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

# Run a consultation

> Open a patient from a department queue, document the encounter, place orders, admit if needed, then sign and lock the record.

export const AuditNote = ({action = 'This action'}) => <div className="ck-callout ck-callout--info" role="note">
    <p className="ck-callout__body">
      {action} is written to your workspace's audit log with your name, the
      record touched and the time — a HIPAA requirement, and one you can review
      yourself under <strong>Audit Log</strong>. See{' '}
      <a href="/platform/security/audit-log">Audit log</a>.
    </p>
  </div>;

export const StillStuck = ({topic}) => <div className="ck-callout ck-callout--note" role="note">
    <p className="ck-callout__body">
      <strong>Still stuck{topic ? ` with ${topic}` : ''}?</strong>{' '}
      Check <a href="/platform/help/troubleshooting">Troubleshooting</a> first —
      it covers the failures we see most often. If that does not resolve it,{' '}
      <a href="/platform/help/contact-support">contact support</a> and include
      your workspace name and the time the problem happened, so we can find the
      matching entry in your audit log.
    </p>
  </div>;

export const TaskHeader = ({before, time, after}) => <div className="ck-task">
    {before ? <div className="ck-task__cell">
        <div className="ck-task__title">Before you start</div>
        <p className="ck-task__body">{before}</p>
      </div> : null}

    {time ? <div className="ck-task__cell">
        <div className="ck-task__title">Takes about</div>
        <p className="ck-task__body">{time}</p>
      </div> : null}

    {after ? <div className="ck-task__cell">
        <div className="ck-task__title">When you're done</div>
        <p className="ck-task__body">{after}</p>
      </div> : null}
  </div>;

export const Path = ({steps = []}) => <span className="ck-path">
    {steps.map((s, i) => <span key={i} className="ck-path__step">
        {i > 0 ? <span className="ck-path__sep" aria-hidden="true">
            ›
          </span> : null}
        {s}
      </span>)}
  </span>;

export const Availability = ({editions = ['all'], plans, roles, note}) => {
  const list = editions.includes('all') ? ['clinic', 'pharmacy', 'lims'] : editions;
  return <div className="ck-avail" role="note" aria-label="Feature availability">
      <span className="ck-avail__label">Available in</span>

      {list.map(e => <span key={e} className={`ck-pill ck-pill--${e}`}>
          {EDITION_LABELS[e] || e}
        </span>)}

      {plans ? <span className="ck-avail__label">Plan</span> : null}
      {plans ? <span className="ck-pill ck-pill--plan">{plans}</span> : null}

      {roles ? <span className="ck-avail__label">Who</span> : null}
      {roles ? <span className="ck-pill ck-pill--role">{roles}</span> : null}

      {note ? <span className="ck-avail__note">{note}</span> : null}
    </div>;
};

<Availability editions={['clinic']} plans="Enterprise" roles="Owner, doctor, physiotherapist and manager can edit; everyone else can view" note="No care area needed — Consultation is always in the Enterprise sidebar" />

A consultation is the encounter record: the note you write, the orders you place, the results that come back, and the signature that closes it. Patients arrive in a consultation queue from [triage](/hospital/outpatient/triage).

<Path steps={['Sidebar', 'Outpatient', 'Consultation', 'Consultation List']} />

<TaskHeader before="A patient routed to your department at triage" time="As long as the encounter takes — the note saves itself throughout" after="A signed, locked consultation with any orders sent to the lab, imaging, pharmacy or billing" />

## Before you start

**Consultation** has no care-area switch — it is always in the sidebar on Enterprise. Your hospital does need departments set up; with none, the module offers **No Departments Found** and a **Set Up Departments** button instead of a queue. See [Departments](/hospital/get-started/departments).

## What you're looking at

The module opens on **Select a Department** — "Choose the department you'd like to access for consultations. Each department has specialized services tailored to patient needs." Pick yours; if it has more than one sub-unit you choose that next, and with only one you go straight through.

The queue that follows covers **the last 48 hours only**, and says so when it is empty: "No consultations found for Cardiology - Adult Clinic in the last 48 hours." Older encounters are on [Consultation history](/hospital/outpatient/consultation-history) — that is the whole reason that page exists.

The toolbar carries **Search for patient**, **New Consultation**, **Refresh** and **View Columns**. Columns are **Patient ID**, **Patient Name**, **Status**, **Blood Pressure** and **Pulse Rate**, with **Doctor** and **Created At** hