Ask ECRI: Standardizing Standing Orders in Multiple Practices

​A risk manager recently sought guidance on implementing standing orders in physician practices (beyond vaccinations) and on standardizing policies related to standing orders across multiple physician practices. In particular, the risk manager wants to ensure that medical practice and patient experience are the same in each of the offices.

Among her concerns, the risk manager notes inconsistencies in staffing; in some offices medical assistants (MAs) instead of nurses perform a variety of functions, and MAs are paid less than nurses and do not require certification in many states. Turnover is high among MAs, and...