Shouldice Hospital Case_operations

SHOULDICE HOSPITAL CASE

1. How successful is the Shouldice Hospital?

• The success of Shouldice Hospital is apparent in the way it operates in the hospitality business, the quality of healthcare and the degree of employee and patient satisfaction.
• In advertising itself, Shouldice values word of mouth advertising, referrals from doctors and research by patients to draw prospective customers.  In the medical community, only 1% of doctors are treated at the facility. In terms of its cost comparison relative to other hospitals, Shouldice offers external hernia treatments at nearly half the market rate.
• The Shouldice treatment of hernia was concieved by Dr Shouldice, performed by specially trained surgeons at the Shouldice Hospital. In typical hospitals, the procedure is performed by novice surgeons. By focusing on one medical condition, Shoulders has been able to meet the aspects of the patient experience to a fast and effective recovery. The patients need minimum sedation, with immediate post-operative mobility. They may eat during the evening after their surgery and are discharged on the fourth morning after their operation.  Patients are encouraged to interact and socialise with other patients by exploring the hospital premises. The positive experience of the stay in the hospital is reflected in the request of patients to stay an extra day. Over 95% of the patients at the reunion conveyed their impression about Shouldice not being like a hospital. While the employee turnover is low, nurses have approximately 10% annual turnover and surgeons with more than five years in Shouldice remain there permanently. The hospital helps them maintain a good work-life balance, resulting in higher productivity

2) How do you account for its performance?

• The high performance of Shouldice is due to the use of swift even flow. Shouldice has reduced variation in the service it provides and reduced the throughput time, helping Shouldice moving towards a service-oriented business. The selection of patients with external hernias, who had not previously been operated on, reduced the variation of treatments required.  The selection and training of surgeons resulted in limited variation in the operating procedures performed on patients.
• The reduction of the seven types of waste facilitates the fast movement of patients through the service. Most of the waiting time is avoided through scheduling of operations and patient assessments to ensure that doctor’s time is optimised. Before the arrival of patients, the procedure is scheduled to reduced waste. The ability of patients to walk freely post operation reduced the resources needed to help them. Ensuring the quality of service is most relevant in the circumstances, especially in the fields of surgical staff, nutrition, administration and employee management. The calibre of surgeons is ensured through their selection, subsequent training in the Shouldice method, coupled with the rotation of staff through surgical teams, sending patients with recurrences to their initial physician and encouraging the operating staff to take regular breaks.
• The quality of food is ensured by preparing meals from fresh ingredients, by three members of staff, resulting in high consistency level and accountability of staff members to the hospital., rather than an external contractor.
• Shouldice reduces its operating costs by ensuring the swift even flow of its service.  The patient experience is standardised and the hospital’s capacity at each stage of service provision is equal to the anticipated demand.  This minimises the potential for bottlenecks and excess capacity occurring.  
• Operating rooms were relatively cheap since they did not require dedicated anaesthesiology equipment. The use of patients as a support network for each other with assurance to newly admitted patients that the procedure was safe, which would have reduced the fears.
• The design of the hospital supported cost saving initiatives.  Installation of carpet was carried out on almost all floors to provide a homely ambience. The hospital did not provide phones and televisions in bedrooms, which encouraged patients to exercise.
• Allowing parents to stay with their children resulted in cost savings in nursing requirements. The ability to stay with the child served as a prerequisite for many parents while selecting the hospital and often played an important marketing role.

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