Shouldice

Issues/BackgroundShouldice Hospital limited was started in 1940 by Dr. Earle Shouldice for treating Hernia. The method of surgery adopted by Shouldice Hospital was unique in a sense that it introduced the concept of flow shop in carrying out surgeries alongwith simplicity in surgery.Ð' Because of this uniqueness and simplicity, the demand for surgeries at Shouldice increased and Shouldice has reached a point where it has to increase its capacity to reduce the wait times being faced by the patients.Ð' Presently, the hospital performs, on an average, 30 to 36 operations per day. The challenge is to devise a way of increasing the hospital capacity while maintaining the same quality standards, the role of government in the operations of the hospital and unauthorised use of Shouldice brand name by potential competitors. Assumptions:We have assumed that at all times ratio of patients coming from outside and local patients remain at 70:30 and surgeries has to be carried out maintaining the ratio.Analysis:Shouldice is already evaluating some options to increase the capacity of the hospital. Some of these are: 1.Ð' Increasing capacity of the hospital by increasing the number of beds and inculcating more staff.2.Ð' Operating on Saturdays and Sundays in order to increase the capacity by 20%.3.Ð' Expanding the capacity thereby entering in other specialist areas offering similar opportunities like eye surgery etc.4.Ð' Changing the scheduling of doctors.The way, the surgeries are carried out at Souldice, any patient needs to stay at hospital for at least 3 days. Appendix вЂ?B’ shows weekly maximum achievable throughput of 149 patients under the current operating cycle. Surgeon Capacity Analysis: In general, a typical first time surgery requires 45 minutes of surgeon time.Ð' Surgeon requires 15 minutes to prepare for the next surgery. Thus, effectively a surgeon can undertake one first time surgery in an hour. Similarly, a surgeon requires 90 minutes for carrying out a recurrence surgery and 15 minutes to prepare for the next surgery. Typically it has been seen that 10% of total surgeries are recurrence surgeries. Hence, it can be inferred that a surgeon is able to carry out 5 first time surgeries, 1 recurrence surgery and can examine all these six patients before the surgery in 8 hours time easily.Ð' With the 10 available surgeons, hospital can carry out 300 surgeries in a 5 working days week, which shows that there is clearly an excess capacity in terms of surgeons. Surgical Room Capacity Analysis: The hospital has 5 surgical rooms, while at a given time we have 10 surgeons. This clearly indicates that 5 surgeons will be idle for most of the time limiting the surgery capacity to 150 per week. In our opinion, this capacity could be raised optimising the surgeon’s schedules.Hospital Beds Capacity Analysis: Under current scenario, hospital has 89 bed capacity. In our opinion, the bed capacity at hospital is bottleneck in increasing the capacity of the hospital. Analysing appendix вЂ?BвЂ?Ð' we conclude that utilisation of bed capacity is very low on Fridays, Saturdays, Sundays and Mondays. Hence, optimise utilisation of this capacity is the key to increase the capacity of the hospital.Patient Demography Analysis: We have observed that the patients coming to hospital are from different geographic locations. Broadly these patients could be divided into two segments namely вЂ?Out Station Patients’ and вЂ?Local Patients’. Out Station Patients constitute the 70% of the total patients while rest are local patients. It is quite evident from the data that there