D/601/0578 Unit 6 Case Study of Surgical Industry in Sialkot

SMEs make various contributions to the economy but when it comes to the international market they are facing more consequences and problems. There are numerous challenges faced by the entrepreneur while expanding their businesses. Some of the issues faced by SME are funding, finance, poor management, and inadequate training (Bondinuba, 2012). Due to this, there was the high result of the failure in SME business. The study investigates various aspects which affect them at international level. Further, it details how they can become the branded entity and what strategies and planning are required to raise the level in the market at any place. The report is based on the particular company Surgical instrument manufacturer in Sialkot which is developing strategies to expand its business in UK. Sialkot is the largest centre of surgical instruments manufacture globally and contributes to business turnover of more than US$22M . However, they require improvement in their working conditions, technology and sector structure to expand at a global level and establish as better brand.

1.2 Rationale of the study

Globalization has ushered new opportunities for the small ventures and with this challenge for them also have been increased. The major objective of the study is to explore the ways that could be used by SME's for growing a brand in the international market. This study is conducted for identifying the ways that could be used by SMEs for developing themselves as a brand in the international market area. This will help them to increase their market value, profit level and brand image in other countries and will act as  international market penetration for these companies. Further, it will increase the trade between the countries. Though, there are opportunities to such companies in the international market however, sometimes they are grabbed by the large enterprise as they have higher financial and market support. For illustration, in order to brand Surgical instrument manufacturer in Pakistan requires financial support, ability to face business challenge, market assessment, innovation tracking and industrial intelligence to achieve global position. Besides this, as they have minimum employees so it is difficult to them to generate reven  ue and profit for business expansion. Along with this, challenges are faced by small enterprises in developing themselves as a brand and through this they ensure long-term economic growth in the market. They also face issues for strengthening their presence at the international platform.

Case Study Of AUBMC

The emphasis on the different countries and enterprise performance in those areas are reflected in the research. Moreover, factors, issues, and methods are used to evaluate the research so that depth analysis of the research can be done. In many countries due to micro and macro environmental factors companies are unable to expand and make their global position such as communication level, brand message and consistency. It has been the main reason why many SMEs are unable to make their brand internationally. Priority on the human capital, environmental factors, and economic sustainability must be given by the SME so that they can make successful changes in the brand level. Therefore, above factors must be considered and focus should be there on how these companies can make an international global presence.

1.3 Significance of the study

Outcomes of the study will help for exploring various ways that could be used by SME for developing themselves as a brand in the international market. Findings of the study can be used by managers and owners of the SME's for developing themselves as a brand at international market. Further, the outcomes and findings gained from the study will also help to the future scholars for carrying out research on the similar topics. Gaps in the literature can be filled in better and effective way. Ways which will be explored in the present research will help the SME's to develop themselves. The ideas suggested in the study will also support in the future studies which are related to this topic. It will focus on the economic issues, insights, and awareness so that additional information can be provided in the research. Moreover, through the research, the researcher wants to contribute to society by providing the value and ethics based services. For the company, Surgical instrument manufacturer, there are various advantages that can be seen. It can effectively communicate at greater level, brand message can be shown, they can use the appropriate tone to make their brand image. Other than this, demographic, purchasing ability, job outlook, governmental, economical-social stability, and economic growth projections in the region can be achieved by the company. All these can be achieved using the international marketing penetration strategies.

1.4 Aims and Objectives

Aim:- To understand the ways in which Sialkot surgical instrument SME's can develop themselves as a brand in the international market, specifically to the UK.

Objectives:-

• To understand how SME's are performing in the international market.
• To identify the challenges faced by SME's like Surgical instrument manufacturer in developing themselves as the brand in the international market.
• To identify the ways that could be used by Sialkot surgical instrument developing themselves as a brand.

Research questions

• How SME's performing n the international market?
• What are the challenges faced by Surgical instrument manufacturer in developing themselves as a brand in the international market, particularly/ specificaly the UK?
• What are the techniques that could be used by SME's for developing themselves as a brand?
• How does a brand changes the working of SMEs at international level?

1.5 Analysis and framework

In the current research study, the major aim of the scholar is to explore ways that could be used by SME's for developing themselves as a brand in the international market. Information for the present study will be collected from valid and reliable sources and it will help the researcher for arriving at conclusion. Various steps which will be taken for completing the study areas mentioned:

Design of research: Research design is the basic general plan which will be used in the research to identify all the answer of the question asked above. There is two type of research design, exploratory and conclusive research. The following research is exploratory in nature and statistical design is considered to complete the research. Data needed is vague/unclear and sources are ill-defined. Further, open-minded or rough data collection form has been taken in the research. For this purpose, the relatively small sample is taken which is done to cover maximum topics. In-depth data collection methods are used in the more flexible way. The analysis is done is non-quantitative and qualitative manner. It is more tentative then final.

Research approach: The research will be completed by making use of the inductive approach. It will support for identifying the ways that could be used by SME's for developing themselves as a brand in the international market. An inductive approach is a suitable approach which will help for completing the entire study in an effective manner as it is based on the interview.

Research philosophy: It is the belief through which research data is collected, analysed and used. In the present study, a combination of interpretivism and positivism philosophy will be used for completing the entire project in an effective manner. Positivism is based on objective viewpoint through which it can be described and observed. In this, it is considered that reality is pure while the former one is based on subjective interpretation and intervention. It helps to fully understand the reality.

Methods for collection of data: Primary and secondary data will be collected and used for completing the research study. Primary data will be collected by organizing the In-depth interview. Secondary data will be collected through books, journals, online articles, and websites.

Sampling technique: In the current study probability and non-probability both the type of sampling methods will be used. It will provide a suitable method for selecting the participants for the research study.

Analysis of data: The study conducted with the aim to explore ways through which SME's can develop themselves as a brand at the global platform. In this study use of qualitative analysis will be taken for analysing the data that have been collected by the scholar.

The scope of the study: The scope of the study is limited to 2005-2017 in SME contribution at the international level. As there is much research done on this topic so several areas which promote the SME to become an international brand are mentioned. There were also some assumptions made related to the SME performance at the global level. Further, their influence is also mentioned in it. The research will help these companies to make the global presence and expand their brand level to such height. Moreover, it will support the future development of new policies and procedures that will help such companies to extend their profitability and performance level.

1.6 Structures of the Thesis

 The following structure will be adopted to further access a structure study for easily attain its under taken goals and objectives:

Chapter 1 Introduction: It is the initial part of the research in which research aims and objectives are mentioned.  Moreover, other information regarding research conducting, process, tools and techniques used in the research are mentioned. It is the brief overview of the topic and objectives which will be achieved in the research project.

Chapter 2 Literature review: The second section of the report which comprises of evaluation of the objectives of the research. Here the topic is analyzed and reviewed on the researcher's perspective and answers to the question are identified. For the current report, themes were formed related to issues with SME's brands and international market. 

Chapter 3 Research methodologies: Main area of the research where discussion related to tools and techniques used are mentioned. For the current research project primary data, qualitative method, inductive approach and an in-depth interview have been taken. Moreover, non-probability sampling methods are used.

Chapter 4 Data analysis: In this section of the research project, data regarding the primary source is analysed. In this details are gathered from the in-depth interviews.

Chapter 5 Conclusion and recommendations: The last section of the report where finding from the in-depth interviews are mentioned. The outcomes from their perspective are written in the report which highlights the issues faced by the SME in establishing their products as the brand at International market. Further, the recommendation is provided which can help them to grow.

CHAPTER 2- LITERATURE REVIEW

This chapter of the research reviews about the literature section based on the subject of this topic. It outlines the introduction and evaluation of certain themes based on the project.

2.1 Introduction

In order to achieve national goals in the countries, it has been analysed that small and medium-sized ventures should be promoted. They are responsible for the creation of competition in the market along with providing various employment opportunities (Wynarczyk, Watson and Keasey, 2016). Thus, automatically livelihood gets enhanced. That's why the government is also supporting them in many countries by creating policies and programs which are intended to develop SME in the international market. With the varied regions, the definition of the small and medium-sized enterprise also varies. There are three factors that are taken into consideration related to it: number of employees working in the organization, the investment that involves capital and use of advanced technology and turnover that is income generated from business operations (Cagno and Trianni, 2014). At present situation SME's are contributing factor in bringing innovations in their related work. Business environment plays important role in development of products and services. In the current research, ways to develop SME's as a brand along with challenges faced by them will be covered. To identify and analyse this, various theories and models will be utilized which would help in identification of ways for the development of small and medium-sized enterprises as a brand in the international market. It would assist the investigator to develop an understanding of the current topic.

2.2 Theoretical framework

2.2.1 International relation theories

            Discipline and diversity are considered as an important aspect for the firm to expand at the international level. Branding is the vital sources that defines the core values of the entity which makes it main reason that branding is critical in international market penetration.  Further, they are main reason through which product can be made branded at international level. It helps to widespread recognition and maintains the realistic tradition of the company in the other countries. Moreover, it reduces the level of complexity which can affect the SME in expanding and promoting their brand at the international level. Modification and changes made under this theory support the company to evolve in the global market.

2.2.2 Sociological Theory

            The theory is based on the different concepts which are associated with the social cultures followed by entrepreneurs. Moreover, these social-culture helps them to extend their entrepreneurship. They are mostly affected by the society and wanted to improve so that they can make a global presence and explore their brand to another country. Capitalism and religion are two important aspects which help an entrepreneur to extend their business. Along with this, integration of an adventurous free-spirit and discipline entrepreneur helps the firm to make the global presence and explore its product in the market.

2.3 Performance of SME's in the international market

In the international market research, it has always been considered that small-sized enterprises are not as competitive as large firms. The reason behind this is the unavailability of resources for carrying out business operations effectively. According to the Giaoutzi, Nijkamp, and Storey, (2016), there has always been the conflicting situation when the size of the firm and its performance is taken into consideration. Performance of the businesses could be enhanced in the international market by developing marketing strategies. Effective strategies result in better and productive outcomes. It has always been seen that most of the entrepreneurs spend their money and capital on marketing their products and services so that customers could be attracted towards it (Giaoutzi, Nijkamp and Storey, 2016). Thus, as a result, an impact is seen on their return on investment which might affect their brand image. 

            Small and medium-sized business enterprises generally consist of 500 employees or less  than that (Jansson, et al., 2017).  There are several benefits of them over big sized organizations. Performance of them could be identified and analysed by the considering following factors.

• Flexibility: these companies are able to give responses quickly in the changing environment. These are also benefited in terms of making decisions for the venture. If business opportunities are identified that could be challenging for the competitors, then it is required to have flexibility so that changes could be adopted in working practices. Brunswicker and Vanhaverbeke, (2015) said that SME's are capable in this context. As there is a limited number of employees, thus it becomes much easier to implement change.
• Team spirit: When employees work with one another, they meet and have the tendency also to cooperate with one another. There is competition also among employees to work much better so that they could hold the strong position in the venture. It thus becomes the responsibility of the company owner and top-level authorities only to recognize strengths and weakness of the workers so that on analyzing, it could be utilized effectively for the growth and success of the firm (Brunswicker and Vanhaverbeke, 2015). Employees are critical elements of success.
• Customer interaction: For all the business to get successful they are needed to acquire customer satisfaction. If the products and services provided by the SME's are not satisfactory for the clients, then no growth could be attained by the firm in the market. In order to have a competitive advantage, it is required by the management and administration team of the company to maintain interactions with customers so that their needs and expectations from the company could be analyzed.

            According to the Laufs and Schwens, (2014) when there is the unavailability of capital with the SME's, then they should opt for those methods that could help them effectively without being creating demands for the huge amount of capital investments. Thus, for marketing goods, websites and business cards could be utilized that does not cost much. Nowadays, Social platform media has become the most efficient medium for business promotion which contributes in enhancing enterprise performance as well (Laufs and Schwens, 2014). Various platforms are available such as Twitter, Facebook, Instagram and much more. On an average of two hours on daily basis are spent by people on the surfing these socializing applications. Whereas Trianni, Cagno, and Farné, (2016) state that scattergun approach could be utilized in which it is hoped that by implementing the marketing plan, something might work rather than waiting for some systematically planned strategy to be executed and worked out (Trianni, Cagno and Farné, 2016). Thus, some of the steps that could be adopted by SME's so that their efficiency in the market could be improved with the help of limited budget.

