There’s no national list of approved medical abbreviations. The Joint Commission publishes a short list of abbreviations organizations can’t use, and it stops there. Every hospital, clinic, and health care system decides for itself which abbreviations staff can use, what each one means, and where it belongs.
That leaves a lot of room for confusion. The same letters can mean different things on two units of the same hospital, and a 2021 inventory of medical abbreviations found that nearly one in four has more than one meaning.
This guide covers who makes the call, what a starter list of common abbreviations looks like, and how to build, teach, and maintain an approved list that your team will use.
Key takeaways
- No national body publishes a list of approved medical abbreviations. The Joint Commission names the abbreviations organizations can’t use, and each organization decides which of the rest are acceptable and where.
- An approved abbreviation needs one meaning in a defined context. About 23% of medical abbreviations have more than one meaning, so a strong list gives each one a single definition and says which documents it can appear in.
- Approval works best as a shared process with a review schedule. Pharmacy, nursing, medical staff, and health information management each face different risks, and the list needs to be updated as practice changes.
- Staff follow the list when it’s the easiest option. Training, reminders, and shared shortcuts that insert the approved term keep the list in daily use, where a policy document alone won’t.
It helps to start with what an approved abbreviation is, since it’s easy to assume someone else has already decided.
What makes a medical abbreviation “approved”?
An approved medical abbreviation is one that your organization has formally accepted for use, with a set meaning, in specific kinds of documentation. Approval is local. A hospital’s medical staff or documentation committee signs off on its list, and the list applies inside that organization.
The Joint Commission’s role is narrower than many people assume. Its Do Not Use list, published in 2004, names abbreviations and dose designations that accredited organizations can’t use in orders and medication documentation. It doesn’t publish a list of acceptable abbreviations, and neither does any other national body in the U.S.
So approval varies by specialty, facility, and type of document. An abbreviation that’s routine in one setting can be risky in another. The NHS App, which lets people in England read their own health records, has a glossary of abbreviations commonly found in medical records that lists “od” as “once daily.” In the U.S., the Institute for Safe Medication Practices (ISMP) flags “OD” as error-prone, because it can be read as “right eye,” and recommends writing “daily” instead.
Neither source is wrong. They’re describing different settings. That’s the whole case for an approved list that your own team agrees on.
Why common abbreviations still put patient safety at risk
Common abbreviations feel safe because everyone on the care team uses them. The trouble is that “everyone” doesn’t always mean the same thing.
In 2021, researchers at Columbia University and other institutions combined eight existing sources into a meta-inventory of medical abbreviations published in Scientific Data. It contains 104,057 abbreviations with 170,426 meanings. About 23% of the abbreviations have more than one meaning, and 7% have four or more. “PA” alone has 142, including physician assistant, Pennsylvania, and pancreatic adenocarcinoma.
A few everyday examples show how this plays out:
- “IVP” can mean intravenous push, a way of giving a medication, or intravenous pyelogram, an X-ray test of the kidneys.
- “MS” can mean multiple sclerosis or mitral stenosis in a problem list, and morphine sulfate or magnesium sulfate in a medication order.
- “BPD” can mean borderline personality disorder, bipolar disorder, or bronchopulmonary dysplasia, a lung condition that affects premature babies and young children.
“I recall an instance where the abbreviation BPD led to a misunderstanding between healthcare professionals,” says Dr. Nick Bach, CEO of Louisville Grace Psychological. The NHS makes the same point to patients, noting that healthcare professionals sometimes use the same abbreviation to mean different things.
That matters more now that patients read their own notes. A clinician who sees “SOB” knows it means shortness of breath. A patient reading about their own symptoms and treatment in a portal may not.
The highest-risk forms are already off the table. “U” for units, “QD” for daily, and “MS” for morphine sulfate are all prohibited, and ISMP flags dozens more.
You’ll find both in our Do Not Use and ISMP error-prone abbreviations list. Your approved list starts where those lists stop.
Who decides which abbreviations get approved?
In most hospitals, a committee owns the approved list, and several groups feed into it. The names vary, but the roles look like this:
- Medical staff or medical records committee. Usually holds final approval, since physicians write many of the orders and notes the list governs.
- Pharmacy and Therapeutics Committee. Reviews anything that touches medications, doses, routes, and frequencies.
- Nursing practice council. Brings the view of the nurses who read orders and act on them around the clock at the point of care.
