Observation Levels
Observation levels define how frequently patients must be observed. Each patient is assigned a level based on their clinical needs.
Standard Levels
| Level | Interval | Description |
|---|---|---|
| Q5 | 5 minutes | High-acuity frequent monitoring |
| Q15 | 15 minutes | Standard observation for behavioral health |
| Q30 | 30 minutes | Less frequent monitoring |
| Q60 | 60 minutes | Hourly checks |
| 1:1 | Continuous | Constant observation (no gaps allowed) |
| Elopement | Continuous | Elopement precautions with geofence monitoring |
How Intervals Work
Observation intervals are measured from the last observation, not from a fixed schedule.
Example with Q15:
- Observation at 10:00
- Next observation due by 10:15
- If observed at 10:12, next due by 10:27
This allows for natural workflow variation while maintaining frequency requirements.
On-Time Calculation
An observation is considered on-time if documented within 1.5× the interval:
| Level | Interval | On-Time Threshold |
|---|---|---|
| Q5 | 5 min | 7.5 min |
| Q15 | 15 min | 22.5 min |
| Q30 | 30 min | 45 min |
| Q60 | 60 min | 90 min |
Beyond 1.5×, the observation is late but still valid. Beyond the interval + 50%, an overdue alert is created.
1:1 Observations
Continuous observation levels (1:1) have special requirements:
- Staff must remain with the patient continuously
- Any gap exceeding 5 minutes triggers a critical 1:1 Gap alert
- The Observe tab is replaced with a dedicated screen showing a coverage timer, activity strip, one-tap log templates, and a Request Break button (see 1:1 Continuous Observation)
- The device's screen stays awake while the 1:1 screen is open
- The duplicate-observation guard is relaxed for 1:1 patients (5-second window instead of 60 seconds) so legitimately frequent taps aren't blocked
- Relief handoffs are implicit: when the relief nurse logs the next observation, the requesting nurse can hand off and step away
Changing Observation Levels
Observation levels can be changed by:
- Physician order (via EMR integration)
- Charge nurse (manual adjustment)
- Clinical protocol (automatic based on assessment scores)
When a level changes:
- The new interval takes effect immediately
- Previous observations remain at their original level in history
- A note is added to the patient record
Elopement Level
The Elopement observation level is for patients at risk of leaving the facility:
- Requires a BLE wristband with configured geofence
- Geofence violations create immediate alerts
- Combined with a timed observation interval configured per patient