# Case Study: Shouldice Hospital-A Cut Above How well is the hospital currently utilizing its beds

## Case Study: Shouldice Hospital-A Cut Above How well is the hospital currently utilizing its beds

Case Study: Shouldice Hospital-A Cut Above

1. How well is the hospital currently utilizing its beds?

90 beds x 7 days a week= 630 available beds

30 patients x 3 days x 5 days a week= 450 utilized beds

450/630 = 71.43%

71.43% of the hospital’s beds are being utilized.

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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?

 Monday Tuesday Wednesday Thursday Friday Saturday Sunday Monday 30 30 30 Tuesday 30 30 30 Wednesday 30 30 30 Thursday 30 30 30 Friday Saturday 30 30 30 Sunday 30 30 30 Total 90 90 90 90 60 60 60

90 beds x 7 days a week= 630 available beds

30 patients x 3 days x 6 days a week= 540 utilized beds

630/540 = 85.71%

85.71% of the hospital’s beds are being utilized if you add operations on Saturday. The hospital’s capacity is sufficient to accommodate the additional patients.

3. Now look at the effect of increasing the number of beds by 50%. 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.)

If you increase the number of beds by 50%, 90 beds will turn into 135 beds available daily. Shouldice hospital can perform 45 operations per day before running out of bed capacity. The 50% increase in beds would mean that 45 surgeries are needed Monday, Tuesday, Wednesday and Thursday to fully utilize facilities 4 days a week. If 30 operations are performed each day in 5 rooms, then 6 are performed in each room. In order to perform 45 operations each day the rooms will need to be occupied 9 hours a day or more rooms will be added. Shouldice will need more operating rooms to perform this many operations.

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. How would you do that?

## Shouldice Hospital Case Paper Expert Answer

1. ) How well is the hospital currently utilizing its bed? 90 beds x 7 days/ week = 630 beds available in a week 30 patients x 3 days x 5 days per week = 450 beds utilized 450 beds utilized / 630 available beds = 71. 43% The hospital is currently utilizing 71. 43% of their beds, this is actually an ideal operating point. To increase its rate of utilization might decrease the service quality. 2. ) Develop a similar table to show the effects of adding operations on Saturday. (Assume that 30 operations would still be performed each day. ) Check-in DayMondayTuesdayWednesdayThursdayFridaySaturdaySunday Monday303030.

Tuesday303030 Wednesday303030 Thursday303030 Friday303030 Saturday Sunday303030 Total60909090906060 How would this affect the utilization of the bed capacity? Is this capacity sufficient for the additional patients? 90 beds x 7 days/ week = 630 beds available in a week 30 patients x 3 days x 6 days per week = 540 beds utilized 540 beds utilized / 630 beds available = 85. 71% Adding operations on Saturday will improved the utilization rate of beds from 71. 43% to 85. 71%. It is still sufficient; however, we might risk the service quality. 3. ) Now look at the effect of increasing the number of beds by 50%.

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). 90 beds x 1. 50 = 135 beds 135 beds x 7 days = 945 beds available in a week 945 beds / 3 days x 5 days in a week = 63 operations per day The hospital could perform a maximum of 63 operations per day if the beds are increase by 50%. How well would the new resources be utilized relative to the current operation? 30 patients x 3 days x 5 days per week = 450 beds utilized 135 beds x 7 days = 945 beds available in a week

450 beds utilized / 945 beds available = 47. 62% With the current operation, the utilization rate would only be 47. 62% if the beds would be increased by 50%. If we would add additional beds, we also need to accept more patients to fully utilize the investment. Could the hospital really perform this many operations? Why? (Hint: Look at the capacity of the 12 surgeons and the five operating rooms. ) Operating room maximum capacity: 8 operations (7:30- 4:00) (one operation per hour) x 5 operating rooms = 40 operations 12 surgeons x 4 operations per surgeon = 48 operations 7 assistant surgeons x 4 operations per surgeon = 28 operations.

The case states that surgeons operate on 4 patients per. If surgeons means all the full time surgeons only, we have a maximum of 40 possible operations; thus the 30 operations per day is feasible. However, if we would include the part-time surgeons as surgeons that operates 4 patients per day, only 28 operations is feasible. 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, with an average rate of \$1,300 per operation. Due to all uncertainties in government health care legislation, Shouldice would like to justify an expansion within a five-year time period. Option 1 – Add 50% more beds Investment cost in adding 50% more beds : 45 beds x \$100,000 = \$4,500,000 Revenue: Maximum of 40 operations per days (maximum capacity for 5 operating rooms) x 5 days per week x 52 weeks per year = maximum 10,400 operations per year 10,400 operations x \$1,300 = \$13,520,000

Surgeon cost: (Assuming \$600 for the full-time surgeon, payment for assistant surgeon is not given /included. ) 10,400 operations x \$600 = \$ 6,240,000 Maximum Annual Profit = \$7,280,000 For five years = \$36,400,000 Five years profit less the 45 beds investment = \$31,900,000 Option 2 – Add 1 more operating day (Saturday) Revenue: Maximum of 40 operations per days (maximum capacity for 5 operating rooms) x 6 days per week x 52 weeks per year = maximum 12,480 operations per year 12,480 operations x \$1,300 = \$16,224,000.

Surgeon cost: (Assuming \$600 for the full-time surgeon, payment for assistant surgeon is not given /included. ) 12,480 operations x \$600 = \$ 7,488,000 Annual Profit = \$8,736,000 Five years profit = \$43,680,000 Recommendation: “With 90 beds and the current operation, the hospital is doing well. Their existing system and reputation have already set them apart as a market leader and has proven to be a profitable setup. However, there is still an unmet demand. Option 1 to add 50% more beds may not be beneficial if we don’t also increase operation.

Increasing the number of bed by 50% would not be advisable unless they would add more surgeons and operating rooms because the existing operating rooms capacity and number of surgeons could not fill an addition of 45 beds. They would be operating the surgery rooms at over capacity. Option 2 that involves adding one more day of operation is also valid as it would utilize resource capacity. However, adding a Saturday can also have a negative impact on the work force that drive down the service quality that gives the hospital a competitive advantage. This could be offset by hiring addition staff and consequently adding operating rooms.

Adding more surgeons only and thinking they could extend operating hours beyond 4:00pm to fully utilized operating rooms is not a good option as this may disturb the scheduled dinner at 6:00pm. This get-together by patients is a major factor that contributes to the hospital’s success. ” Between the two options given, option 2 to add one more operating day is more profitable. I would recommend combining the two options plus hiring more staffs and adding more operating rooms. However, due to limited information given by the case. We can’t compute if this option is indeed more profitable than the rest.

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