...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 Attributes...
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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 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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...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 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 repair their hernias before they could be pronounced physically fit for military training. In 1940, hospital space and doctors...
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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 Limited Group Project: Summer 2012 Operations Management BUSI-411 D02 Ashley Edwards, Yvette Dennis, Andrew Evans, and Rachel Gillespie Respectfully submitted to Dr. Raja Selladurai Liberty University 8/13/12 Facility The facility of Shouldice Hospital took many years to design and was designed to help aid in the recovery of the patients (Hesket, 2005). Everything was designed around helping the patient to be comfortable, yet encourage movement and socializing of the patients. The design encourages postoperative ambulation, which Shouldice believed aided in recovery (Bendavid, 2003). The building is also efficient in its housekeeping and cafeteria services to help minimize costs. The facility is located in one building that has three floors, with the two lower floors opening out to ground level (Hesket, 2005). This design minimized the need for steps, which can cause discomfort for those who just had surgery. The top two floors contained open lounge areas which creates an environment for socializing. The Florida room is an all glass window room that allows plenty of sunlight to come through, allowing a view of the 130 acre estate. According to Franklin (2012), gazing at scenery such as a gardens or mountains can help speed healing from surgery. The recreational area contains pool tables and exercise equipment. These activities require movement. Shouldice believed that movement and socializing would speed up recovery of patients (Bendavid...
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...The Shouldice Method Abstract Dr. Earle Shouldice and his method of hernia operations and recovery methods are discussed. The discussion includes techniques pioneered by Dr. Shouldice, and the founding and operation of a facility bearing his name and utilizing his methods. Keywords: Earle Shouldice, Shouldice Hospital, Shouldice Method, hernia The Shouldice Method The Shouldice Hospital Limited case consists of the story of an Ontario farm boy who grew up to significantly impact the lives of thousands of hernia patients. Dr. Earle Shouldice grew up to become a prominent lecturer at the University of Toronto, ran a private medical and surgical practice, and was a successful researcher (Heskett, 2003, p. 1). He performed an appendectomy in 1932 on a seven year old girl who remained active post surgery. This led to his interest in early ambulation. Years later, Dr. Shouldice began taking a deeper look at the actions of post operative patients. Remembering the case of the seven year old girl, the doctor allowed wash room privileges to four men immediately following their surgeries (Heskett, 2003, p. 1). Ultimately, this led to Dr. Shouldice opening his own hospital facility which eventually consisted of an 89 bed capacity where he performed hernia correcting surgery using local anesthetic, encouraging comfortable movement and a specially designed post operative regimen (Heskett, 2003, p. 2). Shouldice Hospital treated only external hernias which were generally repairable...
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...Do you think Shouldice Hospital should expand off-site? If so, Where and why? Yes I believe there is a great potential for the Hospital to expand internationally. The US is the obvious choice, since as the case states 42% of their patients come from the United States, so this might be the obvious choice. However, this statistics are from 1982, when the US dollar was a lot stronger than the Canadian dollar ($1US : $0.80CND), which in itself represented a 20% discount from the beginning. Nevertheless, again as the case states that in 1980 it is estimated that 600,000 hernia operations performed in the US alone”. Comparing the 6850 surgeries done by Shouldice Hospital and taking into account that no marketing nor advertising is done to attract any more clients, it should be safe to assume that, tackling the US as an option, it would be profitable. 4. Increase the size of the plant where the service is provide involved a large capital investments and time. The construction could be causing discomfort between patients, quality and country club atmosphere , also to expand the capacity, Shouldice needs to hire new specialist and nurses to deal with the expanded capacity. In addition of Saturday operations will result in increased workload for the personal. they should develop a self-contained branch in northern part of USA. they can brass to offer new specialty medical service first in Toronto. If the demand is enough, they can expand their new specialty medical care...
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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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...1. Shouldice can be thought of as being successful but this is dependent on how one defines it. Some indicators of success are seen through their high employee satisfaction, low turnover rate, hours of operation, and great scheduling and availability of doctors. Aside from this, another major indicator is the increase in demand for the facility in such high volumes. There is a waiting list for nurses while most hospitals are understaffed meaning that it is also attractive for employees and patients alike. Patient satisfaction is also very high and in some cases some patients did not even want to leave because of their experience at Shouldice, “They share experiences with other patients, make friends easily, and have the run of the hospital”. Lastly, the fact that they have avenues for expansion and economic growth denotes that they are on a successful path forward because the opportunities to build more facilities, add a weekend schedule, and charge higher prices would not present itself otherwise. 2. Shouldice maximizes perceived customer value through a few different elements. One of the main ways they do this is through their presentation and format for patients. The procedures are done by highly experienced surgeons in a very specific manner, it is seen that procedures are in turn shorter and they also allow for a free post-op check-up later on at the patients request. Aside from this, the patient is emerged into a specific and comfortable lifestyle which really enforces...
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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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...© 2007-2008 Richard E Murphy Even Swaps - Shouldice Hospital 18 November 2007 1. How Successful is Shouldice Hospital? Shouldice Hospital is a highly successful business that maintains a focused service delivery system due to the success rate of its surgeries, its low employee turnover, its ability to maintain high quality standards, its ability to keep costs low and to remain profitable, and most especially the positive evaluations of its patients. Its strengths can be attributed to stringent policies of staff training in the Shouldice surgical method; the preservation of a communal atmosphere amongst both the staff and with the patients; the implementation of efficient and cost-effective facility operations; and high demand for operations. Its less successful aspects include: an inability to serve a considerable unsatisfied demand, as it is operating at near-full-capacity in its present facility; limited marketing; and an inability to prevent proliferation of its surgical techniques. 2. What Accounts for Shouldice’s Performance? a. Unique Operating Techniques Shouldice has vertically integrated nearly all operational functions in an effort to tightly control its distinctive techniques for performing hernia operations, as well as for pre- and post-operative patient care. The hospital has been remarkably successful in its ability to provide its patients with a quick, quality, low cost surgery in a comfortable environment, and has enjoyed an...
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...RESEARCH Proposing a carpal tunnel treatment centre: The Shouldice model revisited Hazim Sadideen, Faddy Sadideen ABSTRACT The Shouldice Hospital prides itself with excellent hernia repair outcomes. The Shouldice concept exhibits a unique, successful business model, and is a clear example of the concept of a highly innovative value proposition. Exploring Shouldice's fundamental principles and extrapolating them to other settings might help healthcare professionals offer improvements to patient care. Carpal tunnel syndrome (CTS) is the most common elective hand disorder, which can be debilitating for patients. Surgical intervention is extremely effective when necessary. It would be prudent to develop efficient pathways for the treatment of CTS, and other common disorders in the future. This review aims to explore the successes behind the Shouldice model, cross-fertilise surgical and management grounds by familiarising surgeons with the Shouldice model to help generate key ideas for the future, and extrapolate key information to postulate the 'carpal tunnel treatment centre' as a potential enterprise that can be designed on the basis of the Shouldice model. Optimal healthcare delivery while improving the patient journey, in a cost-effective manner, requires careful planning and execution. It is important to further explore and capitalise on this knowledge, to improve our service to patients and the multidisciplinary healthcare workforce, particularly in light of restructuring...
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