CASE 1 Shouldice Hospital
Introduction Shouldice Hospital, set up in 1945 by Dr. Earl Shouldice, is located near Toronto. It follows the business model of focus on a single standardised service for a narrow target of consumers, rather than to provide customised solution (as in a general clinic or hospital). It focuses on providing quick, convenient, and reliable cure for external types of abdominal hernias. The Hospital uses its own technique, called the Shouldice Method. It is famous for a relatively short post-operative recovery period.
Description
1. Shouldice Hospital provides low-cost medical service in its area of specialization. Use of the Shouldice Method allows patients to recuperate fast (patients get discharged within 3 days of operation). The Hospital optimises the use of its available resources, like surgeons, nurses, medical infrastructure, administration and maintenance facilities. It also manages to keep operating costs low by keeping capital investment in rooms and equipments very low.
2. About 82% of all surgeries at the Hospital are primaries. The remaining 18% involve recurrence of hernias repaired elsewhere. These are more complex,
3. The Hospital has a capacity of 89 beds. There are 5 operating rooms where 33 to 36 operations are performed on an average day. The Hospital follows a 5 day week. It employs 12 full-time surgeons, 7 part-time assistant surgeons, and one anaesthetist. The nursing staff consists of 22 full-time and 18 part-time members. An operating team consists of a surgeon, an assistant surgeon, a scrub nurse, and a circulating nurse. A surgeon's typical day begins at 7:30 A.M. and ends by 4:00 P.M. Each surgeon typically performs 3 to 4 operations each day.
4. Training of a new surgeon in the Shouldice technique is important because the procedure is highly standardised. There is time-based rotation of teams and frequent consultations among doctors.
5. A patient at Shouldice requires