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Operational Assessment of Mantra-care
1. Summary of Marketing plan and economic analysis
Mantra-Care is a service operation providing plastic surgery clinic for men that require a
different approach to follow up post treatment compared to women. Clinics providing
surgery for males have been increasing year on year with an overall growth of 16% of
procedures in 2013 (Guardian, 2014). Mantra –Care has therefore considered this niche
market as a potential opportunity to develop services within the well -established female
cosmetics industry. The service value proposition for Mantra-care is to offer top quality
treatments with internationally recognised doctors. No treatment is offered without
consultation with the medical director. The point of differentiation for mantra-care is to
offer spa facilities to support the male recovery process with guaranteed fast and easy web
access to support business needs of the clients whilst providing a controlled environment
for post treatment recovery. The company owns a facility in the London Harley Street
location twinned with luxury spa facilities for recovery. All staff are expert in their field,
registered with BAAPS and fully committed to offering excellence in the care, treatment and
recovery experience of its consumers. The target market is men focused on physical
appearance striving for perfection in looks, confidence and social success. The actual market
in UK is about 4,500-5,000 clients per year (Guardian, 2013) Mantra-care want to attract
wealthy people from abroad offering them a combination of high quality, flexible timing and
post- service treatments. This would mean that mantra-care would be moving to the right
side of the UK demand curve by adding consumers from foreign countries. To be successful
in reaching normal profits, Mantra-care would need to limit the number of underutilised
resources in order to minimise costs, waste, and maximise efficiency of output. As Mantra-care
has chosen to supply males only it expects demand to be lower than for its competing
rivals in the short term however in the long run it is predicted that the firm will receive a
steady growth by which time the unique brand will have been established through the
robust marketing strategy. Mantra-care has relatively low fixed costs and most of the
variable costs are related to actual activity and therefore revenue so the Average total costs
(ATC) can be kept to a minimum (BAAPS, 2014; Shepard, 2014).
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2. Operational Issues
2.1. Objectives and Strategy
Business operations are concerned with four main areas; Marketing and sales, Operations
processes, Production and Finance. Mantra-care is a service operation with a corporate
strategy related to provision of plastic surgery services and after care to a growing niche
market of men (Johnson et al, 2005). The corporate strategy and objectives for Mantra-care
are outlined in Table 1 below (Johnson et al, 2005).
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Table 1: Corporate Strategy for Mantra-care
Mission Statement: “Mantra-Care strives to inspire adult males to fulfil their dreams
and truly enjoy life whilst providing superb body sculpting results and outstanding
experience for all of our clients.”
Values: Offering a safe and superior service Mantra-care provide the best care for their
clients. Mantra-care provides clients with the best results.
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Mantra- Care’s Strategic Objectives:
Financial To get the BEP the first year and a 30% Marginal Rate to
Revenues from year 2.
To increase revenue by 16% per year (in line with male
market growth)
To maintain our fixed costs lower than 30% of the
revenues from year 2 and lower than 25% from year 3.
Customer To understand the company’s male clients’ needs and
produce results that exceed expectations
Internal To achieve a zero error rate in all surgeries performed
To utilize top equipment, training and technologies
To exploit expertise and high skill level of staff
Learning and
Growth
To employ top quality staff
To maintain accurate records and information
To maintain up to date training
Mantra- Care’s Strategic Priorities:
Focus On the UK and European market with the aim of expanding globally
Ensure business is running in line with the company’s economic assumptions
prior to expanding
Guarantee all business related activities are supported by an effective quality
system
Strategic Action Plans:
Grow the plastic surgery and spa business and create basis for our unique model
of care and future expansion
Establish Mantra-care as a profitable business with the UK market
The business strategy focuses on surgery and related treatments for men with good quality
recovery and follow up services. (Figure 1)
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Figure 1:
The Business Definition of Mantra-care (Abell, 1980)
Customer – what
Plastic surgery for men interested
in personal appearance
Equates high cost with high quality
High disposable income
Customer Groups- who
Technology – How
Males only
Partner/ support persons
mainly at Spa facilities
Computerised equipment
Latest surgical techniques
Spa treatments
Computerised booking
system
Website for information and
advice
As this is a new business, there is a high possibility of a market driven strategy that will
emerge over time and Mantra-care recognises that their business strategy will need to be
reviewed on a regular basis in order that they can remain competitive.
