服務管理和運營shouldiceHospital蘇弟斯醫(yī)院案例ppt課件

1、DSE7100 Managing Service Operations Discussion ofDiscussion of Shouldice Hospital Limited Case Shouldice Hospital Limited Case1;.2Assignment #2: Assignment #2: Questions for Shouldice Hospital LimitedQuestions for Shouldice Hospital LimitedHow Successful is the Shouldice Hospital? How do you account

2、 for the success 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 any, would you take to expand the hospitals capacity?1.How would y

3、ou implement changes you propose? 3Patents do not feel that that are staying in hospitalPatients are taking a vocationThis is a clubFocusedHow is Shoudice different from other Hospitals?4How Successful is Shouldice Hospital?140,000 highly satisfied “Alumni”(past patients)1,200 backlog of scheduled o

4、perationsDemand appears to expand with supplySuperior quality Shouldice Method of Hernia operation imitated by competitorLow recurrence rate, 0.80% vs 10%High degree of employee satisfaction5Cost Comparison: Shouldices vs. Other HospitalsShouldiceOthersCosts of typical operations$954 (p9) $2000-4000

5、Transportation$200-600 $0Time Lost from work in Hospital4days5daysTime lost from work while recovering5days10daysValue of time lost (ranging from $50 to 500 per day)$450-4500$750-7500Total before Allowancefor recurrence$1604-6054$2750-11500Probability of Recurrence0.80%10.00%Expected Cost of Recurre

6、nce $13-48$275-1150Total cost to patient, employee and insurer$1,617-6,102$3,025-12,6506How 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+ 60 + 75 X 0.20) X6,850) 3,596,250Cost2,000,

7、000Profit1,596,250Total Profit1,837,6507Return on equityTotal Depreciated Assets: $5 milReturn on Asset:1,837,650/5,000,000 = 37%What is the return on Asset if they expand the capacity by 50% at the cost of $2 mil?1,837,650 x 1.50 / 7,000,000 = 40%8“The Dream World ”Shoudice is offering:high quality

8、 service at low priceShodice is having Highly satisfied customersHappy EmployeesShouldice is alsomaking high profit9How 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 the cost of supplyin

9、g services on the other. 10What 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 RecurrenceIndependence/Dignity/ControlSocial experience, fraternityExcused absence from work without guiltA vocation 1

10、1Market Focusfocus on a narrow segment of potential patients who have hernia andthey are predominantly male, older 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

11、 orientedNurses: people oriented, assist patients Staff: flexible, team oriented12Operating ConceptShouldicce achieves outstanding results as a low price and at a high profit because:Everything done by the hospital is designed to maximize the difference between perceived quality and the value of the

12、 service provided patients on one hand andthe cost of providing the service on the other.13How did they do that?Patients are carefully screenedPatients are active participants in the service delivery processThe avoidance of general anesthestics allows a wide range of involvement of patientsStaff is

13、freed from much disagreeable workReducing the cost of nursing, housekeeping and laundryStructure hospital jobs that involves more counseling and positive interaction with the patients14How did they do that?The Clinic is a focused factory resulting in:Highly productive surgeon: 300 hernia/yr Vs. 30 b

14、y 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 and and advise one another Peer group pressure that leads to higher level of self-control of qualityA consci

15、ous effort is made to make Shouldice a “family”experience15The elements in the service system to support the service Concept (managerial elements) Service encounterDoctors and nurses are carefully recruitedEmployees trained to help / counsel patientsCommunal dinning for doctors, nurses , staff and p

16、atientsQualityadherence to Shouldice methodopportunity for surgeon to observe & advise one another16The elements in the service system to support the service Concept (managerial elements)Managing capacity & demandAdmission by appointment: scheduled serviceScreening patients: easier to estima

17、te the service timewalk-in patients or local residents on waiting list to make up cancelled reservationInformationMedical Information questionnaireFree annual check-up - unique data base on the result of the surgeryAnnual reunion to keep alumni informed and gather customer feedbacks- loyal customer

18、base - effective word-of-mouth17The elements in the service system 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 exercise & rapid rec

19、overy 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 walkingOperating rooms are located in semicircle to encourage doctors to help each other and use the same anesthetist1

20、8The elements in the service system to support the service Concept (structural elements)Locationlarge city near air port - access to worldwide marketlarge local population to fill up cancelled bookingsCapacity planningElective procedures - scheduled operationsBalancing Capacity and improving capacit

21、y utilizationNeeds to increase capacity19The Capacity DecisionWhere is the bottle neck?How should they increase the capacity?How should they implement that change?20Shoudice Hospital Limited: Analysis of CapacityCurrent Throughput6,850 Operations/50 weeks = 137 operations/week ( with a peak of 165/w

22、eek)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 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

23、)/(10 min/patient)=240 patients /week21Shoudice Hospital Limited: Analysis of CapacityCapabilities 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: (see transparenc

24、y)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 use of 14 “hostel” rooms for two nights each week)22How to expand the capacity?Aim : increase capac

25、ity & maintain control of service qualityAlternatives:Add Saturday operationsAdd a new floor (45 more hospital beds)Establish a new facility for herniaExpand to other types of operationsOthers?23Please Help Shoudice to make the DecisionsWhich alternative do you recommend?Why?How do you implement

26、 the solution that you are recommending?24Add 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 / weekAdditional patients per year=(179-137) x 50=21

27、00 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%25Add in a new floor (45 beds)DisadvantagesRequire to schedule doctors to the full capacity of five days per weekIncrease work load on admissions, kitchen, laundry,

28、housekeeping and accountingFurther staggering of meal hours for patients (100 seat dinning room)Disruption during constructionAdvantagesEasy to control and maintain qualityRetain the culture and environment26Schedule Saturday as an Operating DayUse 89 + 14 rooms, 3.5 average stayTotal number of pate

29、nts 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 clinic = 1450 x (450+0.20 x 75) = $674,250 Less cost 124,250 Net increase in profit: 550,000

30、for no additional investment27Schedule Saturday as an Operating DayDisadvantagesRequire to schedule 23-25 operations on SaturdaySix surgeons and a supervising surgeon have to work on SaturdaysAdditional other personnel Violates the implied contract that Shouldice has with its surgeons, strong opposi

31、tion by the senior doctorsOperating close the the theoretical capacity of the facilityAdvantagesNo investment is neededCan still maintain quality28A Second Facility for Treating HerniaAdvantagesNew location close to the customers, say USAImprove its competitive position and increase its profitsOpera

32、te in a less restrictive environmentNew Opportunities for existing personnelTransfer of knowledge and expertise to the new facilitiesDisadvantagesRequires a significant investment and Dr. Shoudices timeControl of qualityIt is difficult to create the same culture and atmospherePotential competition with the existing facility29Discussion QuestionsDescribe Shoudice Hospitals service package. How are the distinctive characteristics of a service firm illustrated by Shoudice Hospital?30Shoudice Hospitals Service PackageSupporting FacilityAcres of g