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 pharmacists assistant in the HMOs pharmacy, and his manager, Juan de Pacotilla, was about to be fired. Juans 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 cant show some major improvement or at least a solid plan by next month, Im history.
Ill be glad to help, Juan, but what can I do? Im just a pharmacists assistant.
I dont care what your job title is; I think youre just the person who can get this done. I realize Ive been too far removed from day-to-day operations in the pharmacy, but you work there every day. Youre in a much better position to find out how to fix the problem. Just tell me what to do, and Ill do it.
But what about the statistical consultant you hired to analyze the data on inaccurate prescriptions?
Ben, to be honest, Im 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 dont want to predict the mistakes, I want to eliminate them! I dont think I got through, however, because he said we need a month of aIDitional 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 its my job to figure out what they mean and how to respond. I dont 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 Im becoming convinced that it actually doesnt have much to offer in solving real problems. Youve just gone through this statistical thinking course, though, so maybe you can see something I cant. To me, statistical thinking sounds like an oxymoron. I realize its 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 didnt 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 theres no hope, Ben!
I wouldnt say that at all, Juan. Its just that there may be no quick fix we can do by ourselves in the pharmacy. Let me explain how Im 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): 6780.
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. Youll 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 aIDress the following points:
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