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Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

Case Study SWOT Analysis Solution

Case Study Description of Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges


This case deals with a project to build a hybrid operating room for cardiac surgery at Montreal's Sainte-Justine University Hospital. The case is discussed from the perspective of change management and implementation processes at the personal and organizational levels. The change involved the learning of new practices with state-of-the-art equipment and the collaboration of two medical teams: surgical and cardiology. This initiative, suggested by a cardiologist in 2002, was finally completed in 2010 following several years of fundraising efforts and the departure of several stakeholders. The arrival of a new CEO in 2009 gave fresh impetus to the project. The leaders of the two teams managed the change to the best of their ability, and a Tactical committee was set up to plan activities and prepare the various actors for the change (managers, cardiologists, cardiac surgeons, anesthesiologists, nurses, technologists, etc.). This case study of a successful change reports the perspectives and perceptions of fourteen key actors, including doctors, nurses, managers, administrators, heads of sectors and other units, and the chief executive officer.

Authors :: Ali Fadil, Celine Bareil, Isabelle Demers

Topics :: Leadership & Managing People

Tags :: , SWOT Analysis, SWOT Matrix, TOWS, Weighted SWOT Analysis

Swot Analysis of "Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges" written by Ali Fadil, Celine Bareil, Isabelle Demers includes – strengths weakness that are internal strategic factors of the organization, and opportunities and threats that Cardiac Justine facing as an external strategic factors. Some of the topics covered in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges case study are - Strategic Management Strategies, and Leadership & Managing People.


Some of the macro environment factors that can be used to understand the Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges casestudy better are - – increasing transportation and logistics costs, central banks are concerned over increasing inflation, digital marketing is dominated by two big players Facebook and Google, banking and financial system is disrupted by Bitcoin and other crypto currencies, talent flight as more people leaving formal jobs, cloud computing is disrupting traditional business models, increasing government debt because of Covid-19 spendings, increasing commodity prices, technology disruption, etc



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Introduction to SWOT Analysis of Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges


SWOT stands for an organization’s Strengths, Weaknesses, Opportunities and Threats . At Oak Spring University , we believe that protagonist in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges case study can use SWOT analysis as a strategic management tool to assess the current internal strengths and weaknesses of the Cardiac Justine, and to figure out the opportunities and threats in the macro environment – technological, environmental, political, economic, social, demographic, etc in which Cardiac Justine operates in.

According to Harvard Business Review, 75% of the managers use SWOT analysis for various purposes such as – evaluating current scenario, strategic planning, new venture feasibility, personal growth goals, new market entry, Go To market strategies, portfolio management and strategic trade-off assessment, organizational restructuring, etc.




SWOT Objectives / Importance of SWOT Analysis and SWOT Matrix


SWOT analysis of Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges can be done for the following purposes –
1. Strategic planning using facts provided in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges case study
2. Improving business portfolio management of Cardiac Justine
3. Assessing feasibility of the new initiative in Leadership & Managing People field.
4. Making a Leadership & Managing People topic specific business decision
5. Set goals for the organization
6. Organizational restructuring of Cardiac Justine




Strengths Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges | Internal Strategic Factors
What are Strengths in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The strengths of Cardiac Justine in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges Harvard Business Review case study are -

Training and development

– Cardiac Justine has one of the best training and development program in the industry. The effectiveness of the training programs can be measured in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges Harvard Business Review case study by analyzing – employees retention, in-house promotion, loyalty, new venture initiation, lack of conflict, and high level of both employees and customer engagement.

Organizational Resilience of Cardiac Justine

– The covid-19 pandemic has put organizational resilience at the centre of everthing that Cardiac Justine does. Organizational resilience comprises - Financial Resilience, Operational Resilience, Technological Resilience, Organizational Resilience, Business Model Resilience, and Reputation Resilience.

Sustainable margins compare to other players in Leadership & Managing People industry

– Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges firm has clearly differentiated products in the market place. This has enabled Cardiac Justine to fetch slight price premium compare to the competitors in the Leadership & Managing People industry. The sustainable margins have also helped Cardiac Justine to invest into research and development (R&D) and innovation.

High brand equity

– Cardiac Justine has strong brand awareness and brand recognition among both - the exiting customers and potential new customers. Strong brand equity has enabled Cardiac Justine to keep acquiring new customers and building profitable relationship with both the new and loyal customers.

Analytics focus

– Cardiac Justine is putting a lot of focus on utilizing the power of analytics in business decision making. This has put it among the leading players in the industry. The technology infrastructure suggested by Ali Fadil, Celine Bareil, Isabelle Demers can also help it to harness the power of analytics for – marketing optimization, demand forecasting, customer relationship management, inventory management, information sharing across the value chain etc.

