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Case Study 1: Statistical Thinking in Health Care

Read the following case study.

Ben Davis had just completed an intensive course in Statistical Thinking forBusiness Improvement, which was offered to all employees of a large healthmaintenance organization. There was no time to celebrate, however, because hewas already under a lot of pressure. Ben works as a pharmacist’s assistant inthe 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 afew lawsuits over inaccurate prescriptions. Juan now was asking Ben for hisassistance in trying to resolve the problem, preferably yesterday!

“Ben, I really need your help! If I can’t show some major improvement orat 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’sassistant.”

“I don’t care what your job title is; I think you’re just the person whocan get this done. I realize I’ve been too far removed from day-to-dayoperations in the pharmacy, but you work there every day. You’re in a muchbetter 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 dataon inaccurate prescriptions?”

“Ben, to be honest, I’m really disappointed with that guy. He has spenttwo weeks trying to come up with a new modeling approach to predict weeklyinaccurate prescriptions. I tried to explain to him that I don’t want topredict 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, andthen 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 willonly identify the change points and send me a list; he says it’s my job tofigure out what they mean and how to respond. I don’t know much aboutstatistics — the only thing I remember from my course in college is that itwas the worst course I ever took– but I’m becoming convinced that it actuallydoesn’t have much to offer in solving real problems. You’ve just gone throughthis statistical thinking course, though, so maybe you can see something Ican’t. To me, statistical thinking sounds like an oxymoron. I realize it’s along shot, but I was hoping you could use this as the project you need toofficially complete the course.”

“I see your point, Juan. I felt the same way, too. This course wasinteresting, though, because it didn’t focus on crunching numbers. I have someideas 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 itourselves, however. As you know, there is a lot of finger-pointing going on;the pharmacists blame sloppy handwriting and incomplete instructions fromdoctors for the problem; doctors blame pharmacy assistants like me who actuallydo most of the computer entry of the prescriptions, claiming that we areincompetent; and the assistants tend to blame the pharmacists for assuming toomuch about our knowledge of medical terminology, brand names, known druginteractions, 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 quickfix we can do by ourselves in the pharmacy. Let me explain how I’m thinkingabout this and how I would propose attacking the problem using what I justlearned 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 whichyou apply the approach discussed in the textbook to this problem. You’ll haveto make some assumptions about the processes used by the HMO pharmacy. Also,please use the Internet and / or Strayer LRC to research articles on commonproblems or errors that pharmacies face. Your paper should address thefollowing points:

1. Develop a process mapabout the prescription filling process for HMO’s pharmacy, in which you specifythe key problems that the HMO’s pharmacy might be experiencing. Next, use thesupplier, input, process steps, output, and customer (SIPOC) model to analyzethe HMO pharmacy’s business process.

2. Analyze the processmap and SIPOC model to identify possible main root causes of the problems.Next, categorize whether the main root causes of the problem are special causesor common causes. Provide a rationale for your response.

3. Suggest the main toolsthat you would use and the data that you would collect in order to analyze thebusiness 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) strategyto 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 asacademic resources.

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