1. How successful is the Shouldice Hospital? Generate a P&L statement using available information from the case. Treat each of the two operations—hospital and the surgery—separately.
Hospital:
Revenues (4 days X $111/day x 6,850 patients/year) 3,041,400
Cost 2,800,000
Profit: 241,400
Clinic:
Revenues ((($450 + 60 + 75) X 0.20) X 6,850 patients/year)) 3,596,250
Cost 2,000,000
Profit 1,596,250
Total Profit 1,837,650
2. How do you account for its successful performance?
The following factors account for the success of Shouldice hospital:
• Unique and pioneering surgical technique for Hernia operation which reduced the suffering of the patients and led to rapid
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This also resulted in low nurse to patient ratio compared to other similar hospitals (0.44)
• Offering the cheapest option for treatment of hernia in the region
• High reliability of Hernia operation with very small recurrence rate of 0.8 % as compared to high recurrence rates of close to 10 % as in the United States.
• Doctors and nurses were motivated by way of higher salaries and profit sharing systems in the form of bonuses compared to other hospitals in the region and reasonable workload leading to sense of belongingness amongst the doctors and nurses leading to low attrition.
• Encouraged group cohesiveness and fraternity type of coordination mechanism within the organization leading to greater operational efficiency. The above factors resulted in remarkable credibility for the Shouldice Hospital that position edit in the market as a hospital which ensured cost effective, reliable, caring and responsive service to the hernia patients.
3. Prepare a patient process flow diagram from arrival through surgery and determine the capacities at each stage. For this diagram, only indicate major points in the process, e.g., admitting, examination, operating room surgeries, etc. Use the actual hours of operation for each step in the process to determine the capacity of each step. Where is the
To improve the performance, there need to be upgrades with the systems that the hospital uses to keep track of the patients information. I recommend using Epic as a tool to help keep all of the patient’s information confidential and easy to access with a click of a button. This will allow for every department to have access to a certain patient’s file whether to be from a doctor entering notes about the patient’s visit, to health insurance billing department making sure that copays and such are being paid and their accounts are kept up-to-date. The hospital governance plays an important role because of the need for funds to help keep the hospital. By providing more outside events to raise money for the hospital will be a great start to being able to fully provide for each patient that comes through Middlefield Hospital doors.
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Partners Healthcare had established several financial resources pools, such as the short-term pool (STP) and the LTP, so that they can satisfy different needs of the several hospitals in the network. In more detail, the STP was invested with very high-quality, short-term fixed-income financial instruments. The average maturity of these instruments is about one to two years. STP is always treated as the risk-free part of the hospitals’ holdings. On the other hand, the LTP is thought as the risky part of holdings. It consists of different forms of equity and a smaller fixed-income part.
As pointed out in the previous section, the bottleneck at the beds, which is bleeding to the number of operations and the utility of the existing operation rooms needs to be addressed as soon as possible. At is full capacity Shouldice can perform 38 operations per day, when there is no restriction on the number of beds available. Spread over 5 operation rooms, it averages out to 38/5 = 7.6 operations per room in any given day. These operations needs to be spread out and spaced evenly to make sure the rooms can be used to their full capacity at 6 to 7 operations per day. With the current working hours of 4 in the morning and 4 in the evening, it is difficult to accommodate 6 to 7 operations per day in a room. Hence along with the increase in the number of beds, Shouldice also needs to increase its hours of operations to 10 hours a day or open one extra day in a
On examination, the testicles are descended bilaterally. The right groin is positive for direct reducible hernia. Assessment is right inguinal hernia. Plan is for robotic-assisted laparoscopic right inguinal hernia repair with mesh.
Patient Charlie, a police officer and father of three was experiencing intense pain in his abdominal, pelvic, and sacral regions. Charlie was told he would need a laparoscopic hernia surgery as soon as possible. To begin the surgery doctor Carlos Garcia makes three small cuts, one to the right of the inferior and within the umbilical, the second in the lower abdominal area below the thoracic cavity, and in the final incision the navel is pulled apart. This allows Doctor Garcia to make a half inch lateral incision. Next, the doctor inflates the abdominal cavity with C02 gas to insert the procar which he aims towards the pelvic region. Once the scope is inserted we see the difference between the left and right inguinal. The hernia is in the right
that was very painful. He went into surgery and explained that the hernia was more painful than
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By increasing the number of beds by 50%, the total number of beds available would become 135 (90 x 1.5 = 135 beds). As a result, Shouldice Hospital could perform a maximum of 45 operations per day before running out of bed capacity. With operations still being performed 5 days per week, the total bed capacity would become 675 beds (135 beds x 5 days a week = 675 beds). In relation to the current operation of 30 patients per day, the utilization rate for bed capacity would now be 66.67% (450 / 675 = 66.67%).
Shouldice Hospital follows the business model of focus on a single standardized service for a narrow target of consumers, rather than to provide customized solution (as in a general clinic or hospital). It focuses on providing quick, convenient, and reliable cure for external types of abdominal hernias. The Hospital uses its own technique, called the Shouldice Method and claims to provide relatively short post-operative recovery period.
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