Presented By:Sonia
Kuldeep
Pardeep
PGDM 2nd (Satyug
Darshan Tech.
Campus)
Contents
Shouldice insight
Introduction

2
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
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.

5
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 Procedure
For 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 (905-8894216) 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
If not OK…

Day 1
30/36
Arrivals
1–3 pm

Check by
MD
(15 mins)

If OK:
Check-in &
admin

Surgery
(40 mins)

Rest in room
(2-3hrs)

Blood
test

Explain
process
steps

Dinner
at 6 pm

Tea &
cookies
at 9 pm

Day 2
Local
anaesthesia
(-20mins)

Start
eating &
moving

Dinner
at 6 pm

Tea &
cookies
at 9 pm

Dinner
at 6 pm

Tea &
cookies
at 9 pm

Day 3
Loosen
stitches

Walk, play, & eat with
your buddies

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 building
oHospital
oClinic

Facility divided

Level-1
Kitchen and
Dining room

Level-2
Lounge
area,Addmission
office, Patient room

Level-3
Additional patient
room and
Recreational room
7P’s of Service Marketing
PRODUCT
PRODUCT
PRICE
PRICE
PLACE
PLACE

PROMOTION
PROMOTION
PHYSICAL EVIDENCE
PHYSICAL EVIDENCE

PEOPLE
PEOPLE
PROCESS
PROCESS
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
Transportation

$954
$200-600

$2000-4000
$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)
Total before Allowance
for recurrence
Probability of Recurrence
Expected Cost of Recurrence
Total cost to patient, employee
and insurer

$450-4500

$750-7500

$1604-6054
0.80%
$13-48

$2750-11500
10.00%
$275-1150

$1,617-6,102

$3,025-12,650
Profit
Hospital:
Revenues
(4 days X $111/day x 6,850 patients/year)

( in $ )
3,041,400

Cost

2,800,000

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

241,400
2,000,000

Profit

1,596,250

Total Profit

1,837,650
How did they do that
Patients are carefully screened
Patients are active participants in the service delivery process
The avoidance of general anesthestics allows a wide range of involvement of patients
Staff is freed from much disagreeable work
Reducing the cost of nursing, housekeeping and laundry
Structure 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 quality
A 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.

Company

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.

External
marketing

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
Internal
This is internal marketing for the company.
marketing

Employee
Interactive
marketing

Customer
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 Justification
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
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
Advantages
No investment is needed
Can still maintain quality
Disadvantages
Require to schedule 23-25 operations on Saturday
Six surgeons and a supervising surgeon have to work on
Saturdays
Additional 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= 134
Advantages
Easy to control and maintain quality
Retain the culture and environment
Disadvantages
Require to schedule doctors to the full capacity of five days per
week
Increase work load on admissions, kitchen, laundry,
housekeeping and accounting
Further staggering of meal hours for patients (100 seat dinning
room)
Disruption during construction
Alternatives Evaluation
Establish a new facility for hernia
Advantages
New location close to the customers, say USA
Improve its competitive position and increase its profits
Operate in a less restrictive environment
New Opportunities for existing personnel
Transfer of knowledge and expertise to the new facilities
Disadvantages
Requires a significant investment.
Control of quality
It is difficult to create the same culture and atmosphere
Potential competition with the existing facility
Alternatives Suggested
Add Saturday operations
No fresh investment required.
Can maintain quality.
New surgeons not required
Shouldice hospital final.ppt original