The functional strategy for Mantra-care is concerned with how resources are managed and
how technology and skills of staff contribute to the overall functioning of the company.
Given that mantra-care is committed to providing top quality whilst maximising profits, the
main considerations for the company will be; Cost, quality, speed, dependability and
flexibility. Ferdows and de Meyer’s (1990) sand cone model of operational excellence
(Ferdows and de Meyer, 1990) rejects any ideas of having to make trade- offs for areas of
operations to impact on quality and it helps to consider how each of these aspects
contributes to the core factor of quality (Figure 2)
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Figure 2:
The Sand cone model of operational excellence (Ferdows and de Meyer, 1990)
Costs and assets contribute to the overall costs and will impact on profit. Revenue will be
influenced by the dependability and flexibility of staff skills, attitude and commitment to the
company service proposition. Table 2 shows the domains that impact on Mantra-care’s
ability to create competitive advantage. The company requires core competencies to
contribute to the business goals of providing an excellent service, distinctive competencies,
plus dynamic capabilities to flex to changes in the market (Hardley, 2014).
Table 2:
Domain Mantra-care- maintaining competitive advantage
Costs
Pay costs
Maintenance
Rental costs of equipment
Supplies ( non-pay costs)
Service Level agreement for cost per case provision of Spa Treatment
Recovery package
Assets
Building for clinic
IT equipment
Service Level agreement with High Quality Spa Facilities
People
Front office
Surgeons( zero hours)
Owner Reception/Administrative staff
Treatment staff
Back office
Housekeeping staff
Owner manager
Owner accountant
Profit = Revenue – cost
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2.2. Supply chain For Mantra-care
Mantra-care’s supply chain is comprised of 2 tiers of suppliers and is a crucial aspect for
Mantra-care service delivery as without reliable suppliers, the company will not be able to
deliver their service proposition.(Jacoby, 2009). The supply network has been rationalised in
order to reduce transaction costs, build relationships and simplify the process. The diagram
in Figure 3 demonstrates the supply chain for Mantra-care to support delivery of the
services directly to customers (Jacoby, 2009).
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2.3. Factors affecting output:
There are a number of factors that impact on the output of a company which include both
structure and infrastructure. Table 3 shows the factors affecting Mantra-care.
Table 3:
Domain Impact on Mantra-care
Staff/ Skill level As Mantra-care is a new business it will take time to train new staff to
deliver our service according to our standards. Staff’s pre-existing skill
level will need to be high as initially the business will require only a
skeleton staff to provide for customers until we achieve an adequate
volume. Good skills base will require robust competency based
recruitment processes for all staff.
Process
Operational policies for all procedures as well as clinical professional
guidance will provide process structure.
Customer processing /Customer services –“moment of truth”
Resources Strong supply chains will be required in order to ensure the service
performs to a high standard. This service also requires a high skills and
knowledge set from its staff in order to perform scheduled procedures
and interface with clients. Should anything be unavailable or timing
becomes an issue this will reduce/ delay our capacity to serve our
clients i.e. the Bullwhip Effect (Carranza Torres, and Villegas Moran,
2006)
Product/ Service
Mix
Should there be issues in relation to procedures such as a lack of staff
or delay in equipment provision this will reduce capacity to provide. As
Mantra-care is a service the customer is part of transformation process
and receives the non-tangible service as it occurs
Storage
Storage will be required for treatment products and equipment for
procedures.
Management
Ensuring accurate scheduling, supervision and training will effect
capacity provision.
IT facilities/
technology
Setting up the correct IT systems and having adequate numbers of
staff trained and responsible for maintaining and updating information
will help reduce time.
