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    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 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.




Subject Nursing Pages 7 Style APA


Statistical Thinking in Medical Health Care

            Statistical Thinking for Business Improvement gave me an opportunity to analyze events in different perspectives. To begin with, it is important that we review our prescription filling process so as to identify our mistakes and then develop solutions based on the problem solving techniques learnt. As we both know, prescriptions are written instructions from the doctor to a patient instructing them on the medication to use in order to treat specific ailments. Ostensibly, the doctor is the only person allowed to prescribe medications in a health setting. Here at HMO, we receive the prescriptions as delivered from the doctor and analyze or interpret the instructions on behalf of the patient. After this, we verify whether the patient is within the pharmacy’s data base and if not, we request for their demographic data, insurance information and confirm if they have any allergies. We then feed this information in the pharmacy’s data base. This is the information our statistical consultant uses to track the trends in wrong prescriptions.

            Basically, our prescription process is almost similar to any other pharmacy procedures, however, there are a number of problems in the system. First, transcription errors in the prescriptions are the most common problems. Our doctors omit some words or letters leading to misinterpretation of the prescribed drugs. At times, these doctors use sloppy handwritings that make it difficult to read the prescriptions. Second, the pharmacy lacks confirmation procedures. This is common among us, as pharmacists. Whenever the instructions prescribed are difficult to read, we do not confirm the exact details from the prescriber, instead, we assume based on our knowledge. this is what causes the doctors to assume that we are incompetent as pharmacists. As the lead pharmacist in the institution, your involvement in the daily operations of the pharmacy is also low. in this regard, you may not know when these problems occur. Lastly, as pharmacists, we do not engage our customers adequately when selling the prescribed drugs. In this regard, we miss out on the important details of their conditions that would have enabled us give the correct prescriptions.

            For proper understanding of our business, we use the SIPOC model of analysis as learnt in the Statistical Thinking class. According to Yeung (2009), SIPOC stands for Supplier, Input, Process steps, Output and Customer. Using this method, the supplier is the pharmacy manager and the assistant or sales representative. We are the people in charge of analyzing the  prescriptions, collecting customer data and providing the correct drugs to patients. The input in the pharmacy are the prescriptions from the doctor, the clients’ background and the drugs in the store. In terms of processes, there are three main processes in the pharmacy, interpretation of the prescription, analysis of the patient’s background and notifying that the drug is available. Next is the output in which the patient is given the correct drug as prescribed and finally, the customer is the one who receives the drugs and consumes as prescribed by the doctor. Evidently, our business upholds the SIPOC business model which is simple and efficient as approved by…..

            Inasmuch as the pharmacy is able to successfully achieve the SIPOC structure, problems occur in fulfillment of specific stages. For instance, at the supplier stage, the facility’s manager rarely oversees the drug administration process. It therefore becomes difficult to detect and solve problems all business stages. The input stage is faced with the problem of misinterpretation of the prescription due to doctors’ sloppy handwritings and ignorance among the pharmacists as we do not seek clarification despite the inability to comprehend the prescribed information. Processing of the drugs and patient’s information is also poor as we fail to indulge the patients adequately in order to understand their conditions and relate them to the available drugs. These series of mistakes therefore lead to a poor output where the patient is given a wrong prescription. The customer customer’s condition therefore worsens and through investigations, the pharmacy is found guilty and at the threat of losing its license.

            According to the listed problems based on the SIPOC model, the pharmacy’s problems are due to one special cause and three common causes. The special cause in this case is that the manager (supplier) does not take part in the daily activities of the institution. Therefore, his assistant and other pharmacists conduct business without adequate guidance from the head pharmacists. this qualifies as a special cause since its effect impacts all other business processes. Other common causes include: misinterpretation of the prescription by pharmacists, ignorance as the pharmacists fail to confirm the unclear details from doctors and inadequate collection of patient data. These are common causes since pharmacists all over the world face the challenge of sloppy handwritings from doctors and seek clarifications, counseling patients before dispensing is done in all pharmacy and helps to reduce the chances of errors by up to 83% and finally, pharmacists check the prescriptions repeatedly as required by their practice ().

            As opposed to hiring a statistical consultant who focuses on predicting the occurrence of mistakes instead of identifying the mistakes, I would adopt a pharmaceutical business model where all business transactions are carried out as described by the pharmaceutical procedures. For instance, all pharmacists should adequately seek the client’s conditions before administering any drugs. Second, I would encourage administrative operations where any unclear prescriptions are channeled to the pharmacy manager who verifies the details from the doctors especially whenever the doctor uses a sloppy handwriting and finally, I would integrate the vertical and horizontal support structure which will allow the administration to interact with the clients and pharmacists in-charge more frequently. To ensure that these tools work accordingly, I would generate questionnaires in which the patients will answer questions regarding the quality of services as per the described areas of operations.

            Lastly, the problems experienced at HMO pharmacy are common among other pharmacies. The only unique problem is that of limited involvement by the administration. In this regard, i encourage the management to participate in the daily activities of the pharmacy by being the link between the pharmacists and the doctors. In this regard, they should be the ones to contact the doctor to seek clarification whenever the prescriptions are unclear. This will ensure better accountability and reduce chances of wrong prescriptions. To measure the efficiency of this solution, pharmacists should always note the instances in which the doctor is consulted and record this along with the patient’s information in the data base. In this regard, any complaint can be determined linked to know whether the chain of command was adequately utilized during administration.






Desselle, S. (2012). Good Management Practice and Medication Therapy Management—A Winning Combination. In New York: McGraw-Hill.

Yeung, S. M. (2009). Using Six Sigma – SIPOC for customer satisfaction. International Journal Of Six Sigma And Competitive Advantage, (4)





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