What standing orders can do for your practice

Standing orders are written protocols that authorize designated members of the health care team (e.g., nurses or medical assistants) to complete certain clinical tasks without having to first obtain a physician order. This can improve efficiency by freeing physicians to focus on more complex care. Several studies have demonstrated that standing orders can increase the delivery of routine preventive care services including immunizations, leading the Centers for Disease Control and Prevention's Community Preventive Services Task Force to strongly recommend their use.

For standing orders to be successful, they need broad support. The medical director is responsible for approving standing orders and supervising their use, but all clinicians should agree with them to avoid confusion, mistakes, and care lapses. Begin by developing standing orders for one or two areas where there is clear agreement on the standard and process of care and little potential for patient harm if incorrectly implemented (e.g., urine pregnancy test for women presenting with amenorrhea).

Here are several areas to consider:

• Immunizations: influenza, pneumococcal, and human papilloma virus,
• Routine labs for chronic disease monitoring: diabetes, hypertension, and hypothyroidism,
• Point of care testing: rapid strep test, urine dip, and urine pregnancy.

Read the full FPM article: ”Developing Standing Orders to Help Your Team Work to the Highest Level."