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  • 1.  Provider on-site policies

    Posted 04-09-2026 09:11

    Hello Ambulatory community!

    Question from our team regarding Providers on-site:

    • Does your organization have policies or standard practices around requiring providers to be onsite or in physical proximity when non-sedation-based nursing procedural care is happening?

    Thank you in advance!



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  • 2.  RE: Provider on-site policies

    Posted 04-10-2026 08:37

    Our standard operating procedure is that a provider is required to be "available" – that could be a physician or APP – if nursing or allied clinical staff are performing any procedures independently. There should be someone available to respond if something happens that requires an escalation of care. Our SOP is vague in that it does not specify the provider needs to be within the building; it is inferred but it does not state it in those words.

     

    Jessica Schonefeld, MSN, RN, AMB-BC
    Sr. Director, Clinical Practice Optimization

    Clinical Administration
    Orlando Health Medical Group (OHMG)






  • 3.  RE: Provider on-site policies

    Posted 04-10-2026 09:50

    Good morning Jessica!

    Thank you so much for the information - I will pass along to my team; even though you don't have it written out in an SOP, even just knowing it's expected is helpful :)

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    Original Message


  • 4.  RE: Provider on-site policies

    Posted 04-10-2026 10:11
    Michelle and all,

    Ours is similar to what Jessica shared. We do state "immediately available " and that could be via electronic communications (messaging or texting) or by phone. 

    Thank you,

    Cindy


    Cindy Garrett, MBA, BSN, RN, AMB-BC

    VP Ambulatory Quality, CA

    Dignity Health Medical Foundation

    CommonSpirit Health
    Caution: This email is both proprietary and confidential, and not intended for transmission to (or receipt by) any unauthorized person(s). If you believe that you have received this email in error, do not read any attachments. Instead, kindly reply to the sender stating that you have received the message in error. Then destroy it and any attachments. Thank you.



    Original Message


  • 5.  RE: Provider on-site policies

    Posted 04-10-2026 10:15

    Thanks Cindy!

    So then technically the Provider doesn't have to be physically available but at LEAST electronically available ... ok super helpful, thank you! 

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    Original Message


  • 6.  RE: Provider on-site policies

    Posted 04-13-2026 08:51

    Hello Cindy,

    Are you able to share your organization's SOP? 

    Thanks so much!



    ------------------------------
    Dedria Sowder, MSN-Ed, RN, AMB-BC, NPD-BC, CPN
    Leadership SIG Past Chair
    Clinical Educator, Carilion Clinic
    Roanoke Virginia
    540-314-3028
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    Original Message


  • 7.  RE: Provider on-site policies

    Posted 04-13-2026 08:50

    Hi Jessica,

    Are you able to share a copy of your organization's SOP?

    Thanks so much!



    ------------------------------
    Dedria Sowder, MSN-Ed, RN, AMB-BC, NPD-BC, CPN
    Leadership SIG Past Chair
    Clinical Educator, Carilion Clinic
    Roanoke Virginia
    540-314-3028
    ------------------------------

    Original Message


  • 8.  RE: Provider on-site policies

    Posted 04-14-2026 14:21

    We have that policy - at our clinic, the provider must be available in clinic in case we need immediate help, but doesn't have to be in the room. We put that in place because of Medicare reimbursement requirements. Our nursing procedure also uses an algorithm to map out certain circumstances where the RN must stop the procedure and seek out a provider. 



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    Ingrid Hawkinson
    RN, MSN, AMB-BC
    UCSF Otolaryngology
    San Francisco CA
    415-353-2148
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  • 9.  RE: Provider on-site policies

    Posted 04-14-2026 17:08

    Thank you, so helpful! Would you be willing to share the policy with me? You can email me (Barnhami@ohsu.edu) or reply here... Thank you!

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    Original Message


  • 10.  RE: Provider on-site policies

    Posted 04-21-2026 16:33

    Hi Kristin,

    Would you please share your policy with me as well? My email is drtuck@carilionclinic.org

    Thanks so much!



    ------------------------------
    Dedria Sowder, MSN-Ed, RN, AMB-BC, NPD-BC, CPN
    Leadership SIG Past Chair
    Clinical Educator, Carilion Clinic
    Roanoke Virginia
    540-314-3028
    ------------------------------

    Original Message


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