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• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyze the case, other interesting articles.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

Unlike quantitative or experimental research , a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

However, you can also choose a more common or representative case to exemplify a particular category, experience or phenomenon.

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews , observations , and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

The aim is to gain as thorough an understanding as possible of the case and its context.

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In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis , with separate sections or chapters for the methods , results and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyze its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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• v.11(2); 2022

Defining case management success: a qualitative study of case manager perspectives from a large-scale health and social needs support program

Margae knox.

1 School of Public Health, University of California, Berkeley, Berkeley, California, USA

Emily E Esteban

2 Contra Costa Health Services, Martinez, California, USA

Elizabeth A Hernandez

Mark d fleming, nadia safaeinilli, amanda l brewster, associated data.

No data are available. Data are not publicly available to protect potentially sensitive information. For data inquiries, please contact the corresponding author.

Health systems are expanding efforts to address health and social risks, although the heterogeneity of early evidence indicates need for more nuanced exploration of how such programs work and how to holistically assess program success. This qualitative study aims to identify characteristics of success in a large-scale, health and social needs case management program from the perspective of interdisciplinary case managers.

Case management program for high-risk, complex patients run by an integrated, county-based public health system.

Participants

30 out of 70 case managers, purposively sampled to represent their interdisciplinary health and social work backgrounds. Interviews took place in March–November 2019.

Primary and secondary outcome measures

The analysis intended to identify characteristics of success working with patients.

Case managers described three characteristics of success working with patients: (1) establishing trust; (2) observing change in patients’ mindset or initiative and (3) promoting stability and independence. Cross-cutting these characteristics, case managers emphasised the importance of patients defining their own success, often demonstrated through individualised, incremental progress. Thus, moments of success commonly contrasted with external perceptions and operational or productivity metrics.

Conclusions

Themes emphasise the importance of compassion for complexity in patients’ lives, and success as a step-by-step process that is built over longitudinal relationships.

What is already known on this topic?

• Case management programs to support health and social needs have demonstrated promising yet mixed results. Underlying mechanisms and shared definitions of successful case management are underdeveloped.

What this study adds?

• Case managers emphasised building trust over time and individual, patient-defined objectives as key markers of success, a contrast to commonly used quantitative evaluation metrics.

How this study might affect research, practice or policy?

• Results suggest that lighter touch case management interventions face limitations without an established patient relationship. Results also support a need for alternative definitions of case management success including patient-centered measures such as trust in one’s case manager.

Introduction

Health system efforts to address both health and social needs are expanding. In the USA, some state Medicaid programmes are testing payments for non-medical services to address transportation, housing instability and food insecurity. Medicaid provides healthcare coverage for lower income individuals and families, jointly funded by federal and state governments. Similarly, social prescribing, or the linking of patients with social needs to community resources, is supported by the UK’s National Health Service and has also been piloted by Canada’s Alliance for Healthier Communities. 1

A growing evidence base suggests promising outcomes from healthcare interventions addressing social needs. In some contexts, case managers or navigators providing social needs assistance can improve health 2 and reduce costly hospital use. 3–5 Yet systematic reviews also report mixed results for measures of health and well-being, hospitalisation and emergency department use, and overall healthcare costs. 6–9 Notably, a randomised trial of the Camden Care Coalition programme for patients with frequent hospitalisations due to medically and socially complex needs 10 found no difference in 180-day readmission between patients assigned to a care transitions programme compared with usual hospital postdischarge care. In the care transition programme, patients received follow-up from a multidisciplinary team of nurses, social workers and community health workers. The team conducted home visits, scheduled and accompanied patients to follow-up outpatient visits, helped with managing medications, coached patients on self-care and connected patients with social services and behavioural healthcare. The usual care group received usual postdischarge care with limited follow-up. 11 This heterogeneity of early evidence indicates a need for more nuanced explorations of how social needs assistance programmes work, and how to holistically assess whether programmes are successful. 12 13

Social needs case management may lead to health and well-being improvements through multiple pathways involving both material and social support. 14 15 Improvements are often a long-term, non-linear process. 16 17 At the same time, quality measures specific to social needs assistance programmes currently remain largely undefined. Studies often analyse utilisation and cost outcomes but lack granularity on interim processes and markers of success.

In order to translate a complex and context-dependent intervention like social needs case management from one setting to another, these interim processes and outcomes need greater recognition. 18–20 Early efforts to refine complex care measures are underway and call out a need for person-centred and goal-concordant measures. 21 Further research on how frontline social needs case managers themselves define successes in their work could help leaders improve programme design and management and could also inform broader quality measure development efforts.

Our in-depth, qualitative study sought to understand how case managers defined success in their work with high-risk patients. Case managers were employed by CommunityConnect, a large-scale health and social needs care management programme that serves a mixed-age adult population with varying physical health, mental health and social needs. Each case manager’s workflow includes an individualised, regularly updated dashboard of operational metrics. It is unclear, however, whether or how these operational factors relate to patient success in a complex care programme. Thus, the case managers’ perspectives on defining success are critical for capturing how programmes work and identifying essential principles.

Study design and setting

In 2017, the Contra Costa County Health Services Department in California launched CommunityConnect, a case management programme to coordinate health, behavioural health and social services for County Medicaid patients with complex health and social conditions. The County Health Services Department serves approximately 15% (180 000) of Contra Costa’s nearly 1.2 million residents. CommunityConnect enrollees were selected based on a predictive model, which leveraged data from multiple county systems to identify individuals most likely to use hospital or emergency room services for preventable reasons. Enrollees are predominantly women (59%) and under age 40 (49%). Seventy-seven per cent of enrollees have more than one chronic condition, particularly hypertension (42%), mood disorders (40%) and chronic pain (35%). 22 Programme goals include improving beneficiary health and well-being through more efficient and effective use of resources.

Each case manager interviewed in this study worked full time with approximately 90 patients at a time. Case managers met patients in-person, ideally at least once a month for 1 year, although patients sometimes continue to receive ongoing support at the case manager’s discretion in cases of continued need. Overall, up to 6000 individuals at a time receive in-person case management services through CommunityConnect, with approximately 200–300 added and 200–300 graduated per month. At the time of the study, CommunityConnect employed approximately 70 case managers trained in various public health and social work disciplines (see table 1 , Interview Sample). Case managers and patients are matched based on an algorithm that prioritises mental health history, primary language and county region.

Interview sample

Although case managers bring unique experience from their respective discipline, all are expected to conduct similar case management services. Services included discussing any unmet social needs with patients, coordinating applicable resources and partnering with the patient and patient’s care team to improve physical and emotional health. The programme tracks hospital and emergency department utilisation as well as patient benefits such as food stamps, housing or transportation vouchers and continuous Medicaid coverage on an overall basis. Each case manager has access to an individualised dashboard that includes operational metrics such as new patients to contact, and frequency of patient contacts, timeliness for calling patients recently discharged from the hospital, whether patients have continuous Medicaid coverage, and completion of social risk screenings.

Study recruitment

Semistructured interviews were conducted with 30 field-based case managers as part of the programme’s evaluation and quality improvement process. Participants included four mental health clinical specialists, five substance abuse counsellors, six social workers, nine public health nurses, four housing support specialists and two community health worker specialists. Case managers were recruited by email and selected based on purposive sampling to reflect membership across disciplines and experience working with CommunityConnect for at least 1 year. Three case managers declined to participate. Interviews ended when data saturation was achieved. 23

Interview procedures

Interviews were conducted by five CommunityConnect evaluation staff members (including EEE), who received training and supervision from the evaluation director (EH), who also conducted interviews. The evaluation staff were bachelor and masters-level trained. The evaluation director was masters-level trained and held prior experience in healthcare quality and programme planning.

