relationship tree2

SHOULDICE HOSPITALSHOULDICE HOSPITAL

INTRODUCTIONINTRODUCTION

A look at the network of relationships, A look at the network of relationships, which support the delivery of customer which support the delivery of customer satisfaction throughout “The Shouldice satisfaction throughout “The Shouldice Experience” Experience”

Daryl UrquhartDaryl Urquhart - Director of Business Development, - Director of Business Development, Shouldice HospitalShouldice Hospital

Management PhilosophyManagement Philosophy

We repair Hernias ! Nothing else !We repair Hernias ! Nothing else !

SHOULDICE HOSPITALSHOULDICE HOSPITAL

HERNIAS “R” US !

Management PhilosophyManagement Philosophy

We repair Hernias ! Nothing else !We repair Hernias ! Nothing else ! ““The patient’s welfare is our The patient’s welfare is our

responsibility”responsibility” Employee empowermentEmployee empowerment Track activity and outcomesTrack activity and outcomes

CUSTOMER CUSTOMER SATISFACTIONSATISFACTION

WHAT IS IT?WHAT IS IT?

I got what I expected?I got what I expected? They did what they said they would do?They did what they said they would do? A great experience?A great experience? Creation of an Apostle!Creation of an Apostle!

CUSTOMER CUSTOMER SATISFACTION AND SATISFACTION AND “THE RELATIONSHIP “THE RELATIONSHIP

TREE”TREE”

The The ““DNADNA”” in in Creating Creating

Customer SatisfactionCustomer SatisfactionThroughout the Throughout the

The Shouldice ExperienceThe Shouldice Experience

THE SHOULDICE THE SHOULDICE EXPERIENCEEXPERIENCE

Abdominal wall hernia surgery? Abdominal wall hernia surgery?


A manifestation of emotional, physical and interactive A manifestation of emotional, physical and interactive relationships, orchestrated in a safe environment, built on relationships, orchestrated in a safe environment, built on focus, confidence, trust and success. focus, confidence, trust and success.


A bonding processA bonding process


A healing = strengthening of mind and bodyA healing = strengthening of mind and body

RELATIONSHIP TREERELATIONSHIP TREE

PLANT THE SEEDS!PLANT THE SEEDS!IN GOOD SOIL!IN GOOD SOIL!

RELATIONSHIPSRELATIONSHIPS

Emotional Emotional PhysicalPhysical InteractiveInteractive

EMOTIONALEMOTIONAL RELATIONSHIP RELATIONSHIP THE LASTING IMPRINTTHE LASTING IMPRINT

Surprise or ShockSurprise or Shock - My god ! What’s this?- My god ! What’s this? FearFear - Is it cancer? Am I going to die? - Is it cancer? Am I going to die? AnxietyAnxiety - What should I do? Surgery!!! - What should I do? Surgery!!! HopeHope - Maybe I’ll be okay - Maybe I’ll be okay ResolveResolve - I’m going to see a doctor - I’m going to see a doctor ReliefRelief - Hey, that wasn’t so bad after all!- Hey, that wasn’t so bad after all! GratitudeGratitude - Thanks to Shouldice, I’m fine!- Thanks to Shouldice, I’m fine! LoyaltyLoyalty - One good deed deserves another.- One good deed deserves another.

PHYSICALPHYSICAL RELATIONSHIP RELATIONSHIP THE MOTIVATOR THE MOTIVATOR

ComfortComfort - What we are used to feeling - What we are used to feeling Relative to each individualRelative to each individual Non-motivatingNon-motivating

PainPain - Discomfort - abnormal/exceptional - Discomfort - abnormal/exceptional Relative to the individual Relative to the individual Very motivatingVery motivating

ReliefRelief - Calm, reflective state of mind - Calm, reflective state of mind MotivatingMotivating Promotes wonder - gratitudePromotes wonder - gratitude

INTERACTIVE INTERACTIVE RELATIONSHIP TYPESRELATIONSHIP TYPES

Invisible -Invisible - those in which customer those in which customer contact is not requiredcontact is not required

Visible - Visible - those in which there is those in which there is customer contactcustomer contact

Hidden -Hidden - those which result from the efforts those which result from the efforts spent spent on visible and invisible relationshipson visible and invisible relationships

INVISIBLEINVISIBLE RELATIONSHIPSRELATIONSHIPS

Interconnected relationships behind the scene Interconnected relationships behind the scene which facilitate visible relationshipswhich facilitate visible relationships

Invisible Relationship NetworkInvisible Relationship Network Administration staff / inter-departmentalAdministration staff / inter-departmental GovernmentGovernment SuppliersSuppliers ShareholdersShareholders Lawyers / accountants / scholarsLawyers / accountants / scholars MediaMedia ““Marketing”Marketing”

RELATIONSHIP TREERELATIONSHIP TREEINVISIBLEINVISIBLE RELATIONSHIPSRELATIONSHIPS

Internal Internal coordinationcoordination

Government funding and licensing, Marketing, Private financing, Government funding and licensing, Marketing, Private financing, Management/ownership, Human resources, Suppliers, Lawyers, etc..Management/ownership, Human resources, Suppliers, Lawyers, etc..

Booking for Booking for surgerysurgery

RELATIONSHIP TREERELATIONSHIP TREEINVISIBLEINVISIBLE RELATIONSHIPSRELATIONSHIPS

VISIBLEVISIBLE RELATIONSHIPS RELATIONSHIPS

The people who deliver the serviceThe people who deliver the service The Shouldice StaffThe Shouldice Staff

Visible Relationship NetworkVisible Relationship Network Booking staffBooking staff Admitting staffAdmitting staff NursesNurses DoctorsDoctors Accounting staffAccounting staff House cleaning/kitchen/maintenance staffHouse cleaning/kitchen/maintenance staff ManagementManagement

RELATIONSHIP TREERELATIONSHIP TREEVISIBLEVISIBLE RELATIONSHIPS RELATIONSHIPS

InitialInitial contactcontact

Second Second contactcontact

AdmissionAdmission

Shouldice Shouldice ExperienceExperience

Follow-upFollow-up

RELATIONSHIP TREERELATIONSHIP TREEVISIBLEVISIBLE RELATIONSHIPS RELATIONSHIPS

HIDDENHIDDEN RELATIONSHIPS RELATIONSHIPS

Produce benefits for visible relationships Produce benefits for visible relationships which are key to the Shouldice Experiencewhich are key to the Shouldice Experience

Friend or relativeFriend or relative Prepares the patient with positive referral commentsPrepares the patient with positive referral comments

Patient to patientPatient to patient Empathetic therapeutic consultation, courageEmpathetic therapeutic consultation, courage

Patient to staffPatient to staff Praise stimulates efforts to excel which create more Praise stimulates efforts to excel which create more

praise in a perpetual cycle which assists in fulfilling praise in a perpetual cycle which assists in fulfilling the relationship needs and expectations of high quality the relationship needs and expectations of high quality care.care.

RELATIONSHIP TREERELATIONSHIP TREEHIDDEN HIDDEN RELATIONSHIPSRELATIONSHIPS

Patient referralPatient referral


ReferralReferral

RELATIONSHIP TREERELATIONSHIP TREEHIDDEN HIDDEN RELATIONSHIPSRELATIONSHIPS

RELATIONSHIPSRELATIONSHIPS

Emotional Emotional PhysicalPhysical InteractiveInteractive

THE RELATIONSHIP TREE THE RELATIONSHIP TREE

The strength of the relationship tree depends upon The strength of the relationship tree depends upon the integrity of the relationships that planted it the integrity of the relationships that planted it and upon those which and upon those which itit plants. plants.

From first referral - through hidden relationships, From first referral - through hidden relationships, visible and invisible relationships - and back to visible and invisible relationships - and back to first referral.first referral.

By the time the relationship tree has grown, By the time the relationship tree has grown, its fruit is ripe and an its fruit is ripe and an ““apostle”apostle” is created. is created.


““Shouldice Apostle”Shouldice Apostle”


Initial Initial contactcontact





AdmissionAdmission


Follow-upFollow-upReferralReferral









AdmissionAdmission


Follow-upFollow-upProcrastinatorsProcrastinatorsReferralReferral









AdmissionAdmission


Follow-upFollow-upProcrastinatorsProcrastinators CompetitorsCompetitors

ReferralReferral


Shouldice ApostleShouldice Apostle







AdmissionAdmission


Follow-upFollow-up CompetitorsCompetitors

ProcrastinatorsProcrastinatorsComplicationsComplications

ReferralReferral


Shouldice ApostleShouldice Apostle







AdmissionAdmission


Follow-upFollow-up CompetitorsCompetitors

ProcrastinatorsProcrastinatorsComplicationsComplications

ReferralReferral

TerroristsTerrorists!!

SUCCESS FROM DETAILSUCCESS FROM DETAIL

“…“…while the “focused” part of the focused factory while the “focused” part of the focused factory is essential, it is the details of the factory’s is essential, it is the details of the factory’s operating system that makes the difference operating system that makes the difference

between success and failure.”between success and failure.”

