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• Apologized, empathized

• Replaced medication

• Counseled patient after adverse event

• Corrected at refill

• Changed label

• Refunded payment/provided store or gift card

• Referred to provider or referred for evaluation

• Referred incident to corporate offices for action or follow up

• Other (please describe)

Guide for Use

This question is intended to capture how the pharmacy corrected the problem for the specific patient. This question does not capture how the pharmacy has corrected the system-level problem to prevent future recurrence for all patients. Participants are required to provide at least one cause (why it occurred) and an associated system-level action plan on the Summary Tab. Action plans outline the steps an organization will take to prevent future adverse events and are a critical component of the root cause analysis.

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