A Performance Of Health Maintenance Organizations (Case Study Sample)
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 following points:
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 academic resources.
Your assignment must follow these formatting requirements:
Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student's name, the professor's name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
The specific course learning outcomes associated with this assignment are:
Describe how organizations use statistical thinking to be more competitive.
Apply the basic principles of statistical thinking to business processes.
Apply the SIPOC model to identify OFIs in business processes.
Use technology and information resources to research issues in business process improvement.
Write clearly and concisely about business process improvement using proper writing mechanics.
Subject and Section
Just like any other services in the market, the performance of Health Maintenance Organizations should always be accurate, efficient, and dynamic. It must be able to respond with any issues that arise from its day-to-day operations and be able to propose and adapt a solution that would ensure its clients of an above-par service. In the case at hand, Ben Davis faces a problem that includes accuracy and efficiency of an HMO service. It was stated that there are two main issues that he must resolve, namely (1) improve the performance of an HMO using business statistics and (2) to resolve problems when it comes to inaccurate prescriptions given to patients. In the succeeding section of this article, a process map about the prescription filing process in the pharmacy would be developed in order to address the issues posed above. All in all, the author believes that by streamlining the process with the help of statistics and automation, the HMO would benefit as it improves its performance and decreases risks.
In order to maintain an efficient filing system, a linear process should be adapted from every stakeholder from the prescriber to the patient themselves. The process starts from the healthcare provider writing prescriptions for the patient. These prescriptions should then be given to the pharmacy that is affiliated with the HMO in order to standardized the process. As the pharmacy receives it (e.g., Ben Davis’ workplace) the details would then be entered into the system including everything from the patient’s personal information, medical history, and prescription given that the client gives his consent. As the system counterchecks the patient’s insurance status, it automatically approves the release of the prescription. However, the pharmacist should again consult and educate the patient in order to make sure that the patient is receiving the right medicine and knows how to take it.
Going back to the case, this process model presents a very efficient solution to the problems that Juan is facing. In a study conducted by the World Health Organization (2016), one of the common causes of medication errors is the lack of communication between pharmacists and the doctors who prescribe the patient’s medicines. Specifically, the study found that medication error rates amount to about “3% at the dispensing stage and failure to review repeat me
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