* Shouldice Hospital was a very successful Hospital. * Dr. Shouldice invented a new and successful technique of operating and repairing Abdominal Hernia. * The technique was so successful that a lot of patient’s preferred getting operated in the hospital only. The patients waited days & months for their operation. * One of the reasons for their success was the way the hospital was working, in which the patients took less time in recovery and were able to socialize with other patients as well. * The hospital staff, including the doctors & nurses was very well trained.
* One of the main evidence of the hospital being successful was that other doctors also advertised the Shouldice way to get patients to their respective clinics or hospitals. Q. 2) How do you count for its performance? Performance wise the hospital, their administration and their staff was very successful. Some of the details of each section given below. The Shouldice Method: * The primary external hernia represented approx. 82% of all operations. * The sedation procedure allowed immediate patient ambulation and facilitated rapid recovery. The Patients Experience:
* It was thought that most of the potential patients learned about the hospital and its methods from past patients who had already experienced them. * Aprox. 42% of the shouldice patients came from the United States. A questionnaire was sent to out of town patients and upon return it was diagnosed by the doctors that a patient is suffering from hernia or not. * Upon confirmation the patient was sent a date of operation, if the operation confirmation cards were not returned by the patient 3 days or more prior to the scheduled operation, that patient was contacted by phone.
* The rest of the procedure starting from admittance in the hospital till the time the patient was discharged, was planned in a very good way, that the patients wanted to stay one more day in the hospital. The Nurses Experience: * The minimal patient’s needs for physical assistance allowed Shouldice to operate with a much lower nurse-t-patient ratio than a typical hospital. * The nurses spent an unusually large proportion of their time in counseling activities. * Due to this the turnover for nurses was very low per year.
The Doctor’s Experience: * The operating load varied from 30 to 36 operations per day. As a result each surgeon performed three to four operations each day. * The surgeons were advised to take a coffee break after their second or third operation. Even so after 4 consecutive operations the doctor could very easily be free for the coffee break or lunch in time. * The surgeon, who was not operating, after finishing his post operation chores, was able to get off duty by 4pm. * Training and supervision was provided to each category of surgeons.
The Facility: * Compromised of 2 basic facilities, the hospital and the clinic. * Patients could be seen visiting in each other’s rooms, walking up and down hallways, lounging in the sunroom, and making use of light recreational facilities ranging from a pool table to an exercycle. * The rooms contain no telephones or television sets. This encourages patients to take the stairs and get recovered early. Administration: * They try to meet people’s needs and make this as good a place to work as possible.
* They don’t have a union but they try to maintain a pay scale higher than the union scale of comparable jobs in the area. * Each secretary is trained to do another’s work. Q. 3) What action to take to expand the hospitals capacity? * Operations on Saturday will increase the capacity by 20%. * Salary increase can be proposed for staff working on Saturdays or they can be paid a certain percentage separately for performing operations on Saturday. Q. 4) How would you implement changes you propose? * I would call a meeting of doctors senior and junior both and propose the working Saturday plan.
* Would call a separate meeting of Nurses and support staff and propose a working Saturday. * Will let the Doctors and the staff know the reason behind it and will take consent or majority votes of the hospital staff. * After having the approval of the same, will have a word with the administrator and the head Nurse to make a schedule to implement the changes. * After a week of implementing the change, will then take feedback from the total hospital staff, to see if they are happy and to see that the performance does not go down.