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In the given case, Ben Davies (an assistant pharmacist) is asked by one of his superiors to suggest processual improvements of filling prescriptions in an HMO (Britz, Emerling, Hare, Hoerl, & Shade, 1997). A process map will enable Davies to visualize the processes that are already being implemented, examine them, and develop a better strategy by cutting on wasteful steps within the procedural framework. Juan has provided an explanation on the disagreement between the main actors of the process. The list below demonstrates the involvement of the said actors in ensuring the drugs are dispensed correctly.
The complaints concerning the untimely or incorrect dispensary necessitate a thorough reconsideration of the prescription-filling process starting from the medical practitioners. There is an evidence in the case concerning the untimeliness that states that statistical consultant spent time trying to predict weekly inaccurate prescriptions instead of eliminating them. The parties do little more that finger-point and accuse, which explains the need for mutual involvement to solve the problem effectively.
Process map and analysis
Dispensing should be performed one prescription at a time. When a prescription is carefully chosen to be given out, the pharmacy structure will show the pharmacists the provisioning event that has been pre-accomplished on the base of the prescription facts (Tootelian & Gaedeke, 2012). The pharmacologist checks the data and finishes the input. The system validates that the obligatory information has been input and the medication to be dispensed is available in the pharmacological catalog.
The automated prescription comprises a field where the clinician may have left a note for the dispensary. For instance, it may be information regarding the renewal payment or an appeal to the pharmacy to call off a prescription. The most common errors in the process include dispensing medicines with analogous names or almost identical packaging. The pharmacist should act attentively in order not to pick incorrect medicine or label the medicine incorrectly. It is essential that the pharmacist does not dispense an outdated medication or dispense counter to the prescription.
The HMO system has certain monetary issues, salaries being the major one because they are just enough to cover the medication costs. The associates are “wedged” to the primary care practitioners, and the associates are required to transfer the patients, which complexifies the acquisition of any particular medical services. The complexity is caused by the fact that the cases not classified as transferrable are not accounted for.
Thus, albeit their significance as a category of preventive medicine, the HMO health care strategies subsume the care as such is quite difficult to acquire, and the mistakes are likely to occur (Hopper, 2014). If an error occurs on any of these stages of prescription filling, the consequences can be critical. Inaccurate prescription, however, can be the result of mistakes on all levels, including the medical practitioners.
The SIPOC (Suppliers, Inputs, Process, Outputs, Customers) model would also include other actors who might be responsible for the mistakes as well (Pyzdek & Keller, 2014). The dosage mistakes, for instance, can occur due to the Customer’s (or patient’s) negligence. The Suppliers’ errors can cause delays in the delivery of the necessary medication, which disrupts the “right time” component of medication dispensary. In short, the variations and deviations leading to errors exist on every level of HMO, which speaks of the inconsistency of the accusatory position of the doctors and pharmacists.
The actors of the errors, therefore, determine the commonality of the cause. In other words, when a doctor prescribes a wrong medication or fails to prescribe the right one to a particular patient, the cause is special. On the other hand, when a pharmacist assistant makes a usual mistake by entering the data incorrectly, the cause is common (Hoerl & Snee, 2012). The steps in the SIPOC model involve the following actors/ stages: suppliers (E.g., pharmacy staff, nurses), inputs (prescriptions, medications, patient data), processes (prescription intake, entry, production, and verification; dispensing), outputs (E.g., prescription labels), and customers (Stamatis, 2011).
Tools and data
The problem of inaccurate prescription can be resolved with the help of a set of qualitative tools. I would recommend introducing several data collection tools such as 5 Whys and Fishbone chart for the reason that these two instruments can help get the insight into the underlying causes of the complaints, provided that all actors of the process are involved.
The data needed to resolve the issue has to be collected from the customers, the doctors, and the pharmacists. The patients will provide information as to which medicines they regard as improperly prescribed. The medical practitioners will reveal the kind of prescriptions they sent for further administration. The pharmacists will provide copies with the instructions. Careful assessment of the data obtained using the data collection tools is the key to resolving the continuing issue of constant patient complaints. These instruments also prove to be time-saving and efficient over time.
The problem solutions and the measurements should address the issues of prescription accuracy on all levels of the dispensary process. To handle the issue, one should realize, again, that it is not the pharmacy alone that is to be held accountable for the processual errors. As it can be seen from the case, there are three issues.
The first and the foremost is the most urgent problem. It is the issue of improper management that led to a situation where the team is under pressure because of the incorrect time and resource management. In this situation, it is reasonable to assess the risks and implement the new modeling approach as soon as possible. This problem is crucial and a joint team effort should enough to solve the most urgent problem in the shortest time frame. The most important problem is the continuing flow of incorrect prescription.
This repeatedly happens for the reason that the doctors and the pharmacologists tend to blame each other but this, obviously, does not help to solve the problem. The expert team should conduct research on the methodology and the general workflow of the pharmacological and medicinal systems so as to realize the weak nodes in the system. The patients/ clients should also directly participate in the research.
I believe that there is no problem in this case that is easy to solve for the reason that the issue of inaccurate prescription and dispensing requires time and resources, appropriate human resources management, and a correct understanding of the problem. This is important to remember that more than one healthcare professional is involved in the process of drug prescription and dispensing so, consequently, this complex problem should be solved using a multilayered approach.
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The involvement of all sides of the conflict is as well crucial since the quality of healthcare depends on the patients, too. They can provide the healthcare professionals with objective data that would help make the necessary improvements to the medication prescription and dispensing system. Nevertheless, the effectiveness of the recommended solutions can be assessed over time by evaluating the ratio of patient complaints and medication prescription/ dispensing errors.
Britz, G. C., Emerling, D. W, Hare, L. B., Hoerl, R. W., & Shade J. E. (1997). How to Teach
Others to Apply Statistical Thinking. American Society for Quality, 30(6), 67-79.
Hoerl, R., & Snee, R. (2012). Statistical thinking: Improving business performance (2nd ed.).
Hoboken, NJ: John Wiley and Sons, Inc. Hopper, T. (2014). Workbook and Lab Manual for Mosby’s Pharmacy Technician: Principles and Practice (3rd ed.). St. Louis, MO: Elsevier Health Sciences.
Pyzdek, T., & Keller, P. (2014). The Six Sigma Handbook (4th ed.). New York, NY: McGraw-Hill.
Stamatis, D. H. (2011). Essentials for the Improvement of Healthcare Using Lean & Six Sigma. New York, NY: Productivity Press.
Tootelian, D. H., & Gaedeke, R. M. (2012). Essentials of Pharmacy Management. St. Louis, MO: Pharmaceutical Press.