E note the aforementioned sequence for activating the

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E. Note: The aforementioned sequence for activating the physician’s chain of command does not prevent a registered nurse from calling an attending physician directly at any time if deemed necessary by the patient’s condition or circumstances. F. All steps taken in the patient care chain of command for a clinical issue will be documented in the patient’s medical record. Documentation shall include the date and time of attempted contacts, name of the person contacted, response, orders/directions received, and any other pertinent information. G. The following steps should be implemented when a patient or family request to speak with the attending physician about the patient’s medical care: 1. The staff member should attempt to resolve the patient’s or family’s concerns. If the staff member is unable to resolve the concern, the staff member should contact the attending physician or provide the patient or family with the number to contact the physician if requested. 2. In the event the attending physician or designee does not respond, the staff member will proceed up the physician’s chain of command as indicated in Appendix A (Policy S-050-24.A1) as designated by your Medical Division/area of service. H. Retaliation by any party against another is prohibited when the chain of command procedure is activated. I. Note: A patient’s clinical condition may compel a physician to order a diagnostic study, procedure or treatment (including, but not limited to the administration of pharmaceutical or therapeutic agents) that falls outside a GHS accepted protocol or policy, if doing so is in the best interest of the patient. In such an event, effective communication between the physician and licensed professional staff member facilitates safe and timely treatment. Accordingly, the licensed professional staff member and the ordering physician will adhere to the following: 1. The physician will clearly explain the clinical reasons for his order to the licensed professional staff member involved in the patient’s care. 2. The licensed professional staff member will listen to the physician’s explanation, ask appropriate questions, and exercise his or her independent critical thinking skills within the legal scope of practice for that discipline. 3. If, in the licensed professional staff member’s judgment, the physician has offered a sound clinical reason for ordering a study, procedure, or treatment outside of GHS policy or protocol, the licensed professional staff member will take the necessary steps to carry out the physician’s order in a timely manner. In addition: a. Both the physician and the licensed professional staff member will document fully the clinical reasons for providing care outside of protocol or policy in the patient’s medical chart; b. A physician should be present at the patient’s bedside when care outside of protocol or policy is administered; and, c. The physician is expected to report the treatment decision to the appropriate department chair or designee (e.g. vice chair of quality,
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Business Law Today, Standard: Text & Summarized Cases
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Chapter 36 / Exercise 36-9
Business Law Today, Standard: Text & Summarized Cases
Jentz/Miller
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