The evaluation team drafted the interview guide to ask about a variety of work processes and experiences with the goal of improving programme operations including staff and patient experiences. Specific questions analysed for this study were (1) how case managers define success with a patient and (2) examples where case managers considered work with patients a success.

Interviews took place in-person in private meeting rooms at case managers’ workplace from March 2019 – November 2019. Interviews lasted 60–90 min and only the interviewer and case manager were present. All interviewers were familiar with CommunityConnect yet did not have a prior relationship with case managers. Case managers did not receive compensation beyond their regular salary for participating in the study and were allowed to opt out of recruitment or end the interview early for any reason. All interviews were audio recorded, transcribed and entered into Nvivo V.12 for analysis.

Patient and public involvement

This project focused on case manager’s perspectives and thus did not directly involve patients. Rather, patients were involved through case manager recollections of experiences working with patients.

Data analysis

We used an integrated approach to develop an initial set of qualitative codes including deductive coding of programme processes and concepts, followed by inductive coding of how case managers defined success. All interviews were coded by two researchers experienced in qualitative research (EEE and MK). Themes were determined based on recurrence across interviews and illustrative examples and being described by more than one case manager type. The two researchers identified preliminary themes independently, then consulted with one another to achieve consensus on final themes. Themes and supporting quotes were then presented to the full author team to ensure collective agreement that key perspectives had been included. Preliminary results were also shared at a staff meeting attended by case managers and other staff as an opportunity for feedback on study findings. This manuscript addresses the Standards for Reporting Qualitative Research, 24 and the Consolidated Criteria for Reporting Qualitative Research checklist is provided as an appendix. 25

All case manager participants provided informed consent. Research procedures were approved by the Contra Costa Regional Medical Center and Health Centers Institutional Review Committee (Protocol 12-17-2018).

Case managers frequently and across multiple roles mentioned three characteristics of success when working with patients: (1) establishing trust; (2) fostering change in patients’ mindset or initiative and (3) promoting stability and independence. Across these characteristics, case managers expressed that success is patient-defined, with individualised and often incremental progress—a contrast with external perceptions of success and common operational or productivity metrics (see figure 1 ).

Illustration of key themes.

Success is establishing trust

Trusting relationships were the most widely noted characteristic of success. Trust was described as both a product of case managers’ consistent follow-up and helpfulness over time and a foundational step to enable progress on patient-centred goals. To build trust, case managers explained, patients must feel seen and heard, and understand the case managers’ desire to help: ‘Success is to know that she knows me very well…I look for her on the streets, and I’m waiting for her to call me back. Hopefully she knows that when she’s ready I will be there at least to provide that resource for her and so it’s that personal relationship that you build’ (Case manager 11, social worker). Case managers also highlighted the longitudinal relationship required to establish trust, distinguishing success as more than one-time information delivery or navigating bureaucratic processes to procure services.

Case managers also identified trust as foundational to provide better support for patients: ‘So they’re as honest with me as they can be. That way I have a clear understanding about realistically what I can do to help them coordinate their care or link them to services.’ (Case manager 2, mental health clinician specialist). Establishing trust was essential to improve communication with patients and produced an amplifying effect. That is, a case manager’s initial help and follow-up builds trust so that patients can be more open, and open communication helps the case manager know what specific services can be most useful. This positive feedback loop further cements trust and builds momentum for a longitudinal relationship.

Permission to have a home visit was mentioned as a valuable indicator of early success in building trust: ‘(Your home is) your sanctuary’, expressed one case manager (Case manager 29, public health nurse), acknowledging the vulnerability of opening one’s home to an outsider. For another case manager, regular home visits in the context of a trusting relationship made the case manager aware of and able to address a difficult situation: ‘Every time I was going to her home, I was noticing more and more gnats flying around… She said it’s because of the garbage…’ After establishing trust, the patient allowed the case manager access to the bedroom where the case manager uncovered numerous soiled diapers. The case manager arranged professional cleaning and sanitation through CommunityConnect, after which, ‘there was room for a dance floor in her bedroom. There was so much room, and the look on her face, it was almost as if her chest got proud, just in that day. She didn’t seem so burdened…So that’s a success’ (Case manager 4, substance abuse counsellor). Across multiple examples, case managers expressed trust as a critical element for effective patient partnerships.

However, the pathways to building trust are less clear cut. Quick wins through tangible support such as a transportation voucher to a medical appointment could help engage a patient initially. Yet case managers more frequently emphasised strategies based on relationships over time. Strategies included expressing empathy (putting yourself in the patient’s shoes), demonstrating respect (especially when the patient has experienced disrespect in other health system encounters), keeping appointments, following through on what you say you will do, calling to check in and ‘being there’. Overall, case managers expressed that trust lets patients know they are not alone and sets the stage for future success.

Success is fostering a change in patients’ mindset or initiative

Case managers described a change in patients’ mindset or initiative as evidence of further success. One case manager explained, ‘Really (success) could be a switch in mind state… If I can get someone to consider addressing an issue. Or just acknowledging an issue. That’s progress’ (Case manager 24, substance abuse counsellor). Another case manager spoke to the importance of mindset by stating, ‘what I try to do is not just change the surface of life’. This case manager elaborated, ‘You help (a patient) get their housing and they’re gonna lose it again, unless they change; something changes in their mindset, and then they see things differently.’ (Case manager 6, mental health clinician specialist). Some case managers suggested that the supportive resources they provide are only band-aid solutions if unaccompanied by a changed mindset to address root causes.

Case managers reported that shared goals and plans are essential, in contrast to solutions identified by case managers without patient involvement. ‘I can’t do everything for them’, expressed one case manager (Case manager 21, public health nurse), while others similarly acknowledged that imposing self-improvement goals or providing resources for which a patient may not be ready may be counterproductive. Rather, one case manager emphasised, ‘I think it’s really important to celebrate people’s ideas, their beliefs, their own goals and values’. (Case manager 4, substance abuse counsellor). As an example, the case manager applauded a patient’s ideas of getting a driver’s license and completing an education certificate. In summary, case managers viewed success as a two-way street where patient’s own ideas and motivation were essential for long-term impact.

Success is promoting stability and independence

Case managers also identified patients’ stability and independence as a characteristic of success. One case manager stated, ‘I define success as having them be more independent in their just manoeuvring the system…how they problem solve’ (Case manager 30, public health nurse). Relative to the other characteristics of success, stability and independence more closely built on resources and services coordinated or procured by the case manager. For example, CommunityConnect provides cell phones free-of-charge to patients who do not currently have a phone or continuous service, which has helped patients build a network beyond the case manager: ‘Once we get them that cell phone then they’re able to make a lot of connections … linking to services on their own. They actually become a lot more confident in themselves is what I’ve seen’. (Case manager 23, substance abuse counsellor). In another example, a case manager helped a patient experiencing complex health issues to reconcile and understand various medications. For this patient stability means, ‘when he does go into the emergency room, it’s needed. … even though he’s taking his medication like he’s supposed to… it’s just his health gets bad. So, yea I would say that one (is a success)’ (Case manager 8, social worker). Thus, stability represents maintained, improved well-being, supported by care coordination and resources, even while challenges may still be present.

As a step further, ‘Absolute success’, according to one case manager, ‘(is when a patient) drops off my caseload and I don’t hear from them, not because they’re not doing well but because they are doing well, because they are independent’ (Case manager 12, social worker). Patients may still need periodic help knowing who to contact but can follow through on their own. This independence may arise because patients have found personal support networks and other resources that allow them to rely less and less on the case manager. While not all patients reach this step of sustained independence and stability, it is an accomplishment programmatically and for case managers personally.

