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Description

Describes the pharmacy’s response to the adverse event

On-Screen Instructions

Select all that apply.

Field Type

Checkbox (multiselect)

Responses

  • Apologized, empathized

  • Changed label

  • Corrected at refill

  • Counseled patient after adverse event

  • Referred incident to corporate offices for action or follow up

  • Referred to provider or referred for evaluation

  • Refunded payment, provided store or gift card

  • Replaced medication

  • Other (please describe)

Guide for Use

If “Other” is selected, a text box for a description will also appear.

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.

History

Start Date

2013

End Date

n/a

Change History

July 2013: Removed “provider changed prescription” as an answer option because the provider is not a representative of the pharmacy, therefore “provider changed prescription” cannot be a manner in which the pharmacy responded to the event.

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