We went through this recently as well. TJC issue.
Fortunately, the hospital can alter the order set so the physician placing the order is also signing for the contrast medication at the time of order. TJC allows if the protocols are embedded in the order.
We are an EPIC shop and until this was set up properly, when the techs administered the contrast, they routed the order to one of our PA's to sign the order for contrast until EPIC could be modified so this order authorization occurred with the original provider at time of order.
Required significant IT effort, and first pass was to just make this a radiologist workload requirement. After negotiation/education, the hospital regulatory compliance officer, agreed it could be embedded in original order.
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Beth Williams MHA, FACMPE
Executive Director
Vantage Radiology and Diagnostic Services
Federal Way WA
(253) 661-1700 ext. 1105
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Original Message:
Sent: 03-08-2018 08:44
From: Michael Bohl
Subject: Hospital Contrast Order Requirements
David,
This comes up once in a while in hospitals. The order for contrast is inherently included in the underlying for the [exam] with contrast, and there is no need for a second order. This is a misinterpretation of some rule – often based on the Joint Commission's requirements related to documenting contrast combined with the requirements for using predefined "protocols" governing the administration of contrast. I'll look through my saved documents to see if I have any specifically related to this issue when I get to work.
Original Message------
Can anyone educate me about requirements related to orders for contrast material in a hospital setting? This would be a scenario where the physician who ordered the imaging study already specified with/without contrast, but the hospital wants a radiologist to sign what is essentially a medication order for the contrast material. In this particular case, the radiologist is working remotely.
I'm guessing this ask is simply a function of hospital medical staff bylaws and not some other legal requirement. Anyone know of other rules that may apply? Any reason a radiologist working remotely should not sign such an order?
Thanks
David Smith, FACMPE | Executive Director | 785.393.8387