• Planning: It is the foremost step which should be adopted by the companies to identify potential competitors in the market. To hold the competitive advantage in the market it is essential to analyze what offerings are being offered to the customers by other ventures and what improvements could be made in our work so that more number of consumers could be attracted towards the brand. By proper market analysis, one could identify areas in which firm lacks and accordingly enhancement strategy could be implemented (Laufs and Schwens, 2014). It should also be analyzed that what marketing plan could be used with effective cost saving. Ways should be analysed that could assist effectively in budget management. Cost efficient tools such as internet could be used and peak time could be used for promoting products when most of the people are online. Thus, it would provide assistance in gaining attention in the market. Online research could be helpful to examine why people are looking for specific product and what are there are requirements.
• Set objectives: It is essential for SME's to set objectives of the business so that their needs could be analyzed and on the basis of it, marketing plan could be developed (Voss and Voss, 2013). Effective plan and strategies help in an acquisition of goals and achieve high performance in the marketplace. In this stage, time frames should be formulated which includes at what time specific goal and target should be accomplished. Along with setting up time period for work to get complete, success measurement tools should also be identified. It is essential to identify performance and success of the strategy implemented. Rapid analysis helps in identification of tweaks in the working procedures. To measure the performance of the marketing plan on the social media platforms, various tools could be utilized such as Google Analytics and Hootsuite.

            Before spending time into the formulation of objectives, it should be analysed that what does the enterprise wants from customers and accordingly strategies should be formulated. Thus, for achieving them, resources should be properly accessed which could be utilized to it. The objective and vision should always be clear as it helps in identifying expectations of the firm from the market.

• Knowing local suppliers: Cowling, Liu and Zhang, (2015) stated that for development of products at the international level there is the requirement of raw materials and it is not possible all the time to import materials because they might not be cost-effective and chances are also there that their quality is not up to the mark. Thus, it is always advised that local suppliers should be preferred for buying (Cowlin, Liu and Zhang, 2015). From the research conducted, it should be analysed that what are the objectives and what are the necessary requirements for fulfilling them.
• Become an expert: One of the most effective ways for the establishment of business enterprise is social networking. People should be provided with quality contents. Blogs could also be written so that everybody could be made aware of it. Popular blogs should be utilized as they are the most effective mediums to reach out customers. WordPress, mojoPortal etc. are the popular platforms that could be utilized for combining of blogs with the websites. Marketing is one of the most important aspects when the concept of business promotion is considered as it is beneficial in making people aware of the offerings of the venture but it should also be noticed that everything should not be executed at once rather proper research should be conducted, planning should be prepared and tools should be utilized for branding of products and offered by firm.

 Thus, all such techniques could be utilized for measuring the performance and brand value of the SME's in the international market.

2.4  Developing strategies and standards for expansion and becoming the international brand.

Government regulations also help the company to expand their business. Micro and Small Enterprise Act, 2012, in Kenya, has provided great chances through which evolution of such enterprise can be realized through the devolution. Devolution in such companies is based on the architecture, industrial frameworks, and regulations which support their economy (Brunswicker and Vanhaverbeke, 2015). Policies and procedure decided by them affect the company at more higher level. Further, license, taxation, wages and various other important reasons are there for which such companies need to consider. Economically, if the company is affected then there will be higher rate that company brand standards will also decrease. Most of the companies use it for the advertising, expanding business and marketing. Brand standards can be about the awareness, identity, communication methods, loyalty and strategies. In order to measure the effectiveness of the brand, its equity values are required to be identified which depends on the components level (Crick and Crick, 2014). There are various issues that can be faced by the company in making strategies and planning for the branding as-well-as to move at international market. These are cultural, economic, governmental, and market conditions. For this the organisation must be specific about the overall corporate strategy and objectives. Further,  governmental policies and regulations are required to be understood for such expansion.  All these things must be considered and strategies must be made accordingly.

2.5 Challenges faced by SME's in developing themselves as the brand in the international market.

In the economic development of the country, small and medium-sized enterprises play an important role. They are contributing factor in country's economy. Percentage of contribution varies with the variation in the business sector. According to the Johnson (2015), several employment opportunities are also created by them for the skilled and unskilled people. Everyone could be engaged in certain job roles. Approximately one million jobs are created by them every year.  There are various challenges that are faced by small and medium scale businesses in the competitive world. It is always needed that proper market analysis should be performed before starting any new business because to start something, huge efforts are required irrespective of the years of experience you have in the field (Johnson, 2015). Generally, there is the unavailability of resources and capital in the initial time. All such type of factors creates challenges for the firm. From the research conducted by Forbes, it has been found that out of ten start-up companies, nine would fail. Thus, effective management of them is required so that businesses could survive in the market. van Hoof and Thiell, (2014) states that strategies would vary from company to company. Some of the major issues faced by them are listed below:

• Cash flow management: Every small and medium scale businesses are required to manage cash flow efficiently without considering profits. To set up any business it is required to have capital and money in hand. Without cash, no operations and activities could be carried out. Salaries required to be paid to the employees could also not be managed (van Hoof and Thiell, 2014). Many times it is observed that money is into hands but cash flow is not maintained properly. Thus, steady flow of money is required in the businesses.
• Time management: with the startup companies the major issue commonly noticed is that they are not being able to achieve the target set by them on time because of lack of availability of resources. They are small-sized companies with few numbers of employees, thus it becomes difficult to acquire goals. According to the Cagno and Trianni, (2014) without depending on the employees to cover to objectives, one should themselves find out all the aspects including requirements to carry out the specific task, marketing plan for promoting products, ways to achieve customer satisfaction. It also necessary to analyze possible time frames that would be required for the accomplishment of tasks (Cagno and Trianni, 2014). By analyzing all the areas, necessary investments should b made so that maximum benefits could be generated.
• Learning with experience: While implementing new strategy there is always risk associated with it which is a most common challenge faced by SME's. According to the Resnick, Cheng, and Lourenço, (2016) it is required for small-scale enterprises that they should always keep learning from implementing new strategies and outcomes generated from them should be kept for future reference. This would be helpful for the firms as they would be able to understand what steps should be taken up by them and what improvements should be introduced in the working practices so that errors and its failure in the implementation process could be improved (Resnick, Cheng and Lourenço, 2016). Planning could be seen as hit and miss process because what works for one company would not be applicable to others.
• Recruitment of employees: For efficient working of the organization it is essential to hire workers that could benefit in terms of making profits and increasing productivity. In small and medium-sized businesses, employees are not permanent. It is the common tendency of the people to always grab the opportunity to work with big companies. As a result, they leave their job and ventures have to face its consequences. A huge amount of time gets invested in providing training to the new employees along with capital investment as well. In the given context, one of the major challenges is that to hire skilled workers irrespective of the number of employees within the organization. If the wrong person is hired, then there could have the negative impact on the firm. Thus, it is necessary to have loyal and enthusiastic members that could help in the growth of the company irrespective of the number of issues and problems they come across. Hired staff should be motivating and it should help others as well so that maximum efforts could be given up by everyone. Hired employees should be capable enough to work with all the business environment and integrate with teams so that collectively they could come with productive outputs.
• The balance between long and short termed goals: One of the major challenge faced by the SME's is to maintain the balance between set goals. Here, short termed goals are easy to achieve and long-term are not given much value. Finding the balance between them seems to be the big issue.

 Apart from them, there are certainly more challenges that are being faced by SME's in today's world. These are discussed below:

• National Living Wage: From the April month, it has been made compulsory that minimum of £7.20 will be paid to the employees for working one hour with the organization whereas, till 2020 it would be raised to £9 per hour. Therefore, there would be the rise of 0.3% in the bills. According to the Lund-Thomsen, Lindgreen and Vanhamme, (2016) NLW would create challenges for the SME's in the sectors of hospitality, social care. From the surveys conducted it has been found that there will be the negative impact of it on small and medium scale businesses. There were only a few people who agreed on its positive impact.
• Shortage of skills: for business growth and expansion it is essential to have right skills in the company that could contribute to development and success of the firm. From the surveys conducted it has been found that approximately one-third of the SME's agreed that they are not having the skilled workforce which could assist in meeting requirements of the business (Lund-Thomsen, Lindgreen, and Vanhamme, 2016). It has also been considered as a barrier in the evolution process of the firm.

2.6 Ways that could be used by SME's to develop themselves as a brand.

According to the Renton, Daellenbach, and Davenport, (2016) with the increased competition in the market, the requirement for skilled employees have also increased. To succeed in the competitive world it is required to have talented and skilled employees that could contribute to growth and success of the firm. SME's are growing so fast and has made the significant contribution in the economy of the UK and several other countries. It has been seen that over the past few years rate of unemployment among youth has also seen the significant rise, thus SME's are playing contributing role in creating employment opportunities for the people (Renton, Daellenbach and Davenport, 2016). Ways that could be used by them for developing themselves as a brand are discussed below:

• By promoting benefits of working within SME's could help in attracting applicants. In the promotional process of vacancies, it could be bestowed that they are small companies with huge employment opportunities. Advantages of working within it should also be figured out and it should be presented in such a way that a maximum number of applicants could be attracted to work with them. In such type of organizations, hands-on experience is achieved and a platform is provided where ideas of individuals are valued and heard. Inputs given up by individuals have the remarkable impact on the business performance. When work was done is appreciated, it helps individuals to achieve growth in their carrier.
• Big companies have their own strategies for implementation of the tasks and business plan that helps them in an acquisition of set goals and targets. Thus, their strategies of recruiting skilled staff could also be utilized by SME's that would assist them to achieve success in the competitive environment. Nobre and Silva, (2014) state that training and development programs are essential for the enhancing skills and knowledge of the employees. If they are able to cope with the change introduced in the venture, they would feel valued and as a result, the best possible efforts would be given up by them contributing to the formation of the brand image in the marketplace. Workers should also be encouraged to suggest modifications that could be introduced so that flexibility of the system could be enhanced.
• Students of colleges could reach out to make them know about the employment opportunities in the SME's (Nobre and Silva, 2014). They could also be taught about benefits of working with them such as employees get chance to enhance their skills and could have practical experience, ability to solve queries an individual's end only etc. students could be enforced to face and tackle challenges by themselves and as a result, they contribute to growth of the organisation.
• Employees should be provided with a flexible work environment which helps in getting more skilled employees within the company. Facilities like work from home could be facilitated for the staff members which would gain applicant's attention. When flexibility is provided it becomes easy to work for hours along with providing maximum efforts.

2.6.1 Branding and strategy adopted for it.

 Branding is one of the most important activities in which company should involve themselves. It is beneficial to get connected with customers, selling new products and holding the competitive advantage in the market. In order to have successful branding in the market, it is required to have effective strategy and planning. Branding is not just about the logo of the company rather than what message is being presented to the audience. Therefore, a check is required to be made by the SME's in the promotional strategies where look and feel of the website, the profile on the social media. should be checked that they should be appealing to the customers. The basic stage into this process is to identify and understand what actions are going to be implemented by SME and accordingly planning should be considered.  When values and visions are clear then it becomes easy to formulate branding strategy. According to the Dessart,  Veloutsou, and Morgan-Thomas, (2015) promotional events could also be organized in order to make firm popular within the public. An organization is successful if it is able to satisfy the customers. For this, feedbacks could be taken up from the product users as they would help in analyzing what requirements are missing and what do they want from the product. It is also essential to provide authentic information to the customers. False and misleading information should not be provided to the users as it will present the negative image of the company in front of them and ultimately its development process would get impacted (Dessart, Veloutsou and Morgan-Thomas, 2015). Apart from above-stated means, some of the ways that could be adopted by ventures to establish themselves as a brand in the international market are discussed below:

• Focusing on satisfying customers: to be successful in the market, it is very important for the firms to identify and analyze that what are the areas in which customers are not satisfied. It could be found out by conducting research and analysis. Considering all the improvements, implementation plan could be developed. Customer satisfaction is key considering in the businesses.
• Improvement in social profiles: Nowadays, availability of internet has made people more connected. Thus, marketing strategies have also been modified and extended to online platforms such as LinkedIn, AngelList etc. thus, it becomes important that profiles on these platforms are updated.
• Implementation of video tutorials: one of the effective ways that could be utilized by ventures to reach out customers is through video tutorials. It is challenging method but it could contribute to the establishment of brand image in the international market as well.
• Knowledge sharing: Ghauri and Kirpalani, (2015) states that ideas and knowledge could also be shared up SME's to the people which would be helpful for the firm, as people will take leaders as their mentors and advice would be asked by them.
• Defining Niche: In order to set up the brand name in the global market, it is always advised to offer quality and unique products to the customers so that they make preferences to your venture. SME's generally have productive ideas that make them able to remain unique in the market.

