服務(wù)管理和運(yùn)營(yíng)shouldice hospital蘇弟斯醫(yī)院案例

1、,DSE7100 Managing Service Operations,Discussion of Shouldice Hospital Limited Case,Assignment #2: Questions for Shouldice Hospital Limited,How Successful is the Shouldice Hospital? How do you account for the success

2、of the hospital?What is the strategic service concept of Shoudice Hospital? How are the elements in the service systems designed and managed to support the strategic service concept?As Dr. Shouldice, what actions, if

3、any, would you take to expand the hospital’s capacity?How would you implement changes you propose?,Patents do not feel that that are staying in hospitalPatients are taking a vocationThis is a clubFocused,How is Shoud

4、ice different from other Hospitals?,How Successful is Shouldice Hospital?,140,000 highly satisfied “Alumni”(past patients)1,200 backlog of scheduled operationsDemand appears to expand with supplySuperior quality Shoul

5、dice Method of Hernia operation imitated by competitorLow recurrence rate, 0.80% vs 10%High degree of employee satisfaction,Cost Comparison: Shouldices vs. Other Hospitals,ShouldiceOthersCosts of typical operations

6、$954 (p9)$2000-4000Transportation$200-600$0Time Lost from work in Hospital4days5daysTime lost from work while recovering5days10daysValue of time lost (ranging from $50 to 500 per day)$450-

7、4500$750-7500Total before Allowancefor recurrence$1604-6054$2750-11500Probability of Recurrence0.80%10.00%Expected Cost of Recurrence$13-48$275-1150Total cost to patient, employee and insurer$1,61

8、7-6,102$3,025-12,650,How About the Profitability of Shouldice Hospital?,,Hospital:Revenues (4 days X $111/day x 6,850 patients/year)3,041,400Cost2,800,000Profit: 241,400Clinic:Revenues (($450+

9、60 + 75 X 0.20) X6,850) 3,596,250Cost2,000,000Profit1,596,250Total Profit1,837,650,Return on equity,Total Depreciated Assets: $5 milReturn on Asset:1,837,650/5,000,000 = 37%What is the return o

10、n Asset if they expand the capacity by 50% at the cost of $2 mil?1,837,650 x 1.50 / 7,000,000 = 40%,“The Dream World ”,Shoudice is offering:high quality service at low priceShodice is having Highly satisfied customer

11、sHappy EmployeesShouldice is alsomaking high profit,How is all of this achieved?What are the major reasons for the success?,Maximizing the difference between perceived quality and value to the patient on one hand and

12、 the cost of supplying services on the other.,What is the Unique Service Concept?,What does Shouldice hospital offer to its customers?The hernia surgery (the Shouldice method)Peace of mind/low risk/Low RecurrenceInde

13、pendence/Dignity/ControlSocial experience, fraternityExcused absence from work without guiltA vocation,,Market Focusfocus on a narrow segment of potential patients who have hernia andthey are predominantly male, old

14、er in age, essentially in good healthlarge market potential: 600,000 operations in U.S. in 1979Internal FocusDoctors: Dedicated to quality of shoudice method, tolerance for boredom, family orientedNurses: people orie

15、nted, assist patients Staff: flexible, team oriented,A Focus Strategy,Operating Concept,Shouldicce achieves outstanding results as a low price and at a high profit because:Everything done by the hospital is designed

16、to maximize the difference between perceived quality and the value of the service provided patients on one hand andthe cost of providing the service on the other.,How did they do that?,Patients are carefully screenedP

17、atients 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

18、, housekeeping and laundryStructure hospital jobs that involves more counseling and positive interaction with the patients,How did they do that?,The Clinic is a focused factory resulting in:Highly productive surgeon:

19、300 hernia/yr Vs. 30 by less focused surgeonSharing of expensive services such as anesthetistShort and relatively regular hours for surgeonhigh compensation ($50,000 + $40,000)Opportunities for surgeons to observe an

20、d 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,The elements in the service system to support the serv

21、ice Concept (managerial elements),Service encounterDoctors and nurses are carefully recruitedEmployees trained to help / counsel patientsCommunal dinning for doctors, nurses , staff and patientsQualityadherence to S

22、houldice methodopportunity for surgeon to observe & advise one another,The elements in the service system to support the service Concept (managerial elements),Managing capacity & demandAdmission by appointment:

23、 scheduled serviceScreening patients: easier to estimate the service timewalk-in patients or local residents on waiting list to make up cancelled reservationInformationMedical Information questionnaireFree annual

24、check-up -> unique data base on the result of the surgeryAnnual reunion to keep alumni informed and gather customer feedbacks-> loyal customer base -> effective word-of-mouth,The elements in the service syste

25、m to support the service Concept (structural elements),Delivery systemMaximum degree of customer participationEfficient and low costAvoid a typical hospital atmosphereFacility designAcres of gardens to encourage exe

26、rcise & rapid recovery minimize hospital feeling (carpeting and odorless disinfectant etc)Stairways are designed for patients to use right after operationsNo TVs and Telephones in rooms to encourage walkingOperat

