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Verbal Order Process
Frequently Asked Questions
- Are nurses still writing verbal orders on paper and verifying by read-back?
- Will I sign verbal/telephone orders on paper once Phase II is live?
- What is the physician process for refusing a verbal order?
- What happens if someone enters a verbal/telephone order using the wrong physician's name?
- What happens if the verbal order is correct on paper, but transcribed incorrectly into the system?
- Will physicians be expected to discontinue orders if they are incorrect in the system?
- How will we document read-back verification of the order?
- What is the process for getting the incorrect order corrected in the system?
- Can BEACON generate a report of unsigned orders in Phase II?
- Will there be a trail of the clinician taking the order?
- How will we co-sign verbal orders for the PAs and ARNPs?
Are nurses still writing verbal orders on paper and verifying by read-back?
Yes. The nurse will still write the verbal order on the paper physician order sheet in the chart. Units with CPOE will be an exception to this. Nurses on these units will enter the verbal order from the physician directly into BEACON and continue to verify the order by read-back.
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Will I sign verbal/telephone orders on paper once Phase II is live?
No. You will sign all verbal/telephone orders electronically via your BEACON Message Center Inbox.
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What is the physician process for refusing a verbal order?
- Open the verbal order for signature in your Inbox.
- Review the order.
- Click "refuse" at the bottom of the screen.
- Enter the reason for refusal.
- Enter comments if appropriate.
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What happens if someone enters a verbal/telephone order using the wrong physician's name?
The physician receiving the order by mistake can take one of two actions:
- Forward the order to the correct physician if known, (ex: partner in practice who was on-call)
- Or, refuse the order and choose an appropriate reason: "Not my patient."
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What happens if the verbal order is correct on paper, but transcribed incorrectly into the system?
There are checks and balances for this:
- The nurse will review all orders in the system against what is written on the paper chart and would notice the discrepancy.
- The physician will refuse the verbal order on the Inbox, and enter a reason that indicates the order is incorrect.
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Will physicians be expected to discontinue orders if they are incorrect in the system?
Physicians are not expected to discontinue orders today, and this policy will continue in Phase II.
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How will we document read-back verification of the order?
Order communication types have been created within the system: verbal/VORB and telephone/TORB. These act as the read-back verification that was written on the paper form.
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What is the process for getting the incorrect order corrected in the system?
When physicians notice an incorrect order that comes in through their BEACON Message Center, they need to get the incorrect order stopped and the correct one in place. The Message Center can not do that for them. Physicians will need to contact the floor or pharmacy and give the correct order (or write a clarification order if they happen to be on the unit). If the order is a med order, pharmacy would look to see if the med had been given.
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Can BEACON generate a report of unsigned orders in Phase II?
Yes. One of the reports that will be created will be to track the unsigned verbal/telephone orders. HIM will also track these orders on a Deficiency Queue which allows them to follow up on these orders in real-time instead waiting until the patient has been discharged.
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Will there be a trail of the clinician taking the order?
Yes. There is a history screen attached to each order that can be viewed by users with access to orders in Phase II. This history screen will capture the following: the name of person entering the order, the date and time entered, the order communication type, the nurse order was sent for review, and the physician the order was routed for co-signature.
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How will we co-sign verbal orders for the PAs and ARNPs?
Verbal orders that are given to staff by a PA or ARNP and need to be co-signed by a physician will be routed to the mid-level provider's Inbox. The mid-level provider will review the order, but not sign it. Then, they will forward this order to the appropriate physician Inbox for co-signature. A trail of this movement is viewable in the system.
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