STATISTICAL THINKING IN HEALTHCARE

Case Study 1: Statistical Thinking in Healthcare.

Roxana Aguilar
Professor: PEI-HWA LO
Strayer
Summer 2016

STATISTICAL THINKING IN HEALTHCARE

Statistical thinking is essential in healthcare as it is in many other fields. Like in all other
fields where the statistical thinking is expressed as a process that happens in a system, with
consideration to all variations and classifications, the same is also expressed in healthcare to
make significant improvements that lead to informed decisions to solve challenging issues. HMO
Pharmacy is riddled in a challenge that can partly be solved through critical statistical thinking.
The problem, as it has been noted by the Pharmacys manager, is majorly in their
prescription process. The key problem here is that The HMOs pharmacy prescription process is
lacking quality control checks to safeguard the patients safety due to inaccurate prescription
disbursed to patients. It is therefore logical that we start our reasoning from the basis in an
effort to identify the root cause, and subsequently develop the solutions. First, we have to
develop the process map about the prescription filling system. Using the SIPOC model ("SIPOC
diagram", 2016), we can note down the possible glitches faced by the pharmacy.

STATISTICAL THINKING IN HEALTHCARE

The above SIPOC model reveals the entire process of an HMO Pharmacy services. The
chart reflects clear mapping of the process along with points in the process that represent the
SIPOC elements, supplier, input, process step, output and customer. This method underlies the
major reason we have to keenly analyze the SIPOC model. At a high level description of the
model, it starts with the Doctor prescribing the medicine and exact dosage, Patient dropping
prescription at the pharmacy counter, Technician receiving order and inputting the prescription in
the system, Medicine being prepared, and patient receiving the drugs ("SIPOC diagram", 2016).
It is important to note that in todays world there are multitudes of drugs with similar
names especially if they come from the same family of drugs and a miniscule mistake can result
in releasing a wrong prescription. A few things need to be considered when analyzing this
practice in order to plan an effective process improvement. There are several areas where
improvements can be implemented to reduce the chances of a patient receiving an inaccurate
prescription. Some of the most notable root causes of the problem Ben are having resided in the
following areas. First, his entire process is not well organized hence the pharmacy establishment
is probably not well stock nor organized for the process flow to work with less frustration and
mistakes for the staff and most importantly for the customer ("SIPOC diagram", 2016). There is
a lack of prescription verification. Checking the information being presented at the counter and
confirming with Doctors office when necessary should be mandatory. This would qualify as
input since the pharmacists assistant needs to ensure he is ordering the correct medicine and to
avoid misinterpretation due to Doctors handwriting that can ultimately result as the pharmacys
negligence. Data management is not accurately being recorded. The pharmacist must keep in
check all medicines against patient records or the wrong medicine can be swapped to another
patient. If Pharmacist is not measuring prescription accordingly is an indication that the

STATISTICAL THINKING IN HEALTHCARE

equipment being used must be obsolete. It is imperative for the Technician to measure the
medicine accurately or the wrong doses can be administered. Incorrect prescription is handed
out to the patient. During the output step, the pharmacist needs to ensure that he is providing the
correct medication to the physician assistant. And lastly, there is evidence of extremely poor
customer service. Successful businesses strive for excellent customer satisfaction which in this
case would translate as indicating the patient how to take the medication and to immediately
consult his/her doctors if side effect should occur. Taking drugs without instructions can lead to
negative effects, which may be assumed to have originated from the pharmacy. Customers
would be the ones who take action against the pharmacy in the event they find errors in the drug
prescriptions. On that note, we can assume they are the ones whose complains were putting the
HMO Pharmacy Manager on pressure of being fired ("SIPOC diagram", 2016).
From the analysis, we can infer that the main causes of the problem are common since
they can be foreseen as happening if proper measurements are not met. These variances may not
be unique to HMO Pharmacy alone. However, that is no excuse not to ensure they are reduced,
or eliminated all at once. Common causes mentioned, if not corrected can lead to a special cause
such as patients receiving inaccurate prescription, which can lead to death or irreversible
conditions.
To develop a solution, the first action is to collect all statistics about the complaints and
all the phases along the SIPOC model (Britz, 1997). Then by critically looking at the complaints,
you can figure out where they are likely to occur along the SIPOC model. Using specific tools to
analyze the data like SPSS systems can aid in the statistical analysis, data management and
documentation to obtain the relationship between complains and erroneous prescriptions. The
pharmacy should be advised to move from its current prescription method to a more advanced,

STATISTICAL THINKING IN HEALTHCARE

health electronics records (Bush, 1991). Using electronic methods for prescriptions reduces the
probability of committing an error during issuance of drugs. Furthermore, other spot checks need
to be implemented during the process. For instance, verifying patients information prior
dropping off prescription and at the time the medicine is handed to the patient. Pharmacy should
be equipped with digital devices that can accurately measure the drugs. Another important
checkpoint is to flag prescriptions that tend to be confused either by name, shape, or color in
order to avoid fulfilling the wrong prescription. Lastly, explaining the medication to the patient,
medication brand and generic name should be enforced along with the uses and side effects of
the medication.
Statistical thinking in healthcare is important and can enable such centers to improve
accuracy subsequently offering better services that can significantly reduce customer complaints.
Putting this plan to work requires consistent assessment to make sure there are no gaps opened
and nothing falls through the crack. In order to achieve this, regular measurement and testing
will have to occur and periodical training must be required to all staff. Refreshing courses on
ethics, customer service, and distributing medical prescriptions should encouraged by
management. These courses will aid the staff improve their competency in the following areas
which are fundamental to the success of the business: Understand the laws that govern pharmacy,
whether federal or state-mandated, Discuss the HIPAA requirements and their application to the
pharmacy, Interpret physician orders and prescriptions, Prepare and distribute medications,
Define medical and pharmaceutical terms and common abbreviations, Understand the
pharmacology of medications in relation to the anatomy affected, Perform pharmaceutical
calculations, and Process insurance billing or collect payments (ed2go, 2015)

STATISTICAL THINKING IN HEALTHCARE

References.
Bush, D. (1991). Quality Management Through Statistics. Journal For Healthcare Quality,
13(5), 40-48. http://dx.doi.org/10.1111/j.1945-1474.1991.tb00200.x
SIPOC diagram. (2016). SearchCIO. Retrieved 20 July 2016, from
http://searchcio.techtarget.com/definition/SIPOC-diagram-suppliers-inputs-processoutputs-customers.
Britz, G., Emerling, D., Hare, L., Hoerl, R., & Shade, J. (1997). How to teach others to apply
statistical thinking. Quality Progress, 30(6), 67.
Career Training. (n.d.). Retrieved from http://www.ed2go.com/career/trainingprograms/pharmacy-technician.