StatisticalThinking in Health Care
StatisticalThinking in Health Care
Question1
Forthose who subscribe to HMO (Health Maintenance Organization), thereis an often requirement that there be the use of on-site pharmacy orthe HMO may need one to use some pharmacies. The below diagram is aprocess map that depicts the prescription filled at an HMO.
ProcessMap
Abovediagram illustrates the process map that is used to prescribe thefilling process for HMO pharmacy. In this task, the causes ofdispensing errors are traced through the root-cause analysis.Further, the errors are also identified by conducting surveys amongthe practicing pharmacist. Using the root-cause method is bettercompared to measurement by surveys. The root-cause analysis givesreality while the use of surveys only gives the perceptions andopinions of the pharmacists. Some of the errors that have emerged inthis area are indicated by a study that was done in a hospital in theUK. While carrying out research in this hospital, semi-structuredinterviews of the different staffs in the pharmacy was done to findout the self-reported dispensing errors. Notably, in this researchquite several conditions that lead to error were mentioned in theinterviews. From the study, it emerged that some of the main causesof error included inadequacy in the staff, busy schedules, tight timeframe, overworked health care providers and interruptions whendispensing medicines.
Astudy commissioned in Denmark analyzed the different self-reports ofcommunity pharmacies to help establish the causes of dispensingerrors. From this research, it was found that the main causes werefour. These causes included poor handwriting that in most cases arecomplex to read, inadequate or no tools for control and interruptionsthat result into the lack of concentration. Further, a differentstudy was carried out in Finland to help determine the perceptions ofthe pharmacist regarding this matter. The main causes from this studywere put in five different categories. The first cause was related tothe organization, and this was represented by 37%. The other issueswere related to the prescriptions offered at 17%, the professionalsin charge at 30%, the drugs that are prescribed at 10% and thecustomers who are problematic at 4%. Some of the identified problemswith the customers included the talkative nature of the customers,customers that have many prescriptions from different physicians andcustomers who are in a hurry.
Analysisof the Process Map and SIPOC
Fromthe research carried out and the process map, the process can becategorized into four main areas. These include ordering,transcribing, dispensing and administering. From every of thesestages, there are several errors that develop. At the orderingprocess, there are several errors that occur, and this includes wrongdose, incorrect drug, giving of the wrong form and drug interaction(Cheung, Bouvy & De Smet, 2009). At the transcription stage,there are several, there are also significant problems, and theyinclude wrong dose, wrong time, wrong patient among others. Thisstudy mainly focused on the dispensing stage. This stage has severalerrors and among them include the wrong dosage of drugs, incorrectlabeling as well as the wrong procedure to dispense the drug (Cheung,Bouvy & De Smet, 2009). At the end of the day, the patient islikely to suffer from allergy or drug interaction. From thediscussions, the main root causes that have been identified arecommon causes and nothing special. They are common as they have beenfound in nearly every other study. The causes are not new to thepatients and the physicians alike.
Suggestthe Main Tools
Someof the tools that would be used to analyze the business probleminclude the use of surveys and use of self-reporting systems.Surveys, in this case, entails taking into consideration theperceptions of the physicians concerning the matter at hand. Throughthe surveys, the true reflection of the issues that are faced comeout. Additionally, using the self-reporting system presents theproblems that are faced first-hand. Some of the data that would becollected include the manner in which the drugs are administered, themethod of prescription, the process, and procedure under whichdispensing occurs. Through collecting data on these parameters,individuals are then in a position to find out the loopholes that arein the process and address them fully.
Solution
Tosort out the problem with the prescription, the pharmacy shouldinvest in technology. Having technology in place ensures that all theprescriptions made by the doctor are typed and if need be printed.Through technology, the prescription is transmitted online from onepoint to another, for instance, from the doctor to the clerk andultimately to the pharmacist who dispenses the drug. In responding tothe outcome of the solution, there can be the use of surveys given tothe customers and the physicians to collect their feedback regardingthe matter under investigation. Through the surveys, the impact ofthe online and technological advances made can be evaluated.Evaluation can then result in the HMO making the appropriatecorrections.
References
Cheung,K. C., Bouvy, M. L., & De Smet, P. A. (2009). Medication errors:the importance of safe dispensing. Britishjournal of clinical pharmacology,67(6),676-680.