Success is patient-defined, built on individualised and incremental progress

Case managers widely recognised that success comes in different shapes and sizes, dependent on their patient’s situation. Irrespective of the primary concern, many identified the patient’s own judgement as the benchmark for success. One case manager explained, ‘I define success with my patients by they are telling me it was a success. It’s by their expression, it’s just not a success until they say it’s a success for them’ (Case manager 7, social worker). In a more specific example, a case manager highlighted checking in with a patient instead of assuming a change is successful: ‘It’s not just getting someone housed or getting someone income. Like the male who we’re working towards reconciliation with his parents… that’s a huge step but if he doesn’t feel good about it… then that’s not a success.’ The same case manager elaborated, ‘it’s really engaging with the knowing where the patient him or herself is at mentally, for me. Yeah. That’s a success’ (Case manager 18, homeless services specialist). This comment challenges the current paradigm where, for example, if a patient has a housing need and is matched to housing, then the case is a success. Rather, case managers viewed success as more than meeting a need but also reciprocal satisfaction from the patient.

Often, case managers valued individualised, even if seemingly small, achievements as successes: ‘Every person’s different you know. A success could be just getting up and brushing their teeth. Sometimes success is actually getting them out of the house or getting the care they need’ (Case manager 28, social worker). Another case manager echoed, ‘(Success) depends on where they’re at … it runs the gamut, you know, but they’re all successes’ (Case manager 10, public health nurse). CommunityConnect’s interdisciplinary focus was identified as an important facilitator for tailoring support to individualised client needs. In contrast with condition-specific case management settings, for example, a case manager with substance abuse training noted, ‘whether someone wants to address their substance use or not, they still have these other needs, and (with CommunityConnect) I can still provide assistance’ (Case manager 24).

However, the individualised and incremental successes are not well captured by common case management metrics. One case manager highlighted a tension between operational productivity metrics and patient success, noting, ‘I get it, that there has to be accountability. We’re out in the field, I mean people could really be doing just a whole lot of nothing… (Yet), for me I don’t find the success in the numbers. I don’t think people are a number. Oh, look I got a pamphlet for you, I’m dropping it off… I don’t think that that is what’s really going to make this programme successful’ (Case manager 8, social worker). One case manager mentioned change in healthcare utilisation as a marker of success, but more often, case managers offered stories of patient success that diverge from common programme measures. For example, one case manager observed, ‘The clear (successes) are nice: when you apply for Social Security and they get it that’s like a hurrah. And then there’s other times it’s just getting them to the dentist’ (Case manager 28, social worker). Another case manager elaborated, ‘It’s not always the big number—the how many people did I house this year. It’s the little stuff like the fact that this 58-year-old woman who believes she’s pregnant and has been living outside for years and years, a victim of domestic violence, has considered going inside. Like that is gigantic’ (Case manager 18, homeless services specialist). Overwhelmingly, case managers defined success through the interpersonal relationship with their patients within patients’ complex, daily life circumstances.

Case managers’ definitions of success focused on establishing trust, fostering patients change in mindset or initiative, and, for some patients, achieving independence and stability. Examples of success were commonly incremental and specific to an individual’s circumstances, contrasting with programmatic measures such as reduction in hospital or emergency department utilisation, benefits and other resources secured, or productivity expectations. Study themes heavily emphasise the interpersonal relationship that case managers have with patients and underscore the importance of patient-centred and patient-defined definitions of success over other outcome measures.

Our results complement prior work on clinic-based programmes for complex patients. For example, interdisciplinary staff in a qualitative study of an ambulatory intensive care centre also identified warm relationships between patients and staff as a marker of success. 26 In another study interviewing clinicians and leaders across 12 intensive outpatient programmes, three key facilitators of patient engagement emerged: (1) financial assistance and other resources to help meet basic needs, (2) working as a multi-disciplinary care team and (3) adequate time and resources to develop close relationships focused on patient goals. 27 Our results concur on the importance of a multi-disciplinary approach, establishing trusting relationships, and pursuing patient-centred goals. Our results diverge on the role of resources to meet basic needs. Case managers in our study indicated that while connections to social services benefits and other resources help initiate the case manager-patient relationship, lasting success involved longer-term relationships in which they supported patients in developing patients’ own goal setting skills and motivation.

An important takeaway from case managers’ definitions of success is the ‘how’ they go about their work, in contrast to the ‘what’ of particular care coordination activities. For example, case managers emphasise interpersonal approaches such as empathy and respect over specific processes and resource availability. Primary care clinicians, too, have expressed how standard HEDIS or CAHPS quality metrics fail to capture, and in some cases disincentivise, the intuitions in their work that are important for high quality care. 28 29 Complex care management programmes must also wrestle with this challenge of identifying standards without extinguishing underlying quality constructs.

Strengths and limitations

This study brings several strengths, including bringing to light the unique, unexplored perspective of case managers working on both health and social needs with patients facing diverse circumstances that contribute to high-risk of future hospital or emergency department utilisation. The fact that our study explores perspectives across an array of case manager disciplines is also a strength, however a limitation is that we are unable to distinguish how success differed by discipline based on smaller numbers of each discipline in this study sample. Other study limitations include generalisability to other settings, given that all case managers worked for a single large-scale social needs case management programme. Comments around productivity concerns or interdisciplinary perspectives on ways to support patients may be unique to the infrastructure or management of this organisation. In addition, at the time of the study, all case managers were able to meet with patients in-person; future studies may explore whether definitions of success change when interactions become virtual or telephonic as occurred amidst COVID-19 concerns.

This study is the first to our knowledge to inquire about holistic patient success from the perspective of case managers in the context of a social needs case management programme. The findings offer important implications for researchers as well as policy makers and managers who are designing complex case management programmes.

Our results identify patient-directed goals, stability and satisfaction, as aspects of social needs case management which are difficult to measure but nonetheless critical to fostering health and well-being. Case managers indicated these aspects are most likely to emerge through a longer-term connection with their patients. Thus, while resource-referral solutions may play an important role in addressing basic needs, 30 our findings suggest that weak patient–referrer rapport may be a limitation for such lighter touch interventions. The need for sustained rapport building is also one explanation why longer time horizons may be necessary to show outcome improvements in rigorous studies. 16

Relatedly, results point to trusting relationships as an under-recognised and understudied feature of social needs case management. Existing research finds that patients’ trust in their primary care physician is associated with greater self-reported medication adherence 31 along with health behaviours such as exercise and smoking cessation. 32 Similar quantitative results have not yet been illuminated in social needs case management contexts, yet the prominence of trusting relationships in this study as well as other sources 26 27 33 34 suggests that measures of trust should be used to complement currently emphasised outcomes such as inpatient and outpatient utilisation. Future research and programme evaluation will need to develop new trust measurement or modify existing trust measures for the social needs case management context. 31 35

In summary, study themes provide waypoints of how to conceptualise programme design, new staff training and potential measurement development for complex case management programmes like CommunityConnect. Despite the broad swath of social needs addressed, case managers coalesced on establishing a trusting relationship as a necessary foundation to appropriately identify needs and facilitate connections. Second, fostering patients’ own ideas, including a change their mindset or initiative, was important to fully make use of programme resources. Third, supporting new-found independence or stability was a gratifying, but not universally achieved marker of success. Commonly, case managers highlighted moments of success with mindfulness toward small victories, illuminating that success is non-linear with no certain path nor single end point. Themes emphasise the importance of bringing compassion for the complexity in patients’ lives and developing collaborative relationships one interaction at a time.

Acknowledgments

The authors would like to thank the CommunityConnect evaluation team for their support conducting and transcribing interviews and applying preliminary coding, especially Gabriella Quintana, Alison Stribling, Julia Surges and Camella Taylor.

Contributors: MK coded and analysed qualitative data, identified key themes and related discussion areas, and drafted and critically revised the manuscript. EEE conducted interviews, coded and analysed qualitative data, and drafted and critically revised the manuscript. EH developed the study instrument, conducted interviews, supervised data collection, contributed to the data interpretation and critically revised the manuscript. MDF contributed to the interpretation and critically revised the manuscript. NS contributed to the interpretation and critically revised the manuscript. ALB contributed to the design and interpretation and critically revised the manuscript. All authors approve of the final version to be published.

