Shouldice Hospital Limited Essay Example

Shouldice Hospital Limited Essay Shouldice is a private hospital founded by Dr. Earle Shouldice in Toronto in July 1945. The hospital started out as a six-room nursing home in downtown Toronto. As demand increased for hernia operations, he expanded the facilities to a capacity of 36-beds, which turned into a 89-bed facility after adding a large wing. Dr. Shouldice devised a method called the Shouldice method to increase the efficiency and the overall experience of the surgery and the post surgery recovery period. The hospital specializes on external hernia cases and will not treat internal hernia patients. The method proved to be a big success. In this case, we will analyze the process flow of the hospital, determine the bottlenecks and finally offer recommendations. Background: Dr. Earle Shouldice is a famous operator for his private method of hernia surgery. Unlike normal methods, his way allowed the patient to walk around right after the end of surgery, and move freely at the end of the day. When the number of patients he had increased, he decided to exploit this by founding his own hospital. He died in 1965, but his hospital continued to grow, and at the end of 1982, his hospital had 6850 operations per year. Analysis: Initially, the hospital sends out a medical questionnaire to figure out whether the patient has hernia. If the patient requires the operation, they were sent a confirmation card for the surgery. However, after initial examination at the hospital, some of the patients were found healthy, so they were also sent back. After the examination, an administrative personnel checks the insurance of the patient. We will write a custom essay sample on Shouldice Hospital Limited specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Shouldice Hospital Limited specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Shouldice Hospital Limited specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Then, a nurse takes blood and urine samples from the patient, and sends the patient to his room. All this is done by 5PM, after which there is an information session regarding the operation. The patients are sent to bed at 9:30PM, and waken up at 5:30AM. The operation takes 1 hour (although the recurring ones take up to 90 minutes, but theyre rare so are not included). The patient then stays in the hospital for 3 more days, but since the resource (nurse, doctor etc) requirements would be low (and are not stated in the case). Shouldice was successful because of the following strategies: 1) Unique and well defined surgical procedure (cannot be varied), 2) Operation and recovery time lower than industry average, 3) Educated, experienced, and efficient surgeons (600 surgeries per year as opposed to 25-50), 4) Lower nurse to patient ratio (reduces costs), 5) Efficient, good quality, and uniform service (dependable), 6) High demand from reputation, 7) Higher pay than union standard for employees, 8) Being selective with patients ensures speed and better outcomes The bottleneck of pre-operation is Insurance check, as shown in Exhibit 2. The second bottleneck is the number of surgeons available to perform surgery and keep patients flowing through the system. Once people have a place in the system, the next wait is for a surgeon to become available. Bottlenecks are both a burden and a blessing in this scenario. We build up a queue because people want the service but we are forced to find a way to alleviate the pressure on the bottlenecks. Recommendations: Simply adding capacity may upset the current balance that exists and lower the quality of the process. If the company would simply expand to add beds or create more hospitals, quality would eventually be lowered because you would be hiring doctors you would have eliminated for the first hospital. One possible improvement to the process would be to minimize idle time of surgeons spend doing anything other than surgeries. Since they are a bottleneck, Shouldice should make surgeons not waste time doing a job that a nurse or someone with a less important role can do. This way throughput rate is lowered because surgeons can get more operations done at the end of the day without affecting the systems balance. Another solution to improve throughput without physically expanding would be to include working on Saturday and Sunday. Shouldice can rearrange its resources to keep the hospital running weeklong. This would alleviate the burden on the bottleneck so that buildup is minimized and more patients are put through the process. One of the major limits to expansion is the number of beds available for patients. Therefore, a possible area of capacity expansion is creating an additional facility where more beds can be put for patients. But  to accommodate the increased amount of demand a bigger kitchen and a dining room would be necessary. Moreover, an additional staff should be hired as long as the amount does not exceed the current staff per patient ratio in order to keep the operational costs from increasing too much. Another limiting factor is the number of doctors. Thus, the more doctors there are, the more patient acceptance will be. However there would be a limit on the amount of additional surgeons hired since each surgeon should at least perform three surgeries a day. Additionally, having a new facility outside of Canada dealing on a different specialty is a good option for capacity in which case a careful analysis should be done to make sure that the successfulness of the additional facility is not lower then the original one. Exhibit 1: The process flow chart is attached. Exhibit 2: Examination ? 17. 5 minutes per patient X 6 ? 20. 57 Patients per Hour Insurance ? 10 minutes per patient X 2 ? 12 Patients per Hour Blood/Urine ? 7. 5 minutes per patient X 2 ? 16 Patients per Hour.

