A. The hospital focused on this new procedure for treatment of external types of abdominal hernias. Some differentiating features of the Shouldice process were the arranging of abdominal muscles into three distinct layers, reinforcing the abdominal wall with six rows of sutures and did not involve any insertion of screen and mesh under the skin.
Beyond the surgical procedure, it was the service process of the hospital that differentiated it from others.
• The patients were sedated in their rooms prior to being taken to the operating rooms.
• The hospital encouraged the patients to explore the premises, talk to other people about their problems and make new friends during their stay.
• The patients were encouraged to move around freely even right after the operation. Lack of telephones or televisions in their rooms also encouraged patients to move about to take a call or watch television.
• Every square foot of the hospital was carpeted except the operating rooms to give a unique experience to the patients. Ministers were treated for free and parents accompanying children were allowed free stay.
The unique process followed by the hospital helps it to better serve its patients. While the typical recurrence rate for the hernia approaches 10%, the gross recurrence rate for all operations performed at Shouldice was only 0.8%. The average patient stay at Shouldice was 3-4 days, which was way below the normal 7-8 days for general hospitals. The patients needed 1-4 weeks of rest compared with 2-8 weeks for the general procedure. Compared with the $2,000-4,000 cost of the operation in general, the cost of the entire procedure at Shouldice was only around $900 (excluding travel). The customer orientation was rounded off by an annual reunion in mid-January where the doctors provided free checkup to its alumni.
The medical staff was unique in the sense that most