houldice Hospital in Canada is widely known for one thing-hernia repair! In fact, that is the only operation it performs, and it erforms a great many of them. Over the past two decades this small 66-bed hospital has averaged 7,480 operations annually. Last ear, it had a record year and performed nearly 7,980 operations. hernia repair operation at Shouldice Hospital is performed by one of the 12 full-time surgeons assisted by one of seven part-time ssistant surgeons. The first operations begin at 7:30 AM each day, Monday through Friday. Surgeons generally take about one hour O prepare for and perform each hernia operation, and they operate on an average of at most four patients per day. This four patient er day limit on the average number of operations performed per surgeon has been found to be the best operating level for the ospital as it take into account time the surgeons need for patient exams and consultations, updating medical charts, writing reports, aveling to professional conferences, vacations, and other times when they are performing other duties or are not available to perform urgeries. A given surgeon may perform more than four surgeries on a given day, but the average cannot exceed four without having dverse effects on overall hospital operations. The surgeons' day ends at 4 p.m. Although hernia repair operations are performed only ve days a week, the remainder of the hospital is in operation continuously to attend to recovering patients. he table below shows the room occupancy plan for the existing system. Each row in the table follows the patients who checked in on given day. The columns indicate the number of patients in the hospital on a given night. CHECK-IN DAY MONDAY BEDS REQUIRED TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY Monday 22 22 22 Tuesday 22 22 22 Wednesday 22 22 Thursday 22 222 22 22 22 22 22 Friday Saturday Sunday 22 22 22 Total 44 66 66 66 44 22 22