Diverse revenue streams

– Cardiac Justine is present in almost all the verticals within the industry. This has provided firm in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges case study a diverse revenue stream that has helped it to survive disruptions such as global pandemic in Covid-19, financial disruption of 2008, and supply chain disruption of 2021.

Highly skilled collaborators

– Cardiac Justine has highly efficient outsourcing and offshoring strategy. It has resulted in greater operational flexibility and bringing down the costs in highly price sensitive segment. Secondly the value chain collaborators of the firm in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges HBR case study have helped the firm to develop new products and bring them quickly to the marketplace.

Superior customer experience

– The customer experience strategy of Cardiac Justine in the segment is based on four key concepts – personalization, simplification of complex needs, prompt response, and continuous engagement.

Low bargaining power of suppliers

– Suppliers of Cardiac Justine in the sector have low bargaining power. Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges has further diversified its suppliers portfolio by building a robust supply chain across various countries. This helps Cardiac Justine to manage not only supply disruptions but also source products at highly competitive prices.

Digital Transformation in Leadership & Managing People segment

- digital transformation varies from industry to industry. For Cardiac Justine digital transformation journey comprises differing goals based on market maturity, customer technology acceptance, and organizational culture. Cardiac Justine has successfully integrated the four key components of digital transformation – digital integration in processes, digital integration in marketing and customer relationship management, digital integration into the value chain, and using technology to explore new products and market opportunities.

Learning organization

- Cardiac Justine is a learning organization. It has inculcated three key characters of learning organization in its processes and operations – exploration, creativity, and expansiveness. The work place at Cardiac Justine is open place that encourages instructiveness, ideation, open minded discussions, and creativity. Employees and leaders in Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges Harvard Business Review case study emphasize – knowledge, initiative, and innovation.

Operational resilience

– The operational resilience strategy in the Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges Harvard Business Review case study comprises – understanding the underlying the factors in the industry, building diversified operations across different geographies so that disruption in one part of the world doesn’t impact the overall performance of the firm, and integrating the various business operations and processes through its digital transformation drive.






Weaknesses Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges | Internal Strategic Factors
What are Weaknesses in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The weaknesses of Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges are -

Slow to strategic competitive environment developments

– As Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges HBR case study mentions - Cardiac Justine takes time to assess the upcoming competitions. This has led to missing out on atleast 2-3 big opportunities in the industry in last five years.

Products dominated business model

– Even though Cardiac Justine has some of the most successful products in the industry, this business model has made each new product launch extremely critical for continuous financial growth of the organization. firm in the HBR case study - Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges should strive to include more intangible value offerings along with its core products and services.

Employees’ incomplete understanding of strategy

– From the instances in the HBR case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges, it seems that the employees of Cardiac Justine don’t have comprehensive understanding of the firm’s strategy. This is reflected in number of promotional campaigns over the last few years that had mixed messaging and competing priorities. Some of the strategic activities and services promoted in the promotional campaigns were not consistent with the organization’s strategy.

High bargaining power of channel partners

– Because of the regulatory requirements, Ali Fadil, Celine Bareil, Isabelle Demers suggests that, Cardiac Justine is facing high bargaining power of the channel partners. So far it has not able to streamline the operations to reduce the bargaining power of the value chain partners in the industry.

High dependence on existing supply chain

– The disruption in the global supply chains because of the Covid-19 pandemic and blockage of the Suez Canal illustrated the fragile nature of Cardiac Justine supply chain. Even after few cautionary changes mentioned in the HBR case study - Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges, it is still heavily dependent upon the existing supply chain. The existing supply chain though brings in cost efficiencies but it has left Cardiac Justine vulnerable to further global disruptions in South East Asia.

High dependence on star products

– The top 2 products and services of the firm as mentioned in the Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges HBR case study still accounts for major business revenue. This dependence on star products in has resulted into insufficient focus on developing new products, even though Cardiac Justine has relatively successful track record of launching new products.

Need for greater diversity

– Cardiac Justine has taken concrete steps on diversity, equity, and inclusion. But the efforts so far has resulted in limited success. It needs to expand the recruitment and selection process to hire more people from the minorities and underprivileged background.

Slow to harness new channels of communication

– Even though competitors are using new communication channels such as Instagram, Tiktok, and Snap, Cardiac Justine is slow explore the new channels of communication. These new channels of communication mentioned in marketing section of case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges can help to provide better information regarding products and services. It can also build an online community to further reach out to potential customers.

Workers concerns about automation

– As automation is fast increasing in the segment, Cardiac Justine needs to come up with a strategy to reduce the workers concern regarding automation. Without a clear strategy, it could lead to disruption and uncertainty within the organization.

Capital Spending Reduction

– Even during the low interest decade, Cardiac Justine has not been able to do capital spending to the tune of the competition. This has resulted into fewer innovations and company facing stiff competition from both existing competitors and new entrants who are disrupting the industry using digital technology.