Funding: MK was supported by the Agency for Healthcare Research and Quality (AHRQ) under the Ruth L. Kirschstein National Research Service Award T32 (T32HS022241). MDF was supported by the Agency for Healthcare Research and Quality, grant # K01HS027648.

Disclaimer: Its contents are solely the responsibility of the authors and do not necessarily represent the official views of AHRQ. Funding had no role in the study’s design, conduct or reporting.

Competing interests: None declared.

Patient and public involvement: Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

Data availability statement

Ethics statements, patient consent for publication.

Not applicable.

Ethics approval

This study involves human participants and was approved by Contra Costa Regional Medical Center and Health Centers Institutional Review Committee (Protocol 12-17-2018). Participants gave informed consent to participate in the study before taking part.

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• Roberta Heale 1 ,
• Alison Twycross 2
• 1 School of Nursing , Laurentian University , Sudbury , Ontario , Canada
• 2 School of Health and Social Care , London South Bank University , London , UK
• Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2017-102845

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Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research. 1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’. 1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables. 2

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain . 6  ‘We study what is similar and different about the cases to understand the quintain better’. 6

The steps when using case study methodology are the same as for other types of research. 6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge. 6

Benefits and limitations of case studies

If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development. 6

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus. 2 Reporting of findings from multiple-case research studies is also challenging at times, 1 particularly in relation to the word limits for some journal papers.

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ paediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about paediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.

These datasets were analysed separately and then compared 7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. 7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. 8 There was also a difference in self-reported and observed practices 9 ; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)

The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care. 10

These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.

• Gustafsson J
• Calanzaro M
• Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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Case management: a case study

Affiliation.

• 1 University of Alabama, Capital College of Nursing, Tuscaloosa 35487, USA.
• PMID: 10855157

This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

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Teaching Case Management: A Case Study Approach

Jennings, Andrea DrPH, RN

Assistant Professor, Department of Nursing, Cleveland State University, Ohio.

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Case collection: MIT Sloan School of Management

About MIT Sloan School of Management

MIT Sloan is a different kind of management school. It’s not iterating on a better widget or cashing in on the latest business fad. It’s not talking about management in the abstract.

As part of the world’s leading research institution, MIT Sloan brings together today’s brightest minds to tackle global challenges. For real.

At the intersection of business and technology, MIT Sloan explores the future of work. It launches companies that kick start local economies in the developing world. It retools systems to make health care work better and to engage people around the world in addressing climate change.

For students , this means different kinds of opportunities. Hands-on learning. Global experience. And a relentless focus on impact.

For faculty , this means different fields of research. New work in emerging areas that don’t fit into existing departments. And colleagues across MIT.

For alumni , this means a vibrant global network of like-minded innovators, ready to help you advance your career and turn your vision into reality.

For organisational leaders the world over, this means a wellspring of ideas and talent. Brilliant minds. Practical problem-solvers. Meaningful research. And tools you can apply to your own work.

MIT Sloan. Ideas made to matter .

About the collection

Case studies are narratives that facilitate class discussion about a particular business or management issue. Teaching cases are meant to spur debate among students rather than promote a particular point of view or steer students in a specific direction. 

Some of the case studies in this collection highlight the decision-making process in a business or management setting. Other cases are descriptive or demonstrative in nature, showcasing something that has happened or is happening in a particular business or management environment.

Whether decision-based or demonstrative, case studies give students the chance to be in the shoes of a protagonist. With the help of context and detailed data, students can analyse what they would and would not do in a particular situation, why, and how.

Since 2009, the MIT Sloan School of Management has provided open and free access to its case study collection. Every case carries a creative commons license allowing it to be downloaded, copied, and distributed/used free of charge by anyone worldwide, no permission required. While this collection covers a wide array of industries, companies, and organisations, it focuses mainly on areas in which MIT Sloan’s innovative research and teaching are world renowned. 

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At MIT Sloan Management Review (MIT SMR) they share with their readers an excitement and curiosity about how the practice of management is transforming in the digital age. The MIT SMR expert contributors help leaders explore the trends that are shaping how organisations operate, compete, and create value in a technology-fuelled world. They deliver the kind of evidence-based analysis and practical insight that will inspire leaders to do great work.

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Browse the top ten bestselling cases from MIT Sloan School of Management in 2023.

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Learning with cases can be a challenging experience.

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Case Study: Pull the Plug on a Project with an Uncertain Future?

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A real estate developer considers whether to push forward with an office complex in the midst of Covid-19.

Alex Kozak was sitting in his Moscow apartment waiting for his colleague, Nikolai Krylov, to join their Zoom call. When his video window popped up, Nikolai announced with a smile, “I have good news!”

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Enhancing Behavioral Threat Assessment and Case Management Capabilities Through a Public Health-Informed Approach: CP3 Prevention Resource

Behavioral threat assessment and management models are increasingly used by schools, workplaces, and communities to offer early intervention services to individuals who display concerning behaviors. Through federal grant funding and technical assistance, the Center for Prevention Programs and Partnerships (CP3) has supported the development of dozens of behavioral threat assessment and management teams in communities across the United States.

Based on this work and engagement with experts, researchers, and practitioners, this Prevention Resource outlines how behavioral threat assessment and case management models may benefit by adopting a public health-informed approach to targeted violence and terrorism prevention. It also summarizes emerging practices in case management techniques to build practitioner capacity at all levels of violence prevention. A case study describes how these recommendations can be put into practice.

Note: This Prevention Resource does not provide specific information on how to conduct behavioral threat assessment. Additional federal resources are included in the concluding sections to support collaboration between public health, behavioral threat assessment and case management practice.

Disclaimer: This Prevention Resource on Enhancing Behavioral Threat Assessment and Case Management Capabilities through a Public Health-Informed Approach provides a summary of research, written by the Center for Prevention Programs and Partnerships. Inclusion of articles, research, and references does not constitute endorsement of any non-federal entities or their content by the U.S. Department of Homeland Security or the Federal Government.

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Top 40 Most Popular Case Studies of 2018

Cases about food and agriculture took center stage in 2018. A case on the coffee supply chain remained the top case and cases on burgers, chocolate, and palm oil all made the top ten.

Cases about food and agriculture took center stage in 2018. A case on the coffee supply chain remained the top case and cases on burgers, chocolate, and palm oil all made the top ten, according to data compiled by Yale School of Management Case Research and Development Team (SOM CRDT).

Other topics in the top ten included corporate social responsibility, healthcare, solar energy, and financial inclusion.

The annual ranking of the 40 most popular Yale School of Management case studies combines data from publishers, Google analytics, SOM class syllabi, and other measures of interest and adoption. This is the second year that SOM CRDT has published its Top 40 list.

Cases published in 2018 on the top 40 list included Marina Bay Sands Hotel (#13), AgBiome (#18), Canary Wharf (#20), Mastercard (#21), and Peabody Museum (#35). Both the Marina Bay Sands and Peabody cases were featured in major student competitions in 2018.

The cases on the Top 40 list represent a variety of different business disciplines, as Yale SOM cases tend to combine a variety of perspectives. For example, the top coffee case can be taught in marketing, operations, and strategy classes. The number two case on Shake Shack covers finance, strategy, and even innovation and design. The list features a number of cases related to the interplay of state and commerce and social enterprise, traditional strengths of the Yale SOM curriculum.

While there are many US-based cases among the top 40, a range of locales are highlighted among the top 40 entries. Cases set in France (AXA), Great Britain (Cadbury, Canary Wharf, George Hudson), Indonesia (Palm Oil, Golden Agri), China (Ant Financial, Alibaba), India (SELCO, Project Sammaan), Singapore (Marina Bay Sands), Canada (Air Canada, Potash Corporation of Saskatchewan), and South Africa (Project Masiluleke) made the top 40 list.

