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Quality management systems


Companies should develop and implement quality management systems which when
integrated with other enterprise systems, focus on actionable decision-making, seek the root
causes of business challenges, and improve systems and processes. The top management is
meant to provide evidence of its dedication to the design and implementation of quality
management systems and continually upgrading its efficiency in omitting all the possible errors
(Evans & Lindsay, 2016). Inaccurate prescriptions develop because of errors made in the
prescription process map. The paper herein discusses how the HMO pharmacy can mitigate
prescription errors by analyzing the efficiency of their quality management systems.

Prescription-Filling Process Map

The prescription filling process begins from the point of patient consultation to identify
the presenting condition by considering the chief complaint, signs and symptoms evident on the
patient. The process ends at the point of handing over the prescribed drugs to the patient for
consumption. Documentation of patient care demands a collection of resources. An examination
of the pharmacy practice area through inventory and the development of a process map will give
insight into the resources available to eliminate errors in patient care (Ells & Sherman, 2013).
Ells & Sherman (2013) also point out that for the manager to be able to monitor the current
workflow from an objective perspective, one has to create a process map. The process map
ensures efficient handling of prescriptions thus prevents occurrences of prescription errors.
Pyzdek & Keller (2014) state that the supplier, input, processes, outputs and customers
(SIPOC) model establishes the boundaries of any business process. The SIPOC model defines a
process-driven approach that demarcates the beginning and ending of a process. Suppliers and

Resources mark the start of the process, whereas the outputs and customers show the end
(Pyzdek & Keller, 2014). The model also serves as a cross-checking mechanism to ascertain
compliance with business objectives. In this case, handling of prescriptions is the primary
determinant of HMO’s staff’s ability to achieve adequate patient care. HMO’s pharmacy is
experiencing a myriad of problems such as inaccurate prescriptions complaints and lawsuits. The
management is reluctant to follow the right process of problem-solving saying it involves
statistics which have an indirect effect on the presenting problem. The SIPOC model can cross-
check prescriptions from the point of diagnosis till the patient is given the appropriate medicines
as per the condition.

Possible Main Causes of the Problem

The pharmacy in question is facing the problem of inaccurate prescriptions as presented
in the complaints. Improper prescription writing can result from the incorrect recording of patient
information, mix-up of patient prescriptions, misdiagnosing the patient, prescribing wrong drugs
for a particular condition, or assuming medical examinations which supplement the clinical
diagnosis (Tabatabaei, 2014). Using the SIPOC model, resources such as the types of drugs
available in the store can influence how the pharmacists prescribe. They could possibly
manipulate the diagnosis to fit the drugs available in the pharmacy, thus wrong prescriptions.
The output as per the SIPOC model could be adverse drug reactions experienced by the patient.
These are common causes of false orders but are preventable through accurate and thorough
prescription processing as outlined by Tabatabaei (2014).
Tools and Data for Problem-solving

Using an adverse drug reaction reporting program, patients can enter data pertaining their
experience with particular drugs prescribed from the HMO pharmacy thus facilitating an easy

way to assess the efficiency of prescription generation and handling (Maddison et al., 2009). The
manager should develop standard operating procedures for quality management systems which
are efficient in analyzing each step in the process map to eliminate any errors occurring at each
step before reaching the patient.



Ells, A.W. & Sherman, J. (2013). Community and Clinical Pharmacy Services: A step by step
Approach: A step by step approach. McGraw Hill Professional.
Evans, J.R. & Lindsay, W.M. (2016). Managing for Quality and Performance Excellence-
Business & Economics. Cengage Learning.
Maddison, J. E., Maddison, J. E., Page, S. W., & Church, D. B. (2009). Small animal clinical
pharmacology. Edinburgh: Saunders/Elsevier.
Pyzdek, T., & Keller, P. A. (2014). The six sigma handbook (p. 25). McGraw-Hill Education.
Tabatabaei, S. M. (2014). Designing a Structured Conceptual Model to Develop an Integrated
Information System between a Hospital and a Pharmaceutical Company. Journal of
Iranian Association of Medical Informatics, 1(1).

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