Clinical User Quick Start Guide

This guide provides a comprehensive overview of essential features in CAREFUL for clinical users. It covers account setup, patient management, task coordination, and handover workflows to help you start using the platform effectively in your day-to-day clinical work.

No special permissions required. This guide is designed for all clinical users (team members, team owners, and administrators). Some advanced features mentioned (such as inviting users or creating teams) require administrator or team owner privileges.

CAREFUL provides dedicated support resources to help you use the platform effectively.

Access support in three ways:

1. From the CAREFUL website - Visit careful.online and navigate to the support section
2. From within the app - Click the Help link in the sidebar menu
3. Direct access - Visit the support pages at careful.online/docs

You can search the support pages for specific issues or browse articles by category. For urgent assistance, contact support@careful.online.

When you join a CAREFUL organisation, an administrator creates your profile and sends you an invitation.

To complete your account setup:

1. Check your mobile phone for a text message containing a verification link
2. Click the link in the message to open the account creation page
3. Create a secure password (must be 10 characters or longer)
4. Read and acknowledge the warnings and user agreement
5. Click the Create account button

Your account is now active and ready to use.

To access CAREFUL:

1. Navigate to the CAREFUL login screen:
   • UK users: app.careful.online
   • Australian users: au.careful.app
2. Enter your mobile phone number in the "Email / Mobile number" field
3. Enter your password
4. Click the Sign In button

On-duty status prompt:

When you first log in, CAREFUL will ask "Would you like to set yourself to on duty?" This indicates whether you're currently available to receive handovers and be contacted by colleagues.

• Click Yes if you're currently working and available
• Click No if you're logging in outside your shift

After selecting your status, you'll be taken to your user profile dashboard.

If you've forgotten your password, you can reset it using the password recovery process.

To reset your password:

1. On the login screen, click the Forgotten your password? link
2. Enter the mobile number associated with your account in the "Email / Mobile number" field
3. Click the Send reset link button
4. Check your mobile phone for a text message containing a password reset link
5. Click the link in the message
6. Enter a new secure password (10 characters or longer)
7. Confirm your new password by entering it again
8. Click the Reset password button

Your password is now updated. Return to the login screen and sign in with your new password.

You can update your profile information, including your name, job details, and photo.

To edit your profile:

1. Navigate to your user profile by clicking your profile picture in the top-right corner, or by clicking My Organization in the sidebar and selecting the Members tab
2. Click the kebab menu (⋮) in the top-right corner of your profile
3. Select Edit from the dropdown menu
4. Update your details in the Edit user dialog:
   • First name
   • Last name
   • Job title
   • Speciality
   • Contact / Bleep number
   • User photo (click to upload)
5. Click Submit to save your changes

Your updated profile information will now be visible to your colleagues.

Changing your password:

To change your password, click the kebab menu (⋮) on your profile and select Change password. Enter your current password, then your new password twice, and click Submit.

Setting your on-duty status:

On your profile page, you'll see a toggle switch labelled On duty or Off duty. Click this switch to update your availability status. When setting yourself to on duty, you'll be asked to verify your contact/bleeper number so colleagues can reach you.

You can view all patients assigned to your teams from multiple locations.

From your user profile dashboard:

1. Log in to CAREFUL
2. On your dashboard, you'll see cards for each team you belong to
3. Click on a team card to view that team's patients

From the sidebar menu:

1. Click Teams in the sidebar to expand the team list
2. Select a team name from the list
3. The team view opens, showing the Patients tab by default

Understanding the Patients tab:

The Patients tab displays a table with key information:

• Patient name and demographics
• Current status (Active, Inactive, Discharged)
• Location (ward, bed, room)
• Outstanding actions count
• Clinical summary
• Referral source

Sorting and filtering:

• Click column headers to sort by name, status, or location
• Use the search bar to find specific patients
• Toggle Show handover categories to display speciality-specific information relevant to your team
• Toggle Show Actions to view outstanding tasks for each patient directly in the table

In CAREFUL, taking responsibility for a patient means you become their primary clinical contact. This is required for certain actions like handovers and creating tasks.

To take responsibility for all patients in a team:

1. Navigate to your team's page using the sidebar menu
2. Click the kebab menu (⋮) in the top-right corner
3. Select Take responsibility for all patients
4. Click Take Responsibility in the confirmation dialog

All patients in that team are now assigned to you and will appear in your My Patients tab.

To take responsibility for an individual patient:

1. Navigate to the patient's profile by clicking their name in any patient table
2. Click the kebab menu (⋮) in the top-right corner
3. Select Take Responsibility

The patient is immediately assigned to you with no further confirmation required.

Viewing your patients:

Once you're responsible for patients, view them all in one place by clicking My Patients in the sidebar menu.

CAREFUL uses "actions" to track tasks and clinical activities that need to be completed for patients.