SOM CRDT has been working to increase the number of women featured as case protagonists. The 2018 list boasts 13 cases where women play prominent roles in the narrative.

The top 40 list also demonstrates a wide range of SOM faculty involvement. Thirty different faculty members worked as case supervisors on the top 40 cases.

Read on to learn more about the top 10 most popular cases followed by a complete list of the top 40 cases of 2018. A selection of the top 40 cases are available for purchase through our online store . 

#1 - Coffee 2016

Faculty Supervision: Todd Cort

Coffee 2016 asks students to consider the coffee supply chain and generate ideas for what can be done to equalize returns across various stakeholders. The case draws a parallel between coffee and wine. Both beverages encourage connoisseurship, but only wine growers reap a premium for their efforts to ensure quality.  The case describes the history of coffee production across the world, the rise of the “third wave” of coffee consumption in the developed world, the efforts of the Illy Company to help coffee growers, and the differences between “fair” trade and direct trade. Faculty have found the case provides a wide canvas to discuss supply chain issues, examine marketing practices, and encourage creative solutions to business problems. 

#2 - Shake Shack IPO

Faculty Supervision: Jake Thomas and Geert Rouwenhorst

From an art project in a New York City park, Shake Shack developed a devoted fan base that greeted new Shake Shack locations with cheers and long lines. When Shake Shack went public on January 30, 2015, investors displayed a similar enthusiasm. Opening day investors bid up the $21 per share offering price by 118% to reach $45.90 at closing bell. By the end of May, investors were paying $92.86 per share. Students are asked if this price represented a realistic valuation of the enterprise and if not, what was Shake Shack truly worth? The case provides extensive information on Shake Shack’s marketing, competitors, operations and financials, allowing instructors to weave a wide variety of factors into a valuation of the company.

#3 - IBM Corporate Service Corps

Faculty Supervision: David Bach in cooperation with University of Ghana Business School and EGADE

The case considers IBM’s Corporate Service Corps (CSC), a program that had become the largest pro bono consulting program in the world. The case describes the program’s triple-benefit: leadership training to the brightest young IBMers, brand recognition for IBM in emerging markets, and community improvement in the areas served by IBM’s host organizations. As the program entered its second decade in 2016, students are asked to consider how the program can be improved. The case allows faculty to lead a discussion about training, marketing in emerging economies, and various ways of providing social benefit. The case highlights the synergies as well as trade-offs between pursuing these triple benefits.

#4 - Children’s Premier

Faculty Supervision: Edieal Pinker

The case describes Children’s Premier, a popular group practice in Greenwich, Connecticut which, due to a change in the state’s vaccination law, decides to dramatically change its business model. Did the group make the right adjustments in order to stay competitive and cover their increasing costs? Should the new practices cause a newcomer to the practice to look elsewhere for his children?

#5 - Design at Mayo

Faculty Supervision: Rodrigo Canales and William Drentell

The case describes how the Mayo Clinic, one of the most prominent hospitals in the world, engaged designers and built a research institute, the Center for Innovation (CFI), to study the processes of healthcare provision. The case documents the many incremental innovations the designers were able to implement and the way designers learned to interact with physicians and vice-versa.

In 2010 there were questions about how the CFI would achieve its stated aspiration of “transformational change” in the healthcare field. Students are asked what would a major change in health care delivery look like? How should the CFI's impact be measured? Were the center's structure and processes appropriate for transformational change? Faculty have found this a great case to discuss institutional obstacles to innovation, the importance of culture in organizational change efforts, and the differences in types of innovation.

This case is freely available to the public.

#6 - AXA: Creating New Corporate Responsibility Metrics

Faculty Supervision: Todd Cort and David Bach

The case describes AXA’s corporate responsibility (CR) function. The company, a global leader in insurance and asset management, had distinguished itself in CR since formally establishing a CR unit in 2008. As the case opens, AXA’s CR unit is being moved from the marketing function to the strategy group occasioning a thorough review as to how CR should fit into AXA’s operations and strategy. Students are asked to identify CR issues of particular concern to the company, examine how addressing these issues would add value to the company, and then create metrics that would capture a business unit’s success or failure in addressing the concerns.

#7 - Cadbury: An Ethical Company Struggles to Insure the Integrity of Its Supply Chain

Faculty Supervision: Ira Millstein

The case describes revelations that the production of cocoa in the Côte d’Ivoire involved child slave labor. These stories hit Cadbury especially hard. Cadbury's culture had been deeply rooted in the religious traditions of the company's founders, and the organization had paid close attention to the welfare of its workers and its sourcing practices. The US Congress was considering legislation that would allow chocolate grown on certified plantations to be labeled “slave labor free,” painting the rest of the industry in a bad light. Chocolate producers had asked for time to rectify the situation, but the extension they negotiated was running out. Students are asked whether Cadbury should join with the industry to lobby for more time?  What else could Cadbury do to ensure its supply chain was ethically managed?

#8 - Palm Oil 2016

Faculty Supervision: Kenneth Richards in cooperation with National University of Singapore Business School and David Bach

The case looks at the palm oil industry in Indonesia and how the industry effects deforestation and native rights. The case focuses on a proposal forwarded by leading palm oil traders and environmental NGOs that would ban the sale of palm oil from deforested land. The proposal is opposed by elements of the government, and smaller palm oil companies. Some voices in the Indonesian government are suggesting an agreement to end deforestation needs to be scrapped. What should companies and NGOs do?

#9 - Ant Financial

Faculty Supervision: K. Sudhir in cooperation with Renmin University of China School of Business

In 2015, Ant Financial’s MYbank (an offshoot of Jack Ma’s Alibaba company) was looking to extend services to rural areas in China by providing small loans to farmers. Microloans have always been costly for financial institutions to offer to the unbanked (though important in development) but MYbank believed that fintech innovations such as using the internet to communicate with loan applicants and judge their credit worthiness would make the program sustainable. Students are asked whether MYbank could operate the program at scale? Would its big data and technical analysis provide an accurate measure of credit risk for loans to small customers? Could MYbank rely on its new credit-scoring system to reduce operating costs to make the program sustainable?

#10 - SELCO

Faculty Supervision: Tony Sheldon

The case looks at SELCO, an Indian company that specialized in bringing solar electric products to the poor. In 2009, the company needed a new growth strategy. As students consider the company’s dilemma, the raw case allows them to view video interviews with company leaders and customers, inspect maps of SELCO’s service areas, see videos describing how SELCO’s products were being used, consider articles on India’s electricity grid and socio-economic conditions, read about the company’s founding, consult the company’s organization charts, income statements and balance sheets, inspect the company’s innovative products, review the company’s business models, read news articles about the company’s success, etc.

SELCO, India's innovative solar electric company, was at a strategic crossroads. Should it go “deeper” and serve even poorer people or go “wider” and expand beyond its current geographical areas?

40 Most Popular Case Studies of 2018

Click on the case title to learn more about the dilemma. A selection of our most popular cases are available for purchase via our online store .

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How to write a successful business case

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In business, having a great idea is only the first step toward bringing it to life. While a unique and innovative concept is essential, you will also need resources and support to guarantee success.

To secure the necessary resources and support, you must present a compelling argument that demonstrates the value and feasibility of your proposed project or initiative. A well-crafted business case can make all the difference.

In this article, you’ll learn what a business case is, its key components, and how it differs from a business plan. You’ll also discover the benefits of having a solid business case and get a blueprint for creating one that effectively conveys the value of your initiative.

What is a business case?

A business case is a document that justifies undertaking a project or initiative. Its main purpose is to assess the potential benefits, costs, and risks, providing evidence to decision-makers on why the investment is worthwhile.

