Seven aspects, each a real question
An incident arrives from PointClickCare and the relevant worksheets are worked: the assessment that should have followed, the care plan revision, the notification, the intervention and its review, the supervision in place beforehand, and the environment.
Each row is answered from the record — the note, the order, the assessment index, the incident itself — and the answer carries the evidence it rests on, with dates.
Four states, because a clean row and an unread row are not the same
| State | Means |
|---|---|
| Met | We read the chart and the documentation is there. The quote is shown. |
| Not met | We read the chart and it is not there. This is a finding. |
| Unknown | We read the chart and cannot tell. Not a finding, and never counted as one. |
| Could not look | A record we do not have access to. Never shown as a clean result. |
Most audit tools have two of these. Collapsing the middle two into either of the outer ones is how a compliance tally quietly stops meaning anything — and it is the single defect this product has spent the most effort removing.
A name we do not recognise is not an absence
Every facility names its own forms and every pharmacy its own products. So when we look for a post-fall assessment and find nothing under that name, there are two possible explanations: it does not exist, or it exists under a name we do not know.
Only the first is a finding. So that row comes back as unknown, and it lists the assessments that were on file around that date — which is the half a reviewer can actually act on. Writing it as "not met" would have been easy, would have looked more decisive, and would have been wrong often enough to matter.
Things we cannot see, named
These are not coming in a later release, and we would rather you knew now than found out during a survey:
- The CNA Kardex. There is no feed for it and no plan for one. Any row whose answer lives only on the Kardex is marked unanswerable and stays that way.
- Signed consent forms. No endpoint exposes the signed-forms library. A coded item cannot stand in for a signature, so we do not let one.
- What an assessment said. We hold the index — type, date, status — not the answer bodies. The audit may say an assessment exists and when; it may not tell you what was in it.
- Whether a dose was given. The medication record is order-level: what is ordered, by what route. Not what was administered, when, or by whom.
That last one is why there is no column for it. A blank field for a fact we cannot read is how "nothing recorded" starts being read as "no dose given".
Restraints, and an open question we have not closed
The restraint review checks the three things F604 turns on: the device, the medical symptom warranting it, and the instruction to release and reposition. Where an order matches, it reports against all three.
Where no order matches, it returns unknown and lists the orders that are on file — because whether a siderail or a lap belt surfaces on the medication and order feed at all, in a live tenant, is a question we have asked PointClickCare and have not yet had answered. Until we have, a no-match says nothing about your building, and the row says exactly that.
Related: The 24-hour chart check · Drafting the plan of correction · What it reads from PointClickCare