1 Model Shouldice Hospital as a processing operation with products, attributes and resources.
2 What are its competitive priorities?
3 What kind of market has it chosen to focus on?
Shouldice Hospital follows the business model of focus on a single standardized service for a narrow target of consumers, rather than to provide customized solution (as in a general clinic or hospital). It focuses on providing quick, convenient, and reliable cure for external types of abdominal hernias. The Hospital uses its own technique, called the Shouldice Method and claims to provide relatively short post-operative recovery period.
Shouldice Hospital focus on hernia repair surgery which is mostly performed on males. Shouldice operation strategy involves early ambulation following hernia repair surgery that was superior to others. Only external kind of abdominal hernias were repaired at Shouldice Hospital. Internal types, such as hiatus (or diaphragmatic) hernias were not treated. First time repairs (primaries) of hernias involved straightforward operating procedures that required about 45 minutes. Such cases represent 82% of all operations and remaining were patients suffering recurrences of hernias previously repaired elsewhere. The market was targeted by providing following services
1) The hospital promised early ambulation following hernia surgery. The hospital facility was designed to encourage movement without unnecessarily causing discomfort. Postoperative regimen designed and communicated by the medical team to patients
2) The Hospital provides free services to the clergy and parents of hospitalized children. Hospital provides annual checkups free of charge to its alumni mostly occurred at the time of the annual reunion.
3) The pa...
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...o the patient been examined by surgeon for 15-20 minutes.
3) After examination, patient wait for another 5-15 minutes so see one of two admitting personnel.
4) Health insurance coverage checked and various details are discussed for 10 minutes.
5) Patient sent to nurse's station for blood and urine test (5-10 minutes) with little wait.
6) At 5:00 PM, nurse orientation provided to patients
7) Dinner server from 5:00-6:30 PM.
8) Recreation and then cookies served at 9:00 PM and tucked in bed between 9:30-10:00 PM.
9) Patient to be operated on early in the day were awakened at 5:30 AM.
10) Patients taken to pre-operating room 45 minutes prior surgery
11) A few minutes prior to first operation at 7:30 AM, the surgeon assigned to patient administer local anesthesia.
12) Arrange for the administration of Demerol to the patient scheduled next on the operating table.
Pre-Op begins momentarily, where the patient meets with nurses, surgical technicians, Dr. Todd, and the anesthesiologist to discuss the operation and go over any new concerns or questions the patient may have. They will be hooked up to an IV where the anesthesiologist with administer the local anesthesia before Dr. Todd begins to operate.
The patient was identified every time they were transferred to a different section of the unit. The admission nurse began the process by asking the patient to state their full name and date of birth to prove that the correct client was being admitted. The nurses in the operating room identified the patient for the second time and clarified with the patient what procedure was being performed. The patient was identified for the third time in the recovery room. The procedure was specified again and the interoperating nurse voiced any complications that occurred during the procedure with the recovery
This could be due to the particular patient's situation or to the type of medical procedure being done. If the surgeon uses a local anesthetic, no modifier is required. If the surgeon uses a general or regional anesthetic, Modifier 47 is used to distinguish this difference.
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Although there is meticulous effort by nurses and other health care professionals in ensuring patient recovery after surgical procedures, many patients experience complications. These post-operative complications include, but are not limited to, wound infection, atelectasis, postoperative ileus, embolism, and deep vein thrombosis. This paper will specifically look at atelectasis, the collapse of lung alveoli due to airway obstruction, and post-operative ileus, the cessation of gastrointestinal movement preventing passage of its contents (Lewis et al., 2014). The purpose of this paper is to provide a greater understanding of the experience of hospitalization for surgical patients by focusing on the two post-operative complications, atelectasis
Shouldice believes that it is important for patients to feel comfortable, like they are at home; they do not want the hospital to feel like a hospital. The facility is full of common spaces for patients to socialize and be active. . These are important pieces to achieving the strategy because if patients are comfortable in their environment, they are more likely to be social, and therefore more like to be active and progressive towards healing.
After surgery, they monitor the patient to see if there are any problems while they are coming off an anesthesia (Nurse Anesthetists, Nurse Midwives…) If there are no problems the surgery will be deemed as successful, and the nurse anesthetist will report all findings to the
The Hospital has a capacity of 89 beds. There are 5 operating rooms where 33 to 36 operations are performed on an average day. The Hospital follows a 5 day week. It employs 12 full-time surgeons, 7 part-time assistant surgeons, and one anaesthetist. The nursing staff consists of 22 full-time and 18 part-time members. An operating team consists of a surgeon, an assistant surgeon, a scrub nurse, and a circulating nurse. A surgeon's typical day begins at 7:30 A.M. and ends by 4:00 P.M. Each surgeon typically performs 3 to 4 operations each day.
The first procedure, hemorrhoidectomy, which is the removal of hemorrhoids, the OR nurse was a traveling nurse from Alabama. In the preoperative role, his were to prep the site, administer any medication if needed, insert any catherization needed, chart the patients’ status or changes, and get other supplies, if needed. In the preoperative check list, the scrub team counted out the inventory for the supplies. The OR nurse documented what was opened. During the preoperative observation, the patients
Historically (before 1880s), only few hospitals were originated in some big cities of U.S. Initially, the hospital system mainly run by religious organization and it served a primary purpose of palliation. According to Shi and Singh (2010), the function of hospitals at that time was more of “social welfare” (such as taking care of homeless people and helping those without families) than practicing medicine (p.56). Over the years, the functionality and the services offered by the hospitals has changed dramatically. However, it’s primary function to treat sick individuals has remained the same. Nowadays, hospitals also function as a research center, a medical educational institution, and is a major source of employment in the community (Sultz
Stomberg, M., Sjöström, B., & Haljamäe, H. (2003). The Role of the Nurse Anesthetist in the Planning of Postoperative Pain Management. AANA Journal, 71(3), 197.
As a medical surgical nurse you work with your patients before, during, and after surgery. Before surgery you want to explain the procedure to them and help prepare...
In relation to a perioperative client, the goals include the use of two correct patient identifiers, such as the client name and date of birth, labeling of medication and containers, maintaining and communicating information accurately on client medications, and lastly using evidence-based practices to prevent surgical infections. Performing the client verification by each member of the team will ensure that the correct client and procedure match. In the surgical setting, the use of labeled medications and containers is necessary. This follows along the principles of safe medication administration but prevents a medication error. In preventing the error and being safe, we must know what each item in the room is to ensure that the client receives proper medication and or...
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.