Shouldice Hospitals Ltd.

The problem under analysis is how to best increase the hospital’s capacity to serve more patients while at the same time maintaining control over quality of service delivered as well as sustaining existing high levels of employee and patient (customer) satisfaction.

SWOT analysis

Strengths

Unique and defined Surgical procedure (could not be varied) Facility that encourages movement
Up to date equipment
Less time taken (time for operation as well as for recovery is lower than industry average) Educated and experienced and efficient surgeons (perform 600 or more operations in a yr while industry average is 25-50 ops/yr) Lower nurse-to-patient ratio required which reduces costs Efficient, good quality and mostly uniform service,

Huge demands
Pay scale of staff higher than union scale of comparable jobs in the area Unique training in administration which allows switching work amongst secretaries Reasonable rates***,

Weaknesses

High backlogs of scheduled operations
Limited beds
Services are not patented
Opportunities

Diversification at other locations into other specialties with similar opportunities Establish another hospital in/outside Canada
Add to capacity
Better advertisingThreats

Competitors (using the Shouldice name )

*** IN SHOULDICE
charge for typical operation with 4days stay = $111
surgical fee for primary inguinal operation = $450 fee for assistant surgeon = $60 general anesthetic (if required) = $75

TOTAL = $ 696

ELSEWHERE

TOTAL cost is between $2000 to $4000.

Therefore, even patients coming from North America found it cheaper to get operated in Shouldice as round trip from major cities in North America to Toronto ranged from roughly $200 to $600.

Alternative strategies:

1) To stay at a present level and continue to do as they are currently doing. 2) Add more capacity in the hospital by starting Saturday operations 3) Add capacity by increasing number of beds.
4) To meet unmet market demand with external capacity in North America. 5) Diversify at other locations into other specialties.
6) Have on site clinic camps at various places

Evaluation of alternatives:

1)But demand is very high and they are unable to meet demands at current levels so expanding becomes important.

2)Adding Saturday as operating day is also reasonable, because they easily
can increase number of patients (but this can slightly decrease the quality of service-so they need to hire additional staff). This would increase hospital capacity by 20%. But this may create a divide amongst the surgeons which is not good for the functioning of the hospital.

3)If they plan to increase the number of beds then they will also have to increase their staff members to avoid any delays in operations.This would require an investment of approx. $2million and permission from provincial government.

4)The option of expanding in North America is good as currently 42% of all Shouldice patients come from USA. But the problem here would be – maintaining control over the quality of service. But this can be overcome as per Theodore Levitt’s argument in “Production-line approach to service” that – if companies stop thinking of service as servitude and personal ministration, they will be able to effect drastic improvements in its quality and efficiency. Also the service at Shouldice is more standardized than hospitals in general and therefore new staff can be trained accordingly. Also they need to have the capability to make such a big investment.

5)

6)

Patients Re-union is a very good concept…… also takes care of after sales service aspect.

Advertising may create more demand…but do they need that?
Right now the customer base includes those who trust Shouldice because they’ve heard positive word of mouth but advertising would make it more commercial.

1. ) How well is the hospital currently utilizing its bed? 90 beds x 7 days/ week = 630 beds available in a week 30 patients x 3 days x 5 days per week = 450 beds utilized 450 beds …

In the Shouldice Hospital case, I have identified two primary constraints: 1) The number of beds available to patients and 2) The number of surgeons available to operate on the patients. Since the demand for this type of operation seems …

1. ) How well is the hospital currently utilizing its beds? The hospital stay cycles have been provided: | Mon Beds| Tue Beds| Wed Beds| Thu Beds| Fri Beds| Sat Beds| Sun Beds| Available Beds| 90| 90| 90| 90| 90| …

The Shouldice center employs its own technique, called the Shouldice method for repair of hernias. Only external types of hernias are treated. Approximately 82% of surgeries are primaries, requiring 45 minutes. The rest 18% involve recurrence of hernias repaired elsewhere. …

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