Transforming a pharmacy together: the Charlotte Maxeke Johannesburg Academic hospital.
Before 2015, the patient experience at the Charlotte Maxeke Johannesburg Academic Hospital pharmacy went something like this: take the day off work to have your prescription filled; line up at dawn before the pharmacy opens in hopes of beating the rush; once inside, wait up to several hours for your prescription to be filled; or worse, wait only to experience a “false stock out”—a phenomenon in which a medication appears out of stock but is in fact available in pharmacy storerooms—and go home empty-handed.
Charlotte Maxeke Johannesburg Academic is one of the largest central hospitals in South Africa, which sits in the province of Gauteng. The hospital pharmacy dispenses almost a quarter of a million prescriptions each year—yet it had a reputation for poor service and facilities. For example, patients discharged from the hospital with prescriptions—a patient category known as “to take outs”—spent on average six hours waiting for prescription medication to be delivered to the ward after discharge. Every day, an average of 20 percent of out-patients visiting the pharmacy experienced false stock-outs.
In September 2014, the Gauteng Department of Health began a province-wide project to provide pharmacy customers with more professional and efficient visits. The department wanted to prove that it could offer better service wherever needed, and the troublesome situation at the Charlotte Maxeke pharmacy made it an excellent place to make its case.
With so much ground to cover, the leadership at Charlotte Maxeke needed a step-by-step plan for the pharmacy transformation.   
The consultants began by working with managers to narrow their focus to improving the physical environment, prescription-filling process, and stock management, the main factor behind lengthy waiting times. To kick off the project, the consultants focused on making the physical premises more welcoming and attractive to patients and staff. One Saturday, Department of Health officials, including a member of the executive council, the pharmacy manager and CEO of the hospital, infrastructure-department representatives, and the consultants, all pitched in for a day-long cleaning. The idea was to show staff how committed leadership was to turning around the pharmacy. The volunteers painted and decorated walls; added amenities like water coolers, TVs, and coffee machines in the waiting room; and supplied pharmacists with monogrammed lab coats. Patients and staff immediately appreciated the more cheerful and professional atmosphere.
Then the consultants turned to improving the process of prescription filling. A consulting team mapped the existing process and studied each step to identify bottlenecks and areas of wasted activity. They then devised a streamlined approach using three principles of lean production.
The first was called “first time right” and aimed to stop invalid prescriptions from entering the filling process. A senior pharmacist became the first point of contact for each patient. The pharmacist would filter out patients whose prescriptions were invalid (because they were not yet due for refills) or could not be filled because of stock shortages. Second, they removed the batch system, which meant prescriptions were no longer dispensed in batches of ten, but were made available to be dispensed as soon as each one was ready. Finally, the team introduced a “demand-pull” system, which enabled staff actually to dispense these prescriptions to patients in a timely fashion. The existing process began with taking in scripts as fast as possible, and then filling them. The result was a huge buildup of filled scripts that were waiting to be labelled and dispensed to patients (in other words, a “push” approach). The team shifted the focus to the end of the process—dispensing—and ensuring that there was sufficient staff to distribute prepared scripts, thus “pulling” prescriptions through the process more efficiently.
Relatedly, the team addressed false stock-outs, another important factor behind long wait times. These were resolved by implementing a two-bin system on the pharmacy shelves with pre-defined refill levels. Essentially, when one bin of medications was empty, pharmacists would begin retrieving medications from a second bin. The refill levels for a bin—how many medications to place inside—were calculated for each medication based on dispensing frequency. The consultants also revised each staff member’s role in the process and adjusted the layout of the pharmacy to make it more orderly. This included outfitting each workstation with laminated posters that displayed the new process rules. They also designed management tools—for example, a daily roster with role allocation and a performance dashboard—that the pharmacy manager was then responsible for implementing.
Under the new system, pharmacy staff rotated between duties to ensure that there was no build-up of scripts. This required knowing how many people to assign to each stage of the process and shifting staff when someone was absent, at lunch, or when there was a backlog. The team initially oversaw these shifts, but then coached the pharmacy staff on identifying and resolving bottlenecks quickly, with the senior pharmacist on the floor ultimately responsible for managing the workflow.
In conclusion, the teamwork and process review that was provided helped staff to work smart and not hard. Improving the working environment of staff, listening to their concerns and supporting them through change management has definitely improved the quality of care and the experience that the patients and communities received from the hospital.

QUESTION 1.2
Provide a critical account of how the total quality management (TQM) concept could have been used in the case study? (30)

1. Using the paragraphs you wrote in the Module 1 Required: Maintaining Academic Integrity in Original Writing assignment, copy and paste the paragraphs below and complete the following:

   • Locate one peer-reviewed source in the University Library from EBSCOhost based on the topic of your paragraph.
   • Insert a paraphrase, direct quotation, or summary into your paragraph using the peer-reviewed source.
   • Create an APA-formatted in-text citation for the peer-reviewed source.
   • Create an APA-formatted reference for the peer-reviewed source.
2. Question 1

   1 Point

   Paste your paragraphs here and create an APA-formatted in-text citation for the peer-reviewed source.

