Case: STATISTICAL THINKING IN HEALTH CARE
- Develop a process map about the prescription filling process for HMO’s pharmacy, in which you specify the key problems that the HMO’s pharmacy might be experiencing. Next, use the supplier, input, process steps, output, and customer (SIPOC) model to analyze the HMO pharmacy’s business process.
As patient, I have been to a doctor and then to a pharmacy to get drugs. There are many times problems at the pharmacy that seriously affect their productivity. Sometime, the pharmacy staff is responsible for it while other times the problem actually is in the prescription. For HMO pharmacy, I would utilize two scenarios where mistakes can be made and then I would propose the solutions in the process map illustrated bellow.
By analyzing the above process, we can draw the following conclusion regarding the SIPOC model:
Input: Prescription by the doctor
Process: As discussed in the diagram above
Output: Drugs for the patients
- Analyze the process map and SIPOC model to identify possible main root causes of the problems. Next, categorize whether the main root causes of the problem are special causes or common causes. Provide a rationale for your response.
Errors in the pharmaceutical setups are common. Even with bar codes on drugs and these codes read by bar code readers, there is a chance of error (Poon, Cina & Gandhi, 2006). There seems to be a fundamental issues on two fronts for the pharmacy assistant in the case under discussion. First issue is that he/she might get a prescription that he/she may not be able to read. So here the decision is made to return to the pharmacy clerk. The other issue is that the prescription is read incorrectly and the patient is handed over the wrong drugs. It is an unpredictable variation as this is a special cause issue.
- Suggest the main tools that you would use and the data that you would collect in order to analyze the business process and correct the problem. Justify your response.
I would use the records of the pharmacy to find out the overall number of any complaints that have been registered by any patient regarding issues related to their drug dispensation. Then I would point out how many of them have been either due to the writing of the doctor or the mistakes made by the pharmacy assistant. This data would allow me to assess the urgency with which I would need to rectify the issue.
- Propose one (1) solution to the HMO pharmacy’s on-going problem(s) and propose one (1) strategy to measure the aforementioned solution. Provide a rationale for your response.
We can deal with the issues in two ways. As we discussed earlier, the doctor’s writing may not be readable to the pharmacy assistant and he/she hands over it to the pharmacy clerk who then returns it to the patient. What the pharmacy clerk might do is take a photo of the prescription and send it over to the doctor’s clinic via WhatsApp or anything that is available to rectify any confusion. Another solution is to encourage the doctors to use computers to print out their prescriptions.
To make sure that the pharmacy assistant has not misread the prescription, the clerk can double check the drugs against the prescription before handing the drugs over to the patient. We must not forget that handing over wrong drugs to the patients could end up in damaging the health of the patient and could also end up in legal actions against the pharmacy.
There is a need for communication channels that allow pharmacies to be in contact with doctors so that they can discuss issues related to prescriptions (Scarsi, Fotis & Noskin, 2002). This will allow the doctors to rectify the errors at their side and also allow pharmacies to present their concerns to the doctors.
Poon, E. G., Cina, J. L. & Gandhi, T. K. (2006). Medication dispensing errors and potential adverse drug events before and after implementing bar code technology in the pharmacy. Annals of internal medicine, 145(6), 426-434.
Scarsi, K. K., Fotis, M. A., & Noskin, G. A. (2002). Pharmacist participation in medical rounds reduces medication errors. American Journal of Health System Pharmacy, 59(21), 2089- 2096.