 Regulatory factors such as government policies, foreign exchange rates also affect business processes of the company. By tailing legal structures, the company could hold their position (Ghauri and Kirpalani, 2015). Thus, by following all the above-stated things, SME's could hold the competitive edge in the market and establish the brand image in the global marketplace.

2.6.2 Branding Dimension Model

 There are various possibilities due to which SMEs are unable to establish as a brand. One of the reason can be due to inappropriate guidance and knowledge. For any company to extend globally the company has to overlook the marketing strategy. So branding can be issued to these companies as they are not familiar with such models or methods. Moreover, the models are applicable to the established companies which have already made the market reputation and the great brand. There are various challenges experienced by the entrepreneur which foster their growth. These can be due to strategies, the new marketplace, management, pricing, brand competition and much more. Along with this, SME must do empirical research in the branding areas of the new research. If such factors are considered than dynamic changes can be seen in the branding level of the company.

• Culture: There is an important part played by the entrepreneur culture in the business. They create great influence on the structure and development of the company. Through their culture, they enable the company to provide new innovation. Such aspect reinforces the development of strong brand by effective efforts of the complete group. Through this company can achieve their goals and can accomplish their strategic objectives. To make global brand companies need to follow culture, working process, and management system. Moreover, all three of them must differ from the other companies. Branding is all about the customers getting services from the organization and employees which they can easily recognize. There are several studies which suggest that there is the positive relationship between culture and entrepreneur behaviors. Many firms have successfully transformed and promoted their brand at the international level. Such opportunities must be grabbed by the entrepreneur and inflated errors must be reduced.
• Income: Before adopting or implementing any strategic it is mainly considered. If there is lack of financial sources in terms of the firm and customers then brand can never be established in such condition. A Certain brand can be defined only through the firm's cost structure and monetary circumstances of customers. Moreover, the business failure can be due to inappropriate business strategic planning. In such case, there is the hike in business cost but income is not generated.

            There is another model known as The Aaker Five-Dimensional Model of Brand Personality which which states that there are ever growing changes that can be seen in the consumer's perceptions and expectations regarding the brand of entity(Choi et al., 2017). For any consumer, adjectival descriptors of personality traits defines the brands. However, at the market level better positioning among the companies are needed to be focused. They have to overlook about the competitors  perceptions and consequently focus on their brand positioning and strategies. As per the Aaker model there are various sets of facets which can define the brand for the company. It  can be sincerity, family-oriented, secure, technical and many more that can help customers at international level to select the products. As stated by the  David Reibstein, a professor at the University of Pennsylvania's Wharton School, that for the companies product are  considered as valuable if customers are will to pay for it at whatever price decided by the company and are liking it. They also mentioned that “Brands get their value from how customers perceive them,”. It is the similar strategies that is adopted by the Apple (Ailawadi and Farris, 2017).

2.7 Research Gap

There are various researches related to ways in which SME's can develop themselves as a brand in the international market. Most the countries mentioned in this research are based developed or at urban areas. Further, their studies are based on their own objectives. There is scarcity in the investigation related to SME as the brand at the global level. For this purpose, the study is based at the international level so that factors can be evaluated. Besides this challenges are focused and impact is accessed so that companies can make strategies related to it. The impact is accessed on the international companies which are unable to make their brand. There is another gap in the research that reliable and valid data were unavailable due to which certain obstacles are faced in gaining depth knowledge about the SME at international level.

            As stated by Nabi et al. (2017), research gaps can be proposed using the  PICOS framework. It stands for the  population (P), intervention (I), comparison (C), outcomes (O), and setting (S). Based on the above frameworks,

• Population: No information is there about the age, sex, race/ethnicity, clinical stage, etc. of the population. All of them are members of that organization.
• Intervention: As the research is based on the interview that provides the specific information but requires time and person available at that time so no specific details are available about the intervention.
• Comparison: For the present study there is no specific comparison of interest.
• Outcomes: As study is made on the particular business entity so the outcomes can vary for other organization.
• Setting: Important decision of the company are carried out by the managers so for this report, the suitable places where they felt they can provide the interview was selected but in Pakistan.

CHAPTER 3- RESEARCH METHODOLOGY

3.3.1 Introduction

This  chapter presents the research methodology which is implemented and adopted during the time of conducting the study so that objective of the case study and question related to it can be achieved. Research methodology can be defined as theoretical analysis tool that supports in answering research questions. It helps the research in developing knowledge about the subject matter. It is considered as systematic plan that assists in conducting investigation in appropriate manner (Odoom and et.al. 2017).  It is the tool and technique that define research problems and support in gathering such detail through which the/a researcher can reach to the final results and can meet with the dissertation objectives. The main agenda of using these tools are to gain familiarity with the topic and get essential information about facts related to the topic. For resolving research problem the researcher has to use different methods and selection of each tool depends upon the type and nature of question that need to be addressed and phenomena of investigation.. Through this methodology researcher tries to find out the realistic information about problems so that individual can draw valid conclusion.  Hence, all the selected tools and techniques will provide high level of assistance in assessing the manner in which SME's can develop themselves as brand in the international market.

3.3.2 Research Approach

Research approaches are considered as planning process for particular study that span several steps related to data collection, analysis and interpretation (Mackey and Gass, 2015).  Approaches of the research imply the manner in which research study is conducted, performed and evaluated in a prominent way. Moreover, it will help in conducting research in an appropriate manner and contributes in the attainment of goals as well as objectives. Investigation method and type support in reducing the chances of faults in the findings, research and supports in carrying out of the methodological analysis being selected. There are two ways through which research is conducted these are inductive and deductive, for the current thesis inductive approach has been chosen (Taylor, Bogdan and DeVault, 2015). In other words, it can be stated that, under inductive approach, researcher starts with the observation and lays emphasis on the development of new theoretical framework through evaluating pattern or tentative hypothesis.  Both these approaches are used in different types of investigations. Inductive and deductive approaches selected by the researcher on the bases of nature of the investigation. Inductive method is generally applied in such studies where researcher uses theories and models in order to give answers of research questions. In this method no hypotheses is being formulated by researcher.. It is the type of tool in which researcher start the investigation from specific aspects but move towards general aspects. On other hand deductive approach is different from the inductive approach. In deductive individual start the study from general and move to specific direction. By this way researcher becomes able to get valid results at the end of investigation (Taylor, Bogdan and DeVault, 2015). In inductive type of tool researcher has to use models and theories in order to develop understanding about the subject matter. In the deductive approach individual formulate hypotheses and test these hypotheses. On the bases of this test researcher gets results and draw conclusion. Theory generation and building of concept is the main significance of the inductive type of research approach on other hand theory falsification is the major significant element of deductive type of approaches. Both these tool are helpful in identifying  ways in which Sialkot surgical instrument SME's can develop themselves as a brand in the international market

In addition to the inductive approach, at the initial level the researcher focuses on the observation of information so that goals and objectives can be accomplished in desired manner. It is necessary for experts to ensure that collection is offering some observation factors so that key idea about the subject can be developed. With an assistance of this, it can be said that diverse factors like innovation, technological advancement, profit and global image can be analysed properly in context to SME working (Lund-Thomsen, Lindgreen and Vanhamme,  2016). By having a proper learning in regard to observation skills the better support can be provided to the research style. It also allows to present the psychological values of individual so that key norms can be well maintained. After collecting data, the pattern of data analysis is being taken into account. It means the systematic approach to have interpretation is being considered. It allows to ensure about the objectives accomplishment and ensure that goals and objectives are being accomplished.

            After having an effective consideration of pattern the tentative hypothesis is being framed. Researcher has to ensure that research questions are being addressed properly.  In the last stage of the process the theory is being employed by the experts in order to have sustainable outcome.

            The focus of this dissertation is given to the ways in which SME's can improve presence in international market. Further, ways are identified through which they can develop themselves as a brand in the international market. Inductive approach concentrates on theories related to topic and try to address research questions. Analysis on the international market branding can be specifically outlined through the inductive approach while deductive will require new themes or pattern to elaborate the issue. By using inductive research approach researcher has become able to generate theories related to SME business and how they develop themselves as brand in the international market. This inductive approach has supported the researcher in gathering in depth information about working of small medium organization and what issues faced by them in order to perform in the international market. 

            If researcher had used deductive approach then individual may get failed to get actual results, This has helped in formulating hypotheses and testing theories.(Voss and Voss, 2013). Apart from this it was qualitative type of investigation so use of deductive approach would not give appropriate results to the investigator. In this scholar has to identify challenges face by SME so deductive method would not be appropriate for this topic. Thus, use of inductive approach is the best tool through which researcher has developed understanding about working of small medium organization in the international market. This is the method that has helped in involving theories related to SME and brand issues. By this way scholar has become able to address research questions. This has made this study simple but effective. With an assistance of this, challenges faced by SME's like Surgical instrument manufacturer in developing themselves as the brand in the international market can be identified.

3.3.3 Research Philosophy

Research philosophy is considered as belief of researcher about the way of conducting an investigation and gathering information about the topic. It is in the upper layer of the research onion model (Saunders …_). It is the tool which major deals with nature and source of knowledge. For completion of the dissertation researcher has to improve their knowledge about the topic and has to become familiar with the data. This creation of knowledge supports the researcher in developing understanding about the subject matter. It is the type of tool which makes the researcher aware with the deep information about the topic and helps in formulation of assumptions (Taylor,  Bogdan and DeVault 2015). 

Research philosophy is the basis on which scholars build knowledge and improve understanding about subject matter. . Philosophies of the research can be divided into different orientations : interpretivism and positivism (Mackey and Gass, 2015). Both such philosophies are highly influenced by the type or nature of the study selected. Interpretivist philosophy is generally applies in qualitative studies because individual involves human being those who can give answers of research questions. This helps in finding solution of research questions.  On the other side, under positivist philosophy, the researcher makes assessment of quantitative facts and figures and thereby presents solution of the issue. Usually, scholars consider such method when solution of the issue is based on quantitative aspects. Positivism is the method which pays more attention on observations and believe in developing understanding about topic from an objective view point. In this type of tool researcher does not involve human being in the investigation and conduct the entire study on the bases of own observations. It is the type of tool which is highly structured and measurement is done through qualitative and quantitative both techniques.  It is the method which helps in identifying issue so that truth can be uncovered (Resnick, Cheng and Lourenço, 2016). Logical deduction is done in this technique. The main purpose of using positivism philosophy is to control and predict the truth. On other hand interpretivism is completely different philosophy from the positivism. In this researcher needs not to formulate the hypotheses, it conducts the study from subjective point of view. It supports the researcher in gathering in-depth information about the subject matter.

For the current study, interpretivism philosophy has been used. The rationale behind the selection of such philosophy is that it has helped in finding actual detail related to issues faced by SME. Hence, as per such philosophy, by interpreting aspects researcher has presented the way through which small sized business units can develop and improve its image in the international market. As present study is qualitative in nature so researcher has not used positivism philosophy. If individual had used this approach then it may create complications in the investigation. . That is why decision of not choosing positivism philosophy was appropriate. Interpretivism philosophy is more suitable for the present dissertation (Odoom and et al., 2017). By this way researcher has  realised that small medium organizations have great chance to grow well in the global market and it can enhance their profitability to great extent. It was appropriate method for present study because scholar has become able to gather subjective information about topic and finding real facts related to subject.