An observation report discussion about the behavior of a Siamas (Hylob

An observation report discussion about the behavior of a Siamas (Hylobates Syndactylus) Specie: Hylobates Syndactylus Order: Primate Diet: fruits, leaves and insects Location: Zoo Negara Time: 12pm- 3pm Date: 05 February 2010 Colour: Black Gender: Male I visited Zoo Negara Negara to observe the Siamang which is a gibbon. Siamang has a large inflated larynx sac which looks grey in colour which it uses to make loud sounds and is located right below its chin. It usually makes the sounds in the morning. It is categorized as an ape because, it has no tail and is very intelligent. It is similar to other gibbons in the sense that it has ischial callosities which is the horny pads on its buttocks which are very tough. I was mainly interested in observing its interaction with me and other humans, also with its neighboring animals, which was placed right next to its cage in both the left and the right side, the cage was next to other gibbons, the one on the left was the same type of species called Hylobates Syndactylus and it looked like as if it was a mother and her child. The other one in the right was a genus Hylobates ape which was also a mother and her child. I also wanted to observe how it shows that it was desperately in need of food, the way it excrete, its facial features and body signals. I prepared everything that I needed to carry out the observation. I took a pen and my new diary which I used to record everything that I saw the gibbon doing that was applicable to what I specifically wanted to observe. At first I had assumed that the zoo cage would not be that much well facilitated and to my surprise I was wrong. As I approached the Siamang cage, there were trees inside the cage, robes that was hanging from different position and there were some that was designed like a swing so that the animal can play around in the cage. Above the ground, next to the tree branches was a bed designed like a swing which looked like it was his resting place. At the end of the cage there was a cemented place where there were holes on the wall to insert its food. When I arrived it was setting down but immediately when it saw me, it came running towards me and held the fence with both hands and attached its legs to the fence. When it noticed that I was eating pop corns, it started licking its left hand and its mouth widely open and touched its lower jaw from the inside with its left hand fingers. It then reached out its left hand out of the fence with its fingers fully stretched. I ignored it and it ran to its food placement to check if the workers have placed any food for it and luckily after a long search it came back with a banana. It was walking with both of its hands lifted up with its fingers facing down. It was looking at me when it climbed on to a tree to eat. It heard the sound of my pop corn plastic and it came running to beg again. I ignored it again. It then began lick its hands again and started eating fresh leaves which it cut from the plant just next to its cage. It detached a branch from the plant and held it with its hands and legs while sitting down and ate the leaves with its mouth. It then started to shake both hands when it finished and sat down for some time. Then I cut leaves from the plant and threw them near its cage and it was watching me and the leaves on my hand. It watched where they fell first, the two of them and when it saw that I have stopped, it then searched for them and ate them one at a time. When searching for the leaves, it actually searched close to where they fell. After it finished eating the leaves, it saw its neighboring apes eating their food, it ran to watch them and after a while went to check if its own food

