...Question 1 Model Shouldice Hospital as a processing operation with products, attributes and resources. Model Shouldice Hospital as a Processing Operations unit can be viewed as having the following Process structure. Input: The patients entering the Clinic after getting the confirmation on the date of the operation. Output: The output in this case is the number of successfully operated patients who underwent the entire process. Flow Unit: This is one patient that go through the process. The Process starts when the patient enters the hospital and ends on the day of the discharge. We can also find that the number of inputs in the process may not be equal to or could be less than the number of output. There are patients who are sent back because of the medical complications such as overweight and if the diagnose proves to be negative. The process can be viewed in a diagram. There are waiting times in between each location. Process view of Shouldice hospital Limited Network of activities and Buffers (Patients at different departments ) (Waiting time for each) * Input Output Patients operated patients Capital and Labour Products Since the case is from a service sector the set of process outputs include tangible and intangible interpretation. The product of the service can be inferred as the number of cured patients but along with that there are some intangible aspects such as the experience of the patients in the Hospital. Service...
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...Shouldice Hospital: Operations Assessment Shouldice Hospital has been devoted to repairing hernias for over half a century. Although the Shouldice system has led to great competitive positioning, the hospital is falling victim to its own success. Demand for Shouldice services is so much higher than its current capacity of 89 beds that it is in a constant state of operations backlog, which grows by 100 patients every 6 months. Thus, Shouldice needs to find a solution to its single most critical question – how to expand the hospital’s capacity while simultaneously maintaining quality control of service delivery. The analysis below is designed to assess the current operations at the hospital, in addition to explaining our recommendation that Shouldice should invest $4MM in a new unit, which will increase bed capacity by 50% and require its surgeons to perform Saturday surgeries. As the financial analysis shows, this change will allow Shouldice to capture unmet demand without compromising its unique system of patient and employee care. Lastly, our recommendation will be also juxtaposed to other options we evaluated as potential solutions, but that neither make financial sense nor solve the current dilemma for the hospital. Hospital Overview Shouldice Hospital is a “focused factory:” a hospital with a specific area of expertise that gives it competitive strength resulting in lower cost, higher quality service for its patients, and better pay for and loyalty...
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...1. How successful is the Shouldice Hospital? Process: Day 1 Day 2 Day 3 Day 4 Steady state scenario Monday Tuesday Wednesday Thursday Friday Saturday Sunday Monday 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 29 29 29 29 Table 1 Shouldice hospital is currently only focussed on hernia operations. Their USP is their focus on early ambulation. They also put more emphasis on post-operative care for 2-3 days offering accommodation. Other hospitals do not focus on early ambulation or accommodation after operation. This gives Shouldice a competitive advantage. The procedure is well defined and structured. As it is mentioned in the case, change in procedure usually requires the chief surgeon to be present to look after the proceedings. This fixed procedure ensured that the primary operations got over in 45 mins, and minimal chances of secondary operations on Shouldice operated cases. The secondary operations also take about 90 mins. The number of operations performed by a typical general surgeon is 25-30 per year whereas the surgeons at Shouldice perform 750 operations per year. They are well paid and looked after with a profit sharing plan, and this applies to even the administrative staff along with nurses and surgeons. Some features: Infrastructure - A 17,000 square foot main building on a 130 acre estate with 89 beds for patients with 7600 operations performed per year as of 2004 Theoretical...
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...Introduction Shouldice is a private hospital located in Toronto, and was founded by Dr. Earle Shouldice in July 1945. The hospital started out as a six-room nursing home in downtown Toronto. As demand increased for hernia operations, Dr. Shouldice expanded the facilities to a capacity of 36-beds, which turned into an 89-bed facility after the addition of a large wing. Dr. Shouldice is a famous doctor known for his private method of hernia surgery. Unlike normal methods, his way allowed the patient to be up and about right after surgery, and move freely about by the end of the day. When patient numbers increased, Dr. Shouldice decided to exploit this by opening up his own hospital. His hospital, Shouldice Hospital, specialized in external hernia cases and proved to be a big success. Dr. Shouldice died in 1965, but his hospital continued to grow, and by the end of 1982, his hospital had 6,850 operations per year. Issue Statement The Shouldice Hospital is a successful and admired organization. However, due to its unique surgery method, and without the assistance of mass advertisement, they are operating close to 100% capacity. Thus, Shouldice fears not being able to meet future demand. Moreover, “competing” hospitals and surgeons utilize and perform the Shouldice method (and advertise as such), although they often perform the method incorrectly, ultimately giving the Shouldice Hospital a bad reputation. Shouldice’s critical concerns are meeting future demand, dealing...