3.3.4 Research Design

Research design can be defined as set of methods that are used by the researcher for collecting data and analysing it in appropriate manner. This is the general planning of the researcher of conducting the research in order to answers to the research questions.  It can also be defined as overall strategy that supports in completing dissertation in logical and coherent manner.  The main purpose of the designing is to give proper answers to the research problems  (Mackey and Gass, 2015).  It constitutes blueprint for collecting information about subject matter. For achieving the aims and objectives of the study, blueprint is required in the study. Research designs showcase the study type, problems, hypothetical questions, variables and many more things (Bryman and Bell, 2015). There are various ways of it such as descriptive, experimental and meta-analytic. In descriptive the topic is defined in depth, experimental is based on new ideas and thoughts while statistical data is used meta-analytic where multiple studies and their result to make research effective.

All these research designs such as descriptive, experimental, exploratory etc. have unique features and are used in different types of investigations. Descriptive research design is the type of tool which is applied to describe the topic in appropriate manner. It is the tool which describe each aspect of the topic. . In experimental design researcher involve human being to share their views about the subject matter.. After that independent (researcher) measures variables (Bryman and Bell 2015). On other hand exploratory research design is another type of technique which is used to collect general detail about the topic. In this type of design small samples are selected in order to maximize generalization. Data collection is quite flexible.

In the present research, exploratory and descriptive design are used to complete the research. Meetings, interviews, naturalistic observation and surveys implemented in the study. As there was no use of the previous data therefore meta-analytic design was not used. The main purpose of applying descriptive research design in the dissertation was to describe the each aspect related to SME in effective manner. This has supported the researcher in knowing about the functioning of small medium organizations and how they develop their brand name in the international market. By using survey and observation techniques researcher has become able to get in-depth detail about the subject matter. This has developed understanding of the researcher about the topic and individual has become able to complete the dissertation with stipulated period of time.

3.3.5 Research type

Research type is most important part of any dissertation. It supports researcher in identifying nature of the study and carry out the research in effective manner. It is essential that to select appropriate strategy as per the nature of the topic, otherwise individual may get failed to complete the dissertation in effective manner. If researcher goes with the correct strategy then it can support in getting desired results. There are two main types of research: Qualitative and quantitative (Ailawadi and Farris, 2017). In qualitative study scholar has applied theories and models that has developed understanding about the topic.  It is most suitable type of research because by this way individual can get subjective idea about the subject matter. On other hand quantitative type of research is another strategy in which researcher apply statistical tools and mathematical approaches in order to develop understanding about the topic.

The scholar needs to select the appropriate tool in order to complete the dissertation in an effective manner. Qualitative research type in the most suitable and simple way to complete any study. As current study is based on working of small medium organization in order to develop brand image in the international market for that researcher has applied qualitative type of investigation. This is most suitable and easy way to carry out the investigation. With the help of this technique the researcher has become able to collect in-depth information about the topic and individual has developed great understanding about small medium organization. This has supported in avoiding complexity of mathematical tools. This has supported in completion of the entire study (Bryman and Bell, 2015). By this way investigator has become able to get desired results and meeting with the dissertation objectives. Along with this qualitative research methods also reflects its nature which is employed for conducting the research. Additionally, type helps to carry out research in more effective manner. The starting one is used when numeric values are not mentioned (Odoom et al., 2017). Further, the other method is used when numeric values are present. Beside this analyzing data are employed to complete the thesis.

For the present study, interview was conducted. Reason for choosing the research approach was that it underlies on reason, opinions and motivations. Along with this, to complete the research and analyze the data themes related to the topic were made. Additionally, the respondent response was collected through different methods. As potential samples were available thus researcher has chosen this technique.  Bryman and Bell (2015), said that the best data collection methods used under the qualitative research is the process carried out through interview.  Through, asking questions from managers of SME pertaining brand building and improvement in the context of international market primary data has been collected. This would be suitable method to gather information about topic. By this way scholar has become able to gather real facts about topic. Furthermore, individual has also applied secondary sources related to topic such as books, journals, internet articles. These has supported in developing understanding about topic.

3.3.6 Data Collection Method

Data collection methods are considered an important part of the research project as it presents the ways by which data are collected from different journals, books, articles, interviews, surveys and observation.  With an appropriate implication of the method the collection can be accomplished in order to meet the designed aim and objectives. Along with this, it aids identification of the answers to the research questions in more depth. If inaccurate data collection methods are used then the research will have invalid results. There are two ways by which a researcher can gather data (Bryman and Bell, 2015). These are primary and secondary data collection methods. In the primary data collection methods depth-interviews, survey, observational methods, and questionnaire are developed. However, in the secondary source of data collection articles, journals, online sites, and websites are used. In other words, secondary data implies for the one that had already been gathered and analyzed by other researchers in the past time frame. In order to conduct this research scholar has applied primary sources of data collection. Questionnaire technique has been used for addressing research questions.

With an assistance of primary research new information can be collected in context to the subject so that objectives can be accomplished. Appropriate collection of information allows to have better understanding about the purpose of study. It has been noticed that primary study cannot be accomplished without involvement of respondents. It means the involvement of managers of SME's is essential to refer so that key aspect can be well maintained. It is a method collection which has been suitable considering the geographical barrier. It provided the respondents with opportunity to fill the questionnaire at their pace.

In terms of the primary data, depth-interviews were conducted with the people associated with the SME groups. For this strategic planning was made on the areas and questions which needed to be asked while conducting the in-depth interview. In this confidential and secure conversation is done among the two people that are the researcher and respondent from the SME groups (Resnick and et. al., 2016). It has been noticed that primary data collection will assist in developing understanding about the work practice of SME and how they use branding strategies. Along with this, business activities of SME in context to international business can be attained properly so that objectives can be accomplished. Repeated interview sections of 15 people were conducted and study is made based on their result.  Researcher has send consent form to respondents, once they have signed this form then scholar has asked questions with them. All participants have shared their views about topic which has helped researcher in finding facts about topic. They have give current knowledge related to subject . By this way individual has become able to address research questions.

3.3.7 Sampling Method

Sampling can be defined as process of selecting the samples. These samples are able to give accurate answers of research questions. It supports the researcher in gathering relevant information about the topic and developing understanding about subject matter. With the help of this sampling tool individual can carry out investigation in effective manner and can give answers of the research problems. It is essential to select correct sample as per the requirement of the investigation (Ailawadi and Farris, 2017).  Sampling method is the way by which researchers select the people, place, and areas for conducting the research in their interest.  There are two methods by which sampling is done in the research projects, these are probability and non-probability sampling (McCarthy and et. al., 2014). In research, sampling techniques can be distinguished into two types such as probabilistic and non-probabilistic that researcher can undertake for the purpose of sample selection. Under probability sampling, there are different methods such as Cluster, Multistage, Simple Random, Stratified and Systematic sampling (Bryman and Bell, 2015). However, in non-probability sampling volunteer and convenience samples are taken.

Both probability and non-probability tools have unique features and are applied in different types of investigations. Probability is the technique in which researcher select samples probability on other hand non probability is the tool in which samples are being selected as in convenience. There are various sub types of probability and non probability techniques.

Simple random sampling, stratified sampling, cluster sampling, systematic sampling are the part of probability sampling. Simple random sampling is the most appropriate tool which is applied in most of the investigations. It is the type of tool in which researcher selects the sample on random bases. In this method all people get equal opportunities to be selected. They can share their views about the topic easily (Bryman and Bell, 2015). With the help of this technique individual can collect the data in effective manner. It is far away from biasness so there is high chances to get valid and reliable information about the subject matter. On other hand stratified sampling is another type of sampling technique in which researcher divide the population in strata. People are divided on the bases of age, income, education, designation. After creating strata data is being collected from these strata. It supports the investigator in gathering specific information about the topic and answering research questions in effective manner.

Systematic sampling is another type of probability sampling technique which is often used in the place of random sampling method. After calculating sample size researcher select members from the entire population. If there is no hidden order then it is considered as second best technique after random sampling method.  The main advantage of using systematic tool is that it is simple to apply and it can be used frequently when number of samples are high. Apart from probability sampling technique there are various types of non probability technique as well such as volunteer samples and convenience sampling. Convenience sampling is the method which is generally applied in the exploratory type of investigations. In this type of studies researcher takes more interest in getting truth about the topic. Samples are being selected as per the convenience of the topic. It is generally used during preliminary research in order to get desired results. Apart from this Quota sampling is another type of tool in this researcher create quota of samples those who can give good detail about the subject matter. Snowball sampling is another non-probability sampling in which participants are being selected by other members.

For conducting the present research non-probabilistic sampling methods has been employed of 15 people. Hence, by using purposive sampling technique managers of SME's have been selected by the researcher. The rationale behind the selection of such technique is that it helps in selecting suitable managers of SME who explored ventures at global level. Such non-probabilistic sampling technique provides assistance in meeting the purpose of research more effectually (Bryman and Bell, 2015). This is considered as one of the best sampling technique With the help of this tools researcher has become to gather such participants those who have great knowledge about the small medium organizations and are able to give in-depth detail about the topic. 15 Respondents are being selected in the study by the judgement of researcher. This has supported in saving time and money.

3.3.8 Research Process

As the present research is based on the interview so research process must be selected by the researcher. It is the systematic focus to achieve the objectives of the research (Mitchell and et. al., 2015). For the present research, the process chosen areas used for the design. An in-depth interview will be conducted which in turn helps in getting suitable information from managers about branding in the international market.

It has been noticed that research process is referred as practice which allows to have sustainable consideration of values so that better outcome can be attained. As consideration of interview is being taken into account in order to have proper collection of information. In present dissertation, the interview guides being framed as an instrument so that interview can be conducted properly.  It is a method which allows to have authentic and detailed collection of information from the respondents. Most importantly, it is easier to code as well as statistically analyze the answers of open ended questions. It is a method through which respondents can have better representation of their views on the topic. It allows to have valid and reliable data collection so that framed objectives can be accomplished.  Research process was systematic and as per ethical consideration. All the instruments that have been applied in this study was suitably and effective. That is why individual has become able to address research questions (Mitchell and et al., 2015).

3.3.9 Type of Data Analysis Plan

Data-Analysis plan is also among the key aspects which are required in the research to accomplish the objectives. Along with this, while collecting the data through interview with managers (Renton and et al., 2015). It is mainly on considering the chosen research approach, namely inductive, it has supported in gathering facts and theories related to topic. This has supported in addressing research questions (Bryman and Bell, 2015).

 It means the collected information can be interpreted in desired manner by having an effective application of data analysis theme  (Mitchell and et. al., 2015).. With an assistance of data analysis technique application the researcher can easily have inspection about the data so that results can be framed in systematic manner. It will assist in developing better learning about the topic on the basis of framed objectives.

In the present study, data analysis method used is qualitative in nature where the themes were formed on considering the responses acquired from the participants. The data is collected through 15 interviews which are taken with the members associated with the SMEs (Ismail and Kuivalainen, 2015). Through this complete detail regarding the research topic can be easily realised. Besides this, the reason for not choosing the other option that is quantitative methods was that there were no numeric values present.

In the present dissertation scholar has concentrated on effective planning so that analysis can be done properly and valid results can be find out. Qualitative research has supported in evaluating facts related to  SME's are performing in the international market. Furthermore, individual has analysed challenges faced by SME and surgical instruments that are used by these firms. Qualitative approach is the most suitable method for the present research because it has helped scholar in eliminating complication calculation and finding real facts related to topic. By this way this has become easy for investigator in getting real answers of research questions.

3.3.10 Reliability and Validity

These two terms are essential for completing the research project. . Researchers used different techniques and experimental methods in order to achieve these two terms. Consistency/reliability is the extent where research can be simulated (Bryman and Bell, 2015). It is achieved when the researchers are getting the similar results or stable outcomes. There are different methods through which reliability of the research project can be maintained such as internal consistency, parallel forms and test-retest reliability (Crick and Crick, 2014). It is basically based on the target chosen and target they made. However, validity is related to the measurement. They both are interdependent on each other. If the measurement is not valid then reliability can never be established. To accomplish this, the similarity in the concept and method was seen. Researcher has involved all relevant theories related to topic that has helped in reaching to final results and addressing research questions. All the data that are being used in this study are collected from reliable sources. .

In order to have effective accomplishment of the overall study the application of relevant tools and techniques is essential. It provides a great significance to the validity and reliability so that research can be accomplished. Validity is the quality of being logically or factually effective (Crick and Crick, 2014). It is the degree to which a research study assesses what it is aimed at assessing. It has been noticed that internal validity is being referred as term of validity in which standards are being measured by itself.

