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Can you please review my paper and help me to be sure that it is meeting all the criteria that the Professor is requesting? I have enclosed my final draft, the summary of the assignment and additional information of which the professor is requesting. This is due on Monday but I would like to have his submitted before than, also does it meet APA guidelines and does it make any sense in what I stating in my paper.


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.


Hello Class,

    I would like to remind you that there is a video recording in your Instructor Insights that help you work on the case study. In this post, I will summarize key points on the case study. Please note that I do not count pages. I like to see your thoughts on how to convince upper managers to save Juan's HMO job.

(1) Identify HMO pharmacy problem. You can read the references or use your own experience / thoughts on what the problem may be. 

(2) You may consider using SIPOC model or process map to clearly identify the process step(s) that is broken and needs the improve improvement (if it is a common cause variation) or problem solving (if it is a special cause variation).

(3) Once you propose the solution to the HMO pharmacy problem, what tool(s) would you use to measure the results so that you know the problem(s) are resolved or improved?

(4) How would you (assume you are Ben) help Juan to convince his boss that HMO pharmacy is on the path of recovery and he should be kept for his job.

I hope this brief description is helpful for you to complete the case study. Please ask questions if you have any.

Gail L. Richardson
Professor PEI HWA -LO
May 1, 2017 1 CASE STUDY 1: STATISTICAL THINKING IN HEALTH CARE 2 Abstract This case study is about a student that just completed a course in Statistical Thinking for
Business Improvement. In this particular study, I assume the character of Ben Davis and is
attempting to provide an understanding of the issue concerning prescription errors that are
mishandled at the HMO pharmacy. In the health care field, many types of medication errors
including missed dose, wrong dosage forms, wrong time interval, untimely routes, are a big deal
for better patient care (Pharm, 2010). Today, problems related to medications are common in the
healthcare profession and are responsible for significant morbidity, mortality, and cost. Mr.
Davis’s concerns are valid concerns for many patients and doctors across the world. While
researching this case, there are standard errors that were found in prescribing faults, prescription
errors, transcription, dispensing, and administrative errors. These areas can arise at any given
time, but it is paramount to bring attention to them so that patients can benefit physically,
mentally and emotionally from taking the rightly prescribed medication. CASE STUDY 1: STATISTICAL THINKING IN HEALTH CARE 3 PROCESS MAP
If an insured belongs to an HMO (Health Maintenance Organization), they may be
required to use an on-site pharmacy (at the location of the HMO), or the HMO may require you
to use a particular medication list drugstore. Your insurance company may have a predetermined list of drugs listed in the contract (Hoerl & Snee, 2012. Listed below is an example
of getting a prescription filled at an HMO pharmacy using a flowchart:
Several omissions can be encountered from the time the patient drops off the order to the
time it’s filled. The patient is given the wrong remedy for the ailment. Dispensing errors in
which a patient is given incorrect medication include any inconsistencies or disparity from the
instruction for the order, such as dispensing the incorrect drug, dosage form, wrong quantity, or
inappropriate, improper, or inadequate labeling. Also, understanding the doctor’s penmanship
can cause errors in processing a prescription (Phelps, 2016) All of these issues can happen while
the prescription is being filled. Using the (SIPOC) model, has been proven that the HMO
providers can untrained with errors from all levels of the business technique(Hoerl & Snee,
2012). The distribution of the medication, the process being followed into the system includes
doctors, pharmacist, pharmacy techs and all participants of a pharmacy industry. The customers
of the HMO pharmacy are last in the process due to the attention the pharmacy will get
because of the discrepancies they’ve caused to other clients. CASE STUDY 1: STATISTICAL THINKING IN HEALTH CARE 4 SIPOC MODEL patient recieves
treatment and
prescription before
leaving the physician
office patient take prescription
to their pharmacy to get
filled Clerk hands prescription
to the pharmacist to
validate and fill patient receives filled
prescription and leaves
