1.

(a) Building smaller facilities in the healthcare industry can offer several advantages in
terms of improving the treatment process. Here are some reasons why smaller facilities
might be beneficial, with similarities to Shouldice Hospital's operating model:

Increased Efficiency:
Smaller facilities can focus on specific services, allowing for more streamlined and efficient
operations. This can lead to quicker patient assessments, reduced waiting times, and
improved overall service efficiency.

Optimized Resource Utilization:

With a smaller scale, facilities can better manage resources, ensuring that equipment, staff,
and other resources are used optimally. This can contribute to cost savings and better overall
performance.

Patient-Cantered Care:
Smaller facilities can provide a more personalized and patient-centred approach. Staff can
develop closer relationships with patients, leading to better communication, understanding,
and customized care plans.

Reduced Patient Overhead: Smaller facilities often have fewer bureaucratic layers, leading to
more direct interactions between healthcare professionals and patients. This can result in a
more comfortable and less intimidating healthcare experience.

Quicker Turnaround:
Smaller facilities, especially in the context of micro-hospitals or outpatient clinics, may have
shorter wait times for procedures and treatments. This is crucial for certain medical
conditions where timely intervention is essential.

Specialization and Expertise:

Focused Services: Smaller facilities can specialize in specific medical services or treatments,
allowing them to become experts in those areas. This specialization can lead to higher-
quality outcomes for patients.

Efficient Training: Staff in smaller facilities may find it easier to stay updated on the latest
medical advancements and technologies, ensuring a high level of expertise in their specific
field.

Similarities with Shouldice Hospital's Operating Model:

Focus on Specialization: Like Shouldice Hospital, smaller facilities often emphasize

specialization, concentrating on specific types of care or procedures.

Patient-Centred Approach: Both models prioritize a patient-centred approach with

personalized attention and a focus on individual patient needs.

Efficient Resource Utilization: Both Shouldice Hospital and smaller facilities aim to optimize
resource utilization, ensuring that resources are used effectively to enhance patient care.
 1. (b) Helping patients at home:

Total Cost in the System: By providing hospital-level care at home, there could be a reduction
in the overall cost of healthcare. Avoiding hospital stays, especially for less complex
conditions, can result in lower resource utilization and operational expenses.

Quality of Outcomes:
Hospital-level care at home can lead to fewer complications, lower mortality rates, and
higher patient satisfaction. Improved outcomes would result in better overall quality of care.

Throughput of the System:

Home-based care can spare hospital beds and other hospital resources for more critical
cases, improving overall system throughput by efficiently managing patient flow.

1. (c) iQueue & Capacities of Operating Rooms:

iQueue would help identify patterns of over- or underuse of operating room time. By
understanding and addressing these patterns, the system can allocate time more efficiently,
increasing the effective capacity of operating rooms.
Surgeons can be provided with early warnings when their use of operating room time
approaches lower bounds. This ensures that allocated time is fully utilized, reducing
instances of unused or underutilized time slots.

iQueue increases the effective capacity of operating rooms by ensuring more efficient use of
the available time slots. It contributes to better resource utilization, reduced waiting times
for surgeries, and potentially increased throughput for surgical procedures.
In both cases, the key concept is optimizing the use of resources. For helping patients at
home, it involves reallocating healthcare resources outside traditional hospital settings. For
iQueue, it involves maximizing the use of operating room time within the hospital setting.
These approaches align with the broader goal of enhancing efficiency, reducing costs, and
improving the overall quality of care in the healthcare system.
2. A small software developer is reconsidering the design of its customer service and
technical support call centre. The current configuration of the tasks and the queues is
shown below.

The customer service department is staffed by customer service representatives (CSRs).

For any call, a CSR will handle both tasks A1 and A2. The customer service department is
staffed by 10 agents and the technical Support Department is staffed by 15 technical
associates (TAs). Approximately 30% of all calls are transferred to Technical Support
where, for any particular call, a TA will handle both tasks B1 and B2.

What is the maximum number of calls per hour this centre can handle?

Average Processing time by CSR = 0.7 X 4 + 0.3 X 1

= 3.1 minutes per call
Capacity per hour = 60/3.1 = 19.35 calls
Hourly Capacity of all 10 CRSs = 10 X 19.35 = 193.5 calls

Average Processing time by TA = 16 minutes ( 1 minute + 15 minutes)

Capacity per hour = 60/16 = 3.75 calls
Hourly Capacity of all 15 TAs = 15 X 3.75 = 56.26 calls

Let the maximum number of calls received at the service centre be ‘x’.
Then, 30% of x = Hourly Capacity of 15 TAs
i.e., 56.25 = 0.3 X x
Solving for x,
x = 187.5 calls per hour.
This is the maximum handling rate for the call centre that the TAs can handle.
TAs are the bottleneck and the whole system can handle 187.5 calls/hour.