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Octubre 01, 2005

Caso de estudio: Shouldice Hospital Limited

Shouldice Hospital, a Canadian facility that performs hernia operations only, has developed procedures to maximize surgical success rates, save patients money, and speed their recovery in a friendly, noninstitutional environment.

Shouldice Hospital.gif

The hospital specializing in hernia operations is considering whether and how to expand the reach of its services. Various proposals are set forth for expanding the capacity of the hospital. In assessing them, serious consideration has to be given to the culture of the organization and the importance of preserving it in a service delivery system. In addition to issues of capacity and organizational analysis, describes a well-focused, well-managed medical service facility that may well point the way to future economies in the field.

The hospital's advertising consists of word of mouth, and Shouldice's popularity is such that former patients ("alumni") return by the hundreds for reunions.

The hospital has a backlog of prospective patients awaiting surgery, and the case sets forth various proposals for increasing its capacity. In considering change, the importance of the organization's close-knit culture—built around quality service, attention to patients, and an attractive work environment for doctors and staff—must be taken into account.

"I read a short magazine article about Shouldice in 1982, and it nicely illustrated excellence in the delivery of a service," explains the case's author, HBS professor James Heskett. "I knew we had a good story, and when I learned that Shouldice management had discussed the capacity question, it was clear we had a core issue that could be teachable in the classroom". (Indeed, aspects of the case were sometimes a bit too gripping for a few students: Heskett recalls that after a television report on Shouldice became a regular part of the case's classroom presentation, students would occasionally faint during some of the surgery scenes.)

Heskett says studying Shouldice helped him conceptualize the strategic-service vision that he and HBS colleagues would develop into a framework for success for service firms. "The case endures," he declares, "because the mission of Shouldice has remained constant and because Shouldice has inspired other focused medical ventures. More broadly, it is a dynamic illustration of concepts still critical to service-management success".

Like Heskett, HBS professor Regina Herzlinger cites Shouldice as an important intellectual stimulus, helping her develop innovative ideas about consumer-driven health care. "By showing the positive impact of making health care more consumer-oriented, Shouldice has helped recraft thinking about the field," Herzlinger says. In her course Innovating in Health Care, she uses the case to illustrate a medical "focus factory," emphasizing that focus without Shouldice-like consistency and execution is not enough.

One of her favorite aspects of the case is what happens after surgery. "Shouldice believes that walking early and often is a key to postoperative recovery," Herzlinger observes. "So there are no bathrooms, nor meals served, in the rooms. You have to walk to satisfy your basic needs. Your recovery—indeed, the entire Shouldice experience—is advanced by such fundamental inducements, as well as by attractive ones, such as the beautifully landscaped grounds that encourage patients to be ambulatory".

Shouldice Hospital facility.jpg

Study Questions:

1. How do you account for the performance of this organization?

2. Specifically, what decisions would you make concerning a) the possible addition to the hospital of rooms for 45; b) the addition of a Saturday operating schedule to the clinic; c) the development of a new self-contained "branch" of Shouldice; and d) the development of a new specialty medical service? Why?

Fuente: HBS Working Knowledge, "Classic Cases Live on at HBS"

Más información en la página del Shouldice Hospital.

Jorge Fernández | Comentarios (0) | Categoría: Casos de estudio
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