Page 8 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

In addition to the mishaps with communication, lack of

protocols, no record review, and no method of consultation,
there was a missed opportunity to prevent harm because

there had been no process for handling missed appointments.
Physicians and other providers frequently ask the question

“How many attempts to contact the patient will relieve me
of liability?” There is not a one-size-fits-all approach when it

comes to following up on a missed appointment. The courts will
apply a reasonableness standard. Generally, the reasonableness

of the follow-up effort will depend on the potential clinical
consequences and the severity of the patient’s medical

condition. For additional information on handling missed
appointments, visit the resources section at vantage.svmic.com.

Developing Protocols and Collaborative Practice

Agreements

Several state nursing and physician assistant boards including
Alabama, Arkansas, Georgia, Kentucky, Mississippi, and

Virginia provide online sample protocols, collaborative practice
agreements, and templates or forms for prescriptive authority

that may be used to comply with state regulations. However, in
states without specific sample forms, templates, or guidelines,

the protocols should be specific to the patient population, define
the scope of authority provided to the APP, and outline the

standard of care. Some states offer lists of medical guidelines
that may be utilized by the APP. The Georgia Board of Nursing

offers a seven-page sample nurse protocol agreement which
includes 26 provisions. Reviewing it may be useful to physicians

and APPs in other states as well.
1

1 www.medicalboard.georgia.gov

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