Pharmaceutical Case Management Checklist Template
Ensure regulatory compliance, streamline workflows, and minimize risk with our Pharmaceutical Case Management Checklist Template. Designed for BPM platforms, this essential tool guides you through every step - from initial assessment to final resolution - helping you optimize case handling and deliver exceptional results in the complex pharmaceutical landscape.
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Case Intake & Assessment
Initial information gathering, patient history, and risk assessment.
Patient Referral Source
Patient Age
Date of Initial Contact
Primary Diagnosis
Relevant Medical History
Reason for Referral (Detailed)
Referral Documentation (if applicable)
Regulatory Compliance
Ensuring adherence to relevant pharmaceutical regulations (e.g., FDA, EMA).
Applicable Regulations (e.g., FDA, EMA, GCP)
Specific Regulatory Requirements Addressed
Date of Last Regulatory Audit
Audit Score/Rating (if applicable)
Summary of Audit Findings & Corrective Actions
Document Review Status (e.g., Regulatory Submission)
Supporting Documentation (Regulatory submissions, approval letters)
Patient Communication & Education
Documenting patient interactions, providing medication information, and addressing concerns.
Summary of Patient Education Provided
Preferred Communication Method
Date of Last Patient Communication
Time of Last Patient Communication
Topics Discussed (Select all that apply)
Patient Education Materials (e.g., brochures, videos)
Patient Acknowledgement of Education
Medication Management
Tracking medication orders, refills, and any adverse events.
Medication Order Status
Medication Name
Dosage
Route of Administration
First Dose Date
Refills Remaining
Notes Regarding Medication
Last Refill Date
Clinical Monitoring
Recording vital signs, lab results, and other relevant clinical data.
Date of Last Vitals Check
Time of Last Vitals Check
Blood Pressure (Systolic)
Blood Pressure (Diastolic)
Heart Rate (BPM)
Temperature (°C/°F)
Respiratory Rate (breaths/min)
Clinical Observations (e.g., edema, skin condition)
Adherence & Support
Monitoring patient adherence to treatment plans and providing support services.
Medication Dosage Taken (mg)
Date of Last Medication Intake
Time of Last Medication Intake
Reason for Non-Adherence (if applicable)
Description of Challenges with Adherence (if any)
Support Services Provided
Patient Satisfaction with Support
Data Security & Privacy
Maintaining patient confidentiality and complying with HIPAA and other privacy regulations.
Data Encryption Method
HIPAA Compliance Status
Last Security Audit Date
Description of Access Control Measures
Number of Data Breaches Reported (Past Year)
Data Security Training Topics Covered
Data Residency Location
Case Updates & Reporting
Regularly updating case status and generating reports as required.
Date of Last Update
Time of Last Update
Summary of Updates Since Last Report
Number of Interactions (Patient, Physician, etc.)
Overall Case Status
Supporting Documentation (e.g., lab results, physician notes)
Case Closure & Documentation
Finalizing case details, archiving documents, and ensuring complete record keeping.
Case Closure Date
Summary of Case Outcomes & Results
Case Resolution Status
Final Case Report (if applicable)
Notes on Case Closure and Potential Follow-up Needs
Case Manager Signature
Reason for Case Closure
Risk Management & Incident Reporting
Identifying and documenting potential risks, and reporting incidents appropriately.
Incident Severity Level
Detailed Incident Description
Estimated Financial Impact ($)
Incident Date
Incident Time
Related Regulations/Policies
Supporting Documentation (e.g., Photos, Reports)
Case Management Screen Recording
See ChecklistGuro's Case Management in action! This screen recording demonstrates how our BPM platform simplifies case tracking, task assignment, and overall process control. Learn how to improve efficiency and reduce errors with ChecklistGuro. #CaseManagement #BPM #ChecklistGuro #ProcessAutomation #Workflow
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