is an issue with their legal or compliance teams.

3. Conduct research and compile data

Substantiating the claims made in a case study — either by the marketing team or customers themselves — adds validity to the story. To do this, include data and feedback from the client that defines what success looks like. This can be anything from demonstrating return on investment (ROI) to a specific metric the customer was striving to improve. Case studies should prove how an outcome was achieved and show tangible results that indicate to the customer that your solution is the right one.

This step could also include customer interviews. Make sure that the people being interviewed are key stakeholders in the purchase decision or deployment and use of the product or service that is being highlighted. Content writers should work off a set list of questions prepared in advance. It can be helpful to share these with the interviewees beforehand so they have time to consider and craft their responses. One of the best interview tactics to keep in mind is to ask questions where yes and no are not natural answers. This way, your subject will provide more open-ended responses that produce more meaningful content.

4. Choose the right format

There are a number of different ways to format a case study. Depending on what you hope to achieve, one style will be better than another. However, there are some common elements to include, such as:

An engaging headline
A subject and customer introduction
The unique challenge or challenges the customer faced
The solution the customer used to solve the problem
The results achieved
Data and statistics to back up claims of success
A strong call to action (CTA) to engage with the vendor

It’s also important to note that while case studies are traditionally written as stories, they don’t have to be in a written format. Some companies choose to get more creative with their case studies and produce multimedia content, depending on their audience and objectives. Case study formats can include traditional print stories, interactive web or social content, data-heavy infographics, professionally shot videos, podcasts, and more.

5. Write your case study

We’ll go into more detail later about how exactly to write a case study, including templates and examples. Generally speaking, though, there are a few things to keep in mind when writing your case study.

Be clear and concise. Readers want to get to the point of the story quickly and easily, and they’ll be looking to see themselves reflected in the story right from the start.
Provide a big picture. Always make sure to explain who the client is, their goals, and how they achieved success in a short introduction to engage the reader.
Construct a clear narrative. Stick to the story from the perspective of the customer and what they needed to solve instead of just listing product features or benefits.
Leverage graphics. Incorporating infographics, charts, and sidebars can be a more engaging and eye-catching way to share key statistics and data in readable ways.
Offer the right amount of detail. Most case studies are one or two pages with clear sections that a reader can skim to find the information most important to them.
Include data to support claims. Show real results — both facts and figures and customer quotes — to demonstrate credibility and prove the solution works.

6. Promote your story

Marketers have a number of options for distribution of a freshly minted case study. Many brands choose to publish case studies on their website and post them on social media. This can help support SEO and organic content strategies while also boosting company credibility and trust as visitors see that other businesses have used the product or service.

Marketers are always looking for quality content they can use for lead generation. Consider offering a case study as gated content behind a form on a landing page or as an offer in an email message. One great way to do this is to summarize the content and tease the full story available for download after the user takes an action.

Sales teams can also leverage case studies, so be sure they are aware that the assets exist once they’re published. Especially when it comes to larger B2B sales, companies often ask for examples of similar customer challenges that have been solved.

Now that you’ve learned a bit about case studies and what they should include, you may be wondering how to start creating great customer story content. Here are a couple of templates you can use to structure your case study.

Template 1 — Challenge-solution-result format

Start with an engaging title. This should be fewer than 70 characters long for SEO best practices. One of the best ways to approach the title is to include the customer’s name and a hint at the challenge they overcame in the end.
Create an introduction. Lead with an explanation as to who the customer is, the need they had, and the opportunity they found with a specific product or solution. Writers can also suggest the success the customer experienced with the solution they chose.
Present the challenge. This should be several paragraphs long and explain the problem the customer faced and the issues they were trying to solve. Details should tie into the company’s products and services naturally. This section needs to be the most relatable to the reader so they can picture themselves in a similar situation.
Share the solution. Explain which product or service offered was the ideal fit for the customer and why. Feel free to delve into their experience setting up, purchasing, and onboarding the solution.
Explain the results. Demonstrate the impact of the solution they chose by backing up their positive experience with data. Fill in with customer quotes and tangible, measurable results that show the effect of their choice.
Ask for action. Include a CTA at the end of the case study that invites readers to reach out for more information, try a demo, or learn more — to nurture them further in the marketing pipeline. What you ask of the reader should tie directly into the goals that were established for the case study in the first place.

Template 2 — Data-driven format

Start with an engaging title. Be sure to include a statistic or data point in the first 70 characters. Again, it’s best to include the customer’s name as part of the title.
Create an overview. Share the customer’s background and a short version of the challenge they faced. Present the reason a particular product or service was chosen, and feel free to include quotes from the customer about their selection process.
Present data point 1. Isolate the first metric that the customer used to define success and explain how the product or solution helped to achieve this goal. Provide data points and quotes to substantiate the claim that success was achieved.
Present data point 2. Isolate the second metric that the customer used to define success and explain what the product or solution did to achieve this goal. Provide data points and quotes to substantiate the claim that success was achieved.
Present data point 3. Isolate the final metric that the customer used to define success and explain what the product or solution did to achieve this goal. Provide data points and quotes to substantiate the claim that success was achieved.
Summarize the results. Reiterate the fact that the customer was able to achieve success thanks to a specific product or service. Include quotes and statements that reflect customer satisfaction and suggest they plan to continue using the solution.
Ask for action. Include a CTA at the end of the case study that asks readers to reach out for more information, try a demo, or learn more — to further nurture them in the marketing pipeline. Again, remember that this is where marketers can look to convert their content into action with the customer.

