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Shouldice Hospital Case Operation Management - 2

Presented by: • Abhishek Kumar(03) • Abhishek Reddy(05) • Chandan Kumar(11) • Naureen Fatima(34) • Rajendra Sahane(50)
25-Mar-14 IIM Raipur 1

the strong layer of the abdominal wall that surrounds the muscle.  The sac comes through a hole or weak area in the fascia.Hernia Overview  A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). SHOULDICE HOSPITAL LIMITED 25-Mar-14 IIM Raipur 2 .

Edward Earle Shouldice  Corporate Name: Shouldice Hospital Limited  Location: The hospital was located in Toronto in the southern part of Canada. Edward Earle Shouldice SHOULDICE HOSPITAL LIMITED 25-Mar-14 IIM Raipur 3 .Overview Overview  Founder: Dr.  Specialty: Abdominal Wall Hernia Repairs Dr.

• Unique Specialized method “Shouldice Method” developed to operate Harnea. homely and relaxing environment • No competition among doctors • More of a vacation rather than treatment • Parents gets free accommodation at Shouldice so that the cost of nursing is saved and can take better care of their offspring. social. • Operations regarded as simplicity of the surgery.Shouldice Hospital • Provides both clinical and operational facilities. SHOULDICE HOSPITAL LIMITED 25-Mar-14 IIM Raipur 4 . • Peace of Mind/ low risk/ low recurrence • Friendly.

Shouldice Hospital • Careful recruitment of employees • Doctors and nurses are highly trained to help and counsel patients • No one is fired! Turnover is low • Staff is non-union • Pay scale is higher than the competition • Profit sharing plans are in place for doctors and staff • Cross-training & teamwork are strong • Managing director stays late one night per week to interact with patients and staff SHOULDICE HOSPITAL LIMITED 25-Mar-14 IIM Raipur 5 .

• Carpeting makes it feel warm and comfortable. • Patients must travel to make a phone call.socialize. eat.  BOOKING A SURGERY: • • Patients living within 100 km (60 miles) from the hospital should come to office for a personal examination. • Patients and staff eat together in the cafeteria. etc. For patients living at a greater distance were diagnosed by mail using Medical Information Questionnaire shown in Exhibit:1 25-Mar-14 IIM Raipur 6 SHOULDICE HOSPITAL LIMITED . watch TV.Shouldice Hospital • Rooms are not equipped with phone or TV. • Small rise stairways make it easier on patients who have just completed surgery. • Foods are all fresh ingredients and prepared from scratch.

and check out. play. 25-Mar-14 IIM Raipur 7 . walk. play. eat. & eat with your buddies Dinner at 6 pm Tea & cookies at 9 pm SHOULDICE HOSPITAL LIMITED Day 4: Remove stitches.Shouldice Service Model 4 Day Lead Time Day 1 30/36 Arrivals 1–3 pm If not OK send them home… Check by MD (15 mins) If OK: Check-in & admin Blood test Explain process steps Dinner at 6 pm Tea & cookies at 9 pm Day 2 Local anaesthesia (-20mins) Surgery (40 mins) Rest in room (2-3hrs) Start eating & moving Dinner at 6 pm Tea & cookies at 9 pm Day 3 Loosen stitches Walk.

homely and relaxing environment.  Friendly.  Highest compensation. performs 750 plus operations compared to others 50 per year.  Nurse are trained to give counseling to patients and keep encouraging them to do things before and after operations. 25-Mar-14 IIM Raipur 8 . saves time for patient.efficient surgeon  Highly productive surgeon:.Q1 -How successful is the Shouldice Hospital?  Unique Specialized method “Shouldice Method” developed to operate Harnea.benefits for doctors.  Cost of surgery is $2230 less compared to $5240 compared elsewhere.more of a vacation rather than treatment  Doctors and nurses are highly trained to help and counsel patients  Method to book a surgery is convenient for patient living near and far(70%).  Peace of Mind/ low risk/ low recurrence as more experienced .staffs compared to other hospitals. social.

 Parents are allowed free accomodation to save extra expenses.Q2 .  Method to book a surgery is convenient for patients living nearby as well as for patients living far from the hospital.How do you account for its performance?  “Shouldice Method” of operation is being regarded as “bread and butter ” operation or the simplest surgical method. resulting in saving of time for patients.  Most experienced and efficient surgeon who perform 750 plus operations compared to 25 to 50 for other surgeons per year. 25-Mar-14 IIM Raipur 9 .

How do you account for its performance?  Nurse are trained to give counseling to patients and keep encouraging them to do things before and after operations.Q2 . 25-Mar-14 IIM Raipur 10 .  Efficient use of doctors for operations and almost no waiting time for patients.  Opportunity for patients to interact with doctors to boost confidence and a sense to relax.

Q2 .How do you account for its performance? Shouldice Focus on low risk cases Clear single value prop. multiple goals Confusion of value prop. Predictable process Strive for perfection General Hospital No focus. Unpredictable process Strive for threshold perf. Eliminate waste Manage patient flows Pull patients into process Tolerate some excess View patients as functional tasks Push patients through process .

it may generate too much demand to handle. If they go for advertising. may not be met in near future.  Competitors may copy the unique technique “Shouldice Method” and misapply it or misinform their patients.What could go wrong here? Ever rising demands of patients because of word of mouth advertising. Differences between older doctors and younger doctors over the changing certain successful procedures to improve further. IIM Raipur 25-Mar-14 12 .Q3 .

 Confusion on expansion plan.What could go wrong here?  Concerns have been expressed about others using the Shouldice name while not performing the Shouldice procedures.etc.Q3 . IIM Raipur 25-Mar-14 13 .  Facility constraints as number of beds. doctors.

what actions. if any. would you take to expand the hospital's capacity? • Add another floor to the existing hospital facility • Operating on Saturday • Expand in US • Patent the Shouldice method • Proper succession planning of doctors • Better not to diversify from its core competency (Hernia) • Higher more nurses 25-Mar-14 IIM Raipur 14 . Burns Shouldice.As Dr.Q 4 .

laundry.How would you implement the changes you propose? 1.Q 5 . Add in a new floor (45 beds) Total Number of Rooms: 89 +45= 134 • Advantages – Easy to control and maintain quality – Retain the culture and environment • Disadvantages – Require to schedule doctors to the full capacity of five days per week – Increase work load on admissions. housekeeping and accounting – Further staggering of meal hours for patients (100 seat dinning room) – Disruption during construction 25-Mar-14 IIM Raipur 15 . kitchen.

How would you implement the changes you propose? Cont .Q 5 . say USA – Improve its competitive position and increase its profits – Operate in a less restrictive environment – New Opportunities for existing personnel – Transfer of knowledge and expertise to the new facilities • Disadvantages – Requires a significant investment. 2. A Second Facility for Treating Hernia • Advantages – New location close to the customers.. – Control of quality – It is difficult to create the same culture and atmosphere – Potential competition with the existing facility 25-Mar-14 IIM Raipur 16 .

strong opposition by the senior doctors 25-Mar-14 IIM Raipur 17 .. 3. Schedule Saturday as an Operating Day ( Half Day) For surgeons (7am-12:30pm) For staff ( 5am-1:00pm) • Advantages No investment is needed Can still maintain quality Would be more acceptable among hospital members as they Would be free after first half.How would you implement the changes you propose? Cont .Q 5 . • Disadvantages Require to schedule 23-25 operations on Saturday Six surgeons and a supervising surgeon have to work on Saturdays Additional other personnel Violates the implied contract that Shouldice has with its surgeons.

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