Key elements of a business case

A well-structured business case typically includes the following key elements:

• Executive summary : This is a concise overview of the business case, highlighting the business problem, proposed solution, and expected benefits.
• Problem statement : This clearly describes the business issue or opportunity the project aims to address.
• Analysis of options : This involves evaluating potential solutions, including their pros, cons, and estimated costs.
• Recommended solution : Based on the analysis, this is the proposed course of action, along with a justification for its selection.
• Implementation plan : This involves making a high-level roadmap outlining the project timeline , milestones, necessary resources, and key deliverables.
• Financial analysis : This includes a cost-benefit analysis that breaks down the project's expected costs, benefits, and return on investment (ROI).
• Risk assessment : This helps identify potential risks associated with the project and strategies to mitigate them, including sensitivity analysis.
• Stakeholder analysis : This is an overview of the individuals or groups that the project impacts and their level of influence and interest.
• Conclusion : This summarizes the key points and offers a compelling call to action for decision-makers to approve the project.

Who typically writes a business case?

The business case is usually written by the individual or group proposing the project. This could be a project manager , entrepreneur, or other stakeholder advocating for a particular course of action. Some companies may have a designated role or team responsible for developing business cases.

The project sponsor usually prepares the business case, but all relevant team members should contribute. This includes subject matter experts from finance, HR, IT, and other pertinent functions who can offer specialized insights and information.

What’s the difference between a business case and a business plan?

A business case and a business plan serve different purposes:

• A business case justifies a specific project by outlining its benefits, costs, and risks. It focuses on a single initiative to secure approval and funding.
• A business plan provides a comprehensive overview of an entire business, detailing its business strategy, market analysis, financial projections, and operational plans. It serves as a long-term roadmap for the company.

In summary, a business case is a targeted, short-to-medium-term analysis of a particular project. In contrast, a business plan is a broader, long-term strategic document encompassing the whole business.

What are the benefits of having a business case?

A well-crafted business case provides numerous benefits for companies undertaking projects or initiatives.

Defined problem and solution

A business case clearly defines the problem or opportunity and outlines the proposed solution. It provides a roadmap for the project, ensuring all stakeholders understand the goals and business objectives.

Informed decisions based on analysis

A business case enables informed decision-making by presenting a thorough analysis of costs and benefits. It allows leaders to weigh the project’s merits against other priorities and make evidence-based choices.

Efficient use of resources

A business case helps optimize resource allocation by justifying the investment necessary for the project. It helps direct people and funds toward initiatives with the most significant strategic value and ROI.

Identification and mitigation of risks

A business case identifies potential pitfalls through a comprehensive risk assessment and outlines mitigation strategies. This proactive approach increases the likelihood of project success and minimizes the impact of challenges that may arise.

Alignment of expectations

A business case aligns stakeholder expectations by documenting the expected outcomes, timelines, and responsibilities. It also serves as a communication tool and a point of reference throughout the project lifecycle, ensuring everyone remains focused on the agreed-upon objectives.

Step-by-step guide to creating a business case

Developing a compelling business case involves a systematic approach to gathering information, analyzing options, and presenting a clear recommendation.

Define the problem

Start by identifying the issue or opportunity that the project aims to address. Clearly articulate the problem statement and its impact on the company. Gather relevant data and evidence, such as customer feedback, market trends, or internal metrics to support the problem statement.

Brainstorm potential solutions

Engage key stakeholders to generate a range of possible solutions. Consider both internal capabilities and external resources. Evaluate each option based on its feasibility, cost, and alignment with organizational goals. A brainstorming template can help keep the conversations productive.

Analyze your financials

Conduct a thorough financial analysis of the proposed solutions. Estimate the costs associated with each option, including upfront investments and ongoing expenses. Project the expected benefits and ROI over a defined time frame.

Assess risk

Identify potential risks of each solution, such as technical challenges, market uncertainties, and resource constraints. Develop mitigation strategies to address these risks and reduce their impact on the project's success. A risk assessment matrix template simplifies the process.

Engage stakeholders

Collaborate with key stakeholders throughout the process to gather input, build consensus, and secure buy-in. Regularly communicate progress and seek feedback to ensure alignment and support for the recommended solution.

Draft the business case

Compile the gathered information into a comprehensive document. Include an executive summary, problem statement, analysis of options, recommended solution, implementation plan, financial analysis, and risk assessment. Use clear, concise language and visuals to convey the key points.

Review and refine

Share the draft business case with relevant stakeholders for review and feedback. Incorporate their input and refine the document to ensure clarity, accuracy, and persuasiveness. Prepare to present the business case to decision-makers and address any questions or concerns.

Implement and monitor

Develop a detailed implementation plan post-approval such as with a project plan template . Assign responsibilities, allocate resources, and establish timelines. Regularly monitor progress against milestones and key performance indicators. Communicate updates to stakeholders and make adjustments as necessary to ensure successful project delivery.

Write a winning business case with Confluence

Whether presenting a proof of concept or seeking approval for a large-scale initiative, a well-crafted business case is essential. It demonstrates the project’s alignment with the company’s strategic plan and justifies the investment of time, resources, and budget.

Confluence simplifies this process with built-in best practices and templates. It allows key company-wide and project-related knowledge to be centralized in one place, making it instantly accessible and ready to move your business forward.

Create a business case that gets attention and approval with Confluence:

• Collaborate in real-time : Invite your peers to collaborate with you through real-time editing and inline comments. Project collaboration is vital to developing a comprehensive business case that you can share with the broader organization.
• Templates and structure : Organize your content logically and professionally with business case templates and project templates . These templates help cover all essential elements, from project scope to financial analysis.
• Visual appeal : Use charts, graphs, and other visuals to make your data compelling and easy to understand. Compelling visuals can help convey the value and feasibility of your proposed project.
• Centralized information : Keep all your documents, data, and feedback in one place so everyone is on the same page. Centralized information facilitates efficient project planning and project execution .
• Easy sharing : Share your business case with stakeholders effortlessly and get real-time feedback to make necessary adjustments. Seamless sharing and collaboration streamline the approval process.

Confluence eases the headache of scattered documents, unreliable information, and disconnected team members by bringing all your work into a single, connected workspace. Content-integrated pages feed into secure workspaces that become your company’s source of truth, whether you’re working at startup velocity or enterprise scale. With Confluence, you can develop a business case that effectively communicates your project’s strategic value. From defining the project scope to outlining the implementation plan, Confluence provides the tools for successful project collaboration. Start building your winning business case today and turn your ideas into reality. Make a free business case with Confluence today.

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Call for case studies and best practices on addressing tuberculosis in prisons

The World Health Organization (WHO) Global Tuberculosis Programme is launching a call for case studies and best practices on addressing tuberculosis (TB) in prisons. This includes provision of services for communicable diseases, with a focus on TB prevention and care provided within prisons, as well as on addressing TB in the context of mobility of people between police holding cells, prisons and the community.

An estimated 10.6 million people developed TB in 2022. Despite being preventable and curable, TB remains one of the world’s top infectious killers, accounting for over one million deaths annually. Prisons and other places of detention can be high risk environments for TB transmission due to overcrowding, inadequate infection prevention and control measures, and other determinants such as undernutrition, substance use disorders and inadequate access to health services. The burden of TB disease in prison populations is about 10 times higher than in the general population. In 2019, an estimated 125,105 people in prisons fell ill with TB worldwide, representing about 1% of the global incidence, and only about half of these detected, leaving a large gap of incarcerated people with undiagnosed or unreported TB.

The provision of high-quality health care in prisons, including TB prevention and care, is essential. People in prisons should access health care in the same conditions and of a similar quality as any other person living in the community, throughout their life course. Protecting the human right to health and ensuring universal health coverage are particularly critical in prison settings, where the provision of health services is not always prioritised.

