How well would the new resources be utilized relative to the current operation? Could the hospital really perform this many operations? Why?

Shouldice
Hospital—A Cut Above

Review the
Shouldice Hospital case study on page 115 in the textbook. You can find the
questions for this case study in Doc Sharing.

Compose an
APA-formatted Word document, no more than three pages in length; please answer
each of the questions in the presented case study.

Case: Shouldice Hospital — A Cut Above

“Shouldice Hospital, the house that hernias built, is a
converted country estate which gives the hospital ‘a country club’ appeal.”

A quote from American Medical News

Shouldice Hospital in Canada is widely known for one
thing—hernia repair! In fact, that is the only operation it performs, and it
performs a great many of them. Over the past two decades this small 90-bed
hospital has averaged 7,000 operations annually. Last year, it had a record year
and performed nearly 7,500 operations. Patients’ ties to Shouldice do not end
when they leave the hospital. Every year the gala Hernia Reunion dinner (with
complimentary hernia inspection) draws in excess of 1,000 former patients, some
of whom have been attending the event for over 30 years.

A number of notable features in Shouldice’s service delivery
system contribute to its success: (1) Shouldice accepts only patients with the
uncomplicated external hernias, and it uses a superior technique developed for
this type of hernia by Dr. Shouldice during World War II. (2) Patients are
subject to early ambulation, which promotes healing. (Patients literally walk
off the operating table and engage in light exercise throughout their stay,
which lasts only three days.) (3) Its country club atmosphere, gregarious
nursing staff, and built-in socializing make a surprisingly pleasant experience
out of an inherently unpleasant medical problem. Regular times are set aside
for tea, cookies, and socializing. All patients are paired up with a roommate
with similar background and interests.

The Production System

The medical facilities at Shouldice consist of five
operating rooms, a patient recovery room, a laboratory, and six examination
rooms. Shouldice performs, on average, 150 operations per week, with patients
generally staying at the hospital for three days. Although operations are
performed only five days a week, the remainder of the hospital is in operation
continuously to attend to recovering patients.

An operation at Shouldice Hospital is performed by one of
the 12 full-time surgeons assisted by one of seven part-time assistant
surgeons. Surgeons generally take about one hour to prepare for and perform
each hernia operation, and they operate on four patients per day. The surgeons’
day ends at 4 P.M., although they can expect to be on call every 14th night and
every 10th weekend.

The Shouldice Experience

Each patient undergoes a screening exam prior to setting a
date for his or her operation. Patients in the Toronto area are encouraged to
walk in for the diagnosis. Examinations are done between 9 A.M. and 3:30 P.M.
Monday through Friday, and between 10 A.M. and 2 P.M. on Saturday. Out-of-town
patients are mailed a medical information questionnaire (also available over
the Internet), which is used for the diagnosis. A small percentage of the
patients who are overweight or otherwise represent an undue medical risk are
refused treatment. The remaining patients receive confirmation cards with the
scheduled dates for their operations. A patient’s folder is transferred to the
reception desk once an arrival date is confirmed.

Patients arrive at the clinic between 1 and 3 P.M. the day
before their surgery. After a short wait, they receive a brief preoperative
examination. They are then sent to an admissions clerk to complete any
necessary paperwork. Patients are next directed to one of the two nurses’
stations for blood and urine tests and then

115

116

are shown to their rooms. They spend the remaining time
before orientation getting settled and acquainting themselves with their
roommates.

Orientation begins at 5 P.M., followed by dinner in the
common dining room. Later in the evening, at 9 P.M., patients gather in the
lounge area for tea and cookies. Here new patients can talk with patients who
have already had their surgery. Bedtime is between 9:30 and 10 P.M.