While templates are helpful, seeing a case study in action can also be a great way to learn. Here are some examples of how Adobe customers have experienced success.

Juniper Networks

One example is the Adobe and Juniper Networks case study , which puts the reader in the customer’s shoes. The beginning of the story quickly orients the reader so that they know exactly who the article is about and what they were trying to achieve. Solutions are outlined in a way that shows Adobe Experience Manager is the best choice and a natural fit for the customer. Along the way, quotes from the client are incorporated to help add validity to the statements. The results in the case study are conveyed with clear evidence of scale and volume using tangible data.

The story of Lenovo’s journey with Adobe is one that spans years of planning, implementation, and rollout. The Lenovo case study does a great job of consolidating all of this into a relatable journey that other enterprise organizations can see themselves taking, despite the project size. This case study also features descriptive headers and compelling visual elements that engage the reader and strengthen the content.

Tata Consulting

When it comes to using data to show customer results, this case study does an excellent job of conveying details and numbers in an easy-to-digest manner. Bullet points at the start break up the content while also helping the reader understand exactly what the case study will be about. Tata Consulting used Adobe to deliver elevated, engaging content experiences for a large telecommunications client of its own — an objective that’s relatable for a lot of companies.

Case studies are a vital tool for any marketing team as they enable you to demonstrate the value of your company’s products and services to others. They help marketers do their job and add credibility to a brand trying to promote its solutions by using the experiences and stories of real customers.

When you’re ready to get started with a case study:

Think about a few goals you’d like to accomplish with your content.
Make a list of successful clients that would be strong candidates for a case study.
Reach out to the client to get their approval and conduct an interview.
Gather the data to present an engaging and effective customer story.

Adobe can help

There are several Adobe products that can help you craft compelling case studies. Adobe Experience Platform helps you collect data and deliver great customer experiences across every channel. Once you’ve created your case studies, Experience Platform will help you deliver the right information to the right customer at the right time for maximum impact.

To learn more, watch the Adobe Experience Platform story .

Keep in mind that the best case studies are backed by data. That’s where Adobe Real-Time Customer Data Platform and Adobe Analytics come into play. With Real-Time CDP, you can gather the data you need to build a great case study and target specific customers to deliver the content to the right audience at the perfect moment.

Watch the Real-Time CDP overview video to learn more.

Finally, Adobe Analytics turns real-time data into real-time insights. It helps your business collect and synthesize data from multiple platforms to make more informed decisions and create the best case study possible.

Request a demo to learn more about Adobe Analytics.

https://business.adobe.com/blog/perspectives/b2b-ecommerce-10-case-studies-inspire-you

https://business.adobe.com/blog/basics/business-case

https://business.adobe.com/blog/basics/what-is-real-time-analytics

How to write a case study — examples, templates, and tools card image

An official website of the Department of Health & Human Services

Search All AHRQ Sites
Email Updates

1. Use quotes to search for an exact match of a phrase.

2. Put a minus sign just before words you don't want.

3. Enter any important keywords in any order to find entries where all these terms appear.

The PSNet Collection
All Content
Perspectives
Current Weekly Issue
Past Weekly Issues
Curated Libraries
Clinical Areas
Patient Safety 101
The Fundamentals
Training and Education
Continuing Education
WebM&M: Case Studies
Training Catalog
Submit a Case
Improvement Resources
Innovations
Submit an Innovation
About PSNet
Editorial Team
Technical Expert Panel

Leading quality and safety on the frontline - a case study of department leaders in nursing homes.

Magerøy M, Braut GS, Macrae C, et al. Leading quality and safety on the frontline - a case study of department leaders in nursing homes. J Healthc Leadersh. 2024;16:193-208. doi:10.2147/jhl.s454109.

Nursing homes face serious, ongoing patient safety challenges. This qualitative data analysis identified challenges and facilitators that are experienced by nursing home leaders in Norway as they manage the dual responsibilities of Health, Safety and Environment (HSE) and Quality and Patient Safety (QPS). The analysis identified four themes – temporal capacity, relational capacity, professional competence , and organizational structure – highlighting the importance of adequate resources , teamwork, and strong organizational safety culture .

Healthcare leaders' and elected politicians' approach to support-systems and requirements for complying with quality and safety regulation in nursing homes - a case study. September 13, 2023

Managing patient safety and staff safety in nursing homes: exploring how leaders of nursing homes negotiate their dual responsibilities- a case study. February 28, 2024

Investigating hospital supervision: a case study of regulatory inspectors' roles as potential co-creators of resilience. April 14, 2021

Resilience from a stakeholder perspective: the role of next of kin in cancer care. September 23, 2020

Positive deviance: a different approach to achieving patient safety. August 20, 2014

Determination of health-care teamwork training competencies: a Delphi study. December 2, 2009

Naming the "baby" or the "beast"? The importance of concepts and labels in healthcare safety investigation. April 5, 2023

Issues and complexities in safety culture assessment in healthcare. July 19, 2023

The patient died: what about involvement in the investigation process? June 24, 2020

Tools for establishing a sustainable safety culture within maternity services: a retrospective case study. April 26, 2023

Using the WHO International Classification of patient safety framework to identify incident characteristics and contributing factors for medical or surgical complication deaths October 2, 2019