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3. Analysis of potential problems
In order for Mantra-care to work effectively, there has been an evaluation of various top
quality suppliers with defined service level agreements that ensure Mantra-care has ready
access to all materials required to provide the booked treatments, surgical procedures and
after care procedures within a hygienic environment. All staff, regardless of role, are trained
in high quality customer services, all recognise that image is important and have clarity of
role expectation. Treatment staff are well informed and have high technical skills base so
that they are able to manage customer enquiries as well as offer un-booked treatment s
where capacity allows. If any one of the above links in the chain is not present, the
production line would be impacted thus the overall business could lose money (Hardley,
2014)
There are several key issues that can impact on the production line these have been
outlined the table 4 below (Slack, et al., 2009).
Table 4:
Issues Impacting on
production line:
Issue break down for Mantra-care:
Low Labour cost Maintaining low labour costs in order to keep company
profitable
Diversity Issues around understanding cultural differences and the
implications of these when interacting with other staff and
customers.
Understanding LGBT community and identifying their needs
in order to best serve our largest customers base,
Equal opportunities for employment
Discontinuities Relationship breakdown with suppliers
Issues with stock inventory
staff absences and staff turnover
Corporate Social
Responsibility
Environmental sustainability
waste products
Communication Breakdown in communication system along the supply
chain to the end user
verbal communication
IT systems
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Figure 3 (APICS, 2011)
Housekeeping
staff
Spa staff
Therapists
Retailer
Plastics
equipment/
tools
Provider 2
Plastics
equipment/
tools
Provider 1
Laundering
service
House
keeping
Provider
Tier 1
Supplier
Uniform
Supplier
Cleaning product
Supplier
Company
Tier 2
Supplier
Customer
Spa products
Facilities and
Maintenance
Doctors
Catering
Information Flows
INFORMATION FLOWS
Spa
customers
Plastic surgery
customers
Combined
customers
Mantra- Care
Operations
Producer
PRIMARY PRODUCT FLOW (Down Stream) PRIMARY CASH FLOW (Up Stream)
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4. Methods of overcoming problems
The most effective way of overcoming any of the potential operational problems is to
prevent them from occurring. This can be achieved through good operational policies and
procedures, and supporting the induction and training systems in place for the company.
Monitoring of procedures and operations is another important process for identifying
problems and resolving them in a timely manner rather than once any error has occurred
(Barnett,2014).
Table 5 outlines Mantra-care’s solutions for combating the emerging issues.
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Table 5:
Issues Impacting on
Production Line:
Solutions for Mantra-care:
Maintaining Low Labour
cost
Providing cost per case payments to surgeons
Training staff in order to fulfil multiple functions within
organisation i.e. treatment staff provide admin and
reception.
Flexible pay costs for medical staff
Diversity Provide training to staff, become equal opportunity
employer
Discontinuities Ensure good open relationships are maintained with
suppliers, have back up supply options in case of break
down as part of emergency operations plan, stock
managed and updated on system and details
communicated to staff and suppliers on weekly basis,
sickness and return to work policies and guidance provided,
emergency staff and backup provision, regular training and
induction and recruitment drive for new staff
Corporate Social
Responsibility
Green and organic, Fair trade certified products are to be
used within the company, (ask clients to take responsibility
and reduce their laundry use by perhaps using less towels
and reusing these and sheets)
Communication Provide accurate information along the supply chain, one
person responsible for communicating with suppliers in
order to avoid confusion, regular updates from staff via
electronic systems re: supply reorder, regular stock take
and inventory checks updated on systems and sent over to
suppliers, ensure feedback loop
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5. Capacity
Mantra-care produces a high level personalized surgery treatments it means that its
capacity is focus principally on:
1. The number of calls from potential patients who are interested in Mantra-care
services
2. The number of patients who can be seen before a treatment
3. The number of patients ready for an appointment for the treatment
4. The number of patients who receive surgery treatment
Table 6 shows the design capacity for Mantra-care
Table 6:
Points Assumptions Design Capacity
The number of calls from
potential patients who are
interested in Mantra-care
services
2 staff with a single call with
an average duration of 20
minutes each
Design Capacity is 12,096
The number of patients who
can be seen before a
treatment
2 staff with continuous
appointment of 30 minutes
each
Design Capacity of 8,064
The number of patients
ready for an appointment for
the treatment
2 part time doctors that need
minimum 60 minutes for
each appointment,
availability is for 1 day per
week
Design Capacity is 1,613
The number of patients who
receive surgery treatment
Mantra-care defined average
revenue at £4,000 and the
BEP is gained after 250
surgical procedures. This
would mean an average of
roughly 1 treatment per day
Design Capacity is 1,613
Utilization = Actual output
Design capacity
Efficiency = Actual output
Effective capacity
In the first year, Mantra-care will waste many profitable hours for training because staff will
be new to the company. The goal, for year 1 is to gain the Break Even Point (BEP) with 250
operations with an average worth of 4,000.Therefore the “Actual Output” for year 1, means
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that we can achieve this result, for the number of patients who receive surgery treatment
with utilization of 16% and efficiency of 22% (Appendix 1 & 2)
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6. Quality.
