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Guidelines for preprinted orders

Hospitalist Leadership Connection, February 16, 2010

Handwritten physician orders for patient admissions, discharges, transfers, medications, and laboratory tests are typically written on generic hospital order sheets. However, during the past 25 years, preprinted orders, or order sets, have gained popularity in the acute-care setting.

In most hospitals today, any physician or department may request preprinted orders. However, hospitals, departments, and individual physicians should take the following steps to ensure patient safety and outcomes before implementing these orders:

• Department chiefs or medical directors should review and sign off on all preprinted orders likely to be used in their clinical area.
• Authors of preprinted order sets should solicit feedback from interdisciplinary team members who are expected to use the order sets. In addition, the clinician or committee authoring the order set has primary responsibility for ensuring that the request moves through the approval process in a timely manner.
• The pharmacy must review all preprinted order sets to ensure the accuracy and appropriateness of all the medications and doses included on the order sets.
• The appropriate interdisciplinary team should review preprinted order sets at least every three years or as clinical practice standards change.
• Each preprinted order set should include a tracking number and revision date.

The above excerpt is adapted from Tools and Strategies for an Effective Hospitalist Program, published by HCPro, Inc.

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