Direct physician-to-physician communication when requesting a clinical consultation is a matter of both professionalism and patient safety. Currently, we see gaps and delays in patient care when this does not occur. To solidify this communication standard at DMC, we have made important new changes to the consult order process that will take effect Tuesday June 7, 2016.
1. All requests for consults must be documented electronically in the EMR as electronic orders. You will find these in the order catalog under “consult to physician” or “consult to department.”
2. When placing an electronic consult order, it is now required that the name of the attending, resident, or mid-level provider who was notified is entered from a drop-down list into the field “provider contacted re: consult” (see attached screenshots).
3. When a consultation has been completed, the attending consultant or a physician to whom the attending has delegated decision-making authority to move the patient to the next level of care (e.g., a senior surgical resident or fellow) must right click on the original consult order. This will trigger an attestation in the patient’s orderset stating “the patient was examined and evaluated; recommendations made.” This step that completes the consult should only occur after a discussion about the specific recommendations occurs between the consultant and the consulting physician/provider.
4. A routine consultation that has not been completed within 12 hours will trigger an open-chart alert for the primary attending physician. This should serve as an additional reminder that a consult request is still outstanding.
We believe these changes to be in the best interest of patient safety and look forward to your feedback on the process. Please contact Dr. Syed Hussain at firstname.lastname@example.org for any questions.