The Significance of Statistical Thinking in Healthcare

¶ … Map of Prescription Filling at an HMO and SIPOC for Problem Analysis (Bertrand

Filling prescriptions and the estimated time each activity takes consist of four steps in most pharmacies (Bertrand, 2012). The first is entering the prescription when received from two to 10 minutes. It may be longer according to the duration of the billing process and the ease or complicatedness of the prescription. The second is filling the medication, which takes from three to 15 minutes or longer, depending on the type of prescription and its storage or if it has to be reconstituted or compounded. The third is checking it, which can take between three and 10 minutes. The pharmacist makes sure it is the correct prescription, the dose, the interactions and the genuineness of the prescription. The duration depends on the prescription and the patient's history and profile. And the fourth is the release of the prescription. The pharmacist makes sure the medication goes to the right person. She also provides special instructions and precautions about the medication (Bertrand, 2012).

One tool in analyzing the problem encountered at the HMO by Juan is the SIPOC. It means supplier, input, process, output, and customer (Banerjee, 2016). Supplier provides inputs to the process. Input is what produces outputs from the process. Process includes all the actions needed or used in converting inputs into outputs. Output are the physical products or outcomes from the process. And customer is the user of the output the proceeds from the process. A team lists these as categories as columns in the correct order. Process is filling a prescription accurately. Output is the checkout or release of a purchased medication or prescription. Customer is the buyer of the prescription o medication who will benefit from it. Input is a medical prescription. And supplier is the provider of the medication to the HMO (Banerjee, 2016).

The pharmacist is the overall manager or employee responsible for the final checking of the medication before the medication is dispensed (Bertrand, 2012). She is also responsible for all issues related to the medication or prescription being dispensed. These include drug information, education of the buyer, and recommendations to the buyer. The duty of the technician is to enter the prescription, bill to insurance, fill the medication and sell it to the buyer or patient. The pharmacist is bound by strict laws in insuring patient safety and the accurate dispensing of medications. She needs sufficient time to fill and check the accuracy of the prescription in order to avoid medication errors, interactions and side effects, among others. She may not always have sufficient time to do these (Bernard, 2012).

II. Inaccurate prescriptions may be the result of the pharmacist's getting the wrong medication because the containers look very similar or she may have mis-interpreted the prescription because of illegible handwriting of the doctor. She may have also ineffectively checked the prescription (Bernard, 2012). These may be classified as common causes because pharmacists and their assistants are not infallible.

The physician may have also written the prescription incorrectly, wrote a wrong one because the medications sound similar. He may not have explained the medication to the patient when he prescribed it (Bertrand, 2012). These may be categorized as special causes because they do not happen as often as common causes do.

III. Tools and data for analysis in the business process to correct the problem. Justify Ben's HMO company can craft a control plan, which will manage the supplier, the input, the effective process of control over the output, and customer satisfaction (Banerjee 2016). The plan will include effective actions, their frequency, persons responsible, status check, and sustained governance of the entire range of actions by a quality and internal audit person or team. This plan may include data collection trackers, control charts for priority medications, action plan trackers to tackle out-of-control issues and situations, and an evaluation system or program for management and for clients. The HMO owner should assess the relationship status when a major revamp is done and when a major change occurs. This control plan shall insure clear and constant direction and effort at maintaining high output levels (Banerjee 2006).

This control plan will apply the statistical thinking approach, which is a combination of a learning and action (Britz et al., 1997). Statistical thinking utilizes the principles of interconnected principles, variations, and the need to understand and minimize them. Statistical thinking is applicable at all levels of an organization. It stresses long-term directions, an alignment of operations, and improving daily processes (Britz et al., 1997).

IV. A Solution and a Strategy

Inaccurate prescriptions result from error-prone systems and processes in an organization, such as the HMO company in the case study. The appropriate solution is, therefore, to introduce and implement a systems-oriented plan instead of penalizing individuals (Nair et al., 2010). This solution consists of a number of strategies, which the HMO company may choose from or altogether implement. These strategies are:

1. Assuring the correct entry of prescriptions -- Reliable methods should be used to perform this, such as appointing 2 patient identifiers in the hospital setting (Nair et al., 2010). This strategy will reduce errors, such as names that look or sound alike and secure patient information;

2. verification of the prescription as correct and complete -- this is done by contacting the prescribing physician and by promptly documenting information obtained from him or her. Verbal prescriptions should be transcribed and transferred to a blank prescription pad and re-read to the prescriber for accuracy;

3. Caution about Drugs with Similar Sounds or Spelling - These errors account for a third of all and result from confirmation bias (Nair et al., 2010). They can be reduced by placing corrections or reminders on bottles or in the computer system about them (Nair et al., 2010);

4. Caution about zeros and abbreviations -- Use computer alerts or by placing a single strength of a particular medication in the pharmacy;