Shouldice - Finalised

8/10/2019 Shouldice - Finalised

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Current Situation

30-36surgeries/day

10 Surgeons

34 Nurses

5 OperatingRooms

6 ExamRooms

SurgeryMonday

Friday

89 Beds


3/24

Current Process Flow Chart

Check-in on first

afternoon

Surgery

and firstfull day at

Shouldice

day #2:

Rest &Recovery

day #3:

Rest &

Recovery

day #4:

Checkout


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Current Pre-Surgery / Pre-Patient


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Current Arrival: First Afternoon


6/24

Current Surgery: Full Day #1


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Full Day #2 Full Day #3 Check-out

Current Process


8/24

Key Factors for Success

Culture

Expertise

Unique Patient Experience


9/24

Key Issues/Problems

Growing wait list

Invitingcompetition

Standardsurgeries

Complexsurgeries

Pre-patientscreenings

# of Beds

# of operating

rooms GovtRegulation

Capacity Efficiency

DemandScheduling


10/24

Quality

Performance

Features

Reliability/

Durability

Serviceability

Aesthetics

PerceivedQuality


11/24

Quality

Quality Costs

Appraisal Costs

Medical InformationQuestionnaire

Patients turned away

Prevention Costs

Scheduling by Dr.Degani

Poka-yokes

Mandatory follow-up

Pre-Operation Exam

Purchase andImplementation ofSophisticated

Scheduling Software


12/24

Goals & Objectives

Increasethe numberof surgeries

by 20%

Decreasethroughput

time

Increaseefficiency of

screeningprocess

Maintain

currentculture


13/24

Recommendations

ScreeningEfficiency

Implement onlinesubmission of MedicalQuestionnaire

Verification of Dx andweight loss from PCP

ThroughputTime

Decrease patientthroughput time byeliminating one nights

stay

Scheduling

Standard herniasurgeries on Mon, Tues,Thurs, Fri (40 surgeries)

Complex/Recurrencesurgeries on Wed (9

surgeries)


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Current Bed Capacity

Patient Intake and Surgeries Performed (as stated in the case)

Bed Capacity -

CurrentInputs

Ops Per Day 33

# of Beds 89

Length of Stay/Nights 4

Saturday Surgery No

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Sunday 33 33 33 33

Monday 33 33 33 33

Tuesday 23 23 23 23

Wednesday 0 0 0 0

Thursday 33 33 33 33

Friday

Saturday

Total Number inHospital 66 66 89 89 89 56 33

Total Number of Surgeries 33 33 23 0 33

Total122

surgeries


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Improved Bed Capacity

Bed Capacity Inputs

Ops Per Day 40

# of Beds 89

Length of Stay/Nights 3

Saturday Surgery No

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Sunday 40 40 40

Monday 40 40 40

Tuesday 9 9 9

Wednesday 40 40 40

Thursday 40 40 40

Friday

Saturday

Total Number in Hospital 40 80 89 89 89 80 40

Total Number ofSurgeries 40 40 9 40 40

TotalSurgeries 169

Increase 39%


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CURRENT:

DailyOperating

Schedule

7:30 AM 7:45 AM

7:45 AM 8:00 AM 1 2 3 4 5

8:00 AM 8:15 AM

8:15 AM 8:30 AM

8:30 AM 8:45 AM

8:45 AM 9:00 AM 6 7 8 9 10

9:00 AM 9:15 AM

9:15 AM 9:30 AM

9:30 AM 9:45 AM Coffee Break

9:45 AM 10:00 AM

10:00 AM 10:15 AM

10:15 AM 10:30 AM 11 12 13 14 15

10:30 AM 10:45 AM

10:45 AM 11:00 AM

11:00 AM 11:15 AM

11:15 AM 11:30 AM 16 17 18 19 20

11:30 AM 11:45 AM

11:45 AM 12:00 PM

12:00 PM 12:15 PM

12:15 PM 12:30 PM

Lunch12:30 PM 12:45 PM

12:45 PM 1:00 PM

1:00 PM 1:15 PM

1:15 PM 1:30 PM

1:30 PM 1:45 PM 21 22 23 24 25

1:45 PM 2:00 PM

2:00 PM 2:15 PM

2:15 PM 2:30 PM

2:30 PM 2:45 PM 26 27 28 29 30

2:45 PM 3:00 PM

3:00 PM 3:15 PM

3:15 PM 3:30 PM

3:30 PM 3:45 PM 31 32 33 34 35

3:45 PM 4:00 PM


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IMPROVED:

Mon, Tues,

Thurs, Fri

Operating

Schedule(standard hernia surgeries)


18/24

IMPROVED:

Wednesday

OperatingSchedule(Recurrence/Complex

hernia surgeries)


19/24

Improved Process Flow Chart

Arrival:first

afternoon

Surgery:Full Day 1

Rest/Rec

overy:

Full Day 2

Check out


20/24

Improved Pre-Surgery / Pre-Patient


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Results / Outcomes

METRICSProductivity

Linear

Programming

ProcessPerformance

Metrics

Capacity

Utilization

Forecasting


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Conclusion

Recom

mendatio

ns:

Decrease throughputtime by eliminatingone nights stay

Increase number ofsurgeries by adjustingthe surgery scheduling

Increase the efficiency

of the screeningprocess

Outcom

es:

Increase number ofsurgeries per week by

39%

Maintain currentculture & corecompetencies


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Works Cited:

1.Private Hospitals Act(1990, January 1). http://www.canlil.org/en/on/laws/stat/rso-1990-c-p24/latest/rso-1990-c-p24.html.Retrieved Month 3, 2012, from www.canlil.org:http://www.canlil.org/en/on/laws/stat/rso-1990-c-p24/latest/rso-1990-c-p24.html

2. Eckhert, D. (2012, March 1). Shouldice Hospital Administrator. (K. Groga, Interviewer)

3. F. Robert Jacobs, R. B. (2011). Operations and Supply Chain Management(Vol. 13th). New York,New York: McGraw-Hill/Irwin.

4. Hallowell, J. H. (2005, January 21). Shouldice Hospital Limited (Abridged). Harvard BusinessSchool Case. Ontario, Ontario, Canada: Harvard Business Reveiw Publishing.

5. Hospital, S. (1996, January 1). Retrieved March 10, 2012, from www.Shouldice.com:www.shouldice.com

6. Inman, R. A. (2012, January 1). Reference for Business.Retrieved March 3, 2012, from Referencefor Business Encyclopedia of Business, 2nd ed.:http://www.referenceforbusiness.com/management/A-Bud/Aggregate-Planning.html#b

7. Jones, D. W. (2011, September 29). Hernia Surgery Not Always Needed. Windsor Star, Body andHealth; Doctor Game, p. C5.

8. Levy, A., Sobolev, B., Hayden, R., Kiely, M., FitzGerald, J., & Schechter, M. (2005). Time on waitlists for coronary bypass surgery in British Columbia, Canada, 1991-2000. BMC Health ServicesResearch, 522-10. doi:10.1186/1472-6963-5-22

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Shouldice - Finalised