Case Study 1: Statistical Thinking in Health Care
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
"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."
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
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.
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.
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.
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.
Use at least two (2)
quality references. Note: Wikipedia and other Websites do not qualify as