ShouldiceHospitalReport.docx

7/21/2019 ShouldiceHospitalReport.docx

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Shouldice Hospital

Group 02

Joshua Carbone

Maru Desta

Anshul Khare

Kevin Perry

Abdullah Siddiqui

OPRE 6302.0W1 Operations Management

Prof. Milind Dawande

The University of Texas at Dallas

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Shouldice Hospital provides specialized, high quality surgical care as a service to patients

suffering from external abdominal hernias. In order to evaluate the hospitals efficiency and

potentially improve the business, the process of providing patient care must be analyzed in

terms of the five characteristics of business processes.

First one needs to determine the inputs and outputs of the process. At

Shouldice, the primary inputs are patients experiencing symptoms of external abdominal hernia.

Other items, such as medical supplies, food for the patients, and electricity for the machines

are also important inputs to the process which must be in place for the system to work. The

primary outputs of the Shouldice process are successfully treated patients. Medical waste is an

important byproduct that must be disposed of according to local environmental and public

health laws.

Second, one needs to determine the flow unit of the business process. The flow unit at

Shouldice is the individual patient.

Third, the process must be analyzed and broken down into a network of activities and

buffers. Activities at Shouldice include screening and diagnosing patients, checking patients in

for surgery, pre-surgical counseling/orientation, administering medications, performing surgery,

patient exercise, and others. Buffers exist wherever there is a need to delay patient movement

through the system between activities. This may take the form of a waiting room, having the

patient stay overnight, the pe-operating room, or other such tools. A flowchart outlining the

process at Shouldice is found in Appendix A.

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The fourth element of the process view involves the resources used by the business.

Resources are usually divided into two categories, capital and labor. The land, building, medical

equipment, surgical tools, and computers are all examples of capital resources at the hospital.

Surgeons, nurses, support and administrative staff are the labor resources used at Shouldice.

Finally, the information structure of the process describes what information is needed

by whom at each step of the process. One excellent example of this is the need of the surgeon

to have access to the patients medical history and vital signs before, during, and after surgery.

Such information is crucial for making good decisions for managing patient care. Another

example is the patients need for information about the procedure, with descriptions of what

will happen and details of how to properly prepare for surgery.

Competitive Priorities

The hospital operates with an average backlog of 1200 patients waiting for surgery and

as such competition from rivals is not an issue at least for the short term. However, as could

be seen from Exhibit 4 in the case report, other clinics and hospitals are trying to emulate the

them and Shouldice has to expand its capacity to serve these patients waiting in line before

losing them to its potential competitors.

Market Focus

Shouldice Hospital has chosen to focus upon a particular kind of ailment only. It has

limited its focus to treating external abdominal hernias only. It does not take up cases of

internal or other types of hernias.

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There is a large market for such type of operations, 600,000 per year in the US alone in

1979. Current estimates for all hernia operations are around 20 million per year worldwide(1).

Patients should not be overweight and be in good general health, no heart conditions

etc. This gives them a much higher chance of success and low complication rate, keeping costs

low.

They are able to do screening for remote patients as well through mail diagnosis, thus

increasing their target market.

Their costs are quite low and attractive, coming out to about 50% the cost of traditional

hospitals, as a result they were able to attract international clients who could save money even

when travel costs were factored in.

Operations Strategy

The business strategy that guides Shouldice Hospital is early ambulation following

surgery.

The operations strategy that supports this business strategy defines internal processes

not just from a patient and medical staff perspective but also that of its facility. All these

processes are interconnected and rely and build on each other leading to a competitive

advantage that is more sustainable.

Narrowing of focus to a particular surgical procedure that allows for early ambulation.

Use of local anesthetic plus pain killer to facilitate ambulation and faster recovery.

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Design of the facility to encourage patients to get up and walk around by removing the

phone and tv from the patients room.

Pre-screening to select patients likely to have successful procedures based on weight

and other health factors.

Making the patients stay more comfortable by giving a non-hospital look and feel as

much as possible, example use of carpeting to provide more comfort and give a

different smell than usual.

Encouraging social involvement among doctors/nurses and patients to ease their stress

and worries.

Careful selection of doctors to make sure they would be following the established

procedures to ensure success.

Encouraging collaboration and seeking of guidance among doctors leading to more

successful procedures

Ensure high employee satisfaction and thus better performance by giving them a share

of profits

Discuss its strategic fit

Shouldice hospitals Strategy is achieving early ambulation following surgery by using local

anesthetic , applying a procedure that puts no tension on the natural tissues and by designing

a facility that encourages movement without unnecessarily causing discomfort to the patient.

This technique has made the services available at an affordable price of $450 to $525 per

patient to those in need of the service . It would cost $2,000 to $,4,000. in traditional

hospitals for the same services. As Dr. Byrnes Shouldice said, he is a doctor first before he is

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an entrepreneur focusing more on providing the services than maximizing profits and as such

the hospital's operational and business strategy are in alignment.

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Appendix A

Shouldice Hospital Process Flow

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Appendix A

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References

1. http://surgery.med.nyu.edu/general/patient-care/hernias/overview-hernias

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http://www.google.com/url?q=http%3A%2F%2Fsurgery.med.nyu.edu%2Fgeneral%2Fpatient-care%2Fhernias%2Foverview-hernias&sa=D&sntz=1&usg=AFQjCNGCRAtguiWFmI-75bY2QoPdc_XPaw

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