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CASE BACKGROUND
Dr. Earle Shouldice was the founder of the Shouldice Hospital By 1940s he began to develop a surgical technique for repairing Hernias He created new facilities by buying a 130-acre estate with a 17000 square foot main house in the Toronto suburb of Tornhill Dr. Shouldice died in 1965
TEAM OF DOCTORS
10 Full time surgeons 8 part time assistant surgeons 2 Anesthetists Each operating team required a surgeon, an assistant surgeon, a scrub nurse and a circulating nurse Operating load was 30-36 operations per day
TEAM OF NURSES
34 full time- equivalent nurses staffed Shouldice for 24 hour period 6 full time equivalent nurses were on premises during non-operating hours Nurses to Patient ratio was 1:15 Low ratio from average ratio in acute-care hospitals Spent large proportion of time in counselling activities
Person was sent home after examination, if over weight or no hernia problem
Patients room was allocated on the basis of occupation, background and interests.
Interaction among patients who had their operations earlier the same day at dinner time.
Patients attitude was most important to take complete advantage of shouldice program.
Competitors Advertisement
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Service Quality
Reliability Extensive research by Dr. Shouldice Highly trained and experienced surgeons (600 Hernia operations) Well aligned patient needs and service offered
Assurance Complication free experience High amount of time for counseling Crash cart at every floor in case of emergencies like heart strokes.
Empathy
Use of local anesthetics, pre-operative sedatives to minimize any discomfort Sedatives for rapid recovery Nurses/doctors encourage to talk with other patients Carpeting to reduce hospital feeling and fear of fall Prelim-diagnosis by mails for out of town patients Parents of children being operated can stay free
Responsiveness
Admission by appointment: scheduled service Easier to estimate the service time Orientation provided for incoming patients. Walk-in patients or local residents on waiting list to make up cancelled reservation
Tangibles
Acres of gardens to encourage exercise & rapid recovery Minimize hospital feeling (carpeting & odorless disinfectant etc) Stairways are designed for patients to use after operations No TVs and Telephones in rooms to encourage walking Patients encouraged to explore premises
Service Encounter
Brochure is sent to interested patients Large lounge area, recreational areas. Employees trained to help / counsel patients Orientation for incoming patients Common dining for doctors, nurses , staff and patients
Gap Model
Gap 1
Nurse orientation to patients regarding need of exercise, routine etc Large time on counseling Operation procedure Short waiting period Discharge period Opportunity to interact
Gap 2
Well specified process time limits for every activity Scheduled dinner time, recreational & tea breaks 34 full time nurses Well defined schedules of surgeons are followed
Gap 3
Adherence to Shouldice technique Average Nurses to Patients ratio is 1:15 Fresh food
Gap 4
Word of mouth advertising Reasonable rates( half of other hospitals) Welcoming, supportive atmosphere(website)
Gap 5
Patients sometimes ask to stay an extra day Expectations shaped from word of mouth are well met by the hospital services
Capacity planning
Hernia operations are elective procedures, patients can be scheduled in batches to fill the operating time available
The facility is intentionally designed to encourage exercise and rapid recovery within four days, which is approximately one-half the time at traditional hospitals.
Yield Calculations
Operations = 148/week
Actual Revenue = Actual Capacity * Price Potential Revenue = Total Capacity * Price
Effective word-ofmouth
Failing which
-ve Impact
No Additional Investment
1 2 3 4. 5 6
Need to hire new surgeons, nurses and staff Improve its competitive position and increase its profits
Keeping staff happy by profit sharing policy Less working load on staffs weekends off
Happy Employees
enables people to spend time with their family
Product Surgery Service Expertise of Doctors, dedication of staff, overall feel of place
Target Niche Market to low risk hernia operations USP Good Quality Service at low price
Word of Mouth Publicity Concept of Alumni Meet helps in spread the good word about service
There operating capacity is close to 100% so, they just need to focus on maintaining the Quality of service