Workflow pattern
An alert that becomes an action
Shows the shape where a clinical alert leads a named person to a decision and a recorded action, and how Pensieve carries that through.
A clinical alert earns its place once it reaches a named person who decides and acts on it. This pattern sets out the shape an alert takes from a rule to a recorded action, and the parts of Pensieve that carry it through.
The shape
An alert is a raised signal that a defined condition holds and warrants attention. Sentinel holds the alert ledger, and a rule an administrator writes decides when an alert fires.
The shape has one entry and one settled exit. It begins with a rule and ends with a recorded action in the patient record.
Between the two, one authorisation decision governs each read and each write, and one audit entry accompanies each change. Raven carries delivery, Atlas holds the recorded action, and Cirith Manager decides whether the acting person may act.
Where it starts
The shape starts with a rule. An administrator defines the condition that warrants attention, and Sentinel raises an alert in the ledger the moment the condition holds.
Related alerts group together, so a cluster of signals resolves as one review. The alert then names the person who should act, resolved from role and the duty roster.
The path
- 1
A rule raises the alert
A defined condition holds, and Sentinel raises an alert in the ledger with the rule and the moment it fired.
- 2
The alert names a responsible person
Sentinel resolves who should act from role and the duty roster, and groups the alert with any related alerts.
- 3
Delivery reaches that person
Sentinel hands delivery to Raven, which reaches the person over an approved channel within their consent and quiet hours.
- 4
A named person acknowledges
Acknowledgement records who took ownership of the alert and the moment they did.
- 5
The clinician decides and acts
The clinician acts: places an order, records an override with a reason, or notes a clinical judgement. Automation prepares and routes the alert, and the clinician makes the decision.
- 6
The action returns to the record
The recorded action and its audit entry sit in the patient record, and the alert stands down.
What is recorded
| Recorded item | What it captures |
|---|---|
| The alert | The condition, the rule that raised it, and the moment it fired. |
| The acknowledgement | The person who took ownership and when. |
| The decision | The clinical judgement, with a reason where an override applies. |
| The action | The order, note or form the decision produced. |
| The delivery | The channel used and the delivery outcome. |
Tools in the shape
| Tool | Its part in the shape |
|---|---|
| Sentinel | Holds the alert ledger, applies the rule, tracks acknowledgement, and escalates a waiting alert up the chain. |
| Raven | Delivers the alert over an approved channel within the person's consent and quiet hours, and logs the outcome. |
| Atlas | Holds the recorded action and its reason inside the patient record. |
| Cirith Manager | Decides, for the acting person, whether the action is theirs to take. |
What holds throughout
A decision carries a name
An alert that leads to an action carries the name of the clinician who decided. Automation prepares the alert and routes it. The clinician makes the decision, and the record holds who decided.
Where the shape varies
The shape holds whether the alert is a clinical result, an operational threshold, or a safety limit. What changes is the rule that raises it and the action it leads to. A cluster of related alerts groups together, so several signals resolve as one review rather than many.
Common questions
Who chooses when an alert fires?
An administrator writes the rule that defines the condition. Sentinel raises the alert the moment the condition holds, and delivery follows to the person who should act.
What happens to an alert that waits?
An alert still awaiting acknowledgement escalates up a defined chain over time, so a waiting signal reaches the next responsible person rather than resting.
Where does the resulting action live?
The action and its reason sit in the patient record, alongside the audit entry that names who decided and when.
Read how an override and its reason are retained for review in alerting and override.