Page 1 of 2 Students, please view the "Submit a Clickable Rubric Assignment" in the Student Center. Instructors, training on how to grade is within the Instructor Center. Case Study 1: Statistical Thinking in Health Care Due Week 4 and worth 150 points Read the following case study. Ben Davis had just completed an intensive course in Statistical Thinking for Business Improvement, which was offered to all employees of a large health maintenance organization. There was no time to celebrate, however, because he was already under a lot of pressure. Ben works as a pharmacist's assistant in the HMO's pharmacy, and his manager, Juan de Pacotilla, was about to be fired. Juan's dismissal appeared to be imminent due to numerous complaints and even a few lawsuits over inaccurate prescriptions. Juan now was asking Ben for his assistance in trying to resolve the problem, preferably yesterday! "Ben, I really need your help! If I can't show some major improvement or at least a solid plan by next month, I'm history." "I'll be glad to help, Juan, but what can I do? I'm just a pharmacist's assistant." "I don't care what your job title is; I think you're just the person who can get this done. I realize I've been too far removed from day-to-day operations in the pharmacy, but you work there every day. You're in a much better position to find out how to fix the problem. Just tell me what to do, and I'll do it." "But what about the statistical consultant you hired to analyze the data on inaccurate prescriptions?" "Ben, to be honest, I'm really disappointed with that guy. He has spent two weeks trying to come up with a new modeling approach to predict weekly inaccurate prescriptions. I tried to explain to him that I don't want to predict the mistakes, I want to eliminate them! I don't think I got through, however, because he said we need a month of additional data to verify the model, and then he can apply a new method he just read about in a journal to identify 'change points in the time series,' whatever that means. But get this, he will only identify the change points and send me a list; he says it's my job to figure out what they mean and how to respond. I don't know much about statistics -- the only thing I remember from my course in college is that it was the worst course I ever took-- but I'm becoming convinced that it actually doesn't have much to offer in solving real problems. You've just gone through this statistical thinking course, though, so maybe you can see something I can't. To me, statistical thinking sounds like an oxymoron. I realize it's a long shot, but I was hoping you could use this as the project you need to officially complete the course." "I see your point, Juan. I felt the same way, too. This course was interesting, though, because it didn't focus on crunching numbers. I have some ideas about how we can approach making improvements in prescription accuracy, and I think this would be a great project. We may not be able to solve it ourselves, however. As you know, there is a lot of finger-pointing going on; the pharmacists blame sloppy handwriting and incomplete instructions from doctors for the problem; doctors blame pharmacy assistants like me who actually do most of the computer entry of the prescriptions, claiming that we are incompetent; and the assistants tend to blame the pharmacists for assuming too much about our knowledge of medical terminology, brand names, known drug interactions, and so on." "It sounds like there's no hope, Ben!" "I wouldn't say that at all, Juan. It's just that there may be no quick fix we can do by ourselves in the https://blackboard.strayer.edu/bbcswebdav/institution/MAT/510/1152/Week4/Week%204%... 7/6/2016 Page 2 of 2 pharmacy. Let me explain how I'm thinking about this and how I would propose attacking the problem using what I just learned in the statistical thinking course." Source: G. C. Britz, D. W. Emerling, L. B. Hare, R. W. Hoerl, & J. E. Shade. "How to Teach Others to Apply Statistical Thinking." Quality Progress (June 1997): 67--80. Assuming the role of Ben Davis, write a three to four (3-4) page paper in which you apply the approach discussed in the textbook to this problem. You'll have to make some assumptions about the processes used by the HMO pharmacy. Also, please use the Internet and / or Strayer LRC to research articles on common problems or errors that pharmacies face. Your paper should address the following points: 1. 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. 2. 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. 3. 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. 4. 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. 5. Use at least two (2) quality references. Note: Wikipedia and other Websites do not qualify as academic resources. Your assignment must follow these formatting requirements: Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA format. Check with your professor for any additional instructions. Include a cover page containing the title of the assignment, the student's name, the professor's name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. The specific course learning outcomes associated with this assignment are: Describe how organizations use statistical thinking to be more competitive. Apply the basic principles of statistical thinking to business processes. Apply the SIPOC model to identify OFIs in business processes. Use technology and information resources to research issues in business process improvement. Write clearly and concisely about business process improvement using proper writing mechanics. Click here to view the grading rubric https://blackboard.strayer.edu/bbcswebdav/institution/MAT/510/1152/Week4/Week%204%... 