{"pk":33481,"title":"Physician Orders for Waiting Room Patients: Ethical Considerations","subtitle":null,"abstract":"<p>With increasing emergency department (ED) boarding and crowding, EDs have introduced several novel care-delivery initiatives including split-flow models (e.g., fast tracks), non-linear patient flow models (e.g., protocol bays), nursing triage order sets, physician-in-triage, and the use of non-traditional care areas (e.g., ED hallways). One such emerging practice is the placement of orders for patients in the waiting room (WR) by physicians prior to in-person physician evaluation (e.g., based on triage documentation and the patient’s medical record). This paper describes key ethical obligations to WR patients that support this practice, as well as other considerations that must be balanced against these obligations, including potential risks. </p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Ethical and Legal Issues","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8md274g4","frozenauthors":[{"first_name":"Nicholas","middle_name":"","last_name":"Kluesner","name_suffix":"","institution":"Iowa Methodist Medical Center, Department of Emergency Medicine, Des Moines, Iowa","department":""},{"first_name":"Jennifer","middle_name":"","last_name":"Chapman","name_suffix":"","institution":"HCA Florida Orange Park Hospital, Department of Emergency Medicine, Orange Park, Florida","department":""},{"first_name":"Monisha","middle_name":"","last_name":"Dilip","name_suffix":"","institution":"Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut","department":""},{"first_name":"James","middle_name":"H.","last_name":"Paxton","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan","department":""},{"first_name":"Karen","middle_name":"","last_name":"Jubanyik","name_suffix":"","institution":"Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut","department":""},{"first_name":"Paul","middle_name":"","last_name":"Bissmeyer","name_suffix":"","institution":"Orange Park Hospital, Department of Emergency Medicine, Jacksonville, Florida","department":""}],"date_submitted":"2024-07-25T16:52:51.905000Z","date_accepted":"2025-03-10T05:08:22.578000Z","date_published":"2025-07-12T16:51:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/33481/galley/37035/download/"}]}