The Focus Factory


( Picture of Shouldice Hospital in Ontario)

Every person in our class for sure would have had his or her favorite class of the year. As I went to bed last night, I was reflecting on the classes that we attended over the past three stages and wondered if there was a class that had the most impact on me. I didn’t have to think for long. It was an easy decision!

Over the past few months, we have been exposed to several classes and we have enjoyed attending them. Some of the classes had an "Aha" or a "Wow" effect on us. There were Profs, who bcoz of their excellent teaching style kept the class always involved and interested. And hats off to them for that!

Today, I write about the class that I really loved attending. After attending this class, I just had one thing to say to myself "This class was worth traveling all the way from India to Canada .This class was value for money”

I am talking about the Shouldice Hospital Case in the Operations Management subject. The case is an interesting example of "focused service delivery" system. I enjoyed reading the case. Our team had to come up with three issues and recommendations prior to the class based on the data in the case. On the day of the class, Prof Roman simply amazed me. First, he showed us the "line of sight" , the theory that service companies should adopt.. Then he talked about the "focus" that the Hospital displays and lastly showed us a wonderful documentary on how the Shouldice Hospital operates. And the best part was that we had a guest - The Business Development Manager of the Hospital analyzing our recommendations and presenting his views on that.

Why did I like this class a lot ? As I reflect, I think there are three key reasons for it.
a) I like the concept of Shouldice Hospital and its approach on focus service delivery
b) I loved the documentary that was shown by Prof Roman. Shouldice is not just another hospital. There is a community feeling out there among the patients. The culture existing in the organization is difficult to replicate. I had a good laugh when I saw that the Hernia patients even have a reunion every other year. The video showed how people with the same pain gelled together.
c) I liked the way the Business Development Manager from Shouldice presented his views, answered our questions and worked through our recommendations.

Of course, Prof Roman is one of my favorite professors, and I really admire the way he teaches. I later got to know that the Shouldice Case is one among the Harvard's bestseller case-study list. Here is an interesting article on the Shouldice Hospital that appeared in Globe and Mail a few years ago. I loved attending this class!

Some excerpts from the article:

"The Shouldice model of service delivery has helped train hundreds of thousands of future managers in about 500 business schools. The hernia repair process is part of the basic toolkit on customer service that the world's senior executives carry to the corner office.

In fact, Shouldice's reputation as an executive learning tool rivals its medical stature. "I've maintained that the hospital will not be famous for hernias in 50 years--it will be famous for its service delivery model," says Daryl Urquhart, the private, non-profit hospital's director of business development.

What it teaches are the benefits of doing one thing extremely well and building all processes and infrastructure around achieving that result. In Shouldice's case, the "product" is a three-day admission-to-release process that puts gimpy-groined customers on their feet and back to normal as quickly as possible. ......Everything about the hospital is designed toward that end. Shouldice believes recovering hernia patients should walk around. Thus, there are no televisions or telephones in patient rooms.Meals are not taken to the rooms but provided in a central dining area, for which access requires some traversing of stairs. But the stairs are built with lower risers than normal, and the extensive grounds are gently sloped for easy walking. What's more, the participation of patients in their own recovery cuts Shouldice's costs for things like service to rooms and one-on-one physiotherapy.It is, in essence, a hernia factory. Harvard calls it "a focused factory," which gives the case a relevance that extends beyond health care and customer service and into manufacturing and processing.

Mr. Psellas first learned about the case in Queen's adjunct professor Paul Roman's operations management class last summer. In the past decade, Mr. Urquhart, whose family still owns the hospital, has taken to visiting MBA classes in major business schools to provide personal testimony. He now makes up to a dozen class visits a year, as well as several teleconferencing appearances.

The effort clearly pays off. The study asks students to suggest strategies by which the hospital can expand beyond current capacity, and various options are suggested, such as diversifying into other procedures or going global.Yet the hospital remains a single-purpose hernia factory with the same 89 beds as 25 years ago -- although it has been able to increase the number of patients per year.

Harvard's bestseller case-study list

1. Lincoln Electric Co., published in 1975.
2. Benihana of Tokyo, published in 1972.
3. Wal-Mart Stores, published in 1994.
4. Shouldice Hospital, published in 1983.
5. Sealed Air, published in 1982.
6. People Express, Case A, published in 1983.
7. Optical Distortion, Case A, published in 1975.
8. Caterpillar Tractor Co., published in 1985.
9. Cumberland Metal, published in 1980.
10. Toyota Motor Manufacturing USA, published in 1992.