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Arnab Kumar Das


Gagandeep
Karthik D
Muthu Siddharthan

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 doctors 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
hospitals 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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