Verbal orders placed in new chapter
Verbal orders placed in new chapter
The Joint Commission (TJC) has noted that its verbal order standard, IM.6.50, has been one of the more difficult to comply with, but "ED managers who now wish to brush up on that standard will have to look elsewhere," says Louise Kuhny, RN, MPH, MBA, CIC, TJC's senior associate director of standards interpretation.
"The information management chapter used to have two components — verbal orders and patient information — but we split out verbal orders," she explains. "It really pertains to record of care; so, it is now in a new 'RC' chapter: RC02.03.07."
The standard still addresses the same issues, Kuhny notes. "You need to have a policy that says who can receive verbal orders, and they must be authenticated within the time frame specified," she says.
The latter requirement, she reports, leads to the great majority of requirements for improvement. "[The Centers for Medicare & Medicaid Services] put out a communication about 18 months ago that said if there are no pre-existing state regulations, the default is 48 hours," Kuhny says. "A few states use 24 hours, which is particularly challenging, and others have 30 days; but the vast majority of states go to the default of 48 hours."
What if an ED manager is not sure what the state requirement is? "I recommend they check with the quality folks in the hospital," she replies.
How does Kuhny suggest ED managers ensure compliance? "You need to put systems in place to be sure to prompt providers to sign the order when they next see the patient, and the providers need to be diligent," she advises. "You should put a reminder in your electronic system or a flagging system on your charts to remind the doctor or other allied licensed practitioner."
The Joint Commission (TJC) has noted that its verbal order standard, IM.6.50, has been one of the more difficult to comply with, but "ED managers who now wish to brush up on that standard will have to look elsewhere," says Louise Kuhny, RN, MPH, MBA, CIC, TJC's senior associate director of standards interpretation.Subscribe Now for Access
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