Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster Net Present Value (NPV) / MBA Resources

Introduction to Net Present Value (NPV) - What is Net Present Value (NPV) ? How it impacts financial decisions regarding project management?

NPV solution for Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster case study is a Harvard Business School (HBR) case study written by Gerard Seijts, Ken Mark. The Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster (referred as “Lhsc Sjhc” from here on) case study provides evaluation & decision scenario in field of Leadership & Managing People. It also touches upon business topics such as - Value proposition, Financial markets, Leadership, Mergers & acquisitions.

The net present value (NPV) of an investment proposal is the present value of the proposal’s net cash flows less the proposal’s initial cash outflow. If a project’s NPV is greater than or equal to zero, the project should be accepted.

NPV = Present Value of Future Cash Flows LESS Project’s Initial Investment

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Case Description of Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster Case Study

The transfer of perinatal services at St. Joseph's Health Care Centre (SJHC) to the Women's and Children's Services at London Health Sciences Centre (LHSC), included the relocation of clinical programs, 500 staff and about 40 physicians. SJHC's perinatal program had been among the hospital's premier programs and was recognized as a world-class tertiary perinatal program for more than 30 years. The hospital's comprehensive care for newborns included providing care for very sick infants and extremely premature babies. The move to LHSC was a source of much concern to key stakeholders, leading scientists and specialists with much negative impact on recruitment, retention and staff morale. The vice-president, acute and ambulatory care at SJHC and the vice-president, women and children's clinical business unit at LHSC were appointed to help prepare leaders throughout all stages of the restructuring. On their agenda were the following issues: culture, safety procedures, team conflict, excessive turnover, structure, leadership orientation, among others. Where should they start; and how could they get physicians, patient care leaders and staff to think past six months, given that there are numerous issues that keep them busy on a daily, weekly and monthly basis?

Case Authors : Gerard Seijts, Ken Mark

Topic : Leadership & Managing People

Related Areas : Financial markets, Leadership, Mergers & acquisitions

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Calculating Net Present Value (NPV) at 6% for Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10013189)	-10013189	-	-
Year 1	3445242	-6567947	3445242	0.9434	3250228
Year 2	3975060	-2592887	7420302	0.89	3537789
Year 3	3954016	1361129	11374318	0.8396	3319868
Year 4	3242444	4603573	14616762	0.7921	2568319
TOTAL			14616762		12676205

The Net Present Value at 6% discount rate is 2663016

In isolation the NPV number doesn't mean much but put in right context then it is one of the best method to evaluate project returns. In this article we will cover -

Different methods of capital budgeting

What is NPV & Formula of NPV,
How it is calculated,
How to use NPV number for project evaluation, and
Scenario Planning given risks and management priorities.

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Capital Budgeting Approaches

Methods of Capital Budgeting

There are four types of capital budgeting techniques that are widely used in the corporate world –

1. Profitability Index
2. Net Present Value
3. Internal Rate of Return
4. Payback Period

Apart from the Payback period method which is an additive method, rest of the methods are based on Discounted Cash Flow technique. Even though cash flow can be calculated based on the nature of the project, for the simplicity of the article we are assuming that all the expected cash flows are realized at the end of the year.

Discounted Cash Flow approaches provide a more objective basis for evaluating and selecting investment projects. They take into consideration both –

1. Timing of the expected cash flows – stockholders of Lhsc Sjhc have higher preference for cash returns over 4-5 years rather than 10-15 years given the nature of the volatility in the industry.
2. Magnitude of both incoming and outgoing cash flows – Projects can be capital intensive, time intensive, or both. Lhsc Sjhc shareholders have preference for diversified projects investment rather than prospective high income from a single capital intensive project.

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Formula and Steps to Calculate Net Present Value (NPV) of Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster

NPV = Net Cash In Flowt1 / (1+r)t1 + Net Cash In Flowt2 / (1+r)t2 + … Net Cash In Flowtn / (1+r)tn
Less Net Cash Out Flowt0 / (1+r)t0

Where t = time period, in this case year 1, year 2 and so on.
r = discount rate or return that could be earned using other safe proposition such as fixed deposit or treasury bond rate. Net Cash In Flow – What the firm will get each year.
Net Cash Out Flow – What the firm needs to invest initially in the project.