What is academic integrity from module 1 was informing me on referring to the school reference center in the library to help from committing plagiarism. So, by doing all the steps correctly in writing a paper plagiarism would not occur. So, I feel as if you don't follow the academic integrity of using false information. So as a student and getting performance feedback by a professor need to staff helps in knowing and participating into university policy for regarding misconduct specific to the university, program and course. So as a student and a paper are plagiarized because of some time being lazy and waiting to the last minute to do a paper, but also by not doing the citation in the paper. Also, by just adding their name on someone else paper and turning it in. So, by doing these things for a paper It shows the lack of confidence one may have in self. But if they use the university resource material It may guide a student to use their own exposition or argument and words in a paper.

So, when your finding ways out to avoid plagiarism you should take into consideration the following: You can talk with your professor to get an idea of where you can start getting your information from. So if during your writing you find yourself with a question or concern about how to cite something or if it needs to be cited all ,do not hesitate to speak with your professor to gain ideas when you go to the center of writing excellence. So, a student should consider checking your work and add quotations for cited information that may be used in a paper. So, if you are still not sure that your work is correctly cited, consider checking the paper yourself before submitting it before It shows that you had plagiarized your paper. So by doing it will make you have confident and start making you pay more attention to your note taking and adding citations to your notes before you have doubt about your work early on and you can go back and add the necessary information. But if you don't remember all the steps and you still have doubt and you have followed the university center of writer excellence ,but also consider getting a fellow students who can provide feedback to help guide you in the right direction so it wouldn't occur.

3. Paste your paragraphs here and create an APA-formatted in-text citation for the peer-reviewed source.

4. Question 2

   1 Point

   Create an APA-formatted reference for the peer-reviewed source.

Westerly Woolens is a growing sole proprietorship that is considering going public. The owner knows that she will have to establish a board of directors, but she is confused by such acronyms as SEC and PCAOB. Additionally, she does not understand the difference between internal audit and external audit.

Prepare a memo to the owner of Westerly Woolens describing the concept of corporate governance and the roles of the following: board of directors, CEO, audit committee, PCAOB, external auditor, and internal audit function. Include the relevant requirements of the Sarbanes-Oxley Act of 2002 (SOX).

Type your communication in the response area below.

A.

SOLVE USING MATLAB

Consider the world oil production data of Computer Problem 3.2.3. Find the best least squares (a) line, (b) parabola, and (c) cubic curve through the 10 data points and the RMSE of the fits. Use each to estimate the 2010 production level. Which fit best represents the data in terms of RMSE?

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In 2003, Major League Baseball took steps to speed up the paly of baseball games and make games a more consistent duration. In a sample of 41 games in 2002, the average duration of a game was 2 hours and 58 minutes with a standard deviation of 32 minutes. A similar survey in 2003 of 31 games found that the average duration was 2 hours and 40 minutes with a standard deviation of 19 minutes. When testing the hypothesis (at the 10% level of significance) that the variance has been reduced, what is the critical value? (please round your answer to 2 decimal places)

Legendary for his business and investment acumen, Warren Buffett is frequently called the “Oracle of Omaha” after his birthplace in Omaha, Nebraska. As one of the world’s wealthiest business owner-investors, business executives are always interested in any insight or opinion Mr. Buffett might wish to share.

Explain each one of the following statements made by Warren Buffett. (Quotations from The Wall Street Journal, September 23, 2002.)

“You cannot be the high-cost producer in a commodity business.”

“Sometimes it’s not even any good to be the low-cost producer.”

The riskless rate for this period is 3.5%, and the covariance between returns on IBM stock and the S&P500 over this period is 0.02276.

1F. What is IBM’s CAPM beta according to this data?

1G. What is IBM’s CAPM cost of equity according to this data?

1H. If IBM’s debt to equity ratio is 0.57, what is their unlevered cost of equity according to this model?

Please work out by hand not on excel

May     8- Sold merchandise on account to Rustans, P11,000, VAT included. Terms: 2/10,

                        n/30.

18- Received a check from Rustans for the amount owed on the May 8 sale.

my question is about the transaction 18.. is it the right journal entries??

A stock was priced at $150 per share at the end of 1999. The following table shows dividends per share paid during each year and the price of the stock at the end of the year for the following four years:

year divedends paid during year stock price at end of year

2000 $3.00 $125

2001 $3.00 $150

2002 $3.50 $155

2003 $4.00$200

For each year from 2000 to 2003, calculate the dividend yield, the capital-gains yield, and the total return to the stock. Express your calculations in percentage terms