the store to complete
health regiment patient hands
prescription to the clerk
and is given a time of
wait on recieving the
prescription Possible root causes of the problems could be identified in the transcribing and
administering of the medications. The tech entering the wrong prescription can be the start to the
root of the problem because the prescription is entered wrong to begin with. Patient identifiers
should be intact so that common errors can be eliminated with the knowing of the patient’s age,
last medications filled by the pharmacy and so forth can rule out the wrong medication being
given to a customer. The administering or dispensing of the drug is another root cause of
problems in the pharmacy. If there is any ambiguity of abbreviations or dosage amounts, the
pharmacists should contact the doctor or prescriber before dispensing the medicine to clarify
what is being asked from the prescriber. These two issues can be easily solved by a rechecking of
what’s to be clarified before prescription needs should be given to a customer. Patient
identifiers in the system would be a common cause and the ambiguity of abbreviations and CASE STUDY 1: STATISTICAL THINKING IN HEALTH CARE 5 dosage amounts would be a special cause.
The main tool that I would use to collect data to analyze the business process would be
from the sales representatives that market the drugs for the drugstore. I would suggest that the
pharmacies company host a lunch and learn sessions for their staff so that they can recognize
common trends when they’ve made a mistake[JYo10]. Also, this is a way for the staff to meet
and greet the sales representatives from their area. While state governance, the PhRMA Code on
Interactions with Healthcare Professionals and companies' guidelines have brought greater
attention to reps bearing meals, it remains a proven way for getting doctors, pharmacist, and their
location to stop for a moment and learn[JYo10].
Through various research, I would suggest that pharmacies thoroughly check
prescriptions before they are disbursed with a structure that involves checking and rechecking
written orders with the prescriptions in the computer. First, I would propose an electronic system
where the doctor can send prescriptions over electronically to any pharmacy within its
boundaries. The intricacy of the determining procedure should be reduced by introducing
automated systems or uniform prescribing charts to avoid transcription and omission errors***.
Evaluation control systems and immediate review of prescriptions, which can be performed with
the assistance of a hospital pharmacist, are also helpful. Audits should be performed periodically.
Micromanaging the entries of the clerk from more than one person should also be inserted into
the company’s protocol for filling prescriptions. Employees that input data enters the prescription CASE STUDY 1: STATISTICAL THINKING IN HEALTH CARE 6 in the computer should be checked by the seasoned supervisor in their department that knows
what to look for in traditional data entry.
The strategy used to measure this solution should be an electronic signature requiring a
type of verification in which the person who enters the prescription should have to sign a form
stating the all the ground rules have been followed. There is an old saying “Two eyes are better
than one,” in which two people will serve as a check and balance before any prescription given
to the customer. The information entered could eliminate errors and common mistakes with a
system that makes employees accountable when it comes to people’s lives. This will protect the
company’s image and the customer's health.
In conclusion, this case study has brought attention to the behind the scenes aspects of
dispensing pharmaceutical drugs. Furthermore, this study has highlighted the need to be careful
for the clients trust the pharmacy to know and do what is right. Clients put their lives in doctors,
nurses, lab clerks and pharmacist to have an up – to date knowledge of dispensing medicine. This
trust can’t be taken lightly because of the grave danger that is associated with it. Juan is a
supervisor position but he needs to honor the duty of it and not the privilege of the title and be
teachable and not last minute effort to save face. CASE STUDY 1: STATISTICAL THINKING IN HEALTH CARE 7 References
Giamaolo, P. (2009, June 6). National Library of Medicine. Retrieved from
Hoerl, R., & Snee, R. (2012). Statistical Thinking. Hoboken: John Wiley & Sons, Inc.
Paul, R. (2010, April 1). Pharmexe. Retrieved from
Pharm, J. Y. (2010, March 2). National Library of Medicine. Retrieved April 4, 2016, from
Phelps, A. (2016, September 14). Quora. Retrieved from


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