In regard to have proper validity and reliability of content in reference to secondary sources the experts need to focus on data collection from sources which are latest. Also, it is need to be ensure that proper development of data collection is accomplished from the sources which provide information about branding strategies and working of SME. With an assistance of this, key values can be well maintained and lead to impressive data collection. In respect to meet the standards of primary data collection, it is necessary to ensure that objectives are being referred to design the questionnaire (Ismail and Kuivalainen, 2015). In order to meet the reliability of the information it is necessary to make sure that information collected is relevant to the topic and it provides a detailed learning. Consideration of objectives is essential in order to meet the standards of ethical working. It helps in promoting the valid data collection and accomplish designed objectives.

3.3.11 Ethical Consideration

If ethical consideration is missing then the entire dissertation is doomed to failure (Saunders, 2011). It is specified as the key factor in the research. As stated by Bryman and Bell (2015), ethical considerations related to the areas for conducting the research should be mentioned in the report. Purpose and systematizing of what is right or wrong are involved under research ethical consideration. It is required to gain the outcomes of research in a fruitful manner. Entire data collected in the research is based on the SME members who wanted to expand their business at international level and represent their brand in other countries.  It is referred as process that allows to accomplish the entire research in ethical manner. Ethical norms make the study complete in all aspects. As present investigation is on small business organisations so consideration of ethical values is essential to meet objectives Researcher will send ethical form to all respondents and they will have to sign it. It shows that they are sharing their views positively with the researcher.

While conducting the following research, these ethical guidelines were followed:

During the in-depth interview, no research participants were harmed and their dignity was prioritized. Permission from the surgical instrument manufacturer was taken in order to maintain ethical aspects, researcher has taken permission from them before conducting the study and they were completely detailed about the research aims and objectives. Further, the adequate level of confidentiality, honesty, privacy, and transparency are maintained (Hutchinson and et. al., 2015). Anonymity is ensured. Communication is completely retained and all the misleading and offensiveness is avoided. During the collection of the secondary data, works of the authors were acknowledged and mentioned in the Harvard referencing style wherever is applicable. Respondent has the complete authorization of removing their personal details and data which they have provided while conducting the in-depth interview. 

It has been noticed that participants of study may not always agree to take part in the study. It forces to have focus on the voluntary participation so that study can be accomplished. As present study participants are managers so the prior permission has been taken from managers of SME so that data collection can be accomplished. In order to have proper reference of ethical values the information about the purpose of study is being explained in desired manner. Any kind of forceful act is not being taken into account so that ethical values can be promoted. Overall procedure of the study has also been acknowledged by the members. It allows to ensure that key goals and objectives are being accomplished so that sustainable values can be attained.

Along with this, confidentiality is also a factor which need to be referred by researcher in order to have better promotion of ethical values within study. The researcher assured the participants that in no case will the identifying information be made available to anyone who is not directly involved in the study. It has also been noticed that any kind of personal information of respondents has not been shared with the third party. It has also promoted the confidentiality and ensure that key measures are being accomplished. Moreover, proper principles of confidentiality has been referred by researcher so that respondents can have high degree of privacy which will allow to maintain the information provided by them.

Other than this, there are number of restricted websites that does not allow to have appropriate access to the information. In order to maintain the ethical values the researcher has not accessed any restricted web in unethical manner. Alternative library's subscribed sites were being considered to ensure about the secondary data collection  (Mitchell and et. al., 2015).

Moreover, proper citation of work is also a key factor which has been referred by the researcher. It has allowed to ensure that overall work is being supported with the statements of diverse scholars. It allows to analyse the practice which is being employed by SME's to have better branding. With an assistance of cited work the understanding can be developed in authentic manner which is beneficial for sustainable development. It has also been witnessed that plagiarism is also a critical issue which need to be referred by experts. It is necessary to ensure that any content is not being copy paste so that goals and objectives can be accomplished in ethical manner (Mitchell and et. al., 2015). Researcher has not copied any material from any sites. All the information have been translated in own words so that plagiarism issues can be avoided. Furthermore, scholar has not forced any individual to share their views. They had rights to skip any question if they do not want to answer such question. Furthermore, individual has recorded all data in computer and password was not shared wit any third person.

3.3.12 Research Limitations

When research is conducted there are the certain limitations which is faced by researchers. It is required that such limitation must be minimized and acknowledgement to such limitation must be mentioned in the Conclusion chapter. These were the research limitation which was faced by the researcher while conducting the in-depth interview and in other data collection methods.

By having an appropriate consideration of limitations the overall study key objectives can be accomplished in desired manner. One of key limitation of the present study is that it is long process in which diverse standards need to be followed to complete the overall study. It is time consuming process so if appropriate allocation of time is not being taken into account then it will affect the outcome. Data collection and analysis requires a majority of time from the overall process. However, present study need to be completed in the desired time frame so that standards can be well maintained with a better control over the cost. Hence, it could not be feasible for the researcher to explore all the aspects in detail. This may have limited the information referred by the researcher. 

For conducting the interview time is required and the higher-level manager which were chosen from the company (associated with marketing and branding of the company) were having very limited time (Gonzalez-Perez et al., 2016). Moreover, trustworthiness is another aspects makes the research effective. It can be maintained through choosing the sample from the particular group related to topic (Bryman and Bell, 2015). Above activities acted as the hurdle in the accomplishment of desired aims and objectives. The second issues faced was the location where the interview can be conducted. Along with this, there was the problem related to the implementation of the data collection methods as the researchers do not have extensive experience in primary data collection. There were limited resources available which created the challenges to attain the desired outcomes. For these authentic scholars and reliable sources were used to evaluate the data.

In addition to this, insufficient information available on the secondary sources is also a limitation which might affect the overall outcome. It is necessary for experts to ensure that standards are well maintained even if secondary sources are not offering in-depth analysis on the subject. If sources are not containing proper information then the data which is essential for study might not be collected properly. It will create a situation where researcher might miss the important information about the subject which need to be covered significantly. By having an appropriate consideration of diverse standards the issue need to be resolved. Researcher was having limited time to complete this dissertation, in such short duration it was difficult to complete it in effective manner. Though scholar has schedule all task properly and has finished it on time. In addition, researcher was having limited monitory resources which has created problem for the researcher. But effective utilization of resources supported in findings accurate results.

CHAPTER 4 : DATA ANALYSIS AND FINDINGS

4.1 Introduction

After the research methodology chapter, data analysis and findings is the fourth chapter. It helps in providing and  analysing the information and data in an effective and appropriate manner (Ott and Longnecker, 2015). On the basis of that information, it can be  easy enough to reach to an appropriate conclusion. On the basis of the questionnaires made for different individuals, themes have been prepared and with the help of them, the data can be analysed effectively.

4.2 Thematic analysis

Theme 1 : Personal description of the business

On the basis of the requirement of these products in the market place, values have been allotted to the same.

Theme 2 : Current engagement in import and export

Theme 3 : Opportunities for operating at international level

Theme 4 : Barriers for expanding internationally

Theme 5 : Impact of chamber of commerce on encouraging to expand internationally

Theme 6 : Leading companies and present market status

Theme 7 : Branding strategies of the competitors

Theme 8 : Impact of big companies on intermediaries in Sialkot

Theme 9 : Current strategies to be used for expanding in international markets

Theme 10 : Required resources/ brand strategies and resources for developing a brand

Theme 11 : Evolution of brand over time

CHAPTER 5 : CONCLUSION AND RECOMMENDATIONS

5.1 Introduction

Surgical instruments plays a vital role in health care practices. It is important for the health care organisation across the globe to ensure proper availability of instruments. There are various instruments which are used in clinical setting and on the other hand these instrument are specially manufactured for the purpose of acute surgeries. From the analysis of data it has been determined that expansion of small manufacturing enterprises in international market will be beneficial for business because these are the necessities which accompany hospital setting. It is important for the small organisation to research about conditions of international market on health and involving the tools used because it is plan of action which can assist the company in managing successful business operation across international boundaries. As per the analysis, it has been evaluated, that the surgical instrument manufacturing is a wide field where the organisation offers variety of surgical products like, general instruments for surgery, electrosurgery, special instruments, orthopaedic surgical tools etc. The entity has high approach of growth as it includes wide variety and has never ending demand but the fact that is to be ensured here is that it is an obvious factor that the customers want an affordable range of products. This will however influence the whole demand rate of the customers.

Expansion in international market can be challenging for manufacturing firm but on the other hand implementing competitive strategies in new markets like Dubai orUK is the approach which can assist the small enterprise in establishing successful business in Sialkot. The expansion of business against rivalries is a challenging plan but on the other hand, risk is the crucial part of business which helps the firm in analysing its stability to resistance in new market. In accordance, expansion plan of small medium organisation of surgical instrument, it is important for the enterprise to first evaluate all the risk related to competitors, strategies, business environment, governmental restrictions. Evaluation of these factor is the strategies which can helps the firm in mitigating risk of expansion across foreign boundaries.  

5.2 CONCLUSION

In the dissertation, conclusion and recommendation are the last chapters where information related to the findings gathered from the research in an effective and appropriate manner is mentioned. From the achieved conclusion, recommendations are provided to the company. The following section of the research focus on the outcomes related to SME's can develop themselves as a brand in the international market in which case study related to the Surgical Instrument Manufacturer is mentioned. The result and recommendation are provided on the basis of primary and secondary data gathered. Moreover, information which is beneficiary for the research is mentioned. Further, the recommendation has been provided to Surgical Instrument Manufacturer so that they can establish their brand in the international market. It can be concluded from the study of the research aims to achieve the ways and methods the small and medium organisations in Sialkot can develop themselves as a brand in the international markets.  Complete research has been effectively evaluated and proper study has been made on the research. The conclusion is made on the basis of the objectives that were taken into consideration during the starting of the research project.   Chapter one has been efficiently described in order to perform a better analysis of the framework and in describing the significance of the study. The research proves helpful enough in discussing about various factors that throw some impact on these small and medium organisations in Sialkot. Many of the factors influences positive enough so that it can bring various opportunities to the companies but some factors are challenging enough that can act as a barrier for these small and medium industries to grow and expand on an international level. The whole chapter has been reported in a way that it provides a complete overview of the research.

Time Constrained Assessment

The second chapter is literature review in which on the basis of themes, proper objectives have been made and a complete study has been done on every single objective. Along with discussing about the performance of small and medium organisations in the foreign markets, it also helped in presenting various ways and strategies that can be used in order to overcome the barriers and challenges for the companies getting their operations and functions being performed in the international markets. Developing as a brand in international market involves so many challenges which need to be resolved while entering the new marketplace.  It has been examined that the biggest challenge for a small-medium enterprise such as Surgical Instrument Manufacturer in the branding is the investment. It is because an accurate amount of money is required to continue the processing of all the functions and operations. Without having an efficiency in the financial status, it can be quite difficult for the companies to continue the processing. Therefore, it is considered as an important source. The process of enhancing trade name involves the huge amount of capital in various operations such as franchising, marketing, promoting, partnering, etc. SMEs also lacks sufficient resources and time that influences the creation of effective strategies for brand development. Further, this dissertation covers the legal challenges that are faced by small-medium entities in developing as the brand art international level. These legal challenges are due to the new marketplaces of other countries comprising different laws and regulations.

It has been examined that the organization is having issues in the brand management as the entity is having the limitation of human resources and promptness, which means that the organisation is having lack of resources. So, by including various means, the organisation can try to increase the overall rate of resources so that it cannot lead to further complications.   This report helps in concluding that these limitations are making managers concentrate on the short-term business strategy which does not play role in the brand development edge. It has been examined that the organization has issues in its internal effectiveness which are generating challenges in meeting the desire of image development on the global platform. Further, it has been evaluated that the firm is not having clarity and synergy in operations of brand development and thus, they are required to create a brand-portfolio as their guide tool. Besides this, the strategies of the entity are not found to be international business-oriented which needs to be revised.

