Case Study

Leading in a Hurricane: The Midvale Healthcare system

4 pages
February 2024
Reference: IMD-7-2566

The Midvale Healthcare System case explores the impact of complexity, uncertainty, volatility and ambiguity (CUVA) on leadership decision making and prioritization. Midvale, a traditionally stable healthcare provider, is experiencing an escalating cascade of internal and external challenges. These include shifting patient demographics, reimbursement uncertainties, workforce shortages and evolving competitive pressures. Amid this whirlwind, CEO Sarah Martinez must grapple with the uncertain future of healthcare policy and rapid technological advancements while striving to maintain Midvale’s core focus on quality patient care. The case highlights the complexity of interconnected problems facing many business leaders today and the importance of recognizing, prioritizing and mobilizing to deal with emerging challenges and opportunities. It is a vehicle for exploring the key elements of strategic thinking, including pattern recognition, systems analysis, mental agility, structured problem solving, visioning and political savvy as presented in the book The Six Disciplines of Strategic Thinking.

Learning Objective
  • Identify and analyze CUVA factors: Explore how leaders can better deal with complexity uncertainty, volatility and ambiguity.
  • Apply strategic thinking disciplines: Recognize how disciplines such as pattern recognition, systems analysis and structured problem solving can help leaders recognize and prioritize emerging challenges and opportunities.
  • Prioritize under pressure: Understand how to assess key problem areas and propose priority sequences for action using data, even when it is incomplete or contradictory.
  • Evaluate decision trade-offs: Explore the implications of critical decisions facing leaders and their teams and the unavoidable sacrifices entailed regardless of the path chosen.
  • Engage with stakeholders: Develop strategies for transparently communicating and building support for strategic choices to internal and external stakeholders.
Strategic Thinking, Complexity, Decision Making, Problem Solving
Northern America, United States of America
Generalized Experience
© 2024
Available Languages
Related material
Teaching note
Case clearing houses
IMD case studies are distributed through case clearing houses. In order to browse the collection and purchase copies please visit the links below.

The Case Centre

Cranfield University

Wharley End Beds MK43 0JR, UK
Tel +44 (0)1234 750903
Email [email protected]

Harvard Business School Publishing

60 Harvard Way, Boston MA 02163, USA
Tel (800) 545-7685 Tel (617)-783-7600
Fax (617) 783-7666
Email [email protected]

Asia Pacific Case Center

NUCB Business School

1-3-1 Nishiki Naka
Nagoya Aichi, Japan 460-0003
Tel +81 52 20 38 111
Email [email protected]


Research Information & Knowledge Hub for additional information on IMD publications

Discover our latest research
IMD's faculty and research teams publish articles, case studies, books and reports on a wide range of topics