Presented By:- Sonia Kuldeep PardeepPGDM 2nd (Satyug Darshan Tech. Campus)

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Contents

Shouldice insightIntroduction

Administrative Information

• Corporate Name: Shouldice Hospital Limited

• Established: 1945

• Location: 7750 Bayview Avenue, Thornhill Ontario, Canada, L3T 4A3

• Telephone: (905)889-1125

• Fax: (905)889-4216

• Toll Free: 1-800-291-7750

• Specialty: Abdominal Wall Hernia Repairs

Insight Shouldice

5

History

Dr. Edward Earle Shouldice graduated from the University of Toronto in 1916.

During World War II, he was called to serve on the Medical Examining Board.

Dr. Shouldice, a major in the army, found that many young men willing to serve their country had to be denied enlistment. These men needed surgical treatment to repair their hernias before they could be pronounced physically fit for military training.

Unique Appointment Procedure

Patients living within 100 km (60 miles) from the hospital should come to the office for a personal examination.

Examination Hours are:

Monday to Friday :

WALK IN CLINIC, NO APPOINTMENT NECESSARY

from 9:30 am to 3:30 pm

Saturday :

BY APPOINTMENT ONLY from 10:00 am to 2:00 pm

Unique Appointment ProcedureFor patients living at a greater distance who wish to arrange an examination, admission and operation all in one visit, please complete Questionnaires 1 and 2 by taking the following steps:

Step 1. Click on Medical Information , and print the questionnaire on your printer.

Step 2.Return to the Booking for Surgery page, click on Insurance Information, and print it on your printer.

Step 3. Complete all documents as required and forward by fax (905-889-4216) or regular mail to our office

Upon receipt of your completed documents, a surgeon will review the information, and office will make the necessary arrangements to schedule you for surgery.

Unique Operating Method

There is no use of foreign bodies such as synthetic screens or meshes, except in extremely rare cases where there has been destruction of the tissue usually due to previous surgery.

The vast majority of our (their) hernia repairs are done with a sedative (sleeping pill), analgesic (pain relief pill) and local anesthesia. If necessary, additional medication is administered.

The youngest patient to date was a child of 4 months, while the oldest was a man of 100 years.

Shouldice Business Process

30/36 Arrivals1–3 pm

If OK:Check-in & admin

Dinnerat 6 pm

Check by MD

(15 mins)

Tea & cookiesat 9 pm

Blood test

Day 1

Day 2

Explain process steps

Local anaesthesia

(-20mins)

Surgery (40 mins)

Rest in room

(2-3hrs)

Start eating & moving

Dinnerat 6 pm

Tea & cookiesat 9 pm

Day 3

Loosen stitches

Walk, play, & eat with your buddies

If not OK…

Dinnerat 6 pm

Tea & cookiesat 9 pm

Day 4: Remove stitches, walk, play, eat, check out

Service Concept

What does Shouldice hospital offer to its customers?

The hernia surgery (the Shouldice method)

Peace of mind/low risk/Low Recurrence

Independence/Dignity/Control

Social experience, fraternity

Excused absence from work without guilt

Facility at Hospital

Two facilities at one buildingoHospital oClinic

Facility divided

Level-2Lounge area,Addmission office, Patient room

Level-3Additional patient room and Recreational room

Level-1Kitchen and Dining room

7P’s of Service Marketing

PRODUCTPRODUCT

PRICEPRICE

PLACEPLACE

PROMOTIONPROMOTION

PHYSICAL EVIDENCEPHYSICAL EVIDENCE

PEOPLEPEOPLE

PROCESSPROCESS

Continued…..

Physical evidence -A relaxing, resort-like setting

Process- A unique program of care and recovery

Promotion – A lifetime of care and support by mutual relationship and follow up.A total environment- a total environment of comprehensive, compassionate and supportive patient care – is the reason that we continue to be the world’s leading centre of excellence in hernia repair.(World of mouth)

Continued….

