Lee Hospital Pharmacy

You have been called in as a consultant to improve a pharmacy process at Lee Hospital which is trying to reduce costs yet improve patient and medical services. A hospital pharmacy, a primary process, uses two types of medications fluids such as intravenous liquids and pharmaceuticals such as pills. The pharmacy buys drugs in bulk and containers and bottles and dispenses them in smaller unit-dose amounts based on doctors orders. The hospital pharmacists are responsible for monitoring the supply of all medicines used in the hospital and are in charge of purchasing, manufacturing, dispensing and quality testing their medication stock along with help from pharmacy assistants and pharmacy technicians. The objective of the pharmacy is to get the right drug in the right amount to the right patient at the right time. The consequences of errors in this process range from no visible effects on patient health to allergic reactions, or in the extreme case, to death of the patient. National studies on hospital pharmacies found error rates ranging from .01 percent (1 in a 1,000) to 15 percent (15 in 100).The hospital pharmacy process at Lee Hospital includes seven major steps:

Step 1 receive the doctors patient medication order via a written prescription, over the telephone, or through the hospital Internet system. This step averages 0.5 minutes per prescription and could be done by the medical technician or a legally registered pharmacist.

Step 2 Verify and validate the order through whatever means necessary. For example, if the handwriting was not legible, the doctor must be contacted to verify the medical prescription. Only a registered pharmacist can do this step, which takes from one-third of a minute to 10 minutes depending on the nature of the prescription and checking out potential problems. Baseline measures indicated that only 10 percent of prescriptions require extensive verification (10 minutes), and the remaining 90 percent requiring one-third of a minute for verification and validation.

Step 3 Determine if duplicate prescriptions exist, and check the patients allergic reaction history and current medications. This work activity averages 1.4 minutes using the hospital pharmacys computer system. Only a registered pharmacist can perform this step.

Step 4 Establish that the drug(s) are in stock, have not expired, and are available in the requested form and quantity. Only a registered pharmacist can perform this step. 97 percent of drugs are in the pharmacys shelves taking 1 minute for this step to be completed. However, 3% of the drugs are not available and the pharmacist has to contact hospitals central supply. In this case, the average time for to complete this step is 18 minutes, including transit time and inventory update at the central location.

Step 5 Prepare the prescription, including the label, and attach the proper labels to the proper bottles. Only a registered pharmacist can do this work activity and it averages 3.2 minutes.

Step 6 Store the prescription in the proper place for pickup and delivery to the patient. Only a registered pharmacist can do this step and it takes 0.8 minute.

Step 7 prepare all charges, write notes or comments if needed, and close the patients pharmacy record in the pharmacy computer system. The record is also sent to accounting for quality control and auditing purposes. This step takes 1.5 minutes and may be done by a registered pharmacist but the law does not require it.

Currently, pharmacists always perform steps 2 to 7 for each patients prescription. Medical technicians are on duty at all times to receive the prescriptions, answer the telephone, receive supplies and stock shelves, deliver prescriptions through the service window, and interact with nurses and doctors as they visit the pharmacy service window.

As a consultant for the Lee Hospital, prepare a report with your analysis of the pharmacy process by considering the following questions:

1. What is the #1 competitive priority for this hospital pharmacy process?
2. What sustainability issues are there in a hospital pharmacy?
3. Draw the process flow chart with appropriate swimming lanes, including processing times for each work activity.
4. Using the forecast value you developed in Phase I of the assignment as the number of prescriptions arriving between 8 a.m. and 9 a.m., prepare a report with the estimated labor utilization when six pharmacists and one technician are on duty doing all seven steps. (You do not have the data to evaluate staffing levels by hour of the day for Monday.)
5. Clearly identify two additional process design, and discuss the advantages and disadvantages of them. Include in the analysis the average number of prescriptions in the system and consider how you will design the jobs for medical technicians and pharmacists.
6. Wheres the bottlenecks in your process design? Explain.
7. Address the quality versus cost argument by considering whether it is preferable to have one pharmacist handling a prescription from A to Z or can these tasks be assigned to different pharmacists.
8. What are your final recommendations?
9. Is there anything else that can be done to improve the pharmacys efficiency?

Guidelines:

• Submission: Bring one printed copy to instructor on or before due date.
• This is a technical report. Make sure process map and figures are legible, centered, within margins. Use standard process map symbols. In the write up portion, use Times New Roman, size 11. If you are using Excel, make sure the printed document is legible and organized.
• In the first page, only include the students names and the title of the report.
• The last page includes only an evaluation of the process for solving the case as a group effort. Include a brief history of how members worked together, dates members met each other for discussions, decision making as a group, and workload assigned to members. All members should participate in this evaluation as well. Please note all members bear the same responsibilities for solving the assignment, and not having enough time to contact other members and participate in the discussion is not acceptable and may be grounds for removing the student from the group.