- Health information management. Maintains the record, handles coding and release of information, and often keeps the published list.
- Quality and patient safety. Tracks incident reports and audits, then flags abbreviations that continue to cause problems.
Smaller practices, like a primary care clinic, don’t need a committee structure. A practice manager and a lead clinician can jointly own the list, as long as one person maintains the current version and everyone knows where it lives.
Whoever owns it, the same four questions decide each abbreviation. Who writes it? Who reads it, including patients? Which documents can it appear in? And could it be read as something else?
Common abbreviations to include on an approved list
Most organizations approve a core set of common abbreviations that staff use every day. The starter list below shows what that core often looks like, grouped by category. It’s an example to bring to your committee, so confirm each entry, its meaning, and where it can be used before you adopt it.
| Category | Abbreviation | Meaning | Watch for |
|---|---|---|---|
| Frequency | BID | Twice a day (Latin bis in die) | Patients may not know it. Write “twice a day” in patient instructions. |
| Frequency | TID | Three times a day (ter in die) | Same as BID for patient-facing text. |
| Frequency | QID | Four times a day (quater in die) | “QD” (daily) is prohibited partly because it gets confused with this one. |
| Frequency | PRN | As needed (pro re nata) | Some organizations require a reason, such as “as needed for pain.” |
| Frequency | AC, PC | Before meals, after meals (ante cibum, post cibum) | Spell out in patient instructions, such as “take with food.” |
| Route | PO | By mouth (per os) | ISMP prefers “PO” or “by mouth” over “per os,” since “os” can be read as “OS” (left eye). |
| Route | NPO | Nothing by mouth (nil per os) | Write “nothing by mouth” in patient instructions. |
| Route | IV | Intravenous | Avoid run-on forms unless your list defines them, such as IVP (intravenous pyelogram). |
| Route | IM | Intramuscular | “IN” (intranasal) is error-prone because it’s read as “IM.” Write “intranasal.” |
| Route | NG | Nasogastric (nose to stomach) | Write it out in anything a patient will read. |
| Condition | HTN | Hypertension | Common and low risk. |
| Condition | DM | Diabetes mellitus | Pair with the type (“type 2 DM”). |
| Condition | CAD | Coronary artery disease | Common and low risk. |
| Condition | MI | Myocardial infarction (heart attack) | Use “heart attack” in patient-facing text. |
| Condition | COPD | Chronic obstructive pulmonary disease | Common and low risk. |
| Condition | SOB | Shortness of breath | Avoid in anything a patient will read. |
| Test | CBC | Complete blood count | Common and low risk. |
| Test | BMP | Basic metabolic panel | Don’t confuse with “CMP” (comprehensive metabolic panel). |
| Test | LFTs | Liver function tests | Some labs list them as a hepatic panel. |
| Test | CRP | C-reactive protein (a marker of inflammation) | Common and low risk. |
| Test | ECG, EKG | Electrocardiogram | Approve one form and use it everywhere. |
| Test | CXR | Chest x-ray | Common and low risk. |
Many of these abbreviations come from Latin, and that’s part of why they’re hard for new staff and patients to guess. For a much longer reference, including nursing shorthand, see our nursing medical abbreviations guide.
How to build an approved abbreviation list in 7 steps
A good approved list is short enough to remember and specific enough to settle arguments. These seven steps get you there.
1. Audit the abbreviations staff already use
Start with what’s in the record. Pull a sample of recent orders, progress notes, discharge instructions, and patient messages, plus the templates, macros, and picklists in your EHR. List all the abbreviations and acronyms you find and how often each one shows up. The most frequent ones become your first draft, and the strange ones become your first questions.
2. Start from the prohibited lists
Remove anything on The Joint Commission’s Do Not Use list, and decide which of ISMP’s error-prone abbreviations your organization will prohibit too. ISMP says every Joint Commission item belongs on an organization’s own Do Not Use list, so that part isn’t optional. Publish the prohibited list alongside the approved list so staff can check both in one place.
3. Give each abbreviation one meaning
This is the step that prevents most confusion. If an abbreviation has more than one common meaning, either pick one and define it or leave it off. ISMP’s guidance for anything not on a list is simple. The writer should define uncommon or ambiguous abbreviations, and a reader who isn’t sure should get an answer from the person who wrote it before acting on it.
4. Set rules for where each abbreviation can be used
An abbreviation can be fine in a progress note and risky in a medication order. Mark each entry with where it’s approved for use, such as orders, clinical notes, or internal messages. Anything a patient reads, such as discharge instructions or portal messages, deserves plain language.
Specialties will ask for their own additions. That’s reasonable, but keep one master list. When cardiology and neurology each maintain separate lists, “MS” can end up meaning two different things in the same building.
5. Approve, publish, and make the list easy to find
Get formal sign-off, then assign a version number, an effective date (July 1, for example), and a named owner to the list. Put it where people work. That might mean inside the EHR, on the intranet home page, and on a pocket card for units with shared workstations. There should only ever be one current version.
6. Teach the list where people work
A list nobody learns doesn’t change much. Teach abbreviations in a clinical context, since a term tied to a real order or note sticks better than a line on a memorized list. Point out Latin and Greek prefixes, suffixes, and roots, which help staff decode new medical terminology. Mnemonics, active recall, and short spaced-repetition quizzes during onboarding help the list stick.
Education also beats enforcement. One health system cut prohibited abbreviations by 81.5% with presentations, posters, and chart stickers. You can read how Capital Health reduced prohibited abbreviations in our Do Not Use guide.
7. Audit and review the list on a schedule
Set a review cadence, such as once a year, and review sooner when a new service line opens, or an incident report points to an abbreviation. Audit a sample of records to measure what’s in use and track the list’s performance, such as how often prohibited forms still appear. Add terms people need, retire terms that cause trouble, and log every change request so the committee can see patterns.
Make the approved form the easy form
A policy says what’s approved. What people type depends on what’s quick. If the approved term takes longer to write than the shorthand it replaces, the shorthand usually wins.
Text expansion closes that gap by separating the shortcut you type from the text that lands in the record. With medical text replacement software like TextExpander, you save an approved term or phrase as a Snippet and insert it by typing a short abbreviation. Type “;npo” and “nothing by mouth” appears. Type “;htn” and you get “hypertension,” or “HTN” if that’s the approved form.
The shortcut can be as short as you like, because nobody else ever sees it. The record only shows the approved text. Many EHRs offer dot phrases or smart phrases that work the same way inside the EHR. TextExpander works in the apps where you already type, so the same approved wording shows up in the EHR, the patient portal, and email.
A few choices keep this safe:
- Choose shortcuts that can’t pass for real abbreviations. A leading semicolon, as in “;bid,” makes an unexpanded shortcut obvious if it ever lands in a chart.
- Use Fill-ins for details that change. Fill-ins prompt for a dose, time, or option when the Snippet expands, so the approved wording stays fixed.
- Keep patient information out of Snippets. Reusable Snippets shouldn’t contain PHI. Patient-specific details belong in Fill-ins at expansion time. See TextExpander and HIPAA for current guidance, including BAA availability on qualified Enterprise plans.
Approved wording matters most when it’s tied to compliance. “Our top concern is compliance and consistency,” says Dr. Tasha Kalra, Associate Medical Director at Allara. “We need to have certain language from a compliance standpoint and consistency across the team when we’re initiating certain medicines.”
The same idea works for whole phrases, such as discharge instructions or medication counseling, where the approved wording is longer than a single term.
Is your approved list the easiest one to use?
An approved abbreviation list only helps when people use it. Save each approved term as a Snippet in a shared group, and your team types a short abbreviation to insert the exact wording your committee approved. Update it once when the list changes.
Get TextExpander for Free. No credit card required.
Keep one approved list across the team with shared Snippets
An approved list lives in two places. One is the policy, and the other is in the templates, macros, and saved phrases people use every day. When each person keeps their own copy, the second place drifts away from the first.
The telehealth platform Amwell saw this with its support team, where every agent once updated their own templates. “There was a chance of someone accidentally using an old version and sending out bad information,” says Amwell’s director of support and operations.
Shared Snippet Groups fix the copy problem. The approved terms live in a single group that the whole team uses, and permissions determine who does what. Clinicians get “Can expand” access, so they use the approved wording without changing it. The list owner gets “Can edit” or “Can manage” access, so changes go through the person accountable for the list. When the committee approves a change, it’s updated once.
That’s close to how CloseKnit Health works across 45 clinics. Practice managers vet every new Snippet before it goes live, and the team works from one shared library across its patient portal, EHR, and other systems. “It took away the second-guessing,” says Kammikia Barnes, Population Health Strategist.
Having the ability to keep Snippet Groups a little bit more gated gives us a lot more control. When you work for a growing business, you’re naturally going to have a little bit less visibility as your teams expand, so having that control over quality is absolutely paramount.
Ben King, Manager of Corporate Client Services, Private Health Management
Shortcut names need the same governance as the terms. One TextExpander customer found that a short shortcut fired before a teammate could finish typing a longer one that started with the same letters. A naming convention, like a consistent prefix and no shortcut that begins with another, prevents that. Put the convention on the approved list itself.
Where to start
Pull 20 recent notes and orders from one unit and list every abbreviation in them. Mark the ones on the Do Not Use and ISMP lists, flag any with more than one meaning, and bring the rest to whoever will own your list.
Start with the 20 or 30 abbreviations your team uses most. Once those have one meaning, one approved form, and a shared Snippet behind them, adding the next set gets much easier. To see how teams roll out shared Snippets, visit TextExpander for healthcare.
TextExpander is free. Your time isn’t.
Create shortcuts for the things you type most and start saving time everywhere you type. Use it solo or build a shared library with your team.
Free forever, no credit card required.
Frequently asked questions
Does the Joint Commission publish a list of approved abbreviations?
No. The Joint Commission publishes a Do Not Use list of abbreviations that accredited organizations can't use in orders and medication documentation, but it doesn't publish a list of acceptable ones. Each organization builds its own approved list, usually through a medical staff or documentation committee. The Do Not Use items must appear on that organization's prohibited list. Many organizations also adopt some or all of ISMP's error-prone abbreviations. Whatever your organization approves, keep the list current and easy to find.
Is "BID" an approved medical abbreviation?
"BID," meaning twice a day, isn't on The Joint Commission's Do Not Use list or ISMP's error-prone list, and it's commonly approved. It comes from the Latin "bis in die." Whether you can use it depends on your organization's approved list, which may limit it to orders and clinical notes. In anything a patient will read, like discharge instructions, "twice a day" is clearer. Check your facility's policy before using any abbreviation, even a common one.
What's the difference between approved and prohibited abbreviations?
Approved abbreviations are the ones your organization has accepted for use, each with a set meaning and a defined place in the record. Prohibited abbreviations are the ones staff can't use, starting with The Joint Commission's Do Not Use list and often including ISMP's error-prone list. Anything on neither list is unapproved and should be written out. The two lists work together, so publish them side by side. For the full list of prohibited medical abbreviations, see our guide to Do Not Use medical abbreviations.
Can different departments keep separate abbreviation lists?
Departments can add specialty abbreviations, but most organizations maintain a single master approved list. Separate lists make it easy for the same abbreviation to carry two meanings in one building. "MS" might mean multiple sclerosis in neurology and mitral stenosis in cardiology. A master list with specialty sections lets each department add what it needs while the committee checks for conflicts. Patients move between departments and care teams, and so do their records, so the meanings need to hold everywhere.
How do electronic health records use medical abbreviations?
Electronic health records rely on standardized abbreviations to document patient encounters, from conditions like HTN (hypertension), DM (diabetes mellitus), and CAD (coronary artery disease) to treatment plans, patient charts, and prescriptions. Many EHRs group common abbreviations by clinical category in picklists, templates, and smart phrases, so clinicians can find the right term quickly. Those built-in lists should match your organization's approved list, so review them whenever the list changes. Free-text fields still accept anything a clinician types, so training and an easy way to insert the approved term matter as much as the software.
What's the fastest way to learn common medical abbreviations?
Learn them in a clinical context, tied to the orders, notes, and test results you see every day, instead of memorizing an isolated list. Many abbreviations come from Latin and Greek prefixes, suffixes, and roots, so a few roots help you decode new ones. BID comes from bis in die, or twice a day, and PO means by mouth, so NPO means nothing by mouth. Mnemonics, active recall, and spaced repetition help the terms stick. For a longer reference, see our nursing medical abbreviations guide, and check each term against your organization's approved list.
How can TextExpander help a team use its approved abbreviation list?
TextExpander lets a team save each approved term or phrase as a Snippet, then insert it by typing a short abbreviation in the apps where they already type. Shared Snippet Groups keep everyone on the same approved wording, and permissions let clinicians use the Snippets while the list owner manages changes. Fill-ins handle details that change, and reusable Snippets shouldn't contain patient information. TextExpander supports your policy, and the committee still decides what's approved. See how it works for medical text replacement.
