HMO Prescription Process
The process involved in prescribing, filling and picking up a prescription medicine is quite complex (Stasiak et al., 2014). It is in the interest of every health care provider to provide the most effective treatment. In most cases, problems in prescribing arise in this process (Stasiak et al., 2014). HMO pharmacy uses the process map below in its prescription filling process.
Customer receives the medicine from the pharmacist assistant
Pharmacist assistant collects the medicine
Pharmacist reads the prescription in the system and fills the medicine
The pharmacist assistant translates the doctor’s prescription and feeds it into the system
The patient presents the prescription to the pharmacist assistant at HMO Pharmacy
The patient receives the prescription from the doctor
This process map faces several challenges as given below:
• The process map does not substantiate the ability of the customers or their insurance cover’s to cover the cost of the medicine
Delegate your assignment to our experts and they will do the rest.
• The process map does not allow for validation of the information entered into the system by the pharmacist assistant upon receiving the prescription from the patient
• The process map does not allow for validation of the medicine received from the pharmacist in comparison to the patient’s prescription
• It does provide the patient with means to provide feedback on the medication process
Analyzing HMO Pharmacy’s Business Process using SIPOC Model
SIPOC stands for Supplier, Input, Process, Output, and Customer. It is a model used to document the business process from the beginning to the end. The process is used in the Six Sigma statistical methodology to identify all the relevant elements of a process improvement before the commencement of the work. The SIPOC model answers the following questions.
• Who is the supplier of the inputs in the process?
• What are the input specifications?
• Who are the end-user customers of the process?
• What are the specifications of these customers?
A SIPOC presentation of HMO’s prescription process can be given as below
Customers
Patients
Output
Medicine
Dosage
Advice Bill
Process
This is the whole process from receiving the prescription from the patient to handing the patient with the medicine
Inputs
Prescription
Drug directory
Computer
Suppliers
Doctors
Patients
Pharmacy assistant
From the process map and the SIPOC model given above, we can identify and categorize the causes of the problems in HMO as common or root causes.
Common Causes
• Medicines with similar names and packaging (Baker, 2013). It is easy to confuse medicines whose names are similar or package in a similar manner when working in a busy pharmacy such as HMO. For example, enalapril and Anafranil, or the packaging used for amlodipine and allopurinol. These drugs have a higher percentage chance of being mistakenly dispensed in place of the other (Stasiak et al., 2014). The pharmacist could reach for amlodipine instead of allopurinol eventually giving the wrong medicine to the patient.
• Misreading prescriptions. Doctor’s are often accused of having a highly illegible handwriting. Sometimes, the pharmacist assistant applies guesswork while feeding the prescription into the system (Baker, 2013). As a result, the assistant could end up giving the wrong type of information to the pharmacist.
• Incorrect calculations. Medicine that requires complex calculations is usually a common cause of errors in prescription (Baker, 2013). For example, for drugs that require dilution, the pharmacists often fail to differentiate between milligrams and milliliters. These types of errors are very common and often could lead to more complications if the wrong calculation is given (Baker, 2013).
Special causes
• Outdated medicine. The pharmacist may end up giving outdated medicine to the patient, which may result in other harmful side-effects on the patient (Baker, 2013). It is not common to find outdated medicine in HMO since it has a high rate of stock turnover which reduces chances of medicine expiring. However, some of the medicines are not frequently prescribed and the pharmacy might lose track of the expiry time.
• Out-of-stock. In some instances, when a type of medicine goes out of stock, the pharmacist might offer a substitute medicine in place of the prescribed medicine (Stasiak et al., 2014). Though the pharmacy is regularly restocked, out-of-stock medicine could lead to substituting the prescribed medicine which could be of higher costs or have other side effects on the patient.
Problem Analysis Tools
One of the tools that I would use to correct data and analyze in the HMO Pharmacy business process is observation (Baker, 2013). This involves observing the actions in all the stations that the prescription passes through from the point when the prescription is received and when medicine is handed to the patient by the pharmacy assistant (Baker, 2013). By observing, it is possible to identify the number of a number of prescriptions received in a day, note instances of near-miss prescriptions on either station and note the completed wrong prescriptions and the frequency of errors (Baker, 2013).
To analyze the data collected through observation, a statistical package SPSS is recommended. SPSS is user-friendly and produces an analysis that is easy to understand. In HMO Pharmacy, the data collected during observation with regard to the number of prescription files received in the period under survey, the number of wrong prescriptions and near-miss instances and the correlation between the two, and the frequency of the errors (Baker, 2013). The report generated via SPSS will also help the manager to measure the extent of potential damage that the pharmacy faces.
Solution to HMO’s Pharmacy’s Problem
The most viable solution for HMO Pharmacy’s problem is introducing checks and validation of all the steps involved in the prescription process. HMO’s system allows for computerized recording and transmission of patient’s prescription in soft. This is done by the pharmacy assistant and used by the pharmacist to deliver the medicine. Due to lack of validation of the information entered into the system by the assistant, chances of errors are high. Validation can be done either by delivering the doctor’s prescription to the pharmacist or introducing a validation station to confirm that the drugs handed to the patient to conform to the doctor’s prescription. This can be automated by scanning the doctor’s prescription and attaching it on the information entered by the pharmacy assistant.
At the validation point, the validating assistant will confirm the correctness of the information entered into the system against the scanned doctor’s prescription advice, and also confirm that the drugs given by the pharmacist are as per the prescription. This will help to identify instances of wrong drugs being forwarded to the patient, or giving the patient the wrong information with regard to prescription calculations. It will also help validate the patient’s ability to pay for the medication or the insurance coverage.
The effectiveness of this solution can be tested by tracking the number of wrong prescriptions given to the patients. This will include doing a feedback follow-up on the prescription filing on a regular basis to confirm that they were provided with the correct medication and whether the medication is working as per the doctor’s advice (Stasiak et al., 2014). This is guided by the need to ensure that the pharmacy is not being exposed to more complications concerning prescription errors which could result in further costs or reputation damage for the pharmacy.
References
Baker, K. (2013). Medication safety. Australia: Delmar Cengage Learning.
Stasiak, P., Afilalo, M., Castelino, T., Xue, X., Colacone, A., Soucy, N., & Dankoff, J. (2014). Detection and Correction of Prescription Errors by an Emergency Department Pharmacy Service. Cambridge University Press.