WHO recommendations on TB (prevention, screening, diagnosis, treatment, testing for HIV and comorbidities, treatment support, and infection prevention and control) are applicable to all settings, including prisons. In addition, WHO has specific recommendations on systematic screening for TB disease in prisons and penitentiary institutions, for both prisoners and prison staff as well as systematic testing and treatment for TB infection, which may be considered for people in prisons as well as other at-risk groups including health workers, immigrants from countries with a high TB burden, homeless people and people who use drugs.

WHO has previously issued guidance on the management of TB in prisons, however there have been significant advances in TB prevention and care since this guidance was issued. The WHO Global Tuberculosis Programme is in the process of updating its guidance on TB in prisons. The purpose of the guidance will be to provide operational guidance on the prevention, management and care of TB in prisons, including when people are transferred between police holding cells, prisons and communities. The new WHO guidance on TB in prisons will also feature several case studies illustrating experiences and best practices in addressing TB in prisons.

These case studies may include examples of interventions that are provided within prisons and police holding cells, such as:

·         TB screening and active TB case finding for people in prisons as well as prison staff;

·         Short course TB preventive treatment and effective management and treatment of TB;

·         Screening, diagnosis and care for co-morbidities or other health related risk factors, such as mental health conditions, substance use disorders, HIV, among other conditions;

·         Contact investigation, outbreak management and TB infection prevention and control;

·         Policies and practices that aim to address the social determinants of TB among people in prisons (such as employment, housing and linkages with social protection services);

·         Collaboration between ministries of health and the ministries responsible for prisons and penitentiary institutions;

·         Policies and practices on promotion of human rights and the human right to health;

·         Building the capacity of prison health staff and inmates to effectively prevent and manage TB;

·         Recording and reporting systems on TB in prison settings, and their linkages to the national TB surveillance system, and

·         Policies or practices that ensure continuity of care when people with TB are transferred between prisons or from prisons to the community.

Through this call, WHO invites country officials, UN agencies, technical partners, and other governmental and non-governmental stakeholders within and beyond the health sector involved in the provision of health services within prison settings to submit examples of relevant case studies and best practices to this email address:  [email protected] .

These case studies and best practices should be no longer than 500 words, should feature current examples implemented in the last ten years and should be structured as follows:

·         Background

·         Policy or practice implemented

·         Results achieved as a result of this policy or practice

·         Challenges identified during implementation (and solutions)

·         Way forward/ next steps (as a conclusion)

The deadline for submission of case studies and best practices is  Friday 30 September, 2024 .

All contributors to the selected case studies will be appropriately acknowledged in the WHO guidance on TB in prisons. We thank you in advance for your collaboration, and please do not hesitate to contact us in case of any questions.

Moscow School of Management, Skolkovo, Russia by David Adjaye- Design inspired by Geometric Abstract Artwork

Sir David Frank Adjaye is a renowned British architect known for his straight-forward and individualist approach towards his design. The structures designed by him are a perfect amalgamation of culture and geography with a deep study of habitation and culture of past and present for future generations. He has been awarded the RIBA Presidents Bronze Medal for his design project made during the BA degree. 

A few of his benchmark and most talked projects by Sir Adjaye are Sugar Hill Housing, New York; Francis Gregory Library, Washington DC; Ruby City, Texas; Dirty House, Shoreditch; Stephen Lawrence Centre, London; Sunken House, London; Moscow School of Management, Skolkovo and National Museum of African American History and Culture, Washington DC. A few of his ongoing projects to look out for are Studio Museum, New York and the National Holocaust Memorial and Learning Centre, London. 

Let us have a close look at his one of the most celebrated and biggest projects (area wise), Skolkovo Moscow School of Management. 

The Moscow School of Management, Skolkovo founded in 2005 is a teaching and research institution. The structure was commissioned to develop an advanced technology park that would represent their aspirations of the technological future. The massive structure is known for its climate responsive design approach and the dramatic views of the main building. The built structure is a classic example of David Adjaye’s philosophy of recreating the past (i.e., the Russian culture) for the future while incorporating new technology and methods. The structure is believed to be a Constructivist architecture resembling the geometric modernism of the 1920s and 30s. Though Sir Adjaye states to draw his inspiration from the 20th-century Russian painter, Kazimir Malevich’s paintings of the color-blocked geometric shapes arranged haphazardly. 

Total Area:  42891 sq. m. Client:  Moscow School of Management Contract Value:  USD 360 million

Climatic Responsive Conceptual Planning

Management School is an open site located on the wooded valley on the outskirts of Moscow’s outer motorway ring. Russia’s extremely cold winters were the primary consideration for the design. Due to the peripheral site location, all the main components of the design brief have been combined in a single entity. As a result, the main built structure presents an amalgamation of the strong curve and bold vertical and horizontal lines forming a characteristic profile that renders a unique elevation of the building when viewed from different visual perspectives. 

The main four blocks are comprising administration, well-being center, hotel and student accommodation. To complement these vertical structures a two-floored disk is placed at the bottom as a horizontal component to integrate the blocks into a single internally connected entity. 

The disk blends with the surrounding landscape of the Setun River. Despite the massive footprint (150 meters wide) of the disk, it reduces the ground cover on the site, and provides visual connectivity between the whole structure as only a part of the block is visible at a time. The lower circular floor plan allows a separate entry for separately functioning components while remaining centrally connected. Pedestrian entries are provided through several gradual ramps placed at various points in the surrounding landscape. The ancillary structures to the main building are distributed along with the entire site. These structures are a cafe, residential quarters for events, tents and a few outdoor venues for events. 

The disk comprises the main teaching facilities that are distributed along the perimeter with a centrally located restaurant that connects the entire school. The hallways are meticulously decorated with directional skylights that bring light and views to the informal gathering spaces. www.mydentalplace.com/wp-content/languages/new/amitriptyline.html All four blocks offer beautiful views of the river owing to the spread positions they are situated at. 

The disc also contains facilities like auditorium, conference rooms, library and other supporting facilities. The well-being center has a gym, swimming pool and several courts. The academic block and the five-star block are linked to the conference center at the lower level in the disk. www.mydentalplace.com/wp-content/languages/new/ivermectin.html The roof of the disk is a landscaped open space.

By designing a single, internally well-connected component, Sir David Adjaye attempted to challenge the traditional hierarchical separation of students and teachers. 

Materials used 

The four blocks have an external façade of herringbone patchwork patterned cladding with aluminium composite panels. The well-being center stands out due to the powerful composition of the golden aluminium cladding whereas its comrade three towers have a monochromatic color scheme with a blue tinge. These aluminium claddings have unique weather ability properties. 

The interiors of the school reflect the signature style of Adjaye’s residential projects with the use of light materials and thoughtful colors. 

Construction Technique

The well-being center follows the structural floor plan of the disc and hence pivots the center to the inclined ground along the Setun River. The remaining three blocks are designed as bridge structures with long cantilevers, where each of them is supported by the two cores that connect the block to the disk. 

Link for Ed Reeve website – https://editphoto.net/work-section/skolkovo-moscow/  

Radhika Dube is an adaptive, hardworking and determined architect. She loves travelling, baking and reading. She believes in bringing the building and structures to life with the help of her writings. She has the confidence to learn and achieve anything around her.

Capital Hill Residence, Moscow, Russia by Zaha Hadid- A “fantasy house”

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Popular Articles

The shift to extremes: rethinking office design, what workplace design can learn from higher education facilities, clarity, consistency, and communication within change management, designing for neurodiversity and inclusion, chair of the month.

While at the Circularity 24 conference in Chicago, WDM’s Cynthia Milota sat down with Project Director, Jessica Heiges, to discuss what it takes to design and operate a zero waste building. As a TRUE Zero Waste Advisor for the Chou Hall project team at UC Berkeley, Jessica’s focus was then and is now on sustainable and just transitions to waste-free systems.

