CM Hospital is trying to reduce costs yet improve patient and medical services. A hospital pharmacy uses two types of medications-fluid such as intravenous liquids and pharmaceuticals such as pills. The pharmacy buys drugs in bulk containers and bottles and dispenses them in smaller unit-dose amounts based on the doctor’s orders. 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 ranged 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 0.01 percent (0.0001) to 15 percent (0.15).

The hospital pharmacy process at CM Hospital includes seven major steps:

Step 1-Receive the doctor’s patient medication order via a written prescription, over the telephone, or through the hospital internet system. This step averages 0.2 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 1 to 10 minutes depending on the nature of the prescription and check out potential problems. Since only 10 percent of prescriptions require extensive verification, the weighted average time for this step is 1.9 minutes [0.9 x (1 minute) + 0.1 x (10 minutes)].

Step 3- Determine if duplicate prescriptions exist, and check the patient’s allergic reaction history and current medications. The work activity ranges from 1.4 minutes using the hospital pharmacy’s 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 and it takes 1 minute.

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 4.5 minutes.

Step 6- Store the prescription in the proper place for pick-up and delivery to the patient. Only a registered pharmacist can do this step and it takes 1 minute.

Step 7- Prepare all charges, write notes or comments if needed, and close the patient’s pharmacy record in the pharmacy computer system. This step takes 2 minutes and may be done by a registered pharmacist but the law does not require it.

Currently, the pharmacist performs steps 2 to 7 for each patient’s prescription. Two 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.

Accordingly, your group has been called in as a consultant to improve the designing its process and to make a final recommendation.

Further investigations conducted indicated that approximately 32 prescriptions arrive between 8 am and 9 am on Monday and five pharmacists are on duty.

Accordingly, the management would like to understand the following areas in your analysis and recommendations in your report.

How the process has to be organized (in terms of series or parallel workstations)?

How many processing times and capacities that each work activity contributes? Draw the process flowchart/diagram to better depict the process steps.

Where in the process constrained the delivery of services or output?

Do the process steps have achieved the line balancing in this case?

Describe what process design can be demonstrated in this case and discuss its merits and how you will design the jobs for medical technicians and pharmacists.

What appropriate productivity measures in order to support your final recommendations?

(Working with financial statements) Based on the balance sheet,, and income statement,, for T. P. Jarmon Company for the year ended December 31, 2015: a. How much is the firm's net working capital and what is the debt ratio? b. Complete a statement of cash flows for the period. c. Compute the changes in the balance sheets from 2014 to 2015. a. How much is the firm's net working capital and what is the debt ratio? The net working capital is $. (Round to the nearest dollar.) Data Table Cash Marketable securities Accounts receivable Inventory Prepaid rent Total current assets Net plant and equipment Total assets Accounts payable Accruals Notes payable Total current liabilities Long-term debt Common stockholders' equity Total liabilities and equity 2014 $ 15,000 6,000 42,000 51,000 1,200 $ 115,200 $ 286,000 $ 401,200 Liabilities and Equity 2014 Print $ 48,000 6,000 15,000 69,000 $ 160,000 $ 172,200 $ 401,200 $ Done $ 2015 14,000 6,300 33,000 81,760 1,100 $ 136,160 $ 270,000 $ 406,160 $ 2015 56,800 4,900 12,800 $ 74,500 $ 149,600 $ 182,060 $ 406,160 - X i Data Table T. P. Jarmon Company Income Statement for Years Ended 12/31/2015 Sales Less cost of goods sold Gross profit Operating and interest expenses General and administrative Interest Depreciation Total operating and interest expenses Earnings before taxes Taxes Net income available to common stockholders Cash dividends Change in retained earnings Print Done $ 29,900 10,100 30,100 $ 600,000 460,300 $ 139,700 $ 70,100 $ 69,600 27,840 $ 41,760 31,900 $ 9,860 X