Proposing a carpal tunnel treatment centre: The Shouldice model revisited
Hazim Sadideen, Faddy Sadideen
The Shouldice Hospital prides itself with excellent hernia repair outcomes. The Shouldice concept exhibits a unique, successful business model, and is a clear example of the concept of a highly innovative value proposition. Exploring Shouldice's fundamental principles and extrapolating them to other settings might help healthcare professionals offer improvements to patient care. Carpal tunnel syndrome (CTS) is the most common elective hand disorder, which can be debilitating for patients. Surgical intervention is extremely effective when necessary. It would be ...view middle of the document...
For iustauce, direct referral from a GP to a settiug where g confirmatory tests are uudertakeu, followed by I surgery itself, while allowiug patients to returu I home iu a timely manuer, can be an ideal siugle< î stage pathway for a commou surgical condition.
developed solely for surgical hernia repairs uuder local auaesthetic usiug the recognised Shouldice technique (which results iu extremely low recurrence rates), delivers afirst-classcliuical service and is an extremely successful business model. By operatiug ou healthy patieuts wdth uo medical co-morbidities aud uucomplicated heruias, it has focused ou a very narrow segment of the market, optimising its product aud service by elimiuatiug risks aud uucertaiuties associated with diversificatiou. By also providiug a 'holiday experience'
Hazim Sadideen Specialty Registrar, Department of Plastic and Reconstructive Surgery, University Hospitals Birmingham Faddy Sadideen Healthcare Consultant, London; INSEAD Alumni Email: hazim.sadideen@ doctors.org.uk
The renowued Shouldice Hospital iu Cauada,
British Journal of Healthcare Management 2014 Vol 20 No 5 235
post-operatively, it has been reported that Shouldice Hospital provides an extremely high quality of care, excellent patient experience and faster recovery from hernia repairs, while requiring fewer surgeons and nurses, and operating at lower costs and higher efficiency, hence charging lower prices than competitors (Nettissine, 2012). It is unsurprising that the Shouldice business model has been used as a basis for developing other specialised healthcare services globally. In 2011, the winner of The Economist innovation award in the 'business process' category was Devi Shetty of Narayana Hrudayalaya Hospital in Bangalore, for reducing healthcare costs using mass production methods. The latter hospital performs more cardiac surgery—under general anaesthesia—at lower cost, with lower mortality rates when compared to leading Western hospitals (Nettissine, 2012). However, this hospital caters for several surgical specialities, to include oncology and anaesthesia. Adopting the Shouldice concept for a certain market niche requires extensive planning, coordination and execution. What other conditions could be targeted in a similar fashion? To be precise, what other relatively common surgical conditions in healthy patients can be repaired under local anaesthesia, providing immediate therapeutic effect, of reasonable durability? Given the authors' background in plastic, reconstructive and hand surgery, and healthcare management, it is proposed that carpal tunnel decompression (CTD) for carpal tunnel syndrome (CTS) could be a potential target that would fit this model, particularly in the current NHS climate. This review will begin by briefly expanding upon the Shouldice Hospital, its history and success, without exhausting detail, because this information is widely available elsewhere (Shouldice, 2013). It will then...