High cash cycle compare to competitors

Cardiac Justine has a high cash cycle compare to other players in the industry. It needs to shorten the cash cycle by 12% to be more competitive in the marketplace, reduce inventory costs, and be more profitable.




Opportunities Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges | External Strategic Factors
What are Opportunities in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The opportunities highlighted in the Harvard Business Review case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges are -

Redefining models of collaboration and team work

– As explained in the weaknesses section, Cardiac Justine is facing challenges because of the dominance of functional experts in the organization. Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges case study suggests that firm can utilize new technology to build more coordinated teams and streamline operations and communications using tools such as CAD, Zoom, etc.

Lowering marketing communication costs

– 5G expansion will open new opportunities for Cardiac Justine in the field of marketing communication. It will bring down the cost of doing business, provide technology platform to build new products in the Leadership & Managing People segment, and it will provide faster access to the consumers.

Increase in government spending

– As the United States and other governments are increasing social spending and infrastructure spending to build economies post Covid-19, Cardiac Justine can use these opportunities to build new business models that can help the communities that Cardiac Justine operates in. Secondly it can use opportunities from government spending in Leadership & Managing People sector.

Building a culture of innovation

– managers at Cardiac Justine can make experimentation a productive activity and build a culture of innovation using approaches such as – mining transaction data, A/B testing of websites and selling platforms, engaging potential customers over various needs, and building on small ideas in the Leadership & Managing People segment.

Reconfiguring business model

– The expansion of digital payment system, the bringing down of international transactions costs using Bitcoin and other blockchain based currencies, etc can help Cardiac Justine to reconfigure its entire business model. For example it can used blockchain based technologies to reduce piracy of its products in the big markets such as China. Secondly it can use the popularity of e-commerce in various developing markets to build a Direct to Customer business model rather than the current Channel Heavy distribution network.

Buying journey improvements

– Cardiac Justine can improve the customer journey of consumers in the industry by using analytics and artificial intelligence. Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges suggest that firm can provide automated chats to help consumers solve their own problems, provide online suggestions to get maximum out of the products and services, and help consumers to build a community where they can interact with each other to develop new features and uses.

Low interest rates

– Even though inflation is raising its head in most developed economies, Cardiac Justine can still utilize the low interest rates to borrow money for capital investment. Secondly it can also use the increase of government spending in infrastructure projects to get new business.

Finding new ways to collaborate

– Covid-19 has not only transformed business models of companies in Leadership & Managing People industry, but it has also influenced the consumer preferences. Cardiac Justine can tie-up with other value chain partners to explore new opportunities regarding meeting customer demands and building a rewarding and engaging relationship.

Remote work and new talent hiring opportunities

– The widespread usage of remote working technologies during Covid-19 has opened opportunities for Cardiac Justine to expand its talent hiring zone. According to McKinsey Global Institute, 20% of the high end workforce in fields such as finance, information technology, can continously work from remote local post Covid-19. This presents a really great opportunity for Cardiac Justine to hire the very best people irrespective of their geographical location.

Leveraging digital technologies

– Cardiac Justine can leverage digital technologies such as artificial intelligence and machine learning to automate the production process, customer analytics to get better insights into consumer behavior, realtime digital dashboards to get better sales tracking, logistics and transportation, product tracking, etc.

Use of Bitcoin and other crypto currencies for transactions

– The popularity of Bitcoin and other crypto currencies as asset class and medium of transaction has opened new opportunities for Cardiac Justine in the consumer business. Now Cardiac Justine can target international markets with far fewer capital restrictions requirements than the existing system.

Changes in consumer behavior post Covid-19

– Consumer behavior has changed in the Leadership & Managing People industry because of Covid-19 restrictions. Some of this behavior will stay once things get back to normal. Cardiac Justine can take advantage of these changes in consumer behavior to build a far more efficient business model. For example consumer regular ordering of products can reduce both last mile delivery costs and market penetration costs. Cardiac Justine can further use this consumer data to build better customer loyalty, provide better products and service collection, and improve the value proposition in inflationary times.

Creating value in data economy

– The success of analytics program of Cardiac Justine has opened avenues for new revenue streams for the organization in the industry. This can help Cardiac Justine to build a more holistic ecosystem as suggested in the Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges case study. Cardiac Justine can build new products and services such as - data insight services, data privacy related products, data based consulting services, etc.




Threats Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges External Strategic Factors
What are Threats in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The threats mentioned in the HBR case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges are -

Increasing wage structure of Cardiac Justine

– Post Covid-19 there is a sharp increase in the wages especially in the jobs that require interaction with people. The increasing wages can put downward pressure on the margins of Cardiac Justine.

