Business Case Studies & Business Publications

The University of Virginia Health System...

Landel, Robert D.,...

Case

The University of Virginia Health System (B): Are Service Lines the Answer?

Landel, Robert D.; Temkin, Jacqueline; Matherne, G. Paul

OM-1834 | Published May 19, 2025 | 2 pages Case

Collection: Darden School of Business

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Tracey Hoke, MD, chief of quality and performance improvement for the University of Virginia Health System (UVAHS), is deciding how to better achieve organizational goals in safety and quality. UVAHS is at a critical junction: It must adapt to changes in the health care industry to sustain itself financially. To do so, it has introduced new C-suite leadership, health system goals, and a new patient safety and quality-improvement program called Be Safe, which includes Lean performance-management tools. Now, Hoke must define next steps. The A case examines the transformation of UVAHS into a leader of operational excellence focused on both patient outcomes and health care team members’ well-being with its signature quality-improvement and safety program, Be Safe. This B case allows a deeper dive into hospital reorganization in order to effect change. The case set enables a discussion of operational management and leadership decision points. It provides opportunities for class discussions of managing organizational change, understanding senior leadership in launching and implementing a major operational transformation, and applying Lean principles and methods in health care operations. It also exposes students to issues currently facing the health care industry, particularly from an academic hospital standpoint. At the University of Virginia Darden School of Business, it is taught in the second-year elective, “Solutions and Innovations in Health Care”; it would also be suitable in a module covering Lean management systems.

To understand best practices in performance-improvement leadership at all organizational levels when driving operational changes in a complex health care system. To become familiar with the principles of Lean management and the use of Lean performance-management tools in settings where real-time problem-solving and escalating unresolved issues are mission-critical skills for all team members, including frontline providers, performance coaches, managers, and executive leaders. To analyze a major health system reorganization and consider what operational levers leaders could pull to ensure that clinical improvements implemented via Standard Work are being sustained across the board.