Back to basics: checklists in aviation and healthcare. June 17, 2015

Results of a medication reconciliation survey from the 2006 Society of Hospital Medicine national meeting. January 14, 2009

Patient safety risks associated with telecare: a systematic review and narrative synthesis of the literature. January 7, 2015

Designing and pilot testing of a leadership intervention to improve quality and safety in nursing homes and home care (the SAFE-LEAD intervention). August 14, 2019

Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries. March 27, 2013

Linking transformational leadership, patient safety culture and work engagement in home care services. January 29, 2020

How does the WHO Surgical Safety Checklist fit with existing perioperative risk management strategies? An ethnographic study across surgical specialties. March 18, 2020

Exploring challenges in quality and safety work in nursing homes and home care - a case study as basis for theory development. April 29, 2020

Family perceptions of medication administration at school: errors, risk factors, and consequences. April 16, 2008

Remembering to learn: the overlooked role of remembrance in safety improvement. December 7, 2016

Delivering high reliability in maternity care: in situ simulation as a source of organisational resilience. July 10, 2019

Learning from failure: the need for independent safety investigation in healthcare. November 19, 2014

The problem with incident reporting. October 28, 2015

Investigating for improvement? Five strategies to ensure national patient safety investigations improve patient safety. June 5, 2019

Can we import improvements from industry to healthcare? May 1, 2019

Governing the safety of artificial intelligence in healthcare. May 8, 2019

The harm susceptibility model: a method to prioritise risks identified in patient safety reporting systems. June 9, 2010

Early warnings, weak signals and learning from healthcare disasters. April 9, 2014

Imitating incidents: how simulation can improve safety investigation and learning from adverse events. June 27, 2018

Measurement and monitoring of safety: impact and challenges of putting a conceptual framework into practice. April 11, 2018

Safety analysis over time: seven major changes to adverse event investigation. January 24, 2018

Learning from patient safety incidents: creating participative risk regulation in healthcare. February 27, 2008

Communication and information deficits in patients discharged to rehabilitation facilities: an evaluation of five acute care hospitals. October 28, 2009

Deficits in discharge documentation in patients transferred to rehabilitation facilities on anticoagulation: results of a systemwide evaluation. August 6, 2008

Transformational improvement in quality care and health systems: the next decade. November 25, 2020

"Time is of the essence": relationship between hospital staff perceptions of time, safety attitudes and staff wellbeing. December 8, 2021

Dimensions of safety culture: a systematic review of quantitative, qualitative and mixed methods for assessing safety culture in hospitals. September 1, 2021

Unsafe care in residential settings for older adults. A content analysis of accreditation reports. December 13, 2023

Improving patient safety governance and systems through learning from successes and failures: qualitative surveys and interviews with international experts. December 6, 2023

Predictors of response rates of safety culture questionnaires in healthcare: a systematic review and analysis. October 26, 2022

Comparing rates of adverse events detected in incident reporting and the Global Trigger Tool: a systematic review. August 16, 2023

COVID-19: patient safety and quality improvement skills to deploy during the surge. June 24, 2020

A qualitative content analysis of retained surgical items: learning from root cause analysis investigations. May 27, 2020

Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals. October 8, 2014

Harnessing implementation science to improve care quality and patient safety: a systematic review of targeted literature. May 21, 2014

'Between the flags': implementing a rapid response system at scale. May 14, 2014

Health service accreditation as a predictor of clinical and organisational performance: a blinded, random, stratified study. March 24, 2010

Improving patient safety: the comparative views of patient-safety specialists, workforce staff and managers. January 30, 2005

Learning from disasters to improve patient safety: applying the generic disaster pathway to health system errors. February 9, 2011

Beyond patient safety Flatland. June 30, 2010

Cultural and associated enablers of, and barriers to, adverse incident reporting. June 23, 2010

Nurses' workarounds in acute healthcare settings: a scoping review. June 19, 2013

Investigating patient safety culture across a health system: multilevel modelling of differences associated with service types and staff demographics. July 25, 2012

Analysis of Australian newspaper coverage of medication errors. January 25, 2012

Health professional networks as a vector for improving healthcare quality and safety: a systematic review. January 11, 2012

Effects of two commercial electronic prescribing systems on prescribing error rates in hospital in-patients: a before and after study. February 15, 2012

'Broken hospital windows': debating the theory of spreading disorder and its application to healthcare organizations. May 9, 2018

Changing how we think about healthcare improvement. June 13, 2018

Association between organisational and workplace cultures, and patient outcomes: systematic review. January 17, 2018

The application of the Global Trigger Tool: a systematic review. October 26, 2016

False dawns and new horizons in patient safety research and practice. December 20, 2017

Implementation of a patient safety incident management system as viewed by doctors, nurses and allied health professionals. May 6, 2009

A root cause analysis of clinical error: confronting the disjunction between formal rules and situated clinical activity. May 31, 2006

Attitudes toward the large-scale implementation of an incident reporting system. April 9, 2008

Experiences of health professionals who conducted root cause analyses after undergoing a safety improvement programme. December 20, 2006

Turning the medical gaze in upon itself: root cause analysis and the investigation of clinical error. October 26, 2005

The effect of physicians' long-term use of CPOE on their test management work practices. September 27, 2006

Incidence, origins and avoidable harm of missed opportunities in diagnosis: longitudinal patient record review in 21 English general practices. June 30, 2021

Educational levels of hospital nurses and surgical patient mortality. April 3, 2005

A systematic narrative review of coroners’ Prevention of Future Deaths reports (PFDs): a tool for patient safety in hospitals. November 1, 2023

Quality gaps identified through mortality review. February 1, 2017

Assessing the impact of teaching patient safety principles to medical students during surgical clerkships. July 20, 2011

Medical errors: mandatory reporting, voluntary reporting, or both? August 10, 2005

Journal Article

Implementation of a medication reconciliation risk stratification tool integrated within an electronic health record: a case series of three academic medical centers.

Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study. May 19, 2021

What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study. April 12, 2023

Handoff practices in emergency medicine: are we making progress? March 23, 2016

Preventability and causes of readmissions in a national cohort of general medicine patients. May 4, 2016

Project BOOST implementation: lessons learned. September 10, 2014

Making inpatient medication reconciliation patient centered, clinically relevant and implementable: a consensus statement on key principles and necessary first steps. October 27, 2010

Process changes to increase compliance with the Universal Protocol for bedside procedures. June 1, 2011

Single-parameter early warning criteria to predict life-threatening adverse events. June 23, 2010

Impact of an automated email notification system for results of tests pending at discharge: a cluster-randomized controlled trial. November 27, 2013

Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: a randomized trial. July 18, 2012

Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial. May 23, 2012

Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization. August 21, 2013

A toolkit to disseminate best practices in inpatient medication reconciliation: Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS). July 31, 2013

Design and implementation of an automated email notification system for results of tests pending at discharge. February 29, 2012

The impact of automated notification on follow-up of actionable tests pending at discharge: a cluster-randomized controlled trial. April 11, 2018

Curriculum development and implementation of a national interprofessional fellowship in patient safety. September 5, 2018

Readiness of US general surgery residents for independent practice. October 4, 2017

The HOSPITAL score predicts potentially preventable 30-day readmissions in conditions targeted by the Hospital Readmissions Reduction Program. June 14, 2017

Medication safety in a psychiatric hospital. March 21, 2007

A controlled trial of a rapid response system in an academic medical center. June 25, 2008

Adverse events related to accidental unintentional ingestions from cough and cold medications in children. August 26, 2020

Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions. June 23, 2021

Nurses' experience with presenteeism and the potential consequences on patient safety: a qualitative study among nurses at out-of-hours emergency primary care facilities. January 10, 2024

Medication dosage calculation among nursing students: does digital technology make a difference? A literature review. September 14, 2022

Clinical efficacy of combined surgical patient safety system and the World Health Organization's checklists in surgery: a nonrandomized clinical trial. June 3, 2020

Patient Safety Primers

Long-term Care and Patient Safety

Annual Perspective

Special Section: IEA Health Care 2021. February 28, 2024

Patient safety in nursing homes from an ecological perspective: an integrated review. January 17, 2024

National Healthcare Quality and Disparities Reports. January 9, 2024

Nurses' perspectives on medication errors and prevention strategies in residential aged care facilities through a national survey. December 20, 2023

The relationship between nursing home staffing and resident safety outcomes: a systematic review of reviews. December 6, 2023

Innovative approaches to analysing aged care falls incident data: International Classification for Patient Safety and correspondence analysis. November 8, 2023

Early identification and evaluation of severe pressure injuries. October 18, 2023

Exploring medication safety structures and processes in nursing homes: a cross-sectional study. August 30, 2023

Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety. August 16, 2023

Long-term care healthcare-associated infections in 2022: an analysis of 20,216 reports. May 24, 2023

WebM&M Cases

Efforts to improve the safety culture of the elderly in nursing homes: a qualitative study. April 19, 2023

Factors differentiating nursing homes with strong resident safety climate: a qualitative study of leadership and staff perspectives. February 15, 2023

New AHRQ SOPS Workplace Safety Supplemental Item Set for Nursing Homes. February 15, 2023

Surveys on Patient Safety Culture Nursing Home Survey: 2023 User Database Report. February 8, 2023

Nursing home patient safety culture perceptions among licensed practical nurses. February 1, 2023

Interventions to increase patient safety in long-term care facilities-umbrella review. January 25, 2023

Patient safety measurement tools used in nursing homes: a systematic literature review. December 7, 2022

Patient safety culture in assisted living: staff perceptions and association with state regulations. November 30, 2022

Reinforcing the Value and Roles of Nurses in Diagnostic Safety: Pragmatic Recommendations for Nurse Leaders and Educators. October 5, 2022

Nursing Home Survey on Patient Safety Culture. August 31, 2022

Accuracy of pressure ulcer events in US nursing home ratings. August 24, 2022

Using health information technology in residential aged care homes: an integrative review to identify service and quality outcomes. August 17, 2022

Communication disparities between nursing home team members. July 20, 2022

Long-term care healthcare-associated infections in 2021: an analysis of 17,971 reports. July 13, 2022

Supplemental Item Set for Nursing Home SOPS: Call for Pilot Participants. July 6, 2022

Connect With Us

Sign up for Email Updates

To sign up for updates or to access your subscriber preferences, please enter your email address below.

Agency for Healthcare Research and Quality

5600 Fishers Lane Rockville, MD 20857 Telephone: (301) 427-1364

Accessibility
Disclaimers
Electronic Policies
HHS Digital Strategy
HHS Nondiscrimination Notice
Inspector General
Plain Writing Act
Privacy Policy
Viewers & Players
U.S. Department of Health & Human Services
The White House
Don't have an account? Sign up to PSNet

Submit Your Innovations

Please select your preferred way to submit an innovation.

