Effective operating models based on carefully selected resources, processes and logic allow organizations to develop the right products and services and deliver them to customers. However, there has been little investigation of how organizations design and manage their operating models when they enter new contexts due to changes in regulation, competition, markets, technology, location and/or a combination of these factors. This dissertation examines the relationship between an organization’s external context and its operating model by carefully examining the choice of operating resources, processes and logic as organizations enter new contexts. The dissertation specifically focuses on one developing country, India, and adopts an inductive approach to study the design of operating models in response to significant changes in location and/or market in three different empirical settings within the healthcare industry.
The first study, conducted jointly with Stefan Thomke, explores the influence of the institutional context on the R&D processes. Inductive field work, focused on medical device development at a newly established R&D center of a US MNC in India, suggests that institutional flexibility in emerging markets (such as India) might allow for high fidelity experimentation and testing during early stages of product development. This, in turn, has implications for R&D search performance and the locus of innovation and entrepreneurship.
The second study, a joint project with Rob Huckman and Tarun Khanna, identifies the development of an operating model based on the practice of shifting less complex surgical tasks from senior surgeons to skilled junior surgeons as fundamental in enabling Narayana Health (NH) to provide high-quality, low-cost cardiac surgery care to the indigent population in India. Our analysis of surgical outcome data suggests that the task shifting based model – while costing significantly less – does not negatively affect clinical outcomes. Further, we highlight the location-specific contextual factors that allow for such a model in India.
The third study, conducted with Tarun Khanna, focuses on NH’s design of a low-cost, high-quality tertiary care hospital in the Cayman Islands. The prior experience of developing different hospital models in response to the heterogeneous market in India allowed NH to develop a deep understanding of the environmental context and a diverse set of knowledge and practices. This understanding of and experience at diverse contexts informed the Cayman project, and NH was able to selectively borrow and recombine elements from their different models in India while setting up the Cayman hospital. Building on these findings, we develop a process model that highlights how recombination of elements developed to address heterogeneity of context in the home country can allow an organization to develop an effective operating model in the host country.
Collectively, the studies illustrate how the external context shapes an organization’s ability to design, implement and transfer operating models. At the same time, they emphasize that organizations can successfully develop an operating model to accommodate any significant context change by approaching the design effort as a fundamentally new design problem. This latter approach is in contrast to the often discussed replication-adaptation balancing approach that emphasizes marginal adaptation of prior established model(s). Further, by uncovering the importance of the local context in selecting and adopting specific operational resources and processes in healthcare settings in an emerging market, the studies contribute rich insights to the new yet growing streams of literature related to healthcare management in resource-constrained settings, innovation and entrepreneurship in emerging markets, and the transfer of innovations from developing to developed markets. In conclusion, by focusing on the relation among (1) the external context of an organization, (2) the design of operating logic, resources and processes and (3) organizational performance, this dissertation contributes to research in operations strategy, organization theory and the management of innovation and entrepreneurship.
| Identifer | oai:union.ndltd.org:harvard.edu/oai:dash.harvard.edu:1/32744399 |
| Date | January 2016 |
| Creators | Gupta, Budhaditya |
| Contributors | Khanna, Tarun, Thomke, Stefan |
| Publisher | Harvard University |
| Source Sets | Harvard University |
| Language | English |
| Detected Language | English |
| Type | Thesis or Dissertation, text |
| Format | application/pdf |
| Rights | embargoed |
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