People – Very satisfied employees long waiting lines for joining hospital as well as satisfied employees by giving bonus other than their fixed salaries

Price – Less price than their competitor with best service support which offering same at high cost (954$ vs. 2000-4000$)

Product – Providing service related to Hernia

Place –Green and calm place outside from main city

Price Comparison

Costs of typical operations $954 $2000-4000Transportation $200-600 $0

Time Lost from work in Hospital 4 days 5 days

Time lost from work while recovering 5 days 10 days

Value of time lost (ranging from $50 to 500 per day) $450-4500 $750-7500Total before Allowancefor recurrence $1604-6054 $2750-11500Probability of Recurrence 0.80% 10.00%Expected Cost of Recurrence $13-48 $275-1150Total cost to patient, employee and insurer $1,617-6,102 $3,025-12,650

ProfitHospital:

Revenues ( in $ )

(4 days X $111/day x 6,850 patients/year) 3,041,400

Cost 2,800,000

Profit: 241,400Clinic:Revenues (($450+ 60 + 75 X 0.20) X6,850) 3,596,250Cost 2,000,000

Profit 1,596,250

Total Profit 1,837,650

How did they do that

Patients are carefully screenedPatients are active participants in the service delivery processThe avoidance of general anesthestics allows a wide range of involvement of patientsStaff is freed from much disagreeable workReducing the cost of nursing, housekeeping and laundryStructure hospital jobs that involves more counseling and positive interaction with the patients.Highly focused factory

Highly productive surgeon: 300 hernia/yr Vs. 30 by less focused surgeon

High compensation ($50,000 + $40,000) Opportunities for surgeons to observe and advise one another Peer group pressure that leads to higher level of self-control of qualityA conscious effort is made to make Shouldice a “family "experience.

USP of Shouldice

“There is No Substitute for Experience”

Shouldice Hospital has been dedicated to the repair of hernias for over 55 years. The trained team of Shouldice Hospital surgeons have repaired more than 300,000 hernias with a greater than 99% success rate.

Surgeons at Shouldice Hospital have a virtual 100% success rate performing primary inguinal indirect hernia repairs. Shouldice Hospital has offered its Medical Guarantee for more than 55 years. Shouldice’s strategic service concept

Marketing Strategy of Shouldice

The three important aspects of services marketing triangle are the employees, customers and the company itself.

Shouldice keeps its staff happy through profit sharing policy, wherein the employees are paid a part of the profit in addition to their fixed salaries.

This sharing is done based on their contribution towards the success of the firm. This encourages them to work hard and put in more efforts. From the management point of view, they have given their staff a lesser working load and weekends off.

This enables people to spend time with their family and this in term keeps them contented and in the long run reduces the attrition rate

This is internal marketing for the company.

Company

EmployeeCustomer

Internal marketing

External marketing

Interactive marketing

Problem

Increase Capacity

Shouldice is operating at its “best operating level” for a service company with limited flexibility in its plant, a specialized work force but are failing to meet all the demand for its chosen market niche. Adding additional capacity to meet the unmet market need may upset the existing work force and lower service quality. Failing to meet the market demand may invite competition that could eventually cause Shouldice to loss market share and end up with excess capacity.

Problem JustificationThere is limited operating facts presented in the case so assumptions have made based on the information that was presented.

It is assumed that they are operating at the “best operating level” because the way the case describes how efficiently the hospital is ran and how the patients appear to be pleased with there treatment

There is limited operating facts presented in the case so assumptions have made based on the information that was presented.

It is assumed that they are operating at the “best operating level” because the way the case describes how efficiently the hospital is ran and how the patients appear to be pleased with there treatment

Alternatives

Add Saturday operations

Add a new floor

Establish a new facility for hernia

Expand to other types of operations

Alternatives Evaluation

Schedule Saturday as an Operating Day

AdvantagesNo investment is neededCan still maintain quality

DisadvantagesRequire to schedule 23-25 operations on SaturdaySix surgeons and a supervising surgeon have to work on SaturdaysAdditional other personnel Violates the implied contract that Shouldice has with its surgeons, strong opposition by the senior doctors

Alternatives Evaluation

Add a new floor

Total Number of Rooms: 89 +45= 134Advantages

Easy to control and maintain qualityRetain the culture and environment

DisadvantagesRequire to schedule doctors to the full capacity of five days per weekIncrease work load on admissions, kitchen, laundry, housekeeping and accountingFurther staggering of meal hours for patients (100 seat dinning room)Disruption during construction

Alternatives Evaluation

Establish a new facility for hernia

AdvantagesNew location close to the customers, say USAImprove its competitive position and increase its profitsOperate in a less restrictive environmentNew Opportunities for existing personnelTransfer of knowledge and expertise to the new facilities

DisadvantagesRequires a significant investment.Control of qualityIt is difficult to create the same culture and atmospherePotential competition with the existing facility

Alternatives Suggested

Add Saturday operations

No fresh investment required.

Can maintain quality.

New surgeons not required