Continue as a Guest

Track and save your innovation

in My Innovations

Edit your innovation as a draft

Continue Logged In

Please select your preferred way to submit an innovation. Note that even if you have an account, you can still choose to submit an innovation as a guest.

Continue logged in

New users to the psnet site.

Access to quizzes and start earning

CME, CEU, or Trainee Certification.

Get email alerts when new content

matching your topics of interest

in My Innovations.

From Good to Great in Puerto Rico

Taking pedagogical practices to the next level, the challenge, insight + courage + action, developing a high-quality spanish literacy program.

Vimenti School in San Juan, Puerto Rico, is a dual language K-6 school, serving 274 students with 36 teachers. The school is a two-generation project committed to the economic development of families and whose mission is the eradication of child poverty in Puerto Rico. Since the pandemic’s interruptions, Vimenti has focused primarily on strengthening language skills in students’ first language—Spanish. The school’s leaders knew that getting instruction right was critical for their students, as a strong academic foundation is a key factor in ensuring young people have multiple pathways to thriving lives and careers.

While there was potential and readiness for change, the school faced a challenge: How could they elevate teacher practice in Spanish language arts and empower students to become proficient readers, writers, and thinkers in their native language?

Multilingual learners do best when teachers celebrate the linguistic and cultural assets that they bring to the classroom. With that in mind, Vimenti leaders wanted to provide their teachers with concrete models of what high-quality teaching and learning looks like in Spanish. In 2023, they brought in TNTP’s signature in-service teacher professional development program, Good to Great , which strengthens teacher practice by centering high-quality instructional materials and leading teachers through carefully structured cycles of planning, teaching, and reflection. Since 2015, TNTP has led this program with over 700 teachers in 12 states, focusing on multiple subjects and grade-bands and a range of student populations.

Working closely with the leadership team at Vimenti, TNTP began with an analysis of the school’s current instructional landscape for Spanish language arts. This important step helped us better understand the learning environment, the teachers, and the students. Based on that deeper awareness, TNTP created a tailored approach that would coach educators on how they could better meet their students’ needs. The customized professional development and teaching intensive program consisted of three core components:

1. School Landscape Analysis – Listening and Learning:

Led focus groups with teachers
Conducted classroom observations
Completed a curriculum audit
Met with school leaders

2. Professional Development:

Co-constructed an instructional vision
Built deep understanding of teacher identities
Focused on pedagogical practices of close reading and daily writing, effective question sequences and lesson internalization

3. Teaching Intensive:

K-6 teachers implemented one week of lessons during their morning reading block.
Every afternoon teachers participated in reflection and planning sessions to analyze student work and prepare for the next day’s instruction.

We invited educators to dive deeply into the importance of high expectations and grade-appropriate assignments for their students. During the one-week teaching intensive, Vimenti teachers spent the morning reading blocks implementing lessons and devoted the afternoons to reflection and planning sessions.

From Developing Lessons to Lessons Learned

The TNTP team developed grade-appropriate lessons for teachers to implement, offered intensive professional development, accompanied them during their instruction, and facilitated guided reflection of student achievement so they could successfully plan for the next day’s instruction. Seeing students succeed showed Vimenti teachers what their students were capable of, and in turn, raised teachers’ own expectations for how they must structure instruction to boost academic achievement.

Had I seen a [close reading] question like this… I am 95% sure I would have said ‘skip that one, you will not be able to answer it’… but exposing them was good and led to great results.”” — Third-grade teacher, Vimenti School

Higher Teacher Expectations Lead to Increased Student Engagement

When we compared classroom observation data between the first and last observations, the results were dramatic. The percentage of students responsible for thinking in the classroom jumped to 75 percent, a stark contrast from initial observations where this was only observed sparingly if at all. Similarly, work requiring students to use textual details to demonstrate understanding saw similar gains. The percentage of teachers indicating high expectations for their students also increased from 50 percent to 67 percent after the one-week teaching institute.

Horizontal bar chart with the title, "Overall, are all students responsible for doing the thinking in this classroom?" First observation: 25% somewhat; 75% not yet. Second observation: 75% mostly, 12.5% somewhat, 12.5% not yet.

Following the institute, one second-grade teacher shared, “[Students] are more capable than we give them credit for… you realize that they could do it… we put limitations on them ourselves.”

Teachers weren’t the only ones recognizing this mindset shift. We started and ended the program by administering student surveys, to ensure students had a voice in evaluating their academic experiences. Student sentiment improved over the week, with more students reporting that their teachers’ higher expectations encouraged them to do their best in class. Blending high expectations, solid instruction, and grade-level content, including culturally relevant texts, had begun to unlock immense potential for both students and teachers.

Horizontal bar chart with the title, "In general, how high are your teacher's expectations of your performance" Before training: 47% very high; 20% high; 17% somewhat high; 12% a little high; 4% not high. After training: 53% very high; 23% high; 17% somewhat high; 5% a little high; 4% not high.

