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ADMINISTRATIVE INFORMATION
Corporate Name: Shouldice Hospital Limited Established: 1945 Location: 7750 Bayview Avenue, Thornhill Ontario, Canada, L3T 4A3 Telephone: (905)889-1125 Fax: (905)889-4216 Toll Free: 1-800-291-7750 Specialty: Abdominal Wall Hernia Repairs
HISTORY
Dr. Edward Earle Shouldice graduated from the University of Toronto in 1916.
During World War II, he was called to serve on the Medical Examining Board.
Dr. Shouldice, a major in the army, found that many young men willing to serve their country had to be denied enlistment. These men needed surgical treatment to repair their hernias before they could be pronounced physically fit for military training.
In 1940, hospital space and doctors were scarce, especially for this non-emergency surgery Contributing his services at no fee, he performed an innovative method of surgery on seventy of these men. The delighted recruits soon made known their success stories and by the war's end, more than 200 civilians had contacted the doctor and were awaiting surgery.
The scarcity of hospitals beds however, created a major problem. There was only one solution; Dr. Shouldice decided to open his own hospital. Location: The hospital was located in Toronto in the southern part of Canada.
BOOKING A SURGERY
Patients living within 100 km (60 miles) from the hospital should come to the office for a personal examination. Examination Hours are:
Monday to Friday :
WALK IN CLINIC, NO APPOINTMENT NECESSARY
For patients living at a greater distance who wish to arrange an examination, admission and operation all in one visit, please complete Questionnaires 1 and 2 by taking the following steps:
Step 1. Click on Medical Information , and print the questionnaire on your printer. Step 2. Return to the Booking for Surgery page, click on Insurance Information, and print it on your printer. Step 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. Please allow two to three business days for processing
There is no use of foreign bodies such as synthetic screens or meshes, except in extremely rare cases where there has been destruction of the tissue usually due to previous surgery. The vast majority of our hernia repairs are done with a sedative (sleeping pill), analgesic (pain relief pill) and local anesthesia. If necessary, additional medication is administered. The youngest patient to date was a child of 4 months, while the oldest was a man of 100 years.
If not OK
Check by MD (15 mins) If OK: Check-in & admin
Blood test
Dinner at 6 pm
Day 2
Local anaesthesia (-20mins)
Dinner at 6 pm
Day 3 Loosen stitches Walk, play, & eat with your buddies
Dinner at 6 pm
WORK LOAD
A total of 30 to 36 operations were conducted per day. Each surgeon performed three or four operations a day.
Level 3
Level 2
Level 1
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.
PATIENT SATISFACTION
Never did I think that I would write to a hospital and tell them how much I enjoyed my visit, but I find myself doing that very thing. It took me a year to get the courage to have my hernia repaired, but my fears were all unfounded. And the food was excellent." Robert C. Cole-Rochester, New York
days
10
days
3,041,400
2,800,000 241,400
Sharing of expensive services such as anesthetist Short and relatively regular hours for surgeon high compensation ($50,000 + $40,000) Opportunities for surgeons to observe and advise one another Peer group pressure that leads to higher level of self-control of quality A conscious effort is made to make Shouldice a familyexperience
MARKETING STRETEGY
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.
INCRESE 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.
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
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
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.