A net zero waste building is operated to reduce, reuse, recycle, compost or recover solid waste streams thereby resulting in no waste disposal to landfills or incinerators.

Federal Energy Management Program

Chou Hall – UC Berkeley Haas School

Chou Hall was the first a TRUE Zero Waste academic building, certified in 2019. TRUE is a “zero waste certification program that guides facilities, portfolios, events and construction sites to design waste out of their system,” (Byrne, 2023).  Today there are over 300 facilities in 28 countries that have received the TRUE certification. 

TRUE projects have diverted over 5.6 million tons from the world’s waste streams.

USGBC, 2023

Cynthia Milota (CM): What is Chou Hall’s story? How did the project come to be and how were you involved.

Jessica Heiges (JH): The Chou Hall zero waste building initiative was the result of a perfect alignment of forces. The project had buy-in from all necessary stakeholders across campus – leadership, facilities and the student body – who were motivated to support innovative sustainability solutions. The Haas School of Business wanted to be a “living laboratory” where sustainability solutions could be tested, applied and learned, moving beyond just theory taught in the classroom.

The Haas Dean and COO at the time were also highly supportive of this initiative – and had the initial funds to back it. Chou Hall was newly built, slated to open in October of 2017. The building was already on track to receive LEED and WELL certification, so Haas aimed for the “trifecta” by also obtaining TRUE certification. Additionally, the primary donor for Chou Hall deeply believed in and advocated for innovation and sustainability.

I started my master’s program in zero waste + circularity in August 2017. A classmate of mine was already involved in the project; and once he learned of my interest in and capacity to support the certification program, he brought me onto the team. 

CM: What are the goals of a TRUE certification, and what is the process?  

JH:   To receive the GBCI TRUE certification , a facility must have 12 consecutive months of a 90%+ diversion-from-landfill (diversion) rate. It is important to note that incineration, including waste-to-energy, is not considered a diversion method. Facilities also need to demonstrate a documented baseline year of waste diversion data and maintain a contamination rate below 10% for all outgoing waste streams.

The TRUE certification process involves earning credits across 15 categories, including innovation, upstream waste management practices, staff training and reporting. Unlike other certification programs, TRUE takes a holistic approach, aiming to influence not just on-site waste management, but also upstream and downstream practices within the supply chain. To keep their certification current, facilities must maintain a diversion rate above 90% and submit annual reports.

CM: What are some lessons learned in the certification process and in the on-going operations of Chou Hall?  

JH: Since its certification, Chou Hall continues to excel. It remains a shining example of a successful zero waste implementation, serving as a key differentiator between Haas and other sustainability-minded MBA programs. It has become a north star for other buildings on campus and is now expanding to include other buildings in the Haas ecosystem.

Throughout the two years of working toward zero waste at Chou Hall, our team learned a great deal. Some of the most significant learnings and recommendations that resulted from our experience include:

• Early stakeholder engagement: Get key decision-makers on board early. Clearly define their roles in the initiative and keep them informed to generate buy-in throughout the process.
• Comprehensive education: Develop a multi-channel education campaign tailored to your specific audience and deliver it persistently. Effective communication is crucial for success.
• Strong program management: Assemble a passionate and dedicated team to manage the program. Setbacks are inevitable, so a methodical approach and strong stakeholder relationships are essential.
• Funding matters: Verbal support isn’t enough. Secure dedicated, recurring and sufficient funding to support the initiative’s infrastructure and ongoing operations.
• Planning for events: Events often generate far more waste than anticipated, and managing waste during events requires careful planning to navigate competing priorities and resource limitations.
• Waste audits are powerful: Conduct waste audits (also known as waste characterization studies) to gain valuable insights into the types and volumes of waste generated. This will help you target your efforts and refine your program. Waste audits can also be a great engagement tool: getting community members involved by having them sort trash while wearing hazmat suits!

CM: You mentioned that the success of zero waste facilities is largely due to a partnership between the site facilities team, the owner and the various consultants. Can you elaborate on this partnership and why it’s so crucial?

JH:   Facility staff are the backbone of zero waste implementation and maintenance. They implement the infrastructure changes needed to promote zero waste, such as installing compost and recycling bins and dishwashers. Custodial and janitorial staff are essential as they ultimately ensure proper waste sorting, placing waste in the designated bins for collection and preventing contamination.

Building owners play a key role in approving components within a facility as well, such as installing dishwashers, which is vital for reducing waste. Their support is essential for unlocking zero waste initiatives. And lastly, the success of any zero waste program hinges on the cooperation of building occupants. This means properly sorting waste and avoiding unnecessary printing. 

CM: How does the familiar camping phrase “pack-in, pack out” apply to Zero Waste buildings?  

JH : The “pack-in, pack-out” mentality is essential for zero waste practices. The core idea is two-fold:

• It is based on an understanding that we should not bring and leave our waste elsewhere, and
• It creates a “nudge of inconvenience.” By making it less convenient to throw away waste, individuals may be less inclined to engage in waste-generating practices.

That said, it is not a solution for every situation, and it is important to recognize accessibility concerns. Not all individuals have equal access to reusable versus single-use consumption items. Accessibility can vary based on a variety of factors, and there are financial and time constraints to choosing less convenient consumption practices. Physical constraints can be a barrier as well for those with disabilities who may not have the option to choose reusable consumption (e.g. drinking a beverage without a straw).

Yet ultimately, the “pack-in, pack-out” mentality aims to view all locations like the wilderness and make a conscious effort to monitor and minimize our negative impact. It is one tactic to promote behavioral change toward reducing our current unsustainable rate of waste generation.

Chou Hall does not have any landfill bins. You heard it right! Their pack-in, pack-out policy for trash helps students and staff be aware of the waste they generate. 

Northern California Recycling Association

CM: How has Chou Hall influenced the operation of other buildings on the Berkeley campus? Do you see overall student behavior changing regarding waste generation?   

JH: UC Berkeley has developed its own zero waste program embodying many principles from the TRUE certification, which is being implemented in buildings across campus. Though not certified by TRUE, all new buildings at UC Berkeley are designed to be zero waste. There is a clear change in student behavior – they are taking more ownership and pride in the sustainability of their campus. Across campus there are student-generated signs, programs, clubs and policies in support of waste reduction education and infrastructural and programmatic change. It is powerful and energizing. Having that kind of student engagement is not unique but makes an impact toward achieving such ambitious sustainability goals.

Getting Started in your Workplace

To get started on a Zero Waste journey at your office, Dr. Nick Becker provides “18 Zero-Waste Tips to Implement in the Workplace,” (Becker, 2024).  Here are some concepts to get started.

For the complete list visit ClimateSort/zero-waste-tips.

More strategic zero waste strategies include encouraging employee and customer ideas on sustainability, going beyond pilots to create long-term initiatives for zero office waste. Partner with the facilities team, building management and your community to highlight zero waste initiatives. 

Chou Hall is a stand-out example of a zero waste building, holding the TRUE certification and positively influencing zero waste around the entire UC Berkeley campus. Functioning as a zero waste facility for 6 years, the success of the Chou Hall project in planning and on-going operation is dependent on effective collaboration between the facility staff, building owners, building users and consultants. Eliminating waste can be accomplished by reducing, reusing, recycling and composting to divert waste from landfills or incinerators. 

Becker, N., 2024. “18 Zero-waste tips to implement in the workplace,” Retrieved from: https://climatesort.com/zero-waste-tips/ Byrne, S., 2023. “300 TRUE projects are embodying net zero waste,” Retrieved from https://www.usgbc.org/articles/300-true-projects-are-embodying-net-zero-waste

Photos courtesy of Haas School of Business, University of California, Berkeley

• building community
• circular economy
• Cynthia Milota
• Jessica Heiges
• sustainability
• TRUE certification
• UC Berkeley Haas School

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