7/6/2016 1 Case Study 1: Statistical Thinking in Health Care 2 Case Study 1: Statistical Thinking in Health Care Process map Rather than wait for a problem to arise and start looking for causes of the problem, it may be better to look at some of the ways that the errors may occur, and thus look for solutions that will help in reducing the potential risks of such errors. The following is a mapfor this process. Step 1 Define the issue by raising four major questions: what is the main problem? When did the problem occur? Where did the problem occur? What were its consequences? This being a proactive investigation, it focuses on the medication error. For instance, in this case, there is a problem with regards to the inaccuracies in prescriptions as well as a "blame game" where those involved keep blaming each other, and thus no one to take responsibility. In the pharmacy, the next step would involve looking at the potential impacts of the errors (reduction in health care services, serious harm to the patient as well as law suits to the hospital etc.) Step 2 The second step in this case will involve identification of the. This is the cause-and-effect relationship in this analysis step. By asking the why question, it is possible to determine why the negative impacts/consequences occurred. Some of the answers may include the wrong type of medication, poor handwriting or patient not having received the required medication etc. By identifying the problem, it becomes easier to correct potential issues in future. Step 3 3 Havingdetermined the causes of the problem, solutions can be presented, and ultimately select the best possible solution to reduce risks involved. This may involve; flagging the frequently confused medication, double checking prescription before it leave she pharmacy, making out the prescription for brand. Generic name and what it is used for, telling the patient what it is for, having one dose stored in any given location and using abbreviations from the list only. SIPOC model Suppliers - suppliers to the hospital's pharmacy include those who supply drug preparation equipment, information about new types of drugs, pills and solutions etc. Inputs - inputs in to the pharmacy include doctor's prescription, material supplied by the suppliers, and even previous patient's prescriptions. Process- with individuals getting sick, there is a need for physicians to determine what they are ailing from. They then prescribe medications that are required to treat them. The pharmacist is responsible for proving the patient with the prescribed medication, some of which they have to prepare in the pharmacy. Suppliers will provide pharmacies with all the required material and thus ensure they have all requirements to provide the required medication to patients. The patient will get the necessary medication from the pharmacy. In the event that the medication does not work as expected, the patient will return to the physician to get better medication. In some cases, the patient has to continue using the type of medication for a long period of time (Kerri, 2012). Cause 4 One of the causes of the problem as mentioned is the poor handwriting and incomplete instructions by doctors. There is a lot of finger pointing with no party willing to take the blame. This is a common problem. However, it becomes clear that the parties involved have not come together to discuss how they can effectively eliminate the issues causing the problem, and thus ensure better services. Tools and data To resolve this problem, I would use such tools as questionnaires, observation and historical records to determine the history of the problem. To be able to correct the problem, it will be essential to look at historical records of such problems, and thus determine when they started becoming prevalent. This will make it easier to determine those involved, and thus who or what would be the primary cause. Through questionnaires and observation, it will be possible to teach what the involved parties think is the main cause of the problem, and thus determine a line of thought for all involved. This will help come up with a direction as to what a majority of the involved party perceive the problem to be. For instance, whereas most of those involved may feel that the main problem is as a result of poor writing and incomplete instructions by a given doctor, the historical records may prove this to be true by showing that the problem began when the doctor started working at the hospital. Data collected from all involved party would help point out the main source of the problem (Adolf, and Kalton, 1971). Solution 5 With each party pointing their finger to the others, the best solution would start by asking the doctors to provide those in the pharmacy department with clear and complete instructions. Having done their part effectively, the rest would be up to the pharmacists. With clear instructions, they would not have an excuse for giving patients the wrong prescriptions. To measure how the strategy will work, each party will be required to report any incident that makes them unable to perform their duties as required. For instance, the pharmacist and assistant pharmacist may present evidence that the doctor gave poor instructions, which made it difficult for them to give the right prescription. This would help determine the party at fault. This would also help determine whether other factors are at play with respect to the problem. For instance, it may highlight the incompetency of some of the staff involved in the process (Anderson, McGuinness and Bourne, 2010). References 6 Anderson, P. O., McGuinness, S. M. and Bourne, P. E. (2010). Pharmacy Informatics. New York: CRC Press.Moser, Claus Adolf, and Graham Kalton. "Survey methods in social investigation." Survey methods in social investigation. 2nd Edition (1971). Simon, Kerri. "SIPOC Diagram". Ridgefield, Connecticut: iSixSigma. Retrieved 201207-03. 