> ## Documentation Index
> Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt
> Use this file to discover all available pages before exploring further.

# Clinical Notifications User Guide

> Version: 1.0.0 Last Updated: 2026-05-11 Module: CL (Clinical) Spec: CL-56 Status: Active

**Version:** 1.0.0
**Last Updated:** 2026-05-11
**Module:** CL (Clinical)
**Spec:** CL-56
**Status:** Active

> **Purpose:** Helps clinicians review, acknowledge, and act on time-bound clinical alerts (critical labs, medication exceptions, task assignments, and more).

***

## Overview

The Notification Center surfaces every clinical signal routed to you — critical lab results, medication exceptions, task assignments, and other policy-driven alerts. Each alert has a service-level agreement (SLA) deadline; if you do not acknowledge in time, it automatically escalates to the next person in the chain.

### Key Capabilities

* **Active queue** sorted by SLA deadline (most urgent first)
* **One-click acknowledgement** that removes the alert from your active list
* **Auto-escalation** when an alert is not acknowledged before its SLA deadline
* **Deduplication** so the same signal does not flood your inbox

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## Prerequisites

| Permission                    | Description                        |
| ----------------------------- | ---------------------------------- |
| `cl.notification.view`        | See alerts routed to you           |
| `cl.notification.acknowledge` | Acknowledge alerts assigned to you |

If the Notification Center shows "Feature unavailable," your administrator has not enabled the service for your organization.

***

## Getting Started

1. From the main menu, open **Clinical → Notifications**.
2. The page opens on the **Active** tab. Alerts are sorted by SLA deadline ascending.
3. The page auto-refreshes every 30 seconds.

### Reading an Alert Card

| Element        | Meaning                                                              |
| -------------- | -------------------------------------------------------------------- |
| Severity badge | `Critical`, `Warning`, or `Info` — drives color and escalation chain |
| Signal type    | Human-readable label (e.g. "Critical Lab Result")                    |
| Patient link   | Opens the linked chart, when available                               |
| SLA countdown  | Time remaining before the alert escalates                            |
| Acknowledge    | Primary action; removes the alert from your queue                    |

***

## Common Tasks

### Acknowledge an Alert

1. Open **Clinical → Notifications**.
2. Locate the alert in the **Active** tab.
3. Click **Acknowledge**.

The alert disappears from the active list immediately and moves to the **Acknowledged** tab. If the request fails, the alert reappears with a retry toast.

### Review Recently Acknowledged Alerts

1. Switch to the **Acknowledged** tab.
2. The most recent 50 acknowledgements are shown with timestamps.
3. For older history, ask your administrator to pull the **Audit Log**.

### Open the Linked Chart

Click the patient name on the alert card to jump to the chart. Use this before acknowledging when clinical follow-up is required.

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## Tips and Best Practices

### Do's

* ✅ Triage the **Active** tab top-down — items at the top are closest to SLA breach.
* ✅ Open the chart and complete clinical action **before** acknowledging.
* ✅ Acknowledge as soon as you have ownership; this prevents unnecessary escalation to your supervisor.

### Don'ts

* ❌ Do not acknowledge "to clear the queue" without acting — the audit log records who acknowledged each alert.
* ❌ Do not rely on the queue as a real-time pager; severe events should still be communicated by phone per local policy.

***

## Troubleshooting

#### Issue: I expected an alert but see nothing

**Cause:** The signal may have been deduplicated against a recent identical alert, or your role is not the first step of the escalation chain.

**Solution:** Confirm with your administrator that a policy exists for the signal type and that your role is mapped in the chain.

#### Issue: "Feature unavailable" is displayed

**Cause:** The `cl.notification_service_enabled` feature flag is off for your organization.

**Solution:** Contact your administrator to enable it.

#### Issue: Acknowledge button fails

**Cause:** Network error, or you do not have `cl.notification.acknowledge`.

**Solution:** Retry from the toast. If it persists, contact your administrator.

***

## Related Documentation

* **Admin Guide:** [cl-56-notification-service-admin-guide.md](notification-service-admin-guide.md)
* **Specification:** `specs/cl/specs/CL-56-centralized-clinical-notification-service.md`

***

**Last Updated:** 2026-05-11