27、ing rooms are located in semicircle to encourage doctors to help each other and use the same anesthetist,The elements in the service system to support the service Concept (structural elements),Locationlarge city near ai

28、r port -> access to worldwide marketlarge local population to fill up cancelled bookingsCapacity planningElective procedures -> scheduled operationsBalancing Capacity and improving capacity utilizationNeeds to

29、 increase capacity,The Capacity Decision,Where is the bottle neck?How should they increase the capacity?How should they implement that change?,Shoudice Hospital Limited: Analysis of Capacity,Current Throughput6,850 Op

30、erations/50 weeks = 137 operations/week ( with a peak of 165/week)CapabilitiesExamination Rooms:(6 rooms x 3 hrs (1-4 PM) x 5 days x 60 min/hr) / (20 min / exam) = 270 patients /weekAdmitting Procedure:(2 people x

31、 4 hrs (1-5 PM) x 5 days/week x 60 min/hr) / (10min/patient) = 240 patients/weekNursing Station:(2 stations x 4 hrs (1-5 PM) x 5 days/week x 60min/hr)/(10 min/patient)=240 patients /week,Shoudice Hospital Limited: Anal

32、ysis of Capacity,Capabilities Operating Rooms:(5 rooms x 8.5 hrs/room/day x 1.1 hrs/patient x 5 days/week)/ = 188 patients /weekSurgeons:11 surgeons x 3.5 operations /day x 5 days = 178 patients/weekHospital rooms:

33、 (see transparency)89 rooms = 134 patients per week (assuming use of weekends for convalescence and 3.5 days average stay)103 rooms = 148 patients (assuming use of weekend for convalescence, 3.5 days average stay, and

34、use of 14 “hostel” rooms for two nights each week),How to expand the capacity?,Aim : increase capacity & maintain control of service qualityAlternatives:Add Saturday operationsAdd a new floor (45 more hospital bed

35、s)Establish a new facility for herniaExpand to other types of operationsOthers?,Please Help Shoudice to make the Decisions,Which alternative do you recommend?Why?How do you implement the solution that you are recomm

36、ending?,Add in a new floor (45 beds),Total Number of Rooms: 89 +45= 134Total number of patents per week = 193137 current throughput/148 theoretical= x / 193 theoreticalNew throughput = 193 x (137/148)= 179 patients

37、/ weekAdditional patients per year=(179-137) x 50=2100 additional revenue for the clinic = 2100 x (450+0.20 x 75) = $976,500 Less cost 176,500 Return on investment = 800,000/2,000,000=40%,Add in a new floor (45 be

38、ds),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

39、seat dinning room)Disruption during constructionAdvantagesEasy to control and maintain qualityRetain the culture and environment,Schedule Saturday as an Operating Day,Use 89 + 14 rooms, 3.5 average stayTotal number

40、of patents per week = 180137 current throughput/148 theoretical= x / 180 theoreticalNew throughput = 180 x (137/148)= 167 patients / weekAdditional patients per year=(167-137) x 50= 1450 additional revenue for the

41、 clinic = 1450 x (450+0.20 x 75) = $674,250 Less cost 124,250 Net increase in profit: 550,000 for no additional investment,Schedule Saturday as an Operating Day,DisadvantagesRequire to schedule 23-25 operations on S

42、aturdaySix 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 doctorsOperating

43、close the the theoretical capacity of the facilityAdvantagesNo investment is neededCan still maintain quality,A Second Facility for Treating Hernia,AdvantagesNew location close to the customers, say USAImprove its c

44、ompetitive position and increase its profitsOperate in a less restrictive environmentNew Opportunities for existing personnelTransfer of knowledge and expertise to the new facilitiesDisadvantagesRequires a significa

45、nt investment and Dr. Shoudice’s timeControl of qualityIt is difficult to create the same culture and atmospherePotential competition with the existing facility,Discussion Questions,Describe Shoudice Hospital’s servic

46、e package. How are the distinctive characteristics of a service firm illustrated by Shoudice Hospital?,Shoudice Hospital’s Service Package,Supporting FacilityAcres of gardens to encourage exercise & rapid recovery

47、Carpeting and odorless disinfectant etc to minimize hospital feeling Stairways are designed for patients to use right after operationsNo TVs and Telephones in rooms to encourage walkingOperating rooms are located in

48、semicircle to encourage doctors to help each other and use the same anesthetistLocated to a large city: Toronto, access to worldwide market, large local population to fill up cancelled bookings.,Shoudice Hospital’s Ser

49、vice Package,Facilitating Goods:Medical suppliesFood, medicine etc.Explicit ServicesQuality hernia surgery using the Shouldice method, low recurrenceVery experienced doctors,Shoudice Hospital’s Service Package,Impl

50、icit ServicesPeace of mind/low riskIndependence/Dignity/ControlSocial experience, fraternityExcused absence from work without guiltA vocation,Shoudice Hospital’s Distinctive Characteristics,Customer Participation in