1 Case Study 1: Statistical Thinking in Health Care 2 Case Study 1: Statistical Thinking in Health Care Process map Rather than wait for a problem to arise and start looking for causes of the problem, it may be better to look at some of the ways that the errors may occur, and thus look for solutions that will help in reducing the potential risks of such errors. The following is a mapfor this process. Step 1 Define the issue by raising four major questions: what is the main problem? When did the problem occur? Where did the problem occur? What were its consequences? This being a proactive investigation, it focuses on the medication error. For instance, in this case, there is a problem with regards to the inaccuracies in prescriptions as well as a "blame game" where those involved keep blaming each other, and thus no one to take responsibility. In the pharmacy, the next step would involve looking at the potential impacts of the errors (reduction in health care services, serious harm to the patient as well as law suits to the hospital etc.) Step 2 The second step in this case will involve identification of the. This is the cause-and-effect relationship in this analysis step. By asking the why question, it is possible to determine why the negative impacts/consequences occurred. Some of the answers may include the wrong type of medication, poor handwriting or patient not having received the required medication etc. By identifying the problem, it becomes easier to correct potential issues in future. Step 3 3 Havingdetermined the causes of the problem, solutions can be presented, and ultimately select the best possible solution to reduce risks involved. This may involve; flagging the frequently confused medication, double checking prescription before it leave she pharmacy, making out the prescription for brand. Generic name and what it is used for, telling the patient what it is for, having one dose stored in any given location and using abbreviations from the list only. SIPOC model Suppliers - suppliers to the hospital's pharmacy include those who supply drug preparation equipment, information about new types of drugs, pills and solutions etc. Inputs - inputs in to the pharmacy include doctor's prescription, material supplied by the suppliers, and even previous patient's prescriptions. Process- with individuals getting sick, there is a need for physicians to determine what they are ailing from. They then prescribe medications that are required to treat them. The pharmacist is responsible for proving the patient with the prescribed medication, some of which they have to prepare in the pharmacy. Suppliers will provide pharmacies with all the required material and thus ensure they have all requirements to provide the required medication to patients. The patient will get the necessary medication from the pharmacy. In the event that the medication does not work as expected, the patient will return to the physician to get better medication. In some cases, the patient has to continue using the type of medication for a long period of time (Kerri, 2012). Cause 4 One of the causes of the problem as mentioned is the poor handwriting and incomplete instructions by doctors. There is a lot of finger pointing with no party willing to take the blame. This is a common problem. However, it becomes clear that the parties involved have not come together to discuss how they can effectively eliminate the issues causing the problem, and thus ensure better services. Tools and data To resolve this problem, I would use such tools as questionnaires, observation and historical records to determine the history of the problem. To be able to correct the problem, it will be essential to look at historical records of such problems, and thus determine when they started becoming prevalent. This will make it easier to determine those involved, and thus who or what would be the primary cause. Through questionnaires and observation, it will be possible to teach what the involved parties think is the main cause of the problem, and thus determine a line of thought for all involved. This will help come up with a direction as to what a majority of the involved party perceive the problem to be. For instance, whereas most of those involved may feel that the main problem is as a result of poor writing and incomplete instructions by a given doctor, the historical records may prove this to be true by showing that the problem began when the doctor started working at the hospital. Data collected from all involved party would help point out the main source of the problem (Adolf, and Kalton, 1971). Solution 5 With each party pointing their finger to the others, the best solution would start by asking the doctors to provide those in the pharmacy department with clear and complete instructions. Having done their part effectively, the rest would be up to the pharmacists. With clear instructions, they would not have an excuse for giving patients the wrong prescriptions. To measure how the strategy will work, each party will be required to report any incident that makes them unable to perform their duties as required. For instance, the pharmacist and assistant pharmacist may present evidence that the doctor gave poor instructions, which made it difficult for them to give the right prescription. This would help determine the party at fault. This would also help determine whether other factors are at play with respect to the problem. For instance, it may highlight the incompetency of some of the staff involved in the process (Anderson, McGuinness and Bourne, 2010). References 6 Anderson, P. O., McGuinness, S. M. and Bourne, P. E. (2010). Pharmacy Informatics. New York: CRC Press.Moser, Claus Adolf, and Graham Kalton. "Survey methods in social investigation." Survey methods in social investigation. 2nd Edition (1971). Simon, Kerri. "SIPOC Diagram". Ridgefield, Connecticut: iSixSigma. Retrieved 201207-03