Shouldice Hospital Case Operation Management - 2

Shouldice Hospital Case Operation Management - 2

Presented by:Abhishek Kumar(03)Abhishek Reddy(05)Chandan Kumar(11)Naureen Fatima(34)Rajendra Sahane(50)

24-Jan-14IIM Raipur11SHOULDICE HOSPITAL LIMITED

Overview

A hernia is a sac formed by the lining of the abdominal cavity (peritoneum).

The sac comes through a hole or weak area in the fascia, the strong layer of the abdominal wall that surrounds the muscle.

24-Jan-14IIM Raipur2

SHOULDICE HOSPITAL LIMITED

OverviewFounder: Dr. Edward Earle ShouldiceCorporate Name: Shouldice Hospital Limited Location: The hospital was located in Toronto in the southern part of Canada.Specialty: Abdominal Wall Hernia Repairs

Dr. Edward Earle Shouldice

24-Jan-14IIM Raipur3SHOULDICE HOSPITAL LIMITEDShouldice Hospital

Provides both clinical and operational facilities.

Unique Specialized method Shouldice Method developed to operate Harnea.

Operations regarded as simplicity of the surgery.

Peace of Mind/ low risk/ low recurrence

Friendly, social, 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.

24-Jan-14IIM Raipur4SHOULDICE HOSPITAL LIMITEDShouldice 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

24-Jan-14IIM Raipur5SHOULDICE HOSPITAL LIMITEDShouldice Hospital

Rooms are not equipped with phone or TV.

Patients must travel to make a phone call, watch TV,socialize, eat, etc.

Small rise stairways make it easieron patients who have just completed surgery.

Carpeting makes it feel warmand comfortable.

Patients and staff eat together in thecafeteria.

Foods are all fresh ingredients and prepared from scratch.

BOOKING A SURGERY:

Patients living within 100 km (60 miles) from the hospital should come to office for a personal examination.

For patients living at a greater distance were diagnosed by mail using Medical Information Questionnaire shown in Exhibit:1

24-Jan-14IIM Raipur6SHOULDICE HOSPITAL LIMITED30/36 Arrivals13 pmIf OK:Check-in & adminDinnerat 6 pmCheck by MD (15 mins)Blood testDay 1Day 2Tea & cookiesat 9 pmExplain process stepsLocal anaesthesia (-20mins)Surgery (40 mins)Rest in room (2-3hrs)Start eating & moving Dinnerat 6 pmTea & cookiesat 9 pmDay 3Loosen stitches Walk, play, & eat with your buddies If not OK send them homeDinnerat 6 pmTea & cookiesat 9 pmDay 4: Remove stitches, walk, play, eat,and check out.Shouldice Service Model 4 Day Lead Time

24-Jan-14IIM Raipur7Q1 -How successful is the Shouldice Hospital?Unique Specialized method Shouldice Method developed to operate Harnea.

Peace of Mind/ low risk/ low recurrence as more experienced ,efficient surgeon

Highly productive surgeon:, performs 750 plus operations compared to others 50 per year.

Friendly, social, homely and relaxing environment,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%), saves time for patient.

Nurse are trained to give counseling to patients and keep encouraging them to do things before and after operations.

Cost of surgery is $2230 less compared to $5240 compared elsewhere.

Highest compensation,benefits for doctors,staffs compared to other hospitals.

24-Jan-14IIM Raipur8Q2 - How do you account for its performance?Shouldice Method of operation is being regarded as bread and butter operation or the simplest surgical method.

Most experienced and efficient surgeon who perform 750 plus operations compared to 25 to 50 for other surgeons per year.

Parents are allowed free accomodation to save extra expenses.

Method to book a surgery is convenient for patients living nearby as well as for patients living far from the hospital, resulting in saving of time for patients.

24-Jan-14IIM Raipur9Q2 - 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.

Opportunity for patients to interact with doctors to boost confidence and a sense to relax.

Efficient use of doctors for operations and almost no waiting time for patients.

24-Jan-14IIM Raipur10ShouldiceGeneral HospitalFocus on low risk casesNo focus, multiple goalsClear single value prop.Confusion of value prop.Predictable processUnpredictable processStrive for perfectionStrive for threshold perf.Eliminate wasteTolerate some excessManage patient flowsView patients as functional tasksPull patients into processPush patients through processQ2 - How do you account for its performance?Q3 - What could go wrong here?Ever rising demands of patients because of word of mouth advertising, may not be met in near future.

Competitors may copy the unique technique Shouldice Method and misapply it or misinform their patients.

Differences between older doctors and younger doctors over the changing certain successful procedures to improve further.

If they go for advertising, it may generate too much demand to handle.

24-Jan-14IIM Raipur12Q3 - What could go wrong here?Concerns have been expressed about others using the Shouldice name while not performing the Shouldice procedures.

Facility constraints as number of beds, doctors,etc.

Confusion on expansion plan.

24-Jan-14IIM Raipur13Q 4 - As Dr. Burns Shouldice, 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

24-Jan-14IIM Raipur14Q 5 - How would you implement the changes you propose?Total Number of Rooms: 89 +45= 134AdvantagesEasy to control and maintain qualityRetain the culture and environmentDisadvantagesRequire to schedule doctors to the full capacity of five days per weekIncrease work load on admissions, kitchen, laundry, housekeeping and accountingFurther staggering of meal hours for patients (100 seat dinning room)Disruption during construction

1. Add in a new floor (45 beds)

24-Jan-14IIM Raipur152. A Second Facility for Treating HerniaAdvantagesNew location close to the customers, say USAImprove its competitive position and increase its profitsOperate in a less restrictive environmentNew Opportunities for existing personnelTransfer of knowledge and expertise to the new facilities

DisadvantagesRequires a significant investment.Control of qualityIt is difficult to create the same culture and atmospherePotential competition with the existing facilityQ 5 - How would you implement the changes you propose? Cont ..

24-Jan-14IIM Raipur1616 3. Schedule Saturday as an Operating Day ( Half Day)

For surgeons (7am-12:30pm)For staff ( 5am-1:00pm) AdvantagesNo investment is neededCan still maintain qualityWould be more acceptable among hospital members as theyWould be free after first half.

DisadvantagesRequire to schedule 23-25 operations on SaturdaySix surgeons and a supervising surgeon have to work on SaturdaysAdditional other personnel Violates the implied contract that Shouldice has with its surgeons, strong opposition by the senior doctorsQ 5 - How would you implement the changes you propose? Cont ..

24-Jan-14IIM Raipur17

24-Jan-14IIM Raipur18