Wendy,
I attached some documentation I compiled when we were dealing with pharmacy thinking they needed to sign off on all orders as well. While this won't answer your question directly, it gets you part way. Radiology is allowed through protocol to define contrast use when the contrast is administered in the radiology department. The department w/ pharmacy involvement should develop protocols and then get them signed off by the medical staff.
Then, in terms of the order, most systems anymore require some sort of a signature when prescription medicine is given. Some state have passed laws requiring signature when contrast is used (or at least have classified contrast as a drug requiring a specific order).
In our case, because we have defined, comprehensive protocols approved by the medical staff governing the use of contrast, we have the "standing order" we need to use contrast.
CMS allows standing orders (sometimes referred to as "protocols") to be used if they are then signed within a "reasonable" amount of time, meaning, like other uses of standing orders, the ordering physician merely needs to return to sign it later. After all, that is why CMS allows them in the first place (if appropriately approved), to expedite care.
Our hospital technical staff enters the protocol approved dose used in the EMR, then the order for the contrast routes back to the ordering physician whose name was associated with that order to begin with for signature later. This occurs within our EMR, and the signature occurs after the fact, and in compliance with CMS standing order/protocol rules.
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Michael Bohl FRBMA
Executive Director
Radiology Group, PC, SC
Davenport IA
(563) 344-5488
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Original Message:
Sent: 10-16-2018 14:54
From: Wendy Lomers
Subject: Signing orders for the contrast dose
I have been asked about which physician needs to sign the dose for the contrast. The hospital is telling the physician that JCAHO is requiring that the radiologist sign off on any type of contrast- oral, etc before the contrast can be administered. The rads think that it should be the ordering physician who signs this order. They have asked me to provide them with regs to support the answer. I would appreciate your help with this. Thanks, Wendy