Five steps for standing orders

Successful implementation of a standing order requires garnering broad-based support, determining who will champion the order, and ensuring that it is carefully and clearly described. If your practice is part of a larger health system, colleagues at other clinics may have already developed effective standing orders for the same tasks. Some organizations, such as the Immunization Action Coalition, provide samples that can serve as starting points. Whether you are writing a standing order from scratch or evaluating an existing one for use in your practice, be sure to address these issues:

1. Consider the effect on existing clinic workflows and responsibilities and patient flow,

2. Explain clearly who is responsible for each task, keeping state licensure limits in mind,

3. Include the date the standing order was written or when it was last reviewed,

4. Describe the patient group to whom the order applies, including any contraindications,

5. Provide the generic name of any medication or vaccine included in a standing order, the exact dosage, and the route of administration. Follow the Institute for Safe Medication Practices guidelines to avoid error-prone abbreviations, symbols, and dose designations.

Adapted from “Developing Standing Orders to Help Your Team Work to the Highest Level.”