Through our customized professional learning experience, TNTP created opportunities for Vimenti’s teachers to jumpstart instructional improvement and challenge their expectations of what their students could achieve. Teachers could see the immediate impact of their instructional improvements in real time, and with coaching support, began to shift the ownership of the learning process to their students. In just one week, students wrote significantly longer responses to questions, included more evidence from the text in their answers, and dove into more complex topics, demonstrating a deeper understanding of the texts.

In partnership with school leaders, we ensured Vimenti’s teachers worked with high-quality, culturally relevant texts that were on the appropriate grade level for their students, empowering them to focus on accelerating learning for students, rather than on struggling to catch up from pandemic setbacks. Overall, Vimenti’s teachers and students had the chance to discover and develop new identities for themselves as educators and learners. The strong results give us confidence that the Good to Great summer institute catalyzed a continuous improvement cycle that will have an ongoing impact for Vimenti students.

Stay in the Know

" * " indicates required fields

Kids backpacks hang on hooks in a hallway.

Case Study | May 14, 2024

Good to Great en Puerto Rico

TNTP ofreció desarrollo profesional a docentes de Español de nivel elemental en San Juan, Puerto Rico.

Teacher works at his laptop with a bookshelf behind him.

Blog Post | May 8, 2024

Innovative Educator Prep Program Centers HQIM and Research-Based Teaching Methods

A community college sees increased enrollment in training programs for new teachers and facilitates social mobility by embedding HQIM in their curricula.

Students sit at desks, concentrating on their work with pencils in hand and laptops nearby.

Blog Post | April 29, 2024

How This High School Network Built a System of Support for Multilingual Learners

Ednovate, a network of six high schools in California, coordinates support for multilingual learners by prioritizing their input and involving leadership.

A teacher sits a table surrounded by four students, all looking at the same book.

Blog Post | April 23, 2024

Ask Them to Stay: Data-Backed Teacher Retention Strategies

TNTP’s Insight surveys show that strategies for retaining teachers can be low-cost and as simple as offering positive feedback and asking them to stay.

Case Study | April 22, 2024

Building a New Foundation with High-Quality Instructional Materials

New Jersey’s Passaic Public Schools and TNTP revamp curriculum with strategic selection of bilingual HQIM and see fast results in student mastery of grade-level standards.

Imali Ariyarathne, seventh-grade teacher at Langston Hughes Academy, stands in front of her students while introducing them to the captivating world of science

Imali Ariyarathne, seventh-grade teacher at Langston Hughes Academy, introduces her students to the captivating world of science.

TNTP is the nation’s leading research, policy, and consulting organization dedicated to transforming America’s public education system, so that every generation thrives.

Today, we work side-by-side with educators, system leaders, and communities across 39 states and over 6,000 districts nationwide to reach ambitious goals for student success.

Yet the possibilities we imagine push far beyond the walls of school and the education field alone. We are catalyzing a movement across sectors to create multiple pathways for young people to achieve academic, economic, and social mobility.

For Individuals
Benefit Leaders and Health Plans
Our Approach
Learning Center

In six months, Prisma Health cut employee MSK pain and likely surgeries in half

Their digital MSK solution has resulted in a 3.6x ROI

Hinge Health Learning Center
Prisma Health Case Study

At Prisma Health, outstanding patient care depends on pain-free employees

Team member well-being is a top priority, south carolina’s largest healthcare organization.

A private, nonprofit company with 18 acute and specialty hospitals, and 320 practice sites

Approximately 29,309 team members serving more than 1.5 million patients annually

Over 5,400 employed and independent clinicians across the clinically integrated inVio Health Network

Like most health systems, cost savings is a primary objective

Quality patient care depends on healthy employees who are pain-free

“I am so thankful for this program. I went on a cruise right before Christmas and had very little to no pain in my foot! It would have been a miserable cruise with the pain I had been having daily for months prior to joining the program and doing the exercises.”

– Prisma Health employee and Hinge Health participant

About Prisma Health

Like most healthcare organizations, many Prisma Health employees have physically demanding jobs. Team members move patients and manipulate equipment around the clock. As a result, it’s common for employees to experience strains and MSK pain.

From an expense perspective, MSK is a significant cost driver for Prisma Health’s benefits plan. Part of Prisma Health’s strategy is to prevent less acute events from turning into severe pain or a surgery.

"[Being] an organization of caregivers means that employees tend to put themselves last, even in the case of their own health," says Antell Mitchell-James, Vice President, Total Rewards & Employee Health, Prisma Health. "We take care of patients, so we can’t not take care of employees. We need to deliver care in a way that engages employees, is accessible, and meets them where they are."

Prisma Health’s workforce and benefits challenges

Prisma Health’s employees have busy and stressful lives. Many have children and some are single parents. Some members rely on public transportation.

Unless healthcare is convenient and easy to access, people may ignore non-acute strains and MSK pain. This can lead to acute conditions that often require costly surgical interventions. And it has.

"MSK is a significant cost driver in our benefit plan," says Mitchell-James. "That’s no surprise when team members lift and move patients every moment of the day and manipulate equipment so we can get the best test results for our patients.”

Although Prisma Health has its own in-house physical therapy (PT) services, many employees and health plan members can’t get to in-person appointments because their schedules don’t align with the PT team’s hours of operation.

Minimizing increases in health plan costs is a high priority for Prisma Health, since the organization is faced with narrow margins like so many healthcare organizations.

"If you can reduce the cost of your health plan, that’s incredible," says Mitchell-James. "A 9% increase in your medical plan year-over-year isn’t sustainable in healthcare. You can’t shift that cost to team members. You need to stay affordable so they can get the care they need.”