Free Essays on Minimum Driving Age

As most may already know, Alabama is considering altering the requirement for attaining a driver’s license. The alteration would mean that all teenagers would have to wait to get their license until they are eighteen, opposed to sixteen. â€Å"According to the American Academy of Pediatrics, 16 year olds are more than 20 times as likely to have a crash as other drivers. For every million miles driven, 16 year olds have 43 crashes. While other a driver over 19 have only 5 crashes. (Lynn, 48-51.) For example, in Europe the driving age is 18, New Jersey makes teenagers wait until 17; six other states allow 14 and 15 year olds to get licenses and 43 other states permit16 year olds to drive alone. (Lynn, 48-51.) â€Å"These new laws, called â€Å"graduated licensing laws† are catching on all over the world. Six months after its graduated licensing laws went into effect; New Zealand’s driving fatalities for 15-17 year olds dropped by nearly one third. This is how the new graduated licensing laws work: Beginning drivers have to â€Å"graduate† through stages of â€Å"restricted driving† before they are allowed to get their unrestricted adult licenses (Lynn, 49). In Kentucky a prospective driver must be at least 16 years old to get a permit and any licensed driver may provide supervision. Also, a learner’s permit must remain in effect only a month before full licensure. (Ellers, 1B.) In Hartford Connecticut under one bill, teenagers could not obtain learners’ permits or driver licenses until they turn 17 years old. Even after obtaining a license at 17, teenagers could only drive from 6a.m. to 11p.m. until they turn 18. It seems as though most teenagers have the same feelings as Tim Marciniak expresses in this statement, †I just think they keep raising the age because society sees us as corrupt. I think the media portrays us as being negative. It’s always something negative toward teenagers. They never show the good we do, society-wise.... Free Essays on Minimum Driving Age Free Essays on Minimum Driving Age As most may already know, Alabama is considering altering the requirement for attaining a driver’s license. The alteration would mean that all teenagers would have to wait to get their license until they are eighteen, opposed to sixteen. â€Å"According to the American Academy of Pediatrics, 16 year olds are more than 20 times as likely to have a crash as other drivers. For every million miles driven, 16 year olds have 43 crashes. While other a driver over 19 have only 5 crashes. (Lynn, 48-51.) For example, in Europe the driving age is 18, New Jersey makes teenagers wait until 17; six other states allow 14 and 15 year olds to get licenses and 43 other states permit16 year olds to drive alone. (Lynn, 48-51.) â€Å"These new laws, called â€Å"graduated licensing laws† are catching on all over the world. Six months after its graduated licensing laws went into effect; New Zealand’s driving fatalities for 15-17 year olds dropped by nearly one third. This is how the new graduated licensing laws work: Beginning drivers have to â€Å"graduate† through stages of â€Å"restricted driving† before they are allowed to get their unrestricted adult licenses (Lynn, 49). In Kentucky a prospective driver must be at least 16 years old to get a permit and any licensed driver may provide supervision. Also, a learner’s permit must remain in effect only a month before full licensure. (Ellers, 1B.) In Hartford Connecticut under one bill, teenagers could not obtain learners’ permits or driver licenses until they turn 17 years old. Even after obtaining a license at 17, teenagers could only drive from 6a.m. to 11p.m. until they turn 18. It seems as though most teenagers have the same feelings as Tim Marciniak expresses in this statement, †I just think they keep raising the age because society sees us as corrupt. I think the media portrays us as being negative. It’s always something negative toward teenagers. They never show the good we do, society-wise.... Free Essays on Minimum Driving Age As most may already know, Alabama is considering altering the requirement for attaining a driver’s license. The alteration would mean that all teenagers would have to wait to get their license until they are eighteen, opposed to sixteen. â€Å"According to the American Academy of Pediatrics, 16 year olds are more than 20 times as likely to have a crash as other drivers. For every million miles driven, 16 year olds have 43 crashes. While other a driver over 19 have only 5 crashes. (Lynn, 48-51.) For example, in Europe the driving age is 18, New Jersey makes teenagers wait until 17; six other states allow 14 and 15 year olds to get licenses and 43 other states permit16 year olds to drive alone. (Lynn, 48-51.) â€Å"These new laws, called â€Å"graduated licensing laws† are catching on all over the world. Six months after its graduated licensing laws went into effect; New Zealand’s driving fatalities for 15-17 year olds dropped by nearly one third. This is how the new graduated licensing laws work: Beginning drivers have to â€Å"graduate† through stages of â€Å"restricted driving† before they are allowed to get their unrestricted adult licenses (Lynn, 49). In Kentucky a prospective driver must be at least 16 years old to get a permit and any licensed driver may provide supervision. Also, a learner’s permit must remain in effect only a month before full licensure. (Ellers, 1B.) In Hartford Connecticut under one bill, teenagers could not obtain learners’ permits or driver licenses until they turn 17 years old. Even after obtaining a license at 17, teenagers could only drive from 6a.m. to 11p.m. until they turn 18. It seems as though most teenagers have the same feelings as Tim Marciniak expresses in this statement, †I just think they keep raising the age because society sees us as corrupt. I think the media portrays us as being negative. It’s always something negative toward teenagers. They never show the good we do, society-wise....