Shouldice hospital final.ppt original

  • 1.
    Presented By:Sonia Kuldeep Pardeep PGDM 2nd(Satyug Darshan Tech. Campus)
  • 2.
  • 3.
    Administrative Information • CorporateName: 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
  • 4.
  • 5.
    History Dr. Edward EarleShouldice 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. 5
  • 6.
    Unique Appointment Procedure Patientsliving 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
  • 7.
    Unique Appointment Procedure Forpatients 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 (905-8894216) 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.
  • 8.
    Unique Operating Method Thereis 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.
  • 9.
    Shouldice Business Process Ifnot OK… Day 1 30/36 Arrivals 1–3 pm Check by MD (15 mins) If OK: Check-in & admin Surgery (40 mins) Rest in room (2-3hrs) Blood test Explain process steps Dinner at 6 pm Tea & cookies at 9 pm Day 2 Local anaesthesia (-20mins) Start eating & moving Dinner at 6 pm Tea & cookies at 9 pm Dinner at 6 pm Tea & cookies at 9 pm Day 3 Loosen stitches Walk, play, & eat with your buddies Day 4: Remove stitches, walk, play, eat, check out 
  • 10.
    Service Concept What doesShouldice 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
  • 11.
    Facility at Hospital Twofacilities at one building oHospital oClinic Facility divided Level-1 Kitchen and Dining room Level-2 Lounge area,Addmission office, Patient room Level-3 Additional patient room and Recreational room
  • 12.
    7P’s of ServiceMarketing PRODUCT PRODUCT PRICE PRICE PLACE PLACE PROMOTION PROMOTION PHYSICAL EVIDENCE PHYSICAL EVIDENCE PEOPLE PEOPLE PROCESS PROCESS
  • 13.
    Continued….. Physical evidence -Arelaxing, 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)
  • 14.
    Continued…. People – Verysatisfied 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
  • 15.
    Price Comparison Costs oftypical operations Transportation $954 $200-600 $2000-4000 $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) Total before Allowance for recurrence Probability of Recurrence Expected Cost of Recurrence Total cost to patient, employee and insurer $450-4500 $750-7500 $1604-6054 0.80% $13-48 $2750-11500 10.00% $275-1150 $1,617-6,102 $3,025-12,650
  • 16.
    Profit Hospital: Revenues (4 days X$111/day x 6,850 patients/year) ( in $ ) 3,041,400 Cost 2,800,000 Profit: Clinic: Revenues (($450+ 60 + 75 X 0.20) X6,850) 3,596,250 Cost 241,400 2,000,000 Profit 1,596,250 Total Profit 1,837,650
  • 17.
    How did theydo that Patients are carefully screened Patients are active participants in the service delivery process The avoidance of general anesthestics allows a wide range of involvement of patients Staff is freed from much disagreeable work Reducing the cost of nursing, housekeeping and laundry Structure 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 quality A conscious effort is made to make Shouldice a “family "experience.
  • 18.
    USP of Shouldice “Thereis 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
  • 19.
    Marketing Strategy ofShouldice 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. Company 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. External marketing 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 Internal This is internal marketing for the company. marketing Employee Interactive marketing Customer
  • 20.
    Problem Increase Capacity Shouldice isoperating 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.
  • 21.
    Problem Justification There islimited 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
  • 22.
    Alternatives Add Saturday operations Adda new floor Establish a new facility for hernia Expand to other types of operations
  • 23.
    Alternatives Evaluation Schedule Saturdayas an Operating Day Advantages No investment is needed Can still maintain quality Disadvantages Require to schedule 23-25 operations on Saturday Six surgeons and a supervising surgeon have to work on Saturdays Additional other personnel Violates the implied contract that Shouldice has with its surgeons, strong opposition by the senior doctors
  • 24.
    Alternatives Evaluation Add anew floor Total Number of Rooms: 89 +45= 134 Advantages Easy to control and maintain quality Retain the culture and environment Disadvantages Require to schedule doctors to the full capacity of five days per week Increase work load on admissions, kitchen, laundry, housekeeping and accounting Further staggering of meal hours for patients (100 seat dinning room) Disruption during construction
  • 25.
    Alternatives Evaluation Establish anew facility for hernia Advantages New location close to the customers, say USA Improve its competitive position and increase its profits Operate in a less restrictive environment New Opportunities for existing personnel Transfer of knowledge and expertise to the new facilities Disadvantages Requires a significant investment. Control of quality It is difficult to create the same culture and atmosphere Potential competition with the existing facility
  • 26.
    Alternatives Suggested Add Saturdayoperations No fresh investment required. Can maintain quality. New surgeons not required

Editor's Notes

  • #9 Mesh= chider, jaal anesthesia= behoshi
  • #11 Fraternity= brotherhood