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CASE: SHOULDICE HOSPITAL – A CUT ABOVE7

`Aquote fromAmerican Medical News`

`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.`

the shouldice experience

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

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

future plans

`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...