The third chapter is the research methodology in which some of  the aspects of the research methodology have been included. Along with the approaches, designs, methods etc., the researcher has made use of the qualitative data. It is because the qualitative data helps in providing appropriate and suitable data as compared to the quantitative. In case of the quantitative data, there is a possibility that the data from books or online sources might not act suitable for the present research. Therefore, the researcher has chosen the primary data to be used in the research. Small and Medium - Sized Enterprises (SME's) holds over 95 % of firms and over 60 - 70 % of employment and provide the large extent of jobs in the international market (Saunders,  2011). They need to be more careful in upgrading their management skills and should focus on product publicity and quality management in the international market. In order to maintain their brand image in the international market, they have to face more challenges and issues. About 30 - 60 % of the SME's are categorized innovative in the international market as they are not likely to provide research and development (R & D) as compared to large firms. But they are considered to be innovative in other ways as they regenerate products to meet up the new demands of the market and enhance new techniques to expand sales. SME's are more likely to be flexible than the large firms to meet up the customer's demand and provide the quality product as to survive in the market. Government policies are intending for them as they are growing in the international market and are important for the economy in the international market.

The use of research methodology has been concluded in study in a way which assisted in carrying out smooth data collection and analysis process. For research philosophy, the researcher implemented use of interpretivism philosophy to develop critical understanding over expansion of surgical manufacturing small business enterprise. It has been identified that scholar used this tools because it helps the individual in analysing data by relating to research from different concepts and situation. Furthermore, in analysing the gathered data the investigator implemented theories and models which helped the person in evaluating measures such as the success rate of the companies in achieving satisfied customers etc. which are beneficial and steps which can impact business performance at the time of expansion. Apart from this, there is research design methodological tool for which the scholar implemented exploratory design, this is focused on exploring information from different sources. 

Moreover, it is implemented because it provides informal way of collecting information from where the person can seek variety of information. It is considered as effective because it does not involve risk of harming individual beliefs and values. Similarly, to frame explored information, the researcher has used descriptive design with the help of which the individual will able to use step wise process of study that is first the person determined statement of problem which was expansion plan of small medium organisation which manufactures surgical instruments. Further, it focuses on identifying data, collecting data, targeting population, designing data collection procedure and analysing information. However, on the other hand, the researcher has implemented use of primary data collection method in which the scholar conducted open-ended interview of 15  respondents. The scholar established this data collection method to explore views of different people over expansion plan of surgical instrument manufacturing small business enterprise. In addition, the interview is analysed with the help of qualitative reasoning with the of 15 themes which are framed from 15 different interviews. The data analysis and collection played a crucial role in entire dissertation in determining effectiveness of expansion plan.

The fourth chapter was data analysis and findings. So, it has included the data and information on different factors and operations, small and medium sized organisations go through while expanding their operations on an international level.  Every single company deals with the manufacturing of surgical instruments. Every company has some specific customers in the market. Some companies have already involved with the import and export as a few of them are engaged in various processes and operations in the international markets but still, there are some who wants to expand their operations in the international markets but because of some barriers and challenging factors, they do not get opportunities so that they can also get involved in expanding their business operations in the foreign markets. Also, as some companies have barriers to expand but there are opportunities as well that the companies can take over for a successful expansion in the international markets. From analysis, it can be concluded that surgical instrument manufacturing is a wide market which owns never ending competition and demand. So, this can also be considered as a sort of opportunity to the various markets dealing with it as they can expand their operations on a wide basis to provide satisfaction to the customers.

According to respondent A, the business comprise wide varieties and at the time of expansion the firm can increase its business by offering products at different pricing with different strategies. From the respondent of company A, it ha been discovered that companies and J offers prime quality of every surgical products whereas company D only offers beauty and shaving products which limits its variety and increases competition. Apparently, the biggest advantage with organisation is their strategy of online marketing which helps the firm attracting large population of UK and Dubai.  However, the theme 1 description, it can be outlined that all the 15 companies offers different surgical instrument with different strategies which is an effective plan that is leading to increasing competition. About Company B, data analysis is based on engagement of organization in import and export, from where it has been discovered that company B is engaged with foreign market operation whereas C is still planning. The critical part of the discussion was interview with organisation D where the individual stated that they do not export their surgical products in Pakistan as they do not have control over their local market apart from these the company export internationally like in European countries etc.

Thus, opportunities plays an important role in expansion plan therefore from them 3, it has been discovered that Company C has bee planning to seek opportunities of international market and therefore the firm has involved family which stays in Dubai. As per the discussion,  C asked family members to seek for buyers in Dubai and same is done with UK. Seeking for buyers initially is the most effective plan of expansion because it aims at providing stability to business functions in foreign markets. Apart from this, many companies implements the use of online marketing to seek opportunities. Hence, as analysed, it can be summarized that according to enterprises who have established their firm in international market and who are planning, it is important for the company to implement the use of online marketing. Online marketing is the approach that helps the firm in seeking attention of buyers across the globe. It is cost effective strategy and also mitigates the risk of expansion. Marketing on digital platform is itself an opportunity because it reduces the risk of after expansion by evaluating favourable factor of expansion.

Theme 4 conerns barriers of expansion which can come across to small business enterprise at the time of expanding surgical manufacturing firm can be, low business capital, lack of resources like, electricity, maximized fuel rates, increased rate of raw material etc. In addition, government barriers on entry and on resources can be risk to small business enterprise. Capital investment, response from buyers, negotiation can be another hindrance to small medium organisation in foreign market. Apparently, it has been demonstrated that competition in international market form local manufacturers is the major risk which directly impact business operation. According to company B the leading competitor of surgical instrument manufacturers is Hilbro International etc. However, Inam surgical company and SSR limited are major competitors who creates pressure on existence of new entrants. Henceforth, from thematic analysis it can be concluded that increasing competition, pressure from rivalries, innovation in surgical tools and lack of existence across foreign boundaries can be huge risk for expansion plan and to mitigate risk it is important for surgical instrument manufacturers to first focus on increasing important, export and online marketing before developing as brand in internal market. Nevertheless, as per company B, developing firm as strong brand by supplying and innovating cost products is the strategy which can helps the entity in establishing and growing its market in new area.

Because of various circumstances such as financial etc., some companies are not getting the opportunity to expand their operations and functions in foreign markets. So, for resolving the issue, various supportive measures can be taken in order to provide them efficient opportunities so that they can also plan further in making expansions. Some very well known and common examples of this can be considered as the ways and strategies such as ways of getting financial help but ensuring that they must be able enough to return the same or not. So, it is very important to consider all these factors before expanding the objectives on an international level. The chamber of commerce also plays a major role. It is said that the chamber of commerce helps the companies to get all their documents registered and help them so that they can get the visa efficiently. For every small and medium sized company, the chamber of commerce can play a very vital role because they help in a wide number of factors that are required and are essential for the companies to develop before expanding its operations in the foreign markets.

According to every company involved, there are various competitors in the market and some well known and very common examples of their competitors involve RKZ, Hilbro international etc. Branding strategies of their competitors have also been included as some of the competitors think that promoting their products and services by various means, participating in exhibitions in the international markets etc. because it is considered as a very effective way because by such means, the company can also get an opportunity to meet buyers of the foreign markets. So, they can interact with them and can have a wide rate of understanding about the ways and methods that are required to expand the business objectives and operations in the international markets.

            Also, the companies from which questions have been asked think that the big companies can have a positive as well as negative influence on their companies. It is because some of these companies think that as they are large enough, so they have bigger opportunities, so it might throw a negative influence on them. But some companies  like company A, B, C and other companies of them think that it can help them in attaining various opportunities as well. There are some specific current strategies that the companies make use of while expanding their operations in the international markets. These can involve using quality products, satisfying all the requirements and needs of the customers, implementing affordable rates so that every person can be able to afford it. Also, for achieving their vision, they can make use of various ways and methods. Also, government of Pakistan can also involve some preventive measures so that the small and medium sized organizations can grow and expand their operations in different foreign markets. Either they can help in providing them the ways or in various other factors as well such as in providing financial support etc. The previous chapter of this dissertation suggested recommendation to increasing operation and expanding firm which can assist small medium-sized organisation to manage successful business operations across foreign boundaries. The recommendations are based on review of data analysis in which the researcher studied interview of 15 different surgical instrument manufacturing companies. It is important for the small size organisation to first focus on developing its existence in market for which the enterprise can market about its innovated surgical instruments on online platform. It is strategy which can helps the firm in developing opportunities by promoting own existence. Moreover, it is possible that with the help of international marketing the firm will be able to grab attention of direct buyers who can assist the organisation in successful establishment of business in other countries. Apart from this, the dissertation will conclude by stating about the quality of products which can be beneficial for small business organisation at theme of expanding business.  Thus, the small firm can focus on developing quality of surgical instrument with innovation in comparison to competitors in order to stable business operations across international boundaries. This can help in increasing the stability of the business.

At the end, it can be concluded from the research that the aim of the study was to analyse different ways and methods that can be involved by the small and medium sized organisations so that they can become able enough to develop themselves as a recognised brand in the market place. There are various factors if being implemented in an efficient and appropriate manner, then it can help the companies to achieve their goal and that too at a much faster rate.

5.3 Recommendations

There are various measures that needs to be added and achieved in order to make some positive changes so that it can help the small and medium sized organisations to grow and expand on an international level and these are discussed as following :

Building a strong brand culture

The surgical instrument manufacturers should ensure the fact that if they would be having a consistency in the brand culture, it will help them to achieve many of their objectives in the international markets.  Consistency means to have an appropriate rate of some permanent customers. A proper structure is a must. So, these surgical instrument manufacturers can focus on making their structure efficient enough so that it involves of every single factor that is essential for an appropriate expansion of these companies on an international level. Also, brand and corporate culture here plays a very important role (Choi and et.al, 2017). If these companies tends to get involved in various sessions, exhibitions etc., then it can provide them an opportunity in meeting new buyers. Also, by means of this, it will also help them to analyse and understand some very basic facts of the specific market and culture. Participating in exhibitions is also termed as a very effective factor because by these means, the manufacturers can become able to promote their products to enormous number of people attending the exhibitions.

So, on the basis of the essential factors, these surgical instrument manufacturers can develop their brand culture so that it can be able enough to satisfy the basic requirements of the market. Customers is considered as a very essential part of the brand culture (Bondinuba, 2012). So, these manufacturer companies should also ensure to consider this fact and make sure that they do not overcome any such barrier regarding language. For this, they can organise and provide sessions to their employees about understanding various different languages. It is important because this will help them to overcome from the language barriers. It is not about building a stronger culture but also, maintaining it is important. It can be measured by analysing the processes of the operations and functions on a regular basis. Also, they can take feedbacks from the customers  because by such means, the customers can tell them  if there are any parts and factors where they are lacking. The surgical instrument manufacturer's can consider these factors and make modifications and improvements wherever  there is an actual need.

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            Surgical instruments manufacturers can ensure that they can make an analysis of various brand strategies so that they can evaluate that which one can act suitable enough for them to use so that they can become able enough to expand their operations and functions in the market place (Ailawadi and Farris, 2017).  Although in different countries, there are different criteria to be added as associated with the brand strategies.  So, the surgical instrument manufacturers after analysing their current market position and the strategies can conclude at a single marketing approach which they think that can prove suitable enough. Also, they can also take risks as well because it is not necessary that the risks can always lead to failures. Either it can also let the company to achieve various factors and get rewards as well by achieving higher objectives. Although, the manufacturers might have to undergo rigidity and some major changes in between because if there will be any changes in the policies. If the surgical instrument manufacturer's will have an efficient brand strategy, then it can let all these small and medium sized organisations to achieve the objectives and goals at a much faster rate.

            Being a global brand can be considered as a very beneficial factor for these surgical instrument manufacturers because this can attract many of the other organisations that are in requirement of these (Ackah and Vuvor, 2011). Therefore , it can attract a huge number of suppliers and the ones in need. So, it is very important that these small and medium sized companies of surgical instrument manufacturers can take risks as well because it will help them to analyse their actual position. Therefore, after that they can also make modifications and improvements required where they think there are some loop holes.  Companies that are operating at the smaller level must maintain their image, finance and other things so that they effectively make strategies related to international expansion.

