Concept explainer
Alerting and override
Describes when Pensieve raises an alert, how a clinician records an override with a reason, and how those overrides are retained for review.
Pensieve raises an alert when a rule an administrator has set matches a clinical event. When a check stands between a clinician and an action, the clinician records an override with a reason, and Pensieve retains that reason for review.
How the parts sit together
Pensieve prepares the check and shows it. The clinician makes the decision. Pensieve records who decided, when, and the reason they gave.
When an alert fires
Sentinel is the alert ledger. An alert is a signal that a rule an administrator has set has matched a clinical or operational event. Sentinel keeps a searchable ledger of every alert, groups related alerts, tracks acknowledgement, and escalates an alert that stays unacknowledged up a chain over time.
When an alert needs sending to a person, Sentinel hands delivery to Raven. Raven sends it over the channel that person accepts, within their quiet hours, from a hospital-approved template, and keeps a delivery log.
Advisory alerts and blocking checks
An alert takes one of two shapes. An advisory alert informs a clinician and asks for acknowledgement, and the work proceeds. A blocking check holds an action until the clinician records a reason to proceed.
Medication carries the firmest checks. Dose range, allergy match and interaction review run as an order is placed. A severe match holds the order until the prescriber records a reason, so a hazardous combination reaches a decision rather than passing in silence.
The section on medication safety sets out each medication check in full.
Recording an override
An override is the reason a clinician records to clear a blocking check and proceed. You record it in four steps.
- 1
See the check
Pensieve shows the check that fired, the value that triggered it, and what the check guards. You read it before you act.
- 2
Choose a mapped reason
You pick a reason from the list the check offers. The reason maps to the check that fired, so the record ties the two together.
- 3
Add a note where it helps
You add a short note where the reason needs context for the next reader.
- 4
Proceed
The action goes ahead. Pensieve records who proceeded, the reason, and the moment, in the same entry as the action.
An override clears one named check
Each override clears one named check, for one mapped reason, by a clinician who holds the override permission for that check. A reason that maps to a check that stayed quiet, or an actor without the permission, holds the action rather than clearing it.
What an override carries
check string Required | The check that fired, carried by its own identifier. |
reason string Required | A reason drawn from the list the fired check offers. |
note string | A short free-text note for context. |
actor string Required | The clinician who proceeded past the check. |
at timestamp Required | The moment the action proceeded. |
Retained for review
Every override is written in the same transaction as the action it clears, so a proceeded action always carries its reason. The entry lands in Sentinel's ledger and in the patient record, searchable by patient, by clinician, and by the check that fired. A reviewer reads the reason, the actor and the time for any override.
The section on the audit trail sets out the fields that each such entry carries.
Common questions
Does every alert hold my action?
An advisory alert asks for acknowledgement and lets the work proceed. A blocking check holds the action until you record a reason.
Who can clear a blocking check?
A clinician who holds the override permission for that check clears it, and Pensieve records their name with the reason.
Where do overrides go?
Each override is retained in the alert ledger and in the patient record, searchable for later review.
Read how a critical result reaches a responsible clinician in critical results.