1. Shouldice Hospital is a focused factory. Consider the following excerpt from the Harvard Business Review.

"A factory that focuses on a narrow product mix for a particular market niche will outperform the conventional plant, which attempts a broader mission. Because its equipment, supporting systems, and procedures can concentrate on a limited task for one set of customers, its costs...are likely to be lower than a conventional plant. But, more important, such a plant can become a competitive weapon because its entire apparatus is focused to accomplish the...task...demanded by the company's overall strategy. [Despite] their advantages, my research indicates that focused manufacturing plants are surprisingly rare. Instead, the conventional factory produces many products for numerous customers in a variety of markets, thereby demanding the performance of a multiplicity of manufacturing tasks all at once from one set of assets and people. Its rationale is "economy of scale" and lower capital investment. However, the result, more often than not, is a hodge-podge of compromises, a high overhead, a[n] ... organization that is constantly in hot water with ... customers." -- Wickham Skinner in "The Focused Factory," Harvard Business Review, May-June 1974, 113-22.

In what ways does the focused strategy of Shouldice enable them to gain efficiencies in their operations?

2. For these next questions, assume the following:

• Every patient spends 4 nights in the hospital. So, for instance, a patient that is admitted on Sunday morning will leave Thursday morning.
• Patients are only admitted Sunday through Thursday (disregard any other dates mentioned)
• Hernia operations are only performed Monday through Friday.
• The 14 additional hostel rooms can hold only one patient each.
• A patient may stay in a hostel room only on his first night, i.e. before the operation.
• There are only 89 regular hospital beds.
• The surgery teams can collectively perform no more than 37 operations in a single day, assuming operating rooms are available.
• 137 patients are operated on per week. (We calculate 137 patients/week from 6850 patients/year in 1982 with 50 operating weeks/year.)
• 20% of patients require a general anesthetic.

(a) Compute the annual net profit of clinic and hospital operations (separately). The clinic performs operations, and the hospital maintains the beds. Which is more profitable?

(b) Use Little's Law to compute the average number of beds occupied.

(c) Develop a weekly schedule of admittances and discharges that achieves a weekly throughput >= 137 patients without violating any major resource constraints (Throughput needs to be a minimum of 137, but can be higher) Develop your weekly schedule using a table something like the following:

	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
# Admittances
# Departures
# Beds occupied overnight

Note that you should assume that each week follows the same schedule of admittances, departures, etc.