Specialty Pharmacy (4.0) 4.0

PSC 2-1: Patient and Prescriber Complaints

Submited by: Tom Goddard

The Basics

This standard requires that your organization have documented processes that measure and analyze data regarding complaints from patients and providers. These data need to be analyzed in a way that helps the organization to spot trends in performance on those metrics and report the results of the analyses to the quality oversight committee no less frequently than quarterly. The organization's documented process also must include evidence that the organization responds to those analyses with implemented action plans where the analyses of data suggest performance is improvement is needed.

Management Tips

Be sure to review for consistency between the processes that you describe here and whatever policies you submit for CPE 4-1 and PMI 1-3 that might relate to this standard. They must match. In fact, you may find that you submit some of those documents here, too. 

Accreditation Tips

Desktop Review

In addition to your policy that describes the analysis of complaint data and the generation of action plans in response to such analysis, submit documentation (e.g., committee meeting minutes) that demonstrates compliance with the requirement that the quality oversight committee has reviewed the complaint analysis and, where appropriate, generated action plans in response to that analysis. If an action plan has been implemented, also submit documentation demonstrating that implementation.

Validation Review

The reviewer will want to see recent committee meeting minutes demonstrating quarterly reporting of prescriber and patient complaint data the quality oversight committee and analyses of those data by the committee. 

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