Trade war between China and United States

– The trade war between two of the biggest economies can hugely impact the opportunities for Cardiac Justine in the Leadership & Managing People industry. The Leadership & Managing People industry is already at various protected from local competition in China, with the rise of trade war the protection levels may go up. This presents a clear threat of current business model in Chinese market.

Shortening product life cycle

– it is one of the major threat that Cardiac Justine is facing in Leadership & Managing People sector. It can lead to higher research and development costs, higher marketing expenses, lower customer loyalty, etc.

New competition

– After the dotcom bust of 2001, financial crisis of 2008-09, the business formation in US economy had declined. But in 2020 alone, there are more than 1.5 million new business applications in United States. This can lead to greater competition for Cardiac Justine in the Leadership & Managing People sector and impact the bottomline of the organization.

Backlash against dominant players

– US Congress and other legislative arms of the government are getting tough on big business especially technology companies. The digital arm of Cardiac Justine business can come under increasing regulations regarding data privacy, data security, etc.

Regulatory challenges

– Cardiac Justine needs to prepare for regulatory challenges as consumer protection groups and other pressure groups are vigorously advocating for more regulations on big business - to reduce inequality, to create a level playing field, to product data privacy and consumer privacy, to reduce the influence of big money on democratic institutions, etc. This can lead to significant changes in the Leadership & Managing People industry regulations.

Technology disruption because of hacks, piracy etc

– The colonial pipeline illustrated, how vulnerable modern organization are to international hackers, miscreants, and disruptors. The cyber security interruption, data leaks, etc can seriously jeopardize the future growth of the organization.

Instability in the European markets

– European Union markets are facing three big challenges post Covid – expanded balance sheets, Brexit related business disruption, and aggressive Russia looking to distract the existing security mechanism. Cardiac Justine will face different problems in different parts of Europe. For example it will face inflationary pressures in UK, France, and Germany, balance sheet expansion and demand challenges in Southern European countries, and geopolitical instability in the Eastern Europe.

Easy access to finance

– Easy access to finance in Leadership & Managing People field will also reduce the barriers to entry in the industry, thus putting downward pressure on the prices because of increasing competition. Cardiac Justine can utilize it by borrowing at lower rates and invest it into research and development, capital expenditure to fortify its core competitive advantage.

Increasing international competition and downward pressure on margins

– Apart from technology driven competitive advantage dilution, Cardiac Justine can face downward pressure on margins from increasing competition from international players. The international players have stable revenue in their home market and can use those resources to penetrate prominent markets illustrated in HBR case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges .

Stagnating economy with rate increase

– Cardiac Justine can face lack of demand in the market place because of Fed actions to reduce inflation. This can lead to sluggish growth in the economy, lower demands, lower investments, higher borrowing costs, and consolidation in the field.

High dependence on third party suppliers

– Cardiac Justine high dependence on third party suppliers can disrupt its processes and delivery mechanism. For example -the current troubles of car makers because of chip shortage is because the chip companies started producing chips for electronic companies rather than car manufacturers.

Environmental challenges

– Cardiac Justine needs to have a robust strategy against the disruptions arising from climate change and energy requirements. EU has identified it as key priority area and spending 30% of its 880 billion Euros European post Covid-19 recovery funds on green technology. Cardiac Justine can take advantage of this fund but it will also bring new competitors in the Leadership & Managing People industry.




Weighted SWOT Analysis of Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges Template, Example


Not all factors mentioned under the Strengths, Weakness, Opportunities, and Threats quadrants in the SWOT Analysis are equal. Managers in the HBR case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges needs to zero down on the relative importance of each factor mentioned in the Strengths, Weakness, Opportunities, and Threats quadrants. We can provide the relative importance to each factor by assigning relative weights. Weighted SWOT analysis process is a three stage process –

First stage for doing weighted SWOT analysis of the case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges is to rank the strengths and weaknesses of the organization. This will help you to assess the most important strengths and weaknesses of the firm and which one of the strengths and weaknesses mentioned in the initial lists are marginal and can be left out.

Second stage for conducting weighted SWOT analysis of the Harvard case study Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges is to give probabilities to the external strategic factors thus better understanding the opportunities and threats arising out of macro environment changes and developments.

Third stage of constructing weighted SWOT analysis of Implementation of a Hybrid Operating Room for Cardiac Surgery at the Sainte-Justine University Hospital: Collaboration and Change Management Challenges is to provide strategic recommendations includes – joining likelihood of external strategic factors such as opportunities and threats to the internal strategic factors – strengths and weaknesses. You should start with external factors as they will provide the direction of the overall industry. Secondly by joining probabilities with internal strategic factors can help the company not only strategic fit but also the most probably strategic trade-off that Cardiac Justine needs to make to build a sustainable competitive advantage.



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