Authorizing med refills

Thanks for the imput! And the article... it is a good one and I've read it before. The office is a primary care office and the refills run across the spectrum of meds. We use an electronc medical record and labs often include comments from the PCP about when to recheck, med dose changes etc. So in a sense there is an individualized patient protocol.

Prior to this new change, the nurse was responsible for reviewing labs and any pertinent comments therein and following up with patient if CBC, for example, was not rechecked in 3 weeks as ordered... We would also review the last office visit note for plan of care and any pertinent notes for follow up, "continue meds", and make sure the patient did indeed follow through with the plan. If anything was amiss the nurse would call the patient, reiterate previous plan, notify the PCP and ask what to do about the refill. The old process required diligent research and judgment on the part of the nurses and opportunities for clarifying with the PCP were always there if anything was out fo the ordinary.

The only difference now (we are still doing all this research), is we have to write it all down and send to the PCP for authorization which takes DAYS sometimes. The nursing judgment and critical thinking has been removed. Especially when the Rx is for Doss or APAP.