            To maintain the brand image at the international level they must make better strategies, planning, and methods that effective and adopted by the already established companies. For example, Surgical Instrument Manufacturer must use the strategies that were adopted by the competitor companies in UK so that they can also make the positive position at the international market and can maintain it there (Gonzalez - Perez, Manotas and Ciravegna, 2016). Focus on the operational and stakeholders must be kept as they only help to promote the business. Other than this organization must keep to their customer as they can aid the company as the brand. Along with this firm must focus on the areas such as promotional activities, advertising and should be present in the international market so that their image can be maintained. To achieve and remain as the global brand they must focus on the performance of the employees, provide them knowledge related to international terms and condition. Overview the operational activities, team-management, culture, and backgrounds of the firm after every year so that modification can be made based on it. The major recommendation must be made in the Global orientation and team management so that constant positive brand image can be established in the international market.

            Understanding the behaviour of customers is very important. It is because it differs as the preferences of people are different. A way to gain a huge number of customers in the international market is that the surgical instrument manufacturers can analyse that in different foreign markets, what is the most required equipments.  Now, the surgical instrument manufacturers can analyse that along with the disposable factor, which are the items on priority which means including the instruments that are mostly used. Then after targeting the markets and the most used equipment's and items, these surgical instruments manufacturers can join these places in the foreign markets. It can actually prove very beneficial for them to gain a higher rate of popularity as well as productivity. Ensuring a proper quality of these is also equally important at the same time. It is because if there might be some faults in the quality of the products, there might be the possibility that the companies in which they are supplying can stop the sales from them. So, it can throw a very negative impact on the popularity of the manufacturer. Therefore, these surgical instrument manufacturers should ensure that they take care of the quality in every single equipment. Therefore, it can be considered as another factor that the surgical instrument manufacturers can ensure to understand the behaviour of the customers and along with that, make sure to maintain the quality in the processing of the functions and operations so that they can get expand in the foreign markets appropriately.

            An efficient brand positioning can also be considered by the surgical instrument manufacturers and for that these surgical instrument manufacturer's can involve various factors as well. Some very common examples of it includes the fact that these manufacturer companies should analyse first that on what stage and level, they belong in the market. They should know about the competition and the ways that they are involving that makes them on top positions. They should know about the ones that are also dealing with the same processing, manufacturer's the same equipments etc. in the country in which they are expanding. It will help them to go through enormous strategies that they all are using. On the basis of that, then can then decide that which one of them can act suitable for their business and which one can help them to satisfy the customers in the foreign markets. Also, by analysing it, the surgical instrument manufacturer's can also get to know if there are any factors in their structure that needs to be modified or improved. So, they can make the replacements as soon as possible so that their processes and procedures can gain some sort of popularity in the foreign markets.

            Broad thinking can  also be considered as another factor that needs to be ensured by the surgical instrument manufacturers because as per the increasing demand of the products and equipments in the market, they can also make expansion in their services in the international market (Nobre and Silva, 2014). So, for that they should stay prepared from before only such that they can seem capable enough of covering all the modifications and improvements in their brand. It should be promoted in a way that it seems acceptable enough by the customers. Also, the surgical instrument manufacturers can analyse the products that are highly required in the market but are not present, so on the basis of that they can make involvements of such products in the market. Such means can help these surgical instrument manufacturers to get a specialised rate of interest for making the products in demand, available in the international markets. Also, by involving these products, various other brands in foreign markets can also get a sort of competition rate, thus making these surgical instrument manufacturers productivity rate high. Also, these surgical instrument's manufacturer's can make some changes on a broader level. A very common example of this can be considered as the fact that if these small and medium sized companies increases their overall strength, then even at times when there is a load on the other surgical instrument companies, then their staff and employees can work hard and get the orders done. This can also increase the popularity of the company at a higher level.

            Investigating about good partners is equally important for the surgical instrument manufacturer's while expanding their operations in the foreign markets. It is because finding good partners there can provide much amount of support to the companies. One single mind can think a few and limited ideas but different minds can think of various different ideas. It is because when a number of people will sit together, various ideas will exclude from their minds, so if these companies will be having some good partners, the whole operation can seem easy enough for them. On the basis of the ideas of every team member, they can conclude to the final idea that seems the most suitable and relevant enough sin a better expansion in the foreign markets. So, finding a better partner can ease the load of the operations and functions to a huge extent. Also, at the time of licensing of ant service or product to some provider who is overseas, then the manufacturers can ensure that the provider should be reputed and shall not make negative use of the name of the surgical instrument manufacturer and can keep in mind the quality of the products.

             There are two factors on which the surgical instrument manufacturer's can keep their focus upon as either they can focus on the fact that what customers need or ensure a better branding. It is because both the factors are important enough while expanding their operations in international markets (Gonzalez - Perez, Manotas and Ciravegna, 2016). So, when the surgical instrument manufacturer's will analyse the current situation of the market, then on the basis of that, they can decide whether they need to focus on the customer satisfaction ways or on the branding. It is because if in some specific place in foreign market, where the company is expanding, if there, people are choosy enough, then the surgical instrument manufacturer's should ensure to focus on ways that can satisfy the customers. On the other side, if the customers want quality, then these organisations can keep their focus on branding. They can continue their processing on the same basis so that they can be able to gain a higher rate of productivity in the international market in which they are expanding. Also, the surgical instrument manufacturer's can investigate about different trade representatives in the country, in which they are expanding.

            Franchising the brand is another factor that is essential enough and if implemented in an appropriate way, can prove much beneficial for the surgical instrument manufacturer's. For this, any company operating under this first can make their brand successful enough by involving various ways for promotion, for satisfying the customers etc. This will help them in an increased rate of productivity. Then the company can allow some of the business owners to open some more branches of their company. They can be referred as their franchisees. They will keep a smaller portion of the total amount and give the rest of the amount to the company owners. This can be classified as one of the major beneficial ways because in case of franchising, breaking the whole business in various parts can be easily achieved. For a successful implementation of the franchisee, the companies can take their business model, pass it to their franchisees that seems suitable for continuing the operations. This can term out to be a very successful procedure while expanding in international markets. A very common example of this can be considered as the fact that the surgical instrument manufacturer's can first create their own brand. For increasing its visibility in the market, they can involve various other ways such as for promotion, providing offers and discounts etc. This will help these companies in an increased rate of visibility and popularity in the market. Then on the basis of that, they can contact to the franchisees and pass them the model of their company along with the structure. Then the franchisees can also implement the same in various different international markets and can gain much higher productivity rates. This can act as another source for the surgical instrument manufacturers.

            The surgical instrument manufacturer's can also involve the way of direct exporting. In this, they can first analyse the international markets in which they have planned to expand their operations and services. Then on contacting with the basic retailers there, these companies can directly export their products to these retailers and smaller firms in the international markets. By this way, the products and equipments of their organisation will reach to the international markets and people can start buying it as well. So, while using their products, it is obviously increasing their popularity from the products that have been supplying throughout the specific areas of the international markets. The middle men or the distributors can be the friends or other relative members as well that live in the country where the company has to supply their products and services. Also, along with these, the company can also lead to involve with some recognised distributors but the fact that is to be ensured here is that the distributor should be recognised and must be having a clean history. It is important to consider these facts as it help these companies to stay protected from any sort of fraud or complication. After the distributor have been fixed, then the company have to focus on the logistics one as it also plays an important role in the whole process of marketing the products and services in international markets. When their products will be supplied all over the market, it will automatically help them to develop as a brand in that specific international market.

            Making effective partners in each country in which the companies are interested in. It is because being a partner in the operations of the country is necessary to make any sort of involvements etc. in that specific international market. But the fact that needs to be ensured here is that the companies should make the partners that are efficient enough so that they can help the company to grow at a much wider level. The partner's history should be checked as well so that they can analyse the previous records and history of the partner. It is important because if at this stage, the history seems to be poor enough, then the company can move on to some other partner. In getting an understanding of the rules and regulations of the specific country or their market, the role of a partner plays an important role because they help in getting the regulations and policies of the specific international markets in which the company has to expand their operations. With the help of a partner, the surgical instrument manufacturers can involve and implement any operation in the international markets but without that, it cannot get done. Also, there are different regulations in every country. So, it is very important that the companies must analyse and understand the regulations and policies in international market in which they have planned to expand because this helps in protecting the company from any such further complication. If all the policies and procedures have been clear enough, then it helps in a better processing rate of the companies like Dubai, UK etc.

            A common example can be considered as the joint ventures, which  is another essential concept that can be involved by these small and medium organisations such as surgical instrument manufacturers. A joint venture is classified as a sort of partnership between two groups or organisations. Linking up and getting it invested for some of the project such as of distribution of the products etc. For both the companies involved, the investment is fifty fifty. As both the companies will be the part of the venture, it means that both organisations will be having an equal participation in every factor, whether it is the overall revenue or the market shares etc. Even the profits are also split equally. Although both the companies do not stay together, they only interact with each other regarding the operations and processes, but their target is to achieve the goal no matter what. For this, they often can involve in various meetings and operations, but the fact they both need to ensure is that they have to realise that an effective decision making is a must for maintaining a sort of balance between the operations of the company. If they will not cooperate with each other, it can result much bad on the overall productivity. So, for managing that, both the companies should ensure that there will be many times when they have to cooperate with each other. So, cooperating with each other at different times can help them to avoid any sort of confusion or mis understanding and thus they can further focus on involving various ways that can help them to achieve all their objectives and targets and that too at a much faster rate.

            Licensing can also be considered as an aspect that can help the surgical instrument manufacturers to develop their brand in the international markets. Although the concept is quite similar to piggybacking but in this, the companies involved simply have an interaction with the firms of the international markets and they can simple put their proposal to them that whether they are interested in purchasing their products. As the current demand of the surgical industry is that they need more equipments that are disposable because they just have to use these items once and then they decompose it. So, the company can assure the international firms the quality and standardisation of the equipments and can wait that whether they require it or not. Although it is a temporary process but can help these surgical instrument firms to get a better productivity rate. Also, it will help them in getting an exposure. Also, licensing is considered as a process that can help these companies to get their brand very efficiently developed in the international markets but it is not easy. There are various processes involved in the complete procedure of licensing, so the firms dealing with the surgical instrument manufacturers should ensure to have patience.

            A proper marketing strategy is also an effective option to be involved because it is obvious that there comes various ups and downs in the organisation. So, at the time when an organisation faces failure, that is the time when it is most important to manage the operations in a way that it do not further lead to any complication or issue. For implementing an exact and appropriate strategy, it is important that the surgical instrument manufacturer can first analyse their current marketing position. It is important because it will help them to analyse where they actually stand in the market. After analysing their market position, then they can focus on the fact that what marketing strategy or approach can act suitable for them. Also, the companies should analyse the fact very clearly that to which foreign market, they are planning to expand their operations. It is because the operations, regulations and policies of every country differs. So, the companies should consider the factors , regulations of the specific country in which they are expanding. Then on the basis of that, they can involve the marketing strategy or approach which they seem can act relevant for the specific location. Involvement of marketing approach as per the requirement of the foreign market is essential enough because if some different marketing approach will be used in their process, then it might not result that much effective. So, selecting the one that acts suitable and relevant enough so that it can help in achieving all the objectives and targets of the company and that too at much higher rates.

            Purchasing a company can also term to be an effective option because this can also help in easing the operations and processing of the surgical instrument manufacturer's company. It is because when the company owner will purchase a whole company in some foreign market, then they just have to do the basic processing as they have implemented in the domestic one. They do not have to go through various external operations, rather they can make a structure as they have made in their domestic company as well. The only factor that they have to consider is that these companies should analyse the culture and requirements of the people there so that they can continue their processing on the same.

            The culture and needs of every country differs to a huge extent. So, the surgical instrument companies can ensure to understand it properly so that they can have a smooth and easy processing. Purchasing a company there is beneficial because by these means, the surgical instrument companies does not have to undergo any formalities or processes such as contacting the international firms and then waiting for a response to come from their side etc. Therefore, along with the other factors, purchasing a firm and then involving all the processes and operations as according to the structure proposed by them is an effective factor because the proposed structure must be compiling of all the factors that are required to be implemented according to the cultural and other factors of the specific international market. It is considered even better than taking the franchisee of the business because in this case, the surgical instrument companies can make their own structure and policies. They do not have to follow the structure or plan of some other company etc. Therefore, it is efficient enough if the company takes over the whole company so that they can continue all the processing in their own way.

