Shouldice Hospital in Canada is widely known for one thinghernia repair! In fact, that is the only operation it performs, and it performs a great many of them. Over the past two decades this small 138-bed hospital has averaged 11,320 operations annually. Last year, it had a record year and performed nearly 11,820 operations.

A hernia repair operation at Shouldice Hospital is performed by one of the 12 full-time surgeons assisted by one of seven part-time assistant surgeons. The first operations begin at 7:30 AM each day, Monday through Friday. Surgeons generally take about one hour to prepare for and perform each hernia operation, and they operate on an average of at most four patients per day. This four patient per day limit on the average number of operations performed per surgeon has been found to be the best operating level for the hospital as it take into account time the surgeons need for patient exams and consultations, updating medical charts, writing reports, traveling to professional conferences, vacations, and other times when they are performing other duties or are not available to perform surgeries. A given surgeon may perform more than four surgeries on a given day, but the average cannot exceed four without having adverse effects on overall hospital operations. The surgeons day ends at 4 p.m. Although hernia repair operations are performed only five days a week, the remainder of the hospital is in operation continuously to attend to recovering patients.

The table below shows the room occupancy plan for the existing system. Each row in the table follows the patients who checked in on a given day. Patients stay in the hospital for three days. On the first day, patients check-in; on the second day, patients are operated, and, on the third day, patients receive post-operative care. The columns indicate the number of patients in the hospital on a given night.

	BEDS REQUIRED
CHECK-IN DAY	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY	SUNDAY
Monday	46	46	46
Tuesday		46	46	46
Wednesday			46	46	46
Thursday				46	46	46
Friday
Saturday
Sunday	46	46					46
Total	92	138	138	138	92	46	46

For example, the first row of the table shows that 46 people checked in on Monday and were in the hospital for Monday, Tuesday, and Wednesday nights before being discharged on Thursday. By summing the column of the table for Wednesday, we see that there are 138 patients staying in the hospital that night.

The medical facilities at Shouldice consist of five operating rooms, a patient recovery room, a laboratory, and six examination rooms.

Now look at the effect of increasing the number of beds by 50 percent.

a. How many operations could the hospital perform per day before running out of bed capacity? (Assume operations are performed five days per week, with the same number performed on each day.) (Round your answer to the nearest whole number.)

b. What would the utilization of the bed capacity become if the new beds were added and the hospital were to perform the number of operations calculated in part a? (Round your answers to 1 decimal place.)

How well would the new resources be utilized relative to the current operation?

With the increase in beds and operations, the bed utilization ___________ relative to the current hospital operations.

(Click to select) increases decreases remains unchanged

c-1. In order to fill the beds as calculated in part a, how many hernia repair operations would need to be performed in each operating room each day? (Since it makes no sense to perform just a part of an operation, round your answer up to the next whole number if necessary.)

c-2. Based on the current scheduling practices, does the hospital have enough operating room capacity for the number of operations required to fill the available beds as calculated in part a? (Assume that the time to clean and set up an operating room between operations is insignificant compared to the time required for an operation.)

• No

• Yes

c-3. In order to fill the beds as calculated in part a, how many hernia repair operations would each surgeon need to be available to perform each day on average? (Since it makes no sense for a surgeon to perform just a part of an operation, round your answer up to the next whole number if necessary.)

c-4. Based on the current scheduling practices, does the hospital have enough full-time surgeons to perform the operations required to fill the available beds as calculated in part a?

• No

• Yes

c-5. Based on the current scheduling practices, with the 50% addition to bed capacity what is the maximum number of hernia repair operations that the hospital could perform each week without exceeding its capacity limits? (Hint: Consider the capacities of the beds, operating rooms and surgeons.)

c-6. Based on the current scheduling practices, does the hospital have enough overall capacity of surgeons and operating rooms to perform the operations required to fill the available beds as calculated in part a?

• No

• Yes