On the day of the operation, patients with early operations
are awakened at 5:30 A.M. for preoperative sedation. The first operations begin
at 7:30 A.M. Shortly before an operation starts, the patient is administered a
local anesthetic, leaving him or her alert and fully aware of the proceedings.
At the conclusion of the operation, the patient is invited to walk from the
operating table to a nearby wheelchair, which is waiting to return the patient
to his or her room. After a brief period of rest, the patient is encouraged to
get up and start exercising. By 9 P.M. that day, he or she is in the lounge
having cookies and tea and talking with new, incoming patients.

The skin clips holding the incision together are loosened,
and some are removed, the next day. The remainder are removed the following
morning just before the patient is discharged.

When Shouldice Hospital started, the average hospital stay
for hernia surgery was three weeks. Today, many institutions push “same day
surgery” for a variety of reasons. Shouldice Hospital firmly believes that this
is not in the best interests of patients and is committed to its three-day
process. Shouldice’s postoperative rehabilitation program is designed to enable
the patient to resume normal activities with minimal interruption and
discomfort. Shouldice patients frequently return to work in a few days; the
average total time off is eight days.

“It is interesting to note that approximately 1 out of every
100 Shouldice patients is a medical doctor.”

Future Plans

The management of Shouldice is thinking of expanding the
hospital’s capacity to serve considerable unsatisfied demand. To this effect,
the vice president is seriously considering two options. The first involves
adding one more day of operations (Saturday) to the existing five-day schedule,
which would increase capacity by 20 percent. The second option is to add
another floor of rooms to the hospital, increasing the number of beds by 50
percent. This would require more aggressive scheduling of the operating rooms.

The administrator of the hospital, however, is concerned
about maintaining control over the quality of the service delivered. He thinks
the facility is already getting very good utilization. The doctors and the
staff are happy with their jobs, and the patients are satisfied with the
service. According to him, further expansion of capacity might make it hard to
maintain the same kind of working relationships and attitudes.

Questions

Exhibit 4.7 is a room-occupancy table for the existing
system. Each row in the table follows the patients who checked in on a given
day. The columns indicate the number of patients in the hospital on a given
day.

exhibit 4.7 Operations with 90 Beds (30 patients per day)

116

117

For example, the first row of the table shows that 30 people
checked in on Monday and were in the hospital for Monday, Tuesday, and
Wednesday. By summing the columns of the table for Wednesday, we see that there
are 90 patients staying in the hospital that day.

1 How well is the hospital currently utilizing its beds?

2 Develop a similar table to show the effects of adding
operations on Saturday. (Assume that 30 operations would still be performed
each day.) How would this affect the utilization of the bed capacity? Is this
capacity sufficient for the additional patients?

3 Now look at the effect of increasing the number of beds by
50 percent. How many operations could the hospital perform per day before
running out of bed capacity? (Assume operations are performed five days per week,
with the same number performed on each day.) How well would the new resources
be utilized relative to the current operation? Could the hospital really
perform this many operations? Why? (Hint: Look at the capacity of the 12
surgeons and the five operating rooms.)

4 Although financial data are sketchy, an estimate from a
construction company indicates that adding bed capacity would cost about
$100,000 per bed. In addition, the rate charged for the hernia surgery varies
between about $900 and $2,000 (U.S. dollars), with an average rate of $ 1,300
per operation. The surgeons are paid a flat $600 per operation. Due to all the
uncertainties in government health care legislation, Shouldice would like to
justify any expansion within a five-year time period.

PLACE THIS ORDER OR A SIMILAR ORDER AND GET HELP FROM A REGISTERED NURSE:)

Click the button below to order this paper AND ENJOY OUR DISCOUNT.

The post How well would the new resources be utilized relative to the current operation? Could the hospital really perform this many operations? Why? appeared first on Premium Nursing Papers.

Welcome to originalessaywriters.com, our friendly and experienced essay writers are available 24/7 to complete all your assignments. We offer high-quality academic essays written from scratch to guarantee top grades to all students. All our papers are 100% plagiarism-free and come with a plagiarism report, upon request

Tell Us “Write My Essay for Me” and Relax! You will get an original essay well before your submission deadline.