On the other hand, when the management of the hospitals has a demand social responsibility they could expand its capacity and facility in different models to reach more patients and they will high and great appreciation of the customers for obtaining extra profits. The economies of scale and diseconomies of scale is important as focusing and reexai'nining the expansion of capacity (Jacobs 8: Chase, 2013). Shouldice's management should assess and evaluate their hospitals situation and gauge the average unit cost of operation rooms after increasing capacity. When the average unit cost will lower, Shouldice hospital is expanded to increase location capacity. In contrast, they have to estimate if the extra profit will exceed the extra cost, which will be incurred after increasing capacity, and obtain a decision appropriately. Some of the metrics, which Shouldice Hospital should monitor, in which determines that growth has plateau includes the sales revenues level, cost of customer acquisition, and profit margin growth rate. The sales revenue level determines the amount of earnings of an organization after providing services to their customers [Castano, 2014). If the sales revenues remain the same from the previous year, it implies that the growth of the organization has a