Shouldice Hospital Case Solution

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Q.What are the unique features of Shouldice’s services, as compared to that of a typical hospital?

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 doctors were interested in having balanced personal and professional lives. Also, any doctor who patient returned with recurrence was asked to look into the case again. The nurse-to-patient ratio and housekeeping staff was low since patients needed minimal physical assistance. Employee turnover was also low since the hospital cared for its employees by not laying off anyone and giving bonuses. The administrative staff had working knowledge of others’ tasks and helped each other out whenever needed. Using the concept of Customer-Contact Matrix, we believe that Shouldice Hospital fits into the Hybrid Office Category. The three main characteristics of a Hybrid Office have been briefly explained in light of Shouldice Hospital’s features: •A Hybrid Office has moderate levels of customer contact and standard services with some options from which the customer chooses. In Shouldice, the doctors and administrative staff, though highly supportive of the patients, still spent much of their time in activities not involving interaction with the patient. •The workflow is complex and some customization exists in the process performance. To elaborate, every patient is unique and treatment requires some degree of customization to take this uniqueness into consideration. Further, there are 2 types of procedures depending on whether the case is a first-time case or a recurrence. •The sub-processes are repeated periodically as part of the parent process. For instance, patients exercise repeatedly and periodically at Shouldice as a part of their treatment process. Further special features include:

The treatment technique used for Hernia was much superior compared to others and included recreational activities that encouraged healthy environment for the patients’ quick recovery. •The way the hospital handled patients is another feature. At all points of patient contact, hospital staff would be encouraging and improve the morale of the patient. They would be motivated to exercise by nurses...
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