To view all your outstanding actions:

1. Click My Actions in the sidebar menu
2. You'll see a complete list of all actions assigned to you, showing:
   • Patient demographics
   • Action title and description
   • Due date (with visual indicators for overdue or soon-due tasks)
   • Assignee

The sidebar icon shows a badge with the count of overdue actions.

To view actions for a specific team:

1. Navigate to the team page from the sidebar
2. Click the Actions tab
3. View all outstanding tasks relevant to this team, regardless of who they're assigned to

To view actions for a specific patient:

1. Click on the patient's name in any patient table
2. Click the Actions tab on their profile
3. View all actions for that patient, both completed and outstanding

CAREFUL provides multiple ways to create, update, and complete actions depending on your workflow.

Quick Action Completion (Fastest Method)

From the team Patients tab:

1. Navigate to your team page
2. Toggle Show Actions on to display actions next to each patient
3. Click the checkmark button (✓) next to an action
4. The button changes to Click to Complete with a highlighted background
5. Click again within 2 seconds to confirm completion

The action closes immediately with no additional input required. This is ideal for simple tasks during ward rounds.

Creating New Actions

Quick method from patient list:

1. Navigate to your team's Patients tab
2. Ensure Show Actions is toggled on
3. Find the patient and type a description in the "Create action" text box next to their name
4. Click the Create button

The action is automatically assigned to you with no due date.

Detailed method with full options:

1. Navigate to the patient's profile
2. Click the kebab menu (⋮)
3. Select Create Action
4. In the "Create new action" dialog:
   • Enter a title (required)
   • Select an assignee by typing their name (defaults to you)
   • Optionally add a due date and time
   • Optionally add attachments
   • Optionally add a detailed description
   • Check Create another after submit to create multiple actions in sequence
5. Click Submit

Completing Actions with Notes

For actions requiring documentation:

1. Click My Actions in the sidebar
2. Click on the action you want to complete
3. Click the kebab menu (⋮)
4. Select Complete action
5. In the dialog:
   • Enter the action result (required)
   • Optionally add attachments
6. Click Submit

Reassigning Actions

To transfer an action to a colleague:

1. Navigate to the action (from My Actions or the patient's Actions tab)
2. Click the kebab menu (⋮)
3. Select Reassign Action
4. Search for the new assignee by typing their name
5. Click Submit

The action is removed from your My Actions list and appears on the new assignee's list.

Updating Action Progress

To add notes without completing:

1. Navigate to the action
2. Click the kebab menu (⋮)
3. Select Update Progress
4. Add your progress notes and any attachments
5. Click Submit

Keeping patient information current ensures effective handovers between shifts and colleagues.

To update handover information from the team view:

1. Navigate to your team's Patients tab
2. Ensure Show handover categories is toggled on to display speciality-specific fields
3. Click directly on any field you want to update (such as NEWS score, escalation plan, or pending investigations)
4. Enter the updated information
5. Click the tick (✓) to confirm

Changes are saved immediately.

To update the clinical summary:

1. Click on the patient's name to open their profile
2. You'll see the current clinical summary in the Profile tab
3. Click the kebab menu (⋮)
4. Select New note to add a new clinical summary entry
5. Enter your updated clinical information
6. Click Submit

To edit your most recent note:

If you've just added a note and need to amend it (within 1 hour):

1. Open the patient's profile
2. Click the kebab menu (⋮)
3. Select Edit Latest Note
4. Make your changes and click Submit

To update patient location or status:

1. Open the patient's profile
2. Click the kebab menu (⋮)
3. Select Edit Demographics
4. Update the patient's ward, bed, room, or clinical status
5. Click Submit

Team chat enables secure, real-time communication with colleagues. This feature is only available if your organisation and team have chat enabled.

To access team chat:

1. Navigate to your team page from the sidebar
2. Click the Chat tab

The tab shows a badge indicating the number of unread messages and mentions.

To send a message:

1. Type your message in the text box at the bottom of the screen
2. Click Send

To mention a team member:

1. Type @ followed by the team member's name
2. Select their name from the autocomplete list
3. They'll receive a push notification if they're on duty with the app installed

To reference a patient:

1. Type ! followed by the patient's name
2. Select the patient from the autocomplete list
3. The patient's name appears as a clickable link in the message

To notify the entire team:

1. Type @Room in your message
2. All team members currently on duty will receive a notification

Creating actions from chat:

When a message contains a single @mention and a single !patient reference, an action creation button appears on that message. Click it to quickly create an action for that patient assigned to the mentioned colleague.

To learn more about chat features:

Click the kebab menu (⋮) on the team page and select Show Chat Tour for an interactive guide.

You can add existing patients from the CAREFUL system or create new patient records.

Quick method from anywhere:

1. Click Add Patient in the sidebar menu (this button may appear as a floating action button on mobile)
2. Search for the patient using:
   • Name (first and last name are required)
   • Date of birth
   • Hospital number (Medical Record Number)
   • National ID (NHS number)
3. If the patient exists, click the green Select button next to their name
4. Select the team you want to add them to from the dropdown
5. Enter the referral source
6. For readmitted patients (previously discharged), update the clinical summary and patient status
7. Click Submit

Method from team page:

1. Navigate to the team page using the sidebar
2. Click the kebab menu (⋮)
3. Select Add patient
4. Follow the same search and selection process as above

Creating a new patient:

If you cannot find an existing patient in the search results:

1. Complete your search as normal (the system needs at least first name and last name)
2. Click the Create Patient button at the bottom of the search results
3. The form pre-fills with any details you've already entered
4. Complete all required fields:
   • First name and last name
   • Date of birth
   • Hospital number (Medical Record Number)
   • National ID (if applicable)
   • Gender
   • Contact details
   • Clinical summary
   • Patient status
   • Referral source
5. Click Add to create the patient and add them to your team

Duplicate detection:

If CAREFUL finds potential duplicate patient records, it will display a warning message: "Potential Duplicate Patients Found. Multiple matching patient records exist in the system. Please select one to use or create a new patient record." Review the potential matches carefully before creating a new record.

Handovers transfer patient responsibility from you to a colleague. This is essential for shift changes and when you go off duty.

Handing Over an Individual Patient

1. Navigate to the patient's profile by clicking their name in any patient list
2. Click the kebab menu (⋮)
3. Select Handover Patient
4. Search for the colleague you want to handover to by typing their name
5. Review their job title and speciality to confirm it's the right person
6. Click Send handover request

The handover appears in your Sent handovers list. Once the colleague accepts, responsibility transfers to them.

If a handover is blocked:

CAREFUL will display a message if you've already sent a handover request for this patient to the same colleague. You cannot send duplicate handover requests.

Handing Over All Patients in a Team

1. Navigate to the team page
2. Click the kebab menu (⋮)
3. Select Handover all my patients in this team
4. Search for and select the colleague receiving the handover
5. CAREFUL performs a preflight check and displays:
   • Patients that can be handed over (with ✓)
   • Patients that cannot be handed over with reasons (with ✗)
6. Review the list and click Submit

Handover requests are sent for all eligible patients.

Handing Over All Your Patients (Across All Teams)

1. Click My Patients in the sidebar
2. Click the kebab menu (⋮)
3. Select Handover all patients
4. Search for and select the colleague receiving the handover
5. Review the preflight check showing which patients can and cannot be handed over
6. Click Submit

This is useful when going off duty and transferring all your responsibilities at once.

Accepting or Rejecting Handovers

To view handover requests:

1. Click Handovers in the sidebar
2. The Received tab shows handovers sent to you (with a badge count)
3. The Sent tab shows handovers you've sent to others

To accept a handover:

1. Navigate to the Received tab
2. Review the patient list and who sent the handover
3. Click the Accept button next to the handover
4. Responsibility for those patients immediately transfers to you

To reject a handover:

1. Navigate to the Received tab
2. Click the Reject button next to the handover
3. Click again to confirm rejection (the button changes to "Click again to reject")
4. The handover is declined and the sender is notified

To cancel a sent handover:

1. Navigate to the Sent tab
2. Click the Cancel button next to the handover
3. The handover request is withdrawn

Referrals request the transfer of a patient to a different team, typically for specialist consultation or ward transfer.

To refer a patient to another team:

1. Navigate to the patient's profile by clicking their name
2. Click the kebab menu (⋮)
3. Select Refer Patient to Team
4. In the referral dialog:
   • Select the team you're referring from (if the patient belongs to multiple teams)
   • Select the team you're referring to from the dropdown
   • Enter your reason for referral using the SBAR format (Situation, Background, Assessment, Recommendation) where appropriate
   • Optionally add attachments (such as test results or imaging)
   • Optionally check Transfer Immediately if you want to accept the referral on the receiving team's behalf and discharge from the sending team immediately (requires appropriate permissions)
5. Click Refer

The referral appears in the receiving team's Referrals tab.

Viewing referrals:

1. Navigate to the team page
2. Click the Referrals tab
3. Received referrals show patients being referred to your team, with the source team, note, and attachments
4. Sent referrals show patients you've referred to other teams

Accepting or rejecting referrals:

1. Navigate to the receiving team's Referrals tab
2. Review the referral note and any attachments
3. Click Accept to add the patient to your team
4. Click Reject to decline the referral

When a referral is accepted, the patient is added to the receiving team. They remain on the sending team unless explicitly discharged.

• Use quick action completion during ward rounds to efficiently close simple tasks without opening dialogs
• Set yourself to off duty when you finish your shift to prevent receiving handover requests
• Toggle Show handover categories to see speciality-specific fields relevant to your clinical area
• Use @Room in team chat sparingly - it notifies all on-duty team members
• Search patients by hospital number when adding patients for faster, more accurate results
• Review the preflight check before submitting bulk handovers to identify any blocking issues
• Use SBAR format for referral notes to provide structured, comprehensive clinical information
• Create multiple actions at once by checking "Create another after submit" in the action creation dialog
• Verify your contact number when setting yourself to on duty so colleagues can reach you