At Mantra-Care quality is a top priority, where Philip Crosby’s phrase “do it right first time-zero
defects” is part of the Mantra of operations (Crosby, 1980). As quality is of paramount
importance that there is an allocated Quality Manager role within the organisation. This role
ensures that all products meet the highest specification, oversee the quality program
including responding to customer feedback to inform the development of new
opportunities for growth and improvement as well as to support staff in achieving total
quality management (TQM). Through this role Mantra-care collaborates with physicians,
customers and all staff to ensure the company is meeting the strategic objectives and
creating opportunities to enhance the quality program through the development of clear
measureable goals. This Quality Manager role is also imperative in creating Mantra-Care’s
Evidence-Based Clinical Practice Guidelines and clinical pathways. Mantra-care believes that
through reviews and appraisal of current literature so the role also supports Mantra-care in
ensuring patient safety and quality practice through sharing relevant guidance and helping
employees to keep up to date with best practice and safety guidance (Al-Hogail, et al.,
2010).
Mantra-care has adopted a TQM approach and uses effective audit tools for physicians and
all other staff involved in the delivery of their product. It will utilise an up to date electronic
record system which is linked with the stock data base and suppliers. Specific staff are called
upon to assist in data collection, entry and analysis and assist us in the evaluation of
procedures (Alhogail, 2011). They also utilize relevant bench marking guidance for plastic
surgeons in order to achieve an international standard of practice and raise the level of our
practitioners who then follow the guidance (Al-Hogail, et al., 2010; JCST, 2014).
One system for quality improvement is the Deming Plan, Do, Check and Act cycle (Rother,
2010). This provides a structure for considering an area of service production that might
require some changes with an aim of service improvement (Rother, 2010) (Figure 4)
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Figure 4:
The Deming cycle (Rother, 2010)
Table 6 demonstrates some examples of how the PDCA cycle might be used for Mantra-care
Table 6:
PDA CYCLE Example
PLAN Zero serious incidents:
Procedures and guidelines are adhered to by all staff
All staff trained and signed off having achieved competency
level.
Staff supervised on 3 occasions
Staff receive Monthly supervision from senior staff
Clinical notes up to date and accurate
DO Collect data on training records, perform clinical audit
CHECK Analyse data on training records and clinical audit results. Look for
patterns and trends over time i.e. differences between shifts and cases
treated
ACT
Feedback given to staff about results obtained
Discuss barriers and generate solutions to ensure objectives are met. In
this case if staff have not completed required trainings ensure that these
are carried out with mandatory attendance required prior to
commencement of next shift.
7. Conclusion: Given that nature of Mantra-care, the company feels that the above
plan forms a comprehensive basis for running the daily operations. Mantra-care
accept that the operations plan requires regular review to ensure that the company
is meeting its strategic aims.
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References:
Abell, D. (1980). Defining the Business. Englewood Cliffs, NJ: Prentice-Hall.
APICS (2011). Certified Supply Chain Professional Learning System. (2011 ed.). Versiona 2.2.
1-6
Alhogail. R. (2011). Self-audit in plastic surgery: toward total quality management of
personal professional practice. Journal of Craniofacial Surgery, 22(2), 409-414.
Al-Hogail, R., Al-Shlash, S., Helmi, A., Jad Alkareem, J., Mirdad, I., Abdulmannan Khan, M.,
Abu Al Hamail, A. (2010). Total quality management in plastic surgery. Journal of
Craniofacial Surgery, 21(1), 10-19.
British Association of Aesthetic Plastic Surgeons [Online] Available from:
http://baaps.org.uk/ [Accessed 9 October, 2014].
Barnett, N. (2014) Creating Customer Value: Operations, [Lecture to MBA],
BMBA709.1:Creating Customer Value. University of Westminster. 17th October,
2014
Crosby, B (1980) Quality Is Free: The Art of Making Quality Certain. Mass Market Paperback
Ferdows, K., and De Meyer, A. (1990). Lasting improvements in manufacturing performance:
In search of a new theory. Journal of Operations Management, 9 (2), 168-84.
Guardian UK Cosmetic Surgery statistics 2013: Which are the most popular? [Online]
Available form: http://www.theguardian.com/news/datablog/2014/feb/03/uk-
Plastic-surgery-2013-most-popular [Accessed 9 October, 2014]
Hardley, L. ed.(2013) Creating Customer Value 2nd Edition. McGraw Hill: UK.
Jacoby, David (2009). Guide to Supply Chain Management: How Getting it Right Boosts
Corporate Performance. The Economist Books (1st ed.). Bloomberg Press.
Johnson, J., Scholes, K., and Wittington, R. (2005) Ecploring Corperate Stretegy, 7th ed,
FT/Prentice Hall, Harlow.
Johnston, R., Clark, G., & Shulver, M. (2012). Service Operations Management: Improving
Service Delivery. Pearson Education, Harlow.
Joint Committee on Surgical Training [Online] Avialable from:
http://www.jcst.org/quality-assurance/documents/cct-guidelines/benchmarking-guidelines-
for-st6-trainees-in-plastic-surgery[Accessed 20 October, 2014].
Rother, M (2010). "6". Toyota Kata. New York: MGraw-Hill.
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Shepard, D. (2014) Creating Customer Value: Economics, [Lecture to MBA], BMBA709.1:
Creating Customer Value. University of Westminster. 4th October.
Slack, N., Brandon-Jones, A., and Johnston, R. (2009). Operations Management, 4th ed.
Page 15 of 17
Perason Education: Harlow.
Webber, L., and Wallace, M. (2007). Quality Control for Dummies. Wiley Publishing: New
Jersey.
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Appendix 1
Average revenue for a firm based on table price and a hypothetical market.
Pricings of different surgeries and techniques
UK:
Cost of liposuction in the UK £2,500-£2,837
Breast reduction costs in the UK UK price range: £5,110 - £5,507
UK prices for upper and lower eyelid surgery £1570- £3980
Rhinoplasty £3,000 - £4,000
Rhinoplasty COMPLEX 2hrs From £6100
UK prices for a face lift £5650- £7235
UK prices for Tummy tuck / abdominoplasty £4960 - £5350
Consultation £200 - £500
Spider Veins £150 - £750
Sclerotherapy £150 - £250
Ear pinning TBA
Brow Lift £800 - £1200 Enquire
Cheek Implants £600 - £1200
Dermal Fillers £150 - £700
Facelift £5000-£7000
Hair transplant £3000-£5000
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Appendix 2
APPENDIX 2
Year 1
Number of calls,
meetings, treatments
Reducing
productivity
year 1
BEP Efficiency Utilization
Number
Staff
Calls
General
Meeting
Meeting pre
operation
Operations
Hours
per day
Number of
work day
Design Capacity
Effective
Capacity
1 General Staff 2 3 8 252 12,096 -40% 7,258
2 Skilled Staff 2 2 8 252 8,064 -40% 4,838
3 Doctors* 2 1 8 100.8 1,613 -30% 1,129
4 Doctors* 2 1 8 100.8 1,613 -30% 1,129 250 22% 16%
*
TIME: how many operations per 1 hour
Doctors are part time, they work 2 days per week