Solutions are one thing, but using them is another. In general, healthcare employees can be slow to adopt new programs. Communicating with members about new approaches to MSK pain and engaging people are challenges for the organization.

Prisma Health’s MSK benefits program implementation

The Hinge Health implementation at Prisma Health went smoothly. The benefits team appreciates that Hinge Health assists with member communications, such as periodic home mailers. Prisma Health also uses engagement tools like videos of team members who have successfully used Hinge Health and team member newsletters.

Member adoption and feedback have been positive. At Prisma Health, Hinge Health has a 9.2/10 member program satisfaction rating.

In less than one year, over 2,000 members have engaged in Hinge Health and 35,650 exercise therapy sessions have been completed. Average weekly interactions per participant year to date include:

3 to 4 exercises therapy sessions

2 to 3 care team interactions

1 to 2 education articles read

“Hinge Health was an access play for us," says Mitchell-James. "A single mom or dad can’t take PTO to get to physical therapy. They want to save it for sick kids and they may need to be home at a certain time to care for children.”

Prisma Health’s Hinge Health participants report:

50% reduction in pain in the first 90 days

81% achieved minimal clinically important differences (MCID)

55% reduction in anxiety

42% reduction in depression

50% reduction in surgery likelihood

53% improved productivity

"I’ve been doing this work for more than 25 years, so I’m not easily impressed, says Mitchell-James. "I’ve spent a lot of money trying a lot of things and not getting the results. But, in this case, I was impressed by the early adoption and positive (non-solicited) feedback we have received from our team members about Hinge Health."

Let's get moving.

