Verbal Orders

Errors in healthcare can often be traced back to poor communication. One particularly risky practice is verbal orders. For many years, health care organizations and regulatory bodies have encouraged reducing or eliminating verbal orders altogether. Although eliminating verbal orders altogether may sound appealing, some verbal or telephone orders must occur. This process can be safer if we apply concepts learned from crew resource management and highly reliable organizations, including:

• Verbal orders should only occur when a more reliable method is not available, i.e., telephone orders from practitioners off site or verbal orders during an emergency when it is impossible for the practitioner to stop and enter the order.
• Formalize and structure communication
• Use closed loop communication, including repeat-backs and read backs.

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