Medication Double Sign-off

athenaClinicals

This page allows you to specify departments and medications that require a double sign-off before a medication order is submitted. You can also limit the requirement for double approval to specific delivery methods (Prescribe, Administer, and Dispense).

 

On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Order Configuration, click Medication Double Sign-off

 

 

  1. Display the Medication Double Sign-off page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Order Configuration, click Medication Double Sign-off.
  2. Click add new (under Existing Medication Double Sign-off).
  3. Department — Select the department that requires double sign-off for medication order submissions. Medication orders from the selected department will need co-signature before orders can be submitted.
  4. Medications — Enter two characters to start the search. Select the medications.
    Select each medication order type, rather than the higher-level group of medication. athenaOne does not support specifying medications at a higher level, such as name (Tylenol) or class (Aspirins).
    Your selections appear under Selected medications.
  5. Method — Select the options to require double sign-off for the selected points of delivery (Prescribe, Administer, or Dispense).
  6. Click Save.

    Note: If you add a medication multiple times, the highest permission level is priority. For example, if one entry for OXYCONTIN 80 MG 12 HR TAB requires double approval for Administer and another requires it for Dispense, athenaOne requires double approval for both Administer and Dispense.

 

 

It is a common practice for certain high-risk medications, such as chemotherapy medications, to go through a double approval process. With the Medication Double Sign-off feature, athenaClinicals meets requirements for chemotherapy medications, so that practices with specialties such as hematology and oncology can prescribe chemotherapy medications using athenaClinicals.

 

 

Setup for the medication double sign-off workflow consists of three parts:

  1. Designate the departments that will use double sign-off for medication orders, and specify any medications that will be subject to double sign-off.
  2. Customize your double sign-off workflow using practice roles and task assignment overrides (optional).
  3. Customize your prescription order form with double sign-off magic words (optional).

 

 

By default, if the Provider Centric Staff feature is enabled for your practice, orders requiring double sign-off are assigned to the PRACTICE row of the Clinical Inbox. If the Provider Centric Staff feature is not enabled for your practice, orders requiring double sign-off are assigned to the department STAFF.

 

You can configure practice roles and task assignment overrides to help expedite your double sign-off workflow. For example, if you would like orders requiring double sign-off to go to a practice role called "doublesignoff," use the Practice Roles page to create the new doublesignoff role and assign users to the new role.

 

Then, use the Task Assignment Overrides page to create an override with these parameters:

  • Group — Select Order — PRESCRIPTION
  • Action — Select Approve: Approve (Medication Double Sign-Off)
  • Order Type — Specify the order type for this override
  • Assignee — Select doublesignoff

Click Add.

 

 

 

You can configure clinical paper forms with double sign-off magic words. For example, you may want to add double sign-off magic words to your medication order form.

 

  1. Display the Order Routes page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Order Configuration, click Order Routes.
  2. Order Type Group column — Locate the row for PRESCRIPTION and note the name of the form in the Clinical Order Form column. This is the clinical paper form that you need.
  3. Display the Clinical Paper Forms page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Forms and Letters, click Clinical Paper Forms.
  4. Locate the paper form that you need and click update.
  5. Add any of the double sign-off magic words:
    • {{COSIGNINGPROVIDERSIGNATURE}}
    • {{COSIGNINGPROVIDERSIGNATURENOPRINT}}
    • {{COSIGNINGPROVIDERSIGNATUREBLOCK}}
    • {{COSIGNATORY}}
    • {{COSIGNATORYDEANUMBER}}
    • {{COSIGNINGPROVIDER_NPINUMBER}}
    • {{COSIGNINGPROVIDERNAME}}
    • {{COSIGNDATE}}

Note: If a medication order does not require secondary sign-off, content from these magic words does not appear on the form. Therefore, you can use the same paper form for all medication orders.

 

 

 

  1. While logged in to a department designated for double sign-off, a prescribing provider creates a medication order, either from an encounter or using a new order form.
  2. The prescribing provider signs the order.
  3. The medication order moves to REVIEW, assigned to the Department STAFF row or the PRACTICE row (depending on whether you use the Provider-Centric Staff feature), or to the practice role or user you've specified in a task assignment override.
  4. A note appears on the order, indicating that the order requires a secondary sign-off before it can be submitted.
    This note appears in three places: in the encounter, in the document action history, and pinned to the top of the document.
    If the first sign-off was completed by a user other than a physician (MD or DO), then the secondary sign-off must be completed by a physician (MD or DO).
  5. After the secondary sign-off is completed, the order moves to SUBMIT status. If, while in SUBMIT status, a user takes the action "Error Identified — Send back to Review," both sign-offs are removed from the document, and the document is sent back to the prescribing provider.