Shouldice Hospital 2005 version

For the Abridged shouldice hospital case (2005). What are the capacity of the hospital in patient per week? Where are the bottlenecks in the system? I am given the following information. • 89 beds at shouldice • 7600 operation per year • Backlog is 2400 and is growing by 100 every 6 months • Primaries hernia surgery = 45 mins • Recurrent repair = 90 mins • 5 Operating rooms • 6 examination rooms • Nurses : 34 full-time equivalent /24 hr period . The nurse to patient ratio is 1:15 • Non-operating nurse: 6 full-time equivalent • 10 full-time equivalent surgeons • 8 part-time assistant surgeons • 2 anesthetists –float between cases • In the ORs: • Must have 1 surgeon, 1 assistant surgeon, 1 scrub nurse, 1 circulating nurse • 30-36 operations/day • Each surgeon does about 3-4 operations per day I am given 2 options, I need to calculate the capacity for each option with the data above: 1. Go to Saturdays operations (increase capacity by 20%) 2. Invest 4 million dollars in new space to increase capacity by 50% I need a value stream map of shouldice case? Where is the waste and what type of waste is in the system (muri, muda, or mura)? What is the value and failure demand in this case? What implementation difficulties do you forsee?