Shouldice Case

After having a very successful performance and getting second place on the first Littlefield simulation game we knew what we needed to do to win the second simulation game. We were very eager to outperform our competition and we almost did so, but ended up in second place again with a cash balance of $2,660,393.

Before making an important decision, it is very important to set up clear goals of the decision. In the prompt, the town of Surette must decide whether to convert the abandoned building into a private office space or a new community center. The town has developed two distinct goals they want to accomplish through the decision. One of the goals is to gain revenue from the conversion of the building. The other goal is to increase the standard of living for the citizens of Surette. This is a very difficult decision because each option has its strengths and weaknesses. Nevertheless, we can simplify this decision by employing the rational decision making model discussed in our textbook. In order to reach a rational decision, I will review the information provided in the

After analyzing this information and reading through the case thoroughly, it would be quite difficult for Shouldice to perform 45 operations a day. They have limitations due to their operating rooms and the number of surgeons at their facility. According to the case, they have 12 full-time surgeons and only 5 operating rooms. Each surgeon operates on 4 patients per day so at most, the 12 surgeons can perform 48 total operations on a daily basis. Additionally, each operation takes 1 hour and since they only have 5 operating rooms, the maximum number of operations they can perform is 5 operations per hour. Operation time

A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today. The patient is checked in at admitting and is called back to the pre-operative area by the nurse. The patient changes and the nursing staff begin to take the patient’s vital signs, review the patient’s history, draw blood for lab work and they let the patient know what to expect before, during and after surgery. The surgeon arrives and checks in with the patient, asks if they have any final questions before surgery and then leaves for the operating room to prepare. The patient is taken to the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and the patient is taken to the post-op area. When the patient comes out of the anesthesia, the surgeon

On 01/27/2016, I observed about 22 patients in Postanesthesia Care Unit. Some of the patients were observed after surgeries while others were observed after endoscopy. During my shift, I observed patients awaiting recovery for removal of kidney stones, malignant melanoma (removal of moles), Endometrial Biopsy (EBX), superficial femoral artery (SFA), Hernia repair, Oophorectomy (ovary removal surgery), Cardiorrhaphy (Ventricular repair), Cystolithalopaxy (bladder stone removal), gall stone removal, Ectopic pregnancy surgery, and leg surgery.

Since 1945, Canada based Shouldice Hospital has gained a reputation around the world for their primary performed surgeries and services in hernia repair. Shouldice’s main objective is to take the inconvenience of being diagnosed with a hernia and turn it into a quick and even enjoyable experience for their patients. This is all possible through Shouldice’s service delivery system, consisting of selecting patients that do not hold an overly complicated hernia in order to perform a superior surgical technique established by Dr. Shouldice. The patients endure an active stay to ensure a proper, speedy recovery, and a quaint estate resembling a country club accompanied with a pleasant staff and encouraged socializing with other patients that give them a unique experience. After the patient's stay, Shouldice Hospital invites them back for a yearly gala Hernia Reunion dinner to follow up and provide a complimentary hernia inspection. The lifelong bond that Shouldice has been able to establish and maintain display the above and beyond service they’ve given their clientele for decades.

The sector, health, that I have chosen includes a variety of people from ranging from elderly too adult too teenagers, children and baby’s. A hospital is a health care institution which provide treatment for many diseases and conditions.

Martinez experienced the discomfort of a ventral hernia found on the right lower quadrant of his abdomen. He went to Dr. Kappelman’s office, as an established patient and known to the surgery service. Dr. Kappelman examined Mr. Martinez’s hernia and wanted to monitor it over time. By March 20 of 2013, the hernia symptoms had become unmanageable. Dr. Kappelman decided the most relief would come from surgical repair. Dr. Kappelman’s 37 years of experience and familiarity with his patient’s type of hernia, he was confident in his approach and preparation for Mr. Martinez’s surgery. “If I thought there was something unusual about the hernia, if there was some question about the actual presence of the hernia, I would have evaluated further, but there was no indication for it. Dr. Kappelman spent the previous year monitoring this defect in his patient’s abdominal wall in addition to his symptomology over the previous year. Mr. Martinez was appropriately consented for the ventral hernia repair with the PROCEED Ventral Patch Mesh implantation. “PROCEED Ventral Patch is a sterile, self-expanding, partially absorbable, flexible laminate Mesh device designed for the repair of hernias and other fascial deficiencies”. (EXHIBIT C) The March 20, 2013 surgery of Mesh implantation went smoothly (EXHIBIT A). “The hernia was mobilized removing it from surrounding tissues. The hernia was then opened and Dr. Kappelman noted it contained preperitoneal fat. The

3. Yes, it would be morally justified for a surgeon to have provided the hernia surgery because who knows Roberta W. can survive the surgery. If there is no other option to helping Roberta W. hernia the surgeon should try their best and do the surgery. This option is way better than for Roberta W. to just sit there and refusing hydration at least the surgeon tried to help her. If we look at the teleological theory it says “denotes even if the act was wrong but the outcome turned out good then it is considered good.” So I think if surgeon don’t have any more option to help Roberta W.’s hernia they should just do the surgery because in the outcome who knows it can come out good. In case that this surgeon doesn’t do the surgery, there is millions of surgeon who would gladly do the surgery for Roberta W., it is 50/50 chance that she could die or

Shouldice Hospital is one where only external abdominal hernias are operated. The hospital has a unique “technique” for this which was developed by Dr.Earle Shouldice, the founder of the hospital. The hospital with its low cost solution, properly routine tasks, facilities for the patients and their visitors, high quality service, and best in industry doctors and staff had a competitive edge. The Shouldice Hospital in itself is not just a curing centre but a holistic experience for its patients, doctors, nurses and supporting staff alike.

In Atul Gawande's mind blowing speech about doctors dramatically improving their practices using something as simple as a checklist. Dr. Gawande gives many thoughts and ideas concerning experience from history to show the audience that doctors and medical practices have changed a lot over history. Doctors also have had many setbacks and many things that should be changed to further improve their practices. Dr. Gawande begins by explaining how medicine first started and how many patients were incorrectly being diagnosed and cared for. He opens the idea that medicine has changed a lot throughout the beginning of time. Also, currently doctors still have a lot of challenges they face in modern medicine. He explains the first diagnosis of medicine and the early times in treating patients. He explains that medicine has come a long way now having over 6000 drugs that can be prescribed. He explains how much society has come together to study and look at Health Care. By the end of the 20th-century 15 doctors were needed in the operating room to serve a patient with the exact same problem 20 years ago. Gawande uses the word specialists a lot as a primary focus to show that not everybody is a doctor but a specialist in their own area. Gawande then opens a big a topic on how 40% of disease patients receive incomplete or inappropriate care. And at the same time, surgeries cost insane amounts nowadays then past prices. Now in his speech, he introduces the term pit crew this sets up the

Shouldice Hospital focus on hernia repair surgery which is mostly performed on males. Shouldice operation strategy

The hospital is currently utilizing 71.43% of their beds, this is actually an ideal operating point. To increase its rate of utilization might decrease the service quality.

Unique and pioneering surgical technique for Hernia operation which reduced the suffering of the patients and led to rapid

A Canadian hospital specializing in hernia operations is considering whether and how to expand the reach of its seraices,