            Also, it will help them to avoid any further complications or issues. Also, it can prove beneficial for these organisations in multiple ways (Ailawadi and Farris, 2017). Some very well known and common examples of it includes licensing, a better market share etc. It is because in case of licensing, the government of the particular country will term the brand as a local firm and provide the licensing efficiently as well. Once the firm will have an efficient time in the market, they will analyse the positioning and other factors of the same market. Thus, on the basis of that, they can stay well prepared for any sort of competition because they must became aware of the ways to deal with the competitiveness in the market place. So, this can also be considered as an efficient way to develop themselves as a brand in the international markets. Marketing strategies are considered as an effective way to be involved so that the overall rate of the operations and functions can be increased to a huge extent. Also, there can be various situations when the company might have to  undergo some risks or challenges. So, these companies should ensure the fact to involve a risk assessment method in their structure that can help them to cope with all the factors that act as risks or challenges in the processing. It is because risk assessment is considered as an efficient tool that should be implemented by every single company as it helps in managing all the risk factors and the ones that act as challenges so that the company can keep their focus on achieving the objectives and targets at a much faster rate. Therefore, it is very important that the surgical instrument manufacturer's should involve the strategies that they think are capable enough of helping them in various different factors and also in achieving the productivity and popularity at  a much higher rate.

            The surgical instrument manufacturers can also make an analysis of different countries that what are the countries that are actually lacking in the surgical instruments and equipments. They can prepare a well chart of different international markets and then on that chart, they can highlight the areas where there is a lack of the supply of the surgical instruments because of various reasons. It is because there might be some areas that are backward or there might be a less availability of the transport. So, because of such reasons, there might be the possibility that they lack in the supply of the surgical instrument manufacturer's. So, these surgical instrument manufacturers can help these areas by providing them an efficient range of the surgical equipments and instruments. Therefore, on that chart, they can specify with the areas who are lacking in these surgical instruments and who have more.

             It is because as in the areas that are lack of supply of these equipments, at least they can supply but in areas with a large supply, they can contact them and can join with them and get involved. This will provide them even a smaller share but a great popularity and productivity. The involvement of making and implementing the chart and then, demonstrating all the areas on the basis of the minority and majority of the areas associated with the availability of the surgical instrument manufacturers is one of the effective ideas because this will help in a better analysis of the requirement of the surgical instruments in those specific areas. Also, this can be considered as a smart way to be included because analysing the areas where there is an actual need and supplying the surgical instruments there can help those people as well in getting the availability of the equipment s and along with that, it will also help the companies as well. Therefore, this can be considered as one of the effective ways that can help the small and medium sized organisation to analyse the areas where there is an actual need of the equipment's so that they can supply the same there and can gain a higher rate of productivity as well.   Operating room management is considered as science that help to run successful operations and functions. In this manner, efficiency and performance could be developed successfully to operate significant advantages. Operational operating room management focuses on the maximization efficiency in number of surgical cases that required proper resources to carry functions. In this way, resources must be carried with related cost so that proper functioning could be made. For instance, it considers that what anaesthetists and scrub nurses needed to accommodate the expected workload (Ott and Longnecker, 2015). It need to minimise cost of drugs that operating in room. Strategic operating room management deals with the long term decision making. Therefore, it is profitable to lead with the additional room with existing facilities, typically in the operating room management, there are profits considered that assists to develop their revenue. As results, it is important to look upon the long term decisions with two additional rooms facilities in existing consideration. In the act of coordinating and running with all parts of surgical, defined and set of goals must be accomplished. In the emerging field, operating room management increasing that studied with successful operations. Hence, following activities implemented in these aspects.

            It is important to ensure that patient safety and optimal outcomes will be attained that assists to make proper coordination in systematic manner. It helps to focus on the each person requirement that helps to develop creativity and performance at workplace. In addition to this, it helps to create loyalty program towards the patient that increases performance and results as well. It increases efficiency and performance that helps to carry relevant results at workplace. With consideration of the operation room utilization, it has been seen that staff and material has been used successfully that take place important role in the institute. With this regard, it is important to look upon the activities that are taken on the basis of availability of resources. Therefore, targets and goals operated in timely manner. As results, it creates positive impact on the outcomes. Furthermore, decreases patient delays required to operate systematic operations and functions in the environmental. It will help to focus on the time performance that is more important for each person in health care. With this consideration, service care taker considered patient safety and increase their part to operate successfully in the environmental. Budget program has been prepared with seeking lower pricing strategy. Therefore, it will assist to make safety and attain more advantages to gain financial and modifying existing resources. Hospital administration perceive efficiency in the operating room throughput and completing budget as well. Later, it is also important to the manager to cooperate with the team members so that they are able to fill important consideration in the hospital administrators which possess focus on the attention. Therefore, it maximises profitability with contribute proper margin. As results, it will boom to the demand of elective surgery which make rapid growth and facilities as well.

            Along with this, nurses are also responsible for the daily functioning in surgical suite so that facilities also hiring with physical medical director. It should be represented by the surgeon, anaesthesiologist so that three branches are covers surgery, anaesthesia and nursing as well. In order to working with the collegiality, all resources must be develop with maximise important elements (Ciravegna, Majano and Zhan, 2014). It increases productivity because of the OR management infrastructure. In order to work with collective system, it is important to mobilise the all resources that are needed on the basis of regulatory requirement. The concept of appointing medical director in the system also operated by room manager that gained acceptance. Clinicians totally focuses on the operational decisions on the day of surgery within the short period. As results, it helps to assign and relieving staff members on the basis of priorities and urgent cases which schedule add on case. Beside this, upper management typically focuses n the strategic making activities which has been opened for the new cancer center. It could be align with regional health care system. There are several principles implemented in operating room management so that decisions are made that clearly defined purposes to maintain consistency. On the basis of priority, principles are governing to perform properly all the time so that doctors and nurses need to think about the day of surgery. When management is poor, medical and nursing activities waste so that efforts and resources has been made to schedule with compromising attention towards patient safety.

            Furthermore, another recommendation could be given to the operating room utilization which assists to measure staff performance and people needed to successfully operate functions and operations.  As results, it will help to focus on the group of surgeons that taken time as per the situations. Furthermore, it carries to make sure that total hours considered with elective procedure so that it block the time improvement in the operating surgical environment shows that it could be create impact to maintain effectiveness of staff members. With the help of the hospital staff, improvement has been made with finance as well. Therefore, with new tools operation management considered several advantages in the system (Ott and Longnecker, 2015). It will look upon the efficiency management activeness that are needed in the business. Improvement in the operating room efficiency is major aspect which towards manager need to look which impact on the hospital staff and financial activities as well. Performance on the operating room management is the surgical areas towards important consideration required. Along with this, it contains scoring elements with applications that develop outside the environment for measurement of the results. Right time and information is the main element which need to implement to attain more desired and systematic work performance at workplace. It will help to look upon the cases that are taken by health care as well.

            Optimal allocation of operation time should be consider with historical use in the particular services. In this way, allocation such as surgeon, group, department and specialty using with the computer software so that relevant results will be develop to focus on the innovative work performance. Excess staffing cost needed so that scheduling of each activity considered positive impact which illustrate development of activities with increase efficiency of use of staff. As results, poor initial staff choices also reduces with historical use of particular services. Allocation of surgeon, software make simple work in the institute so that it reflect positively on the performance and outcomes. Longer compensate and poor initial choice of staffing schedule optimum allocation so that it will look upon the underutilized time and expensive activities as well. Work will be schedule in systematic manner so that additional cost also reduced that considered in the recruitment and retention. It suites to implement reasonably aim that achieve with optimal solution that are perfectly which assumed towards two factors which is related to monetary benefits. As results, reasonably aim implemented in the staff that matched perfectly with appropriate time and services. All services have been based on the historical OR so that it assists to deal with the consistency and services based surgery as well. In each day, it develops consistency work and performance that are scheduling with staffing cost.

            It may be concern of the nurse and manager ability that is needed to staff with enough to avoid excess staffing cost. It could be create difficulties from the human resource standpoint which match to create schedule in the particular cases with staffing perfectly. It can be challenge in term of growing concern that need to develop elective cases with reduce time patients in the surgery system. When they arrived in the hospital, cancellation rates needed to implement in the facilities which depends on the care that are range around 4.6%. Monitoring correctly is also taking on the basis of schedule cases. It is important to understand about the number of hours that available to each nurse so that effectiveness will be increasing to make sure that revenue will be generated in understaffed days. Contribution is also needed which put with excessive schedule  in excessive manner (Wynarczyk, Watso and Keasey, 2016). Another recommendation can be taken that is reduced overtime so that patient enter every time easily. In addition to this, at the turnover time, set-up activities also need to generate among the case which helps to focus on the cost reduction to accomplish allocations and staffing management activities. It will help to look towards the satisfied surgeon who receive proper attention with different instrument in the particular case. Time also defined interval which need to be considered on the prediction basis. It will help to look upon the new case which appears and track duration data. Problems are also needed to reduce with implement inaccurate information which required prolonged turnovers with productivity and profitability as well. Hence, it considered positive impact on the course of patient to deal and determines preference in workload with implement surgical suite. Management must be directed to maintain and schedule with priorities activities.

            Developing and then implementing a strong and balanced business plan can also help them to manage all the operations and processes of the surgical instrument manufacturer's. It is because each market has their different norms and culture, so it is very important that on the basis of that, these manufacturer's can make all the improvements and modifications in the plan that is already existing. For getting properly involved in the economic, governmental and cultural factors, these small and medium sized companies have to make short, medium as well as long strategies so that they can make use of it at the time of the requirement. Also, they must be having some strategies for the immediate basis. It is because if they have to face some complication further, then they must have some urgent ways and techniques that they can use at that time. Also, developing a top down annual budget can help. It is because it can help in maintaining the financial status check of these firms and also, along with that, it will help them in analysing the average revenue they have achieved. Reviewing all the specifications and guidelines of the government of the specific country in which these surgical instrument manufacturers are expanding, because the regulations of each country differs. There are various types of policies and factors that are developed by the government such as there are tax regulations etc., so the surgical instrument manufacturer's should ensure to know about the policies and regulation of each country in which the manufacturers are planning to expand. It is because this helps in implementation of the structure in a better way, whether it is in terms of the tax or the legal policies, a pre information about that can prove actually helpful in implementation of the plan.

            Also, a pre testing plan is important. It is because the surgical instrument manufacturer's after developing the structure or plan, they should ensure the proximity of the same. It can be done by testing the process. On the basis of local standards, the small and medium sized organizations can review their procedures and processes whether the processes they have implemented can be able enough to help them achieve the targets and objectives. These manufacturer firms should have to investigate whether they need to perform the localization of the products or not. It is because if it will be required, then they can localize their equipment's and instruments such as there is a huge demand of the disposable items because the surgeons etc. make use of these instruments and then dispose it off. So, there is a huge opportunity for the same in the market (Resnick and et. al., 2016).

            Therefore, if localization is important, then the surgical instrument manufacturer firms can promote by various means in the international market about the products. It will help in letting the people understand and know about the product so that if they will require the same in the future, they can contact these surgical instrument firms to get them. As they will move in some international market, it is obvious that they have to analyze and understand the culture etc. of that specific foreign market. After learning the language of the country, they should also stay aware of pronouncing the name of the instruments etc. in the local language so that they may not face any issue while interacting with the customers. Interacting with the client in a language that they do not understand, seems to be very disappointing for the customers. It is because when both the parties will not be able to communicate with each other effectively, it can effect the whole processing. So, it is very important that they follow each and every process appropriately so that they do not have to face any further issues or complications in the future.

            For attracting a huge rate of the employees that can work with them in the foreign market in which they have expanded, the surgical instrument firms can also make involvement of various discounts and offers so that they can be able enough to gain their attraction (Ackah and Vuvor, 2011). It is because this is obvious when these firms will try to expand their operations in the international market, then they will be requiring employees as well so that they can get some support and help. Performing and expanding the operations alone in the international market is not easy, so they can decide to make involvement of a few numbers of employees so that they can get some sort of support. Working along with some members is better than working alone because a single mind can have some limited ideas but when a huge number of people sit together, various different ideas pop out of their minds. So, on the basis of that, all the members can sit together and discuss ideas, thoughts and issues with each other. After having an efficient discussion, they can conclude to one single idea that they seem is suitable and relevant enough for achieving the aims and objectives of the process.

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