Shouldice Hospital

Limited
Group 6

 Dr. Edward Earle Shouldice founded the Shouldice hospital

Established : 1945
Location: 7750 Bayview Avenue, Thornhill Ontario, Canada, L3T
4A3
Specialty : Surgical technique to repair Abdominal Wall Hernia
superior to others
By 2004, 7600 operations were performed per year

The Patients Experience

10% patients came from outside the province of Ontario (USA)

60% patients lived from beyond the Toronto area

For these patients who wish to arrange an examination, admission and operation
all in one visit, please complete Questionnaires 1 and 2 by taking the following
steps:

1.

Click on Medical Information , and print the questionnaire on your printer.

2.

Return to the Booking for Surgery page, click on Insurance Information , and
print it on your printer.

3.

Complete all documents as required and forward by fax (905-889-4216) or

regular mail to our office.

Upon receipt of your completed documents, a surgeon will review the information,
and office will make the necessary arrangements to schedule you for surgery.

The Nurses experience

Shouldice appoints 34 full time equivalent nurses for a 24 hour period

During non-operating only 6 full time equivalent nurses were present in

the premises

Performed counselling activities

Ratio of nurses to patients was 1:15

The Doctors Experience

10 full time surgeons

8 part time assistant surgeons.

2 anaesthetics

Each operating team required:

A surgeon

An assistant surgeon

scrub nurse

A circulating nurse

A total of 30 to 36 operations were conducted per day.

Each surgeon performed three or four operations a day.

A surgeons day ended by 4 p.m.

The patients at the Shouldice center take some of care of themselves.

In Shouldice, all the patients were encouraged to walk up and down the halls and to
get in dialog with the other patients and the surgeons. In thought of encouraging the
patients, the steps between the floors are constructed with a smooth inclination

There are not TVs at the bedrooms and the rooms were designed as if it were a home
instead of a hospital.

Every square foot of facility is carpeted to reduce the hospital feeling and the
possibility of a fall.

Patients and staff are served food prepared in the same kitchen.

Operating Costs

The 2004 budgets for the hospital and clinic were close to $8.5million,
and $3.5million, respectively

The Market

The three important aspects of services marketing triangle are the

employees, customers and the company itself.

Shouldice keeps its staff happy through profit sharing policy, wherein the
employees are paid a part of the profit in addition to their fixed salaries.

This sharing is done based on their contribution towards the success of

the firm. This entices them to work hard and put in more efforts. From
the management point of view, they have given their staff a lesser
working load and weekends off.

This enables people to spend time with their family and this in term
keeps them contented and in the long run reduces the attrition rate.

This is internal marketing for the company.

Problems And Plans

INCREASE CAPACITY ??

The problem is that Shouldice is facing a paradox of change. Shouldice

is operating at its best operating level for a service company with
limited flexibility in its plant, a specialized work force but are failing to
meet all the demand for its chosen market niche. Adding additional
capacity to meet the unmet market need may upset the existing work
force and lower service quality. Failing to meet the market demand may
invite competition that could eventually cause Shouldice to loss market
share and end up with excess capacity.

PROBLEM JUSTIFICATION

There is limited operating facts presented in the case so assumptions have made based
on the information that was presented.

It is assumed that they are operating at the best operating level because the way the
case describes how efficiently the hospital is ran and how the patients appear to be
pleased with there treatment .

Because it is a service they can not store there product. To increase their output and
maintain their quality they would need to increase they size of the plant where the
service is provided. This involves large capital investments and considerable time.
Construction would also cause a disruption to the quality and country club atmosphere
of the hospital. Therefore the plant has limited flexibility.

The staff also has limited flexibility. Surgeons and surgeons assistants are specialized
fields that have limited desire to be cross trained.

LIST OF ALTERNATIVE COURSES OF

ACTION

Add Saturday operations

Add a new floor (45 more hospital bed)

Establish a new facility for hernia

Expand to other types of operations

EVALUATION OF ALTERNATIVES

Schedule Saturday as an Operating Day

Advantages

No investment is needed

Can still maintain quality

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, strong
opposition by the senior doctors

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, kitchen, laundry, housekeeping and accounting

Further staggering of meal hours for patients (100 seat dinning room)

Disruption during construction

A Second Facility for Treating Hernia

Advantages

New location close to the customers, 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

Control of quality

It is difficult to create the same culture and atmosphere

Potential competition with the existing facility

BEST ALTERNATIVE
Start operations on Saturdays.

No fresh investment required.

Can maintain quality.

New surgeons not required.

THANK YOU