Step 1 – Understand the nature of the project and calculate cash flow for each year.
Step 2 – Discount those cash flow based on the discount rate.
Step 3 – Add all the discounted cash flow.
Step 4 – Selection of the project

Why Leadership & Managing People Managers need to know Financial Tools such as Net Present Value (NPV)?

In our daily workplace we often come across people and colleagues who are just focused on their core competency and targets they have to deliver. For example marketing managers at Lhsc Sjhc often design programs whose objective is to drive brand awareness and customer reach. But how that 30 point increase in brand awareness or 10 point increase in customer touch points will result into shareholders’ value is not specified.

To overcome such scenarios managers at Lhsc Sjhc needs to not only know the financial aspect of project management but also needs to have tools to integrate them into part of the project development and monitoring plan.

Calculating Net Present Value (NPV) at 15%

After working through various assumptions we reached a conclusion that risk is far higher than 6%. In a reasonably stable industry with weak competition - 15% discount rate can be a good benchmark.

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 15 %	Discounted Cash Flows
Year 0	(10013189)	-10013189	-	-
Year 1	3445242	-6567947	3445242	0.8696	2995863
Year 2	3975060	-2592887	7420302	0.7561	3005716
Year 3	3954016	1361129	11374318	0.6575	2599830
Year 4	3242444	4603573	14616762	0.5718	1853878
TOTAL					10455287

The Net NPV after 4 years is 442098

(10455287 - 10013189 )

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Calculating Net Present Value (NPV) at 20%

If the risk component is high in the industry then we should go for a higher hurdle rate / discount rate of 20%.

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 20 %	Discounted Cash Flows
Year 0	(10013189)	-10013189	-	-
Year 1	3445242	-6567947	3445242	0.8333	2871035
Year 2	3975060	-2592887	7420302	0.6944	2760458
Year 3	3954016	1361129	11374318	0.5787	2288204
Year 4	3242444	4603573	14616762	0.4823	1563679
TOTAL					9483376

The Net NPV after 4 years is -529813

At 20% discount rate the NPV is negative (9483376 - 10013189 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Lhsc Sjhc to discount cash flow at lower discount rates such as 15%.

Acceptance Criteria of a Project based on NPV

Simplest Approach – If the investment project of Lhsc Sjhc has a NPV value higher than Zero then finance managers at Lhsc Sjhc can ACCEPT the project, otherwise they can reject the project. This means that project will deliver higher returns over the period of time than any alternate investment strategy.

In theory if the required rate of return or discount rate is chosen correctly by finance managers at Lhsc Sjhc, then the stock price of the Lhsc Sjhc should change by same amount of the NPV. In real world we know that share price also reflects various other factors that can be related to both macro and micro environment.

In the same vein – accepting the project with zero NPV should result in stagnant share price. Finance managers use discount rates as a measure of risk components in the project execution process.

Sensitivity Analysis

Project selection is often a far more complex decision than just choosing it based on the NPV number. Finance managers at Lhsc Sjhc should conduct a sensitivity analysis to better understand not only the inherent risk of the projects but also how those risks can be either factored in or mitigated during the project execution. Sensitivity analysis helps in –

What can impact the cash flow of the project.

What will be a multi year spillover effect of various taxation regulations.

What are the key aspects of the projects that need to be monitored, refined, and retuned for continuous delivery of projected cash flows.

Understanding of risks involved in the project.

What are the uncertainties surrounding the project Initial Cash Outlay (ICO’s). ICO’s often have several different components such as land, machinery, building, and other equipment.

Some of the assumptions while using the Discounted Cash Flow Methods –

Projects are assumed to be Mutually Exclusive – This is seldom the came in modern day giant organizations where projects are often inter-related and rejecting a project solely based on NPV can result in sunk cost from a related project.

Independent projects have independent cash flows – As explained in the marketing project – though the project may look independent but in reality it is not as the brand awareness project can be closely associated with the spending on sales promotions and product specific advertising.

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Negotiation Strategy of Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster

References & Further Readings

Gerard Seijts, Ken Mark (2018), "Leading Change at SJHC and LHSC: Burr Under the Saddle or a Grain of Sand in the Oyster Harvard Business Review Case Study. Published by HBR Publications.