Charts are an evolution of the CareRight Measurements & Metrics and Smart Forms (Assessments) capabilities.
Experimental feature: This is not generally available to all customers at this time, and is subject to further revision.
We have extended the core capabilities of our Metrics and Assessments functionality; allowing for a Chart to be created. In the CareRight context, a Chart is a series of Smart Forms/Assessments that focus on key metrics, and displayed over time.
The CareRight system is pre-loaded with a number of Observation Chart standards; with the expected ranges for a patient pre-defined per chart.
Example: Configuring a NSW Health Standard Paediatric Observation Chart, 12 years+, Heart Rate criteria; as opposed to a general adult.
CareRight also supports Altered physiology/goals within the context of a chart (aka Altered Calling Criteria), as well being able to captured in general for a clinical to describe what is typical.
We expect to further evolve this functionality to integrate more deeply with our workflow capabilities and automated scoring. IE; where observations and the guidance of your clinical governance standard recommend a Clinical Review; automatically prompting clinical staff to create appropriate Followups, supporting Clinical Notes for any interventions.
System Administration
Administration > Assessments > Charts
CareRight is pre-loaded with a number of charts configurations, focused on Observation charts.
A Chart is effectively:
- A series of observations you will conduct
- An assessment to specifically record your observations
- Configurations for frequency of observation
Additionally, a chart has a number of Metrics to graph and or Metric Graphing/Limits. These identify the key metrics to visualise graphically.
A metric graphing/limit associates a Metric; such as heart rate; with what is expected in terms of physiology.
For example; a the upper range of expected values for a heart rate measurement, as defined by the Adult Deterioration Detection Score chart methodology.
These zones or ranges of values are added to the Metric.
Absolute Maximum and Absolute Minimum should be defined as the absolute boundaries of what is physically possible - ie a heart rate can only between somewhere between 0 and 220 beats per minute - values outside of this range do not make sense.
Upper, Lower display default is what would be typically displayed when presenting this metric visually. For example, a heart rate of 220 is extremely unlikely; and a heart rate of 150 bpm for a patient in a hospital setting is suggestive of a severe issue.
Emergency response above/below define ranges that would generally trigger an immediate life saving intervention at all costs.
Critical above/below defines ranges that would typically result in prompt intervention following appropriate clinical guidance.
Abnormal above/below defines ranges that would be of concern.
Normal range is defined by the boundaries of all other ranges.
Real world example, based on a specific National Early Warning Score methodology.
Changing the order of graphs
This feature is planned for an upcoming release.
Adding non numeric metrics, such as level of conciousness
This feature is planned for an upcoming release.
Changing the default task type created
This feature is planned for an upcoming release.
Changing the default clinical note type created
This feature is planned for an upcoming release.
Configuring metrics to avoid pre-loading in your observation record assessment.
This feature is planned for an upcoming release.
Usage
Start a new Patient Chart
View the Patient record, select Charts and then select New
You will then be able to select from the library of charts your system administrators have configured - Observation, Urinalysis, Bowel, Fluid and many more.
A chart is considered active until the specified end date - you may wish to end previous charts at the point of discharge.
Record your observations via an assessment
To begin recording your observations, simply hit New to start the configured assessment.
Assessments are fully customisable, but generally consist of a number of key metrics. You may wish to additionally include scoring or other logic to display clinical guidance.
Mockup: A reduced observation assessment
Like any assessment, simply approve when complete.
This will now display the captured information both graphically; and via your list of assessments.
Create a task for clinical review
Once your observations are recorded, a number of further actions are enabled. If you wish to call for a clinical review or describe a specific further action, you can simply one click create a task.
This task is linked to the Patient, the Chart and the specific observation/assessment.
Create a clinical note to record interventions
If you perform any interventions, it is a one click process to start a new clinical note.
This note is linked to the assessment and chart.
Altered Calling Criteria
Altered Calling Criteria can be created via Observation Modifications.
A specific metric can be overridden to provide new ranges of concern; for up to 72 hours.
Discharge Letters
Recent observations can be included in discharge letters as a replacement variable.