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...Case 1: Shouldice Hospital Limited Q1: How does shouldice compete? In other words why do patients come to shouldice hospital? Two main reasons drive customers into choosing Shouldice over other competitors/hospitals. The first is quality, and the other is cost. talking about quality of the Shouldice “product” includes both, quality of the operation, and quality of post operation activities and overall services offered by Shouldice. The Shouldice method is a focused, specified operation that deals with Hernias, with a reputation that has been built throughout the years and is still growing; the hospital doesn’t even use advertisement to attract patients, the “word of mouth” way of advertisement has been doing very well for them so far. The superior quality offered by the Shouldice method, gives the patients a motive to operate at Shouldice for what it gives regarding peace of mind, low risk and low recurrence rates. Away from the in-operation excellence in quality, the services that Shouldice hospital offers are more tempting than other hospitals. Patients do not feel that they are in a hospital; they consider it more like a recovery vacation with an excused absence from work without feeling any guilt in that. Moreover, it gives patients the independence and sense of control and preserves patients’ dignity when it comes to the fast recovery after the operation, and when it comes to the fast ambulation process after the operation, where a patient rises up and walks by himself...
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...1. How successful is Shouldice? Shouldice is successful in a technical sense with its combination of low recurrence rate, low cost and short recovery time. According to www.webmd.com an inguinal hernia repair, which is the primary procedure Shouldice Hospital performs, has an average recurrence rate of 1% to 10%. The recurrence rate for hernia repairs performed at Shouldice is less than 0.5%. The average recovery time for this procedure is 1to 2 weeks for light activity and up to 4 weeks for full recovery. Shouldice patients often walk to the wheelchair from the operating table, are participating in light exercise the same day, and are back to work within 8 to 10 days. Costs for this procedure at other facilities range from $2,000 to $4,000 while Shouldice is able to perform it for under $1,000. Shouldice is also successful in providing a positive experience with nearly 80% of patients being swayed by a positive review from friends and family. 2. How does Shouldice maximize perceived customer value? Shouldice maximizes perceived customer value by providing services of quality higher than the market at a cost lower than the market in an environment that has the feel of a country club rather than a hospital. They have succeeded in instilling such camaraderie in their former patients that tickets to an annual alumni convention sell out every year. Shouldice has succeeded in wrapping their medical care within a social experience usually restricted to vacations. ...
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...Shouldice Hospital Case Assumptions 50 weeks Christmas Eve closed Resources Examination Room - 6 = 6.5*5 +4 = 36.5 Nurse Station- 2 Laboratory – 1 Maximum Bed Capacity-90 (No of days in a week=7 Available bed days =90*7 = 630) Lounge- 1 Common Dining Room -1 operating rooms -5 Recovery room-1 Surgeons (FT) – 12 =12 *35 =420 150/420 =35.7% (PT) -7 =7*17.5 =122.5 operations/surgeon =150/12 =12.5 (12 operations by 1 surgeon approx) operations/operating room = 150/5 =30 7000/50 =140/5 (days a week) = 28 | BEDS REQUIRED | CHECK-IN-DAY | MONDAY | TUESDAY | WEDNESDAY | THURSDAY | FRIDAY | SATURDAY | SUNDAY | Monday | 30 | 30 | 30 | | | | | Tuesday | | 30 | 30 | 30 | | | | Wednesday | | | 30 | 30 | 30 | | | Thursday | | | | 30 | 30 | 30 | | Friday | | | | | | | | Saturday | | | | | | | | Sunday | 30 | 30 | | | | | 30 | Total | 60 | 90 | 90 | 90 | 60 | 30 | 30 | Total =450 and 630 bed days therefore = 450/630 = 71.4 % 69.4% < 71% have to do something to the bottleneck option 1: Add one more day option 2: Increase no. of beds to 135 Option 1:...
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...Solution for Q1: Shouldice hospital is a leader in treating patients who suffer from Hernia. Shouldice achieved outstanding performance and reputation through its distinguished services to customers in terms of cost, quality, delivery and flexibility Cost: At Shouldice, Operating cost is not the only cost factor that attract customers. Besides, typical operation cost (including the patients stay at hospital) ranges from only $954 to $1029 compared to a total of $2,000 to $4,000 elsewhere. Even if we consider the transportation charges for patients who came to Shouldice from outside of Canada, it cost them less compared to the operating cost alone at other hospitals. Apart from this, Shouldice has various pre operation procedures that save the customer a lot of money. We can also consider the opportunity cost that the patients have saved as it takes only 4 days to recover at Shouldice rather than 8 to 10 days at other hospitals. Quality: One of the most important factors that have been the backbone for customer satisfaction is the supreme Quality of service. Shouldice hospital has unique operation technique, high success rate of the operations, and professionally designed process from remote examination to Post Operation recovery. For Pre Operation examinations conducted on patients in order to determine if the patient is really suffering from Hernia, If yes, are there any potential risks that the patient might have to face if he undergoes the operation?, Housekeeping facilities...
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...ldi Case Study 1: Shouldice Hospital Limited 1. What has the leadership of Shouldice been excellent at? Shouldice leadership has been able to develop one of its surgical service lines, inguinal hernia repair, to an “internationally-recognized” brand. This has allowed Shouldice to dominate the market share and create a demand for its specialized services resulting in financial stability. The creation of this brand also has a strong influence with how the organization functions and how it is perceived. Levey (n.d.) reveals why branding creates organizational value. Levey expresses that “from a marketing or consumer perspective, it is the promise and delivery of an experience.” Shouldice leadership has also created an organizational culture that provides employees a sense of purpose, motivation, and opportunity to enhance their skills. Levey (n.d.) adds that a “brand is the greatest asset for uniting employees around a singular culture and mission.” 1. What has the leadership of Shouldice been excellent at? Shouldice leadership has been able to develop one of its surgical service lines, inguinal hernia repair, to an “internationally-recognized” brand. This has allowed Shouldice to dominate the market share and create a demand for its specialized services resulting in financial stability. The creation of this brand also has a strong influence with how the organization functions and how it is perceived. Levey (n.d.) reveals why branding creates organizational...
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...Case Study 2: Shouldice Hospital Kenneth Snell, David Drummond 1. How successful is the Shouldice Hospital? a. Perform a comparison of the cost to patients at Shouldice vs other Hospitals The cost to a patient at Shouldice is based on an average 3.5 day stay: ($320.00/day x 3.5 days) = $1120.00 $650.00 surgical fee $300 anesthesia fee (20% of the patients) = 300 x .2 = $60.00 Average cost to patient is $1120.00 + $650.00 + $60.00 = $1830.00 Average charge for operations performed at other facilities: $5,240.00 b. Perform an analysis of the profitability of the operation at Shouldice. Include Return on Investment (7,600 patients/year) x $1120.00/patient = $13,908.00 annually Operating budget for the clinic: $3.5M Operating budget for the hospital: $8.5M Estimated annual net income: $13.9M - $12M = $1.908M *Net income is the numerator for any return calculation, and typically shareholder’s equity and total assets would be in the denominator. Since insufficient data was given to estimate total INVESTED CAPITAL in this business, ROI cannot be effectively calculated. c. How is all this achieved? How do you account for this performance? The keys to financial success for the hospital is that Shouldice manages its expenses to reduce overhead costs through allowing patients to be active participants in the service delivery process, reducing...
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...The Shouldice Hospital was created by Dr. Edward Earle Shouldice who is the inventor of the Shouldice method which is a hernia surgery designed to reduce recovery time and improve surgical results. The method was in response to men who couldn’t enlist in the military due to complications and it would quickly restore their physical fitness for military training. Due to high demand and scarce hospital space, Dr. Shouldice decided to open up his own hospital specializing in his unique hernia repair method. At the Shouldice hospital, only external types of hernias were performed creating a facility that offers expertise and specialization in their service. There are numerous characteristics of the Shouldice hospital that differ from most other hospitals. The most significant difference is the performance of a single operation and nothing else. This helps provide customers were assurance that they are being taken care of by knowledgeable professionals who have performed hundreds of similar operations. Not only were they getting a quality service, but a speedy recovery time helped to add value to their experience. In addition to the surgery received, the entire experience of a quick check in, a comfortable atmosphere, an opportunity to create relationships, well prepared meals, and the freedom to move around are all services which help to differentiate themselves from your typical hospital. This helps to relieve stress and anxiety many people have when getting a surgical procedure...