Akindele Owolabi Essays (1010 words) - Free Essays, Term Papers

Akindele Owolabi Essays (1010 words) - Free Essays, Term Papers Akindele Owolabi Jovonne Bickerstaff English 104-25 November 30, 2015 Ebola in Africa The social issue that I am presenting is Ebola in west Africa. Ebola is a dangerous disease that affected the world population as a whole, and it struck the hardest in West Africa. This was extremely bad because the countries in west Africa have some of the lowest gross domestic products per capitas in the world. This means that they have a lack of means to treat people when they get the disease. Taking into consideration the lack of treatment for the virus and how contagious it is, it's easy to realize why this virus became a pandemic. People were dying at such high rates that the available treatment in western Africa could not keep up with the rate at which people were getting infected. This became a major concern for me because although I no longer live in Nigeria, my grand-mother, uncle, father, and other family members still live in the first infected city of Nigeria. The part of my multi-modal assignment that would be considered the "respectable" portion was a documentary done by Vice news. The documentary took place in Liberia: the start up location for the new cases of Ebola. The documentary definitely puts the issue into perspective by showing it from the outside looking in, as well as the view point of the actual citizens of Liberia. I put certain excerpts from the documentary into my project that I thought held value. The first one was Barack Obama giving a speech about how dangerous Ebola can be and that it is spreading rapidly all around the globe. I also included some interviews that the journalist did in that same documentary where he interviewed the people of the country of Liberia. The journalist asked a man how he feels about the current situation and he responded saying that it is sorrowful that his people are just dying on a daily basis. Also included is the note that there is a complete shortage of medical professionals and he althcare facilities to treat this disease. The people call ambulances and police and get no reply. Their people are just left to die. When someone is infected in the community, they have nowhere to go, being forced to stay in their community. This is the main cause of the disease spreading. That's the main aspect of the documentary; it tells specifically what the diseases is, how hard it is to treat, and how fast the people that are infected are dying. The song portion of my project, or the "ratchet" part is a song made by a native of Liberia that goes by Shadow. The name of the song is Ebola in town. The song is written partly in pidgin English, so it might be a little difficult to understand for some. The main point of the song is that Ebola is highly contagious. The song is supposed to be sort of a comical song stating the facts about Ebola. Some lines are that "Ebola can kill you fast, no touching your neighbors, no eating bush meat like bat and monkey meat" because they tend to have the virus in them. The song also says you can't run from it. You can go to Guinea but the virus is still there. Everywhere you go the virus is there. I feel like the documentary and the song add important aspects to one another. The documentary is more for outsiders and non natives that aren't aware of the situation going on in west Africa and the song is clearly made for natives considering the fact that the artists uses pidgin English. The song also shows the how some Liberians see the disease. Below I have written the lyrics of the song so if its hard to understand, you can follow along with it. Please enjoy! Something happen Something in town Oh yeah the news I said something in town Ebola Ebola in town Don't touch your friend! No touching No eating something It's dangerous! Ebola Ebola in town Don't touch your friend! No kissing! No eating something It's dangerous! (Repeat) I woke up in the morning I started hearing people dem yelling "Da what thing happen?

Case study Example | Topics and Well Written Essays - 1000 words - 17

Case Study Example Labor standards cost is another bottleneck as it is high. Maintenance of the machinery requires people to do the work. These people consume funds that drain the company (Truckseat Case Study, 3). The production line is a bottleneck in the sense that the cost of raw materials has increased by double digits. This impacts negatively on the company has the company is forced to pay more for materials that previously cost less. At the same time the quality of products produced are below the customer expectations. When customer expectations about the product are lowered, loyalty becomes elusive (Truckseat Case Study, 3). The bottlenecks drain the company immensely. The reason for bottlenecks is because when the company does not make maximum gains from the products while spending as much to settle labor cost, maintenance of machines not to mention the quality of the products. Bottlenecks are eminent in the delivery section as well. Case in point is that there is no clear determination as to when products should be made and availed to the customers. Consequently, there is a disconnect in the sense that there is no proper market survey to establish demand and supply chain. So in essence, what happens is that sometimes products are sometimes manufactured and not delivered for the simple reason that there is no ready market to have the goods. Another bottleneck arises when the customers are in need of the products but the production levels are low. This happens due to poor forecasting of the market to determine market needs and wants. The level of customer satisfaction is below average in the sense that the quality is not up to the standards expected by the clients. The qualitative analysis figures are in the appendices. 2. Stocks can be an effective lever to remove the bottleneck: select where (along the production flow) to position the decoupling  point: Compare different feasible alternatives of decoupling

Community Involvement Program Essay Example | Topics and Well Written Essays - 250 words

Community Involvement Program - Essay Example Community Academy Public Charter Schools (CAPCS) and Northwestern University have implemented community involvement programs as part of the learning process. CAPCS incorporates parent involvement in teaching young children at the elementary level. The Amos 3 campus at CAPCS provides early childhood programs that give children a firm academic career foundation (CAPCS, 1). The program focuses on basic concepts of math and reading as part of educational introduction. Social development, respect, good behavior, and passion for learning are promoted at the campus. Parents team up with teachers and administrator to assist the development process. CAPCS has been successful by concentrating on science and technology to emphasis hand-on problem solving skills. Children learn critical thinking and problem solving and acquire basic knowledge required in all academic fields. This has been instrumental in preparing children academically and socially before venturing into secondary school, which h as led to successful academicians from Amos 3 campus (CAPCS, 2). Northwestern university has several programs within their community involvement program that provides students with local and international opportunities. The Applied Medical Society provides events targeting students with interest in healthcare provision. Participants learn basic skills such as CPR in these events (NU, 1). Campus kitchens employ volunteer students who learn the process of recycling un-served food into nutritious meals for seniors, community organizations, and youth programs. Graduates and undergraduates also participate in exchange and capacity building programs with cohorts from over 50 universities in over 40 countries. These workshops provide mentorship and prepare students for career opportunities. Most activities are centered on students and there is little participation from parents. The program prepares students for career ventures and student organizations within the campus have been instrumental in the success of the community involvement program.

Sociology - analysis on social class Research Paper

Sociology - analysis on social class - Research Paper Example The upper class consist of the elite and aristocratic people , an upper middle class consist of highly educated and wealthy professional, a lower- middle class are those doing white collar jobs , working class are those with clerical jobs and poor are the underprivileged and unemployed lot. The life style of people drastically deviates according to their status and power. Their spending power and habits are enormously different and a comparison is less possible. It can be seen that upper class people find enough time for leisure activities and pastimes whereas the poor class hardly have means to survive. People of the upper class have the habit of reading as they are well educated but the poor are not of the habit of reading much. Even though reading materials are at large which cater to the rich and the poor? The magazines and books which the elite read are more parallel with their life style and activities. The business men and women are more loyal to magazines which elaborate on business news and political scenario of the globe. Business people are all time indulged in their profession and when find time they are interested in flipping through the pages of magazines which give a glimpse about business activities and financial updates. Forbes is one of such magazine which has acclaimed to be at the top list for its quality and high demand among the elite class. â€Å"Forbes has some of the best financial articles Ive ever read. The articles are deep, academic, and extremely well thought out†(Schlimmer ,2007). This magazine covers very well the financial and business news and that attracts the men in the upper class. The magazine also gives latest update on the rich list and powerful people in the society which is a big concern of the elite class. Forbes magazine gives a great insight to the industrialist with relate to the investment and stock market. It is a very trusted