COMMENTS

Case Studies
Search more than 1,000 examples of case studies sharing quality solutions to real-world problems. Find more case studies Featured Case Studies Classic Case Studies ... - At the same time, the organization concluded that its accreditation process failed to provide a significant challenge, so it returned its "certification" to the auditing body.
11 activity 1
Kyle Caas, BSHM 301-A Case Study: A Challenge for Quality. If you are part of the senior management team of Reliance Control Systems, how will you convince the CEO that implementing the quality standards of ISO 9000 will solve the organizational problem and will result in achieving a greater market share for the company?
Activity TOTAL QUALITY MANAGEMENT
Case Study: A Challenge for Quality. Reliance Control Systems is a large manufacturer of control systems for the electrical power generation and distribution industry. Over the past few years, Reliance has watched overseas competitors take away market share with products that are priced lower and that, at the same time, have developed a ...
Activity: Case Study: A Challenge For Quality
11_Activity_1(7).pdf - Free download as PDF File (.pdf), Text File (.txt) or read online for free. Reliance Control Systems is losing market share to overseas competitors offering lower prices and better reliability. The board wants to improve competitiveness and solve quality issues causing system glitches. Senior management considered adopting ISO 9000 quality standards but the CEO is ...
Top Challenges for Case Study Programs
Together, the panelists identified key challenges facing case study programs at Harvard and beyond: Poor visibility. A searchable index of all available case materials is a fundamental resource, but surprisingly challenging to achieve when instructors write case studies for their own courses. This index must be featured prominently in faculty ...
Case Study: Integrating Strategic Planning and Quality improvement
This case study demonstrates how the combination of strategic planning, project management, and Lean Six Sigma tools can be used to assess and improve an organization's ability to fulfill its mission and goals. ... Collectively, we are the voice of quality, and we increase the use and impact of quality in response to the diverse needs in the ...
Case Study Method: A Step-by-Step Guide for Business Researchers
Case study reporting is as important as empirical material collection and interpretation. The quality of a case study does not only depend on the empirical material collection and analysis but also on its reporting (Denzin & Lincoln, 1998). A sound report structure, along with "story-like" writing is crucial to case study reporting.
Digitalisation and quality management: problems and prospects
Abstract. Digitalisation provides both challenges and opportunities for Quality Management (QM). The purpose of this study is to identify various roles QM practitioners play in digitalisation initiatives to uncover the challenges and potential of QM's digitalisation journey. This issue is addressed through an analytical framework that ...
Continuing to enhance the quality of case study methodology in health
This presents challenges in assessing quality and rigour for researchers conducting case studies and stakeholders reading results. ... Drawing upon a theoretical or conceptual framework to inform analysis improves the quality of case study and avoids the risk of description without meaning. 18 Using Stake's 5 approach, ...
Case Study A Challenge For Quality
Case Study A Challenge for Quality - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. Reliance Control Systems faces organizational problems and wants to improve its competitive position. Implementing ISO 9000 quality standards would solve these issues and increase market share by: 1) Ensuring consistent, high-quality products and services ...
Quality: Articles, Research, & Case Studies on Quality
by by Jim Heskett. A new book by Gregory Clark identifies "labor quality" as the major enticement for capital flows that lead to economic prosperity. By defining labor quality in terms of discipline and attitudes toward work, this argument minimizes the long-term threat of outsourcing to developed economies.
A challenge for good quality
Case Study: A Challenge for Quality. If you are part of the senior management team of Reliance Control Systems, how will you convince the CEO that implementing the quality standards of ISO 9000 will solve the organizational problem and will result in achieving a greater market share for the company?
Case Study A Challenge For Quality
Case Study a Challenge for Quality - Free download as PDF File (.pdf), Text File (.txt) or read online for free. Scribd is the world's largest social reading and publishing site.
Part II
The Case for Case Studies - May 2022. ... Ensuring High-Quality Case Studies. Published online by Cambridge University Press: 05 May 2022 Edited by. ... Here are three examples of descriptive or reporting challenges drawn from ISS case study research and the intellectual process these challenges triggered.
Total quality management: three case studies from around the world
According to Teresa Whitacre, of international consulting firm ASQ, proper quality management also boosts a company's profitability. "Total quality management allows the company to look at their management system as a whole entity — not just an output of the quality department," she says. "Total quality means the organisation looks at ...
The contribution of case study research to knowledge of how to improve
The gap between the knowledge of what works and the widespread adoption of those practices has become a major preoccupation of researchers and a challenge for funders and policy makers.1-3 Recognition of this 'quality chasm' (the term that the US Institute of Medicine used to describe the distance 'between the healthcare we have and the care we could have'4) has led to an increased ...
PDF A Framework for Data Quality: Case Studies October 2023
A Framework for Data Quality: Case Studies, FCSM-23-02 Data Quality Framework Implementation Subcommittee, Federal Committee on Statistical Methodology. October 2023. ... The framework has evolved into a tool for considering data quality challenges in the design of a data . program or analysis, documenting how each challenge is resolved during ...
Evolution of quality assurance practices in enhancing the quality of
The purpose of this study is to look at the challenges and successes that the case institution has had in implementing and maintaining quality assurance (QA) processes. The study also looks into the role of QA techniques in improving an institution's performance in a developing country.,The research is qualitative.
How to write a case study
Case study examples. While templates are helpful, seeing a case study in action can also be a great way to learn. Here are some examples of how Adobe customers have experienced success. Juniper Networks. One example is the Adobe and Juniper Networks case study, which puts the reader in the customer's shoes.
Case Study A Challenge for Quality.docx
Francisco, Clency Kaye D. BSBA 3-1A ACTIVITY Case Study: A Challenge for Quality Reliance Control Systems is a large manufacturer of control systems for the electrical power generation and distribution industry. Over the past few years, Reliance has watched overseas competitors take away market share with products that are priced lower and that, at the same time, have developed a reputation ...
15 Real-Life Case Study Examples & Best Practices
15 Real-Life Case Study Examples. Now that you understand what a case study is, let's look at real-life case study examples. In this section, we'll explore SaaS, marketing, sales, product and business case study examples with solutions. Take note of how these companies structured their case studies and included the key elements.
Case Study
View Case Study - A Challenge for Quality.docx from STI 123456 at STI College (multiple campuses). CASE STUDY: A Challenge for Quality 1. If you are part of the senior management team of Reliance
Case Study Methodology of Qualitative Research: Key Attributes and
A case study is one of the most commonly used methodologies of social research. This article attempts to look into the various dimensions of a case study research strategy, the different epistemological strands which determine the particular case study type and approach adopted in the field, discusses the factors which can enhance the effectiveness of a case study research, and the debate ...
Leading quality and safety on the frontline
Nursing homes face serious, ongoing patient safety challenges. This qualitative data analysis identified challenges and facilitators that are experienced by nursing home leaders in Norway as they manage the dual responsibilities of Health, Safety and Environment (HSE) and Quality and Patient Safety (QPS). The analysis identified four themes - temporal capacity, relational capacity ...
AHRQ Seeks Examples of Impact for Development of Impact Case Studies
Since 2004, the agency has developed more than 400 Impact Case Studies that illustrate AHRQ's contributions to healthcare improvement. Available online and searchable via an interactive map , the Impact Case Studies help to tell the story of how AHRQ-funded research findings, data and tools have made an impact on the lives of millions of ...
Lean Six Sigma and Industry 4.0 implementation framework for
This study follows a combined approach including a systematic literature review to identify existing gaps in recent research and an expert panel to provide valuable insights and validation during the development of the framework. Additionally, a case study was conducted in an automotive manufacturing company to validate the findings.
From Good to Great in Puerto Rico
Vimenti School in San Juan, Puerto Rico, is a dual language K-6 school, serving 274 students with 36 teachers. The school is a two-generation project committed to the economic development of families and whose mission is the eradication of child poverty in Puerto Rico. Since the pandemic's interruptions, Vimenti has focused primarily on ...
Prisma Health cut employee pain and likely surgeries in half
At Prisma Health, Hinge Health has a 9.2/10 member program satisfaction rating. In less than one year, over 2,000 members have engaged in Hinge Health and 35,650 exercise therapy sessions have been completed. Average weekly interactions per participant year to date include: 3 to 4 exercises therapy sessions. 2 to 3 care team interactions.
The Benefits of National Digital Health in a Short Story
Data Interoperability: Addressing the Challenges Placing Quality Healthcare at Risk. The data interoperability challenge in global digital health, as experienced in the context of the variety of national electronic health record (EHR) deployments around the world, should have been avoidable. ... Case Study. Fisher & Paykel Healthcare ...
Kevlar Drive Belts for Precise Rotational Control: Case Study
Case Study: Gear Manufacturing for Aerospace Applications. Date: May 08, 2024. View Blog Measuring Gear Tooth Strength: A Simple Guide for Engineers. Date: April 23, 2024. View Blog Case Study: Lube-Free Roller Chain for Antenna Positioning System. Date: April 19, 2024. View Blog