Regina Herzlinger 1997Regina Herzlinger 1997

FOLLOW-UPFOLLOW-UP

Annual Follow-Up With Every Patient Annual Follow-Up With Every Patient For The Rest of Their LifeFor The Rest of Their Life

What is the value of follow-up?What is the value of follow-up? Provides Professional Medical ResearchProvides Professional Medical Research Helps us to Deliver our ServiceHelps us to Deliver our Service Allows us to Touch the Patient RegularlyAllows us to Touch the Patient Regularly Provides Continuing Confidence in the Service Product Provides Continuing Confidence in the Service Product

for Both Provider and Clientfor Both Provider and Client

FOLLOW-UPFOLLOW-UP

How Far Do We Go to Follow-up?How Far Do We Go to Follow-up? Over 130,000 Follow-up Letters AnnuallyOver 130,000 Follow-up Letters Annually Five Travelling Clinics AnnuallyFive Travelling Clinics Annually Daily Internet / E-mail ServiceDaily Internet / E-mail Service Annual Shouldice Patient Alumni ReunionAnnual Shouldice Patient Alumni Reunion

Up to 1500 have attendedUp to 1500 have attended Annually since 1947Annually since 1947

12,000 Patient Follow-Up Exams per Year12,000 Patient Follow-Up Exams per Year Free Exams for International Patients Free Exams for International Patients

THE FRUITS THE FRUITS ofof

The RELATIONSHIP TREE The RELATIONSHIP TREE New and Continuing BusinessNew and Continuing Business Positive ReputationPositive Reputation High Quality of ServiceHigh Quality of Service Low Cost of ServiceLow Cost of Service Generally High Employee Morale Generally High Employee Morale Employee RetentionEmployee Retention Favorable Fiscal ResultsFavorable Fiscal Results Reduced VulnerabilityReduced Vulnerability

THE FRUITS THE FRUITS ofof

The RELATIONSHIP TREE The RELATIONSHIP TREE Apostles!Apostles!

NET RESULTS OF NET RESULTS OF RELATIONSHIPSRELATIONSHIPS

Over 20,000 patients a year come to the Shouldice Over 20,000 patients a year come to the Shouldice Hospital for examinationsHospital for examinations

Over 7,400 hernias are repaired annuallyOver 7,400 hernias are repaired annually Over 90% of patients arrive through personal Over 90% of patients arrive through personal

referrals. ie. friend, co-worker or relative referrals. ie. friend, co-worker or relative - backlog of 3,000 patients- backlog of 3,000 patients

Over 300,000 hernia operations to date Over 300,000 hernia operations to date Thousands of lifelong apostles world wideThousands of lifelong apostles world wide

Q1 Q3Q2

At Admission2-3 days post

Surgery1-Month post

Surgery

SURGERY

Canadian patients

n = 391n = 445n = 490

MOLSON SCHOOL OF BUSINESS

SURVEY TIME FRAME

LEVEL OF SATISFACTION AND LEVEL OF SATISFACTION AND OVERALL SERVICE QUALITYOVERALL SERVICE QUALITY

9.1 9.2

44.5

55.5

66.5

77.5

88.5

99.510

Level ofSatisfaction

Overall ServiceQuality

Delighted

Satisfied

Extremely High Quality

Good Quality

OVERALL SERVICE QUALITY AND SATISFACTION OVERALL SERVICE QUALITY AND SATISFACTION ARE POSITIVELY RELATED TO ADVOCACY ARE POSITIVELY RELATED TO ADVOCACY

INTENTIONINTENTION

8.6 8.5

9.39.2

9.6 9.6

7.88

8.28.48.68.8

99.29.49.6

Average Good Excellent

Service Quality Satisfaction

SUMMARYSUMMARY

Excellent process quality before, at admission Excellent process quality before, at admission and during stayand during stay

Excellent technical quality with low discomfort Excellent technical quality with low discomfort and rapid return to normaland rapid return to normal

Excellent human quality in patient/personnel Excellent human quality in patient/personnel interactionsinteractions

SUMMARYSUMMARY

Shouldice patients become advocatesShouldice patients become advocates

Low discomfort = high advocacyLow discomfort = high advocacy

High service quality & high satisfaction = high High service quality & high satisfaction = high advocacyadvocacy

CONCLUSIONCONCLUSION

ManagerialManagerial More than expertise of surgeons and staff More than expertise of surgeons and staff

TheoreticalTheoretical Delivering high overall service quality and Delivering high overall service quality and

ensuring customer satisfaction ensuring customer satisfaction to the point ofto the point of delightdelight => benefit from patient positive WOM => benefit from patient positive WOM

PATIENTS’ REUNIONPATIENTS’ REUNION

relationship tree2

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