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...INTRODUCTION The Shouldice Hospital, located in Thornhil, Ontario is considered a global leader in hernia repair and recovery. The Shouldice Hospital was established in 1945 by Dr. Edward Earle Shouldice. Major Dr. Edward Earl Shouldice saw many men denied enlistment into the army because they were deemed physically unfit to serve due to the need of hernia surgery. Dr. Shouldice developed an innovative technique to repair hernias during this World War II era and has been known in the medical world for his superior methods ever since. Shouldice created a method that included factors such as a local anesthetic, the abnormal nature of the surgical procedure itself, encouraging movement following the surgery, and many other postoperative methods used by his team. Using these factors, Dr. Shouldice developed a surgical technique for repairing hernias that were superior and much more efficient than other methodologies. SWOT ANALYSIS Strengths Very efficient process Specialized Expertise Culture, atmosphere unlike hospitals Reliable and high quality service Competitive Pricing Minimal overhead Capacity utilization Customer satisfaction Quick recovery time for patient Weaknesses Narrow product line Inability to market due to inability to keep up with potential demand Location (Decrease in demand during winter months) Number of locations Age of some key personnel Opportunities New locations, Possible location in United States Create new market segments...
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...CHRISTABEL APPIAH BBAM/ED/110795 CASE DY STUOF SHOULDICE HOSPITAL 2ND JUNE 2014 INTRODUCTION The Shouldice Hospital, located in Thornhil, Ontario is considered a global leader in hernia repair and recovery. The Shouldice Hospital was established in 1945 by Dr. Edward Earle Shouldice. Major Dr. Edward Earl Shouldice saw many men denied enlistment into the army because they were deemed physically unfit to serve due to the need of hernia surgery. Dr. Shouldice developed an innovative technique to repair hernias during this World War II era and has been known in the medical world for his superior methods ever since. Shouldice created a method that included factors such as a local anesthetic, the abnormal nature of the surgical procedure itself, encouraging movement following the surgery, and many other postoperative methods used by his team. Using these factors, Dr. Shouldice developed a surgical technique for repairing hernias that were superior and much more efficient than other methodologies. HISTORY Dr. Edward Earle Shouldice graduated from the University of Toronto in 1916. During World War II, he was called to serve on the Medical Examining Board. Dr. Shouldice, a major in the army, found that many young men willing to serve their country had to be denied enlistment. These men needed surgical treatment to...
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...Summary: Shouldice hospital is a specialized hospital for the treatment of external abdominal hernias in Canada. The hospital was established by Dr. Shouldice the founder of a new and superior surgical technique, now known as the Shouldice method, which yields better medical results as well as a significantly shorter recovery time. Shouldice is operating at its best level of 6850 operations in the year 1982. Over the years the capacity of the hospital is increased from 36 beds to 89 beds. Backlog of scheduled operations of 1200 is a cause of concern even always. Options of Saturday working, increasing an additional floor or new facilities at USA are worked out rigorously and recommended to work on Saturdays (only in peak periods). Total Number of words used : 120 Situation Analysis: Shouldice is a private hospital founded by Dr. Earle Shouldice in Toronto in July 1945. The hospital started out as a six-room nursing home in downtown Toronto. Shouldice offers a new technique to cure the hernia, which is the protrusion of an organ through a weakness in the abdominal wall; this technique was invented by the founder during the World War II. This technique allows the patient to go back to their routine very quickly. Just after four hours of operation patients are encouraged to start walking around the place and feel more comfortable. The typical recurrence rate for the hernia approaches 10%, the gross recurrence rate for all operations performed at Shouldice was only...
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...strategic fit as the answer to “what is the best process for an organization.” Strategic fit highlights the fact that a good process develops competencies that align or “fit” with the product attributes that customers value. Sections 2.3 discusses this idea of strategic fit, which naturally leads into the idea of focus (section 2.4). The idea of focus is operationalized by using the product-process matrix (section 2.5) to emphasize the fact that different process architectures provide strategic fit for different customer needs. We bring up the idea that focus is easier to define in the context of a firm like Shouldice where all customers (patients) have exactly the same set of needs. The Wriston manufacturing case is a good discussion of how strategic fit can be achived when a firm is trying to serve customers with varying (and potentially conflicting) needs. The case discusses how customer needs vary based on the life cycle position of products and how Wriston can achieve strategic fit by having some part of its process focus on...
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