New Rules for Physician Consults

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New Rules for Physician Consults


The issue of access to timely consults and inappropriate requests for urgent consultations were discussed recently at Department Head Council. Department Heads agreed that they would reinforce the following with their members:

  • All requests for urgent consultation must be made with physician-to-physician communication;
  • Only urgent consultations should be directed to the intended consultant outside of weekday hours. If a consultation is required on weekends or holidays when offices are not open, the default best practice is physician-to-physician conversation with the consultant on call;
  • Non-urgent consultation requests may be sent by fax, phone message or other electronic means to the office of the intended consultant at any time;
  • Requests for consultation will not be considered complete and will not be conveyed for consultation where there is no reason for consultation given by the requesting physician;
  • When it is the professional opinion of the patient’s primary nurse that it is appropriate, nurses may convey requests for urgent consultations. Unit clerks will not convey requests for urgent consultations directly to physicians, except to assist connecting the requesting physician who is immediately available for discussion.  All such requests should be prepared in an SBAR format.

It was agreed that the results of the audit process would be provided with further consideration for refinement of the process.