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Procedure

Degraded mode

Steps for clinical work when a service is reduced or offline, covering what stays available, what to record, and how to reconcile afterwards.

A service can run reduced while the platform stays reachable, and a site can lose its link to the platform altogether. Those are two different situations, and this page covers the first. It sets out what stays available while part of the platform is away, what to record while it is away, and how the held effects settle once it returns.

A reduction is not a lost link

A service runs reduced when part of the platform, or a link to an outside system, is away while the record itself stays reachable. Your entries commit to the record throughout. The other case is a lost link, where the site cannot reach Pensieve at all. Then the ward reads from the downtime pack, paper is the record, and the hospital's downtime procedure governs the shift. That case is set out in what happens when the link drops.

What stays available

The record stays open, because the platform itself is reachable. You sign in, open a patient, place an order, and record a dose as usual. Each entry commits to the record as you make it. What waits is the part the reduced service owes, such as a schedule that has to be recomputed or a message that has to reach an outside system, and the platform delivers that part when the service returns.

Clinical taskWhile a service runs reduced
Sign in and open a recordAvailable
Read the history the record already holdsAvailable
Place an orderAvailable. The order commits to the record, and reaches the services it depends on when they return
Record a dose givenAvailable. The dose commits to the record with its true time
View a due list or scheduleShows a pending note until the scheduling service returns
Work while the site cannot reach PensieveA different case. The ward follows the hospital's downtime procedure and works on paper

Steps during a reduction

  1. 1

    Carry on with the patient

    Keep caring for the patient. The record takes your entries as normal, and the platform holds the effect the reduced service owes until that service returns.

  2. 2

    Note the time where a view is pending

    If a screen shows a pending note in place of a value, write the value and the time on your local ward record, so the ward has it in hand.

  3. 3

    Record the clinical facts in the record

    Enter what you did in the patient record. Attribution and timing hold, so the entry reads correctly later.

  4. 4

    Tell the ward lead if a reduction runs long

    If a service stays away beyond a shift, tell the ward lead, who raises it through the support path.

Where the held effect sits

The platform is reachable throughout a reduction, so nothing you enter waits on a link. Each entry commits to the record as you make it. What waits is the effect the reduced service owes, and it is held on the platform, not on the ward. The pending note on screen is an honest sign that the effect is on its way.

A pending view
Patient and ward
Due list pending
Record a dose
Add a note
A schedule view shows a pending note in place of the value while the scheduling service is away. The record still takes your entries.

Reconciling afterwards

  1. 1

    Let the held effects settle

    When the service returns, the platform delivers what it held. Give it a moment, then refresh the screen.

  2. 2

    Check the timeline and due list

    Open the patient's active orders and the due list. Confirm the views have settled and each entry you made shows with its true time.

  3. 3

    Match your ward notes

    Compare any notes you kept against the record, and enter anything the record still lacks.

  4. 4

    Clear the ward notes

    Once the record holds everything, set the paper notes aside for the ward's own retention.

Figure 1.Diagram showing clinical work continuing through a service reduction, each entry committing to the record, the reduced service's effect held on the platform, and that effect delivered once the service returns.

Common questions

Does ordering keep working during a reduction?

Yes. The order commits to the record, and it reaches billing and scheduling the moment those services return.

Where do my entries go while a service is away?

Into the record, which stays reachable through a reduction. What waits is the effect the reduced service owes, held on the platform and delivered in order when that service returns.

Is a reduction the same as the ward losing its link?

No. A reduction leaves the platform reachable and the record taking entries. A lost link leaves the site unable to reach Pensieve, so the ward reads from the downtime pack and records on paper under the hospital's downtime procedure, and each paper entry is brought back into Pensieve afterwards as a late entry carrying its true clinical time.

What shows on screen while a view is pending?

A pending note stands in place of the value, an honest sign that the effect is on its way rather than a blank or a false success.

Read the other case, where the site cannot reach the platform at all, in what happens when the link drops.