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:

• No gaps between observations
• Any gap triggers a 1:1 gap alert
• Staff must remain with the patient continuously
• Relief handoffs must be documented

Changing Observation Levels

Observation levels can be changed by:

1. Physician order (via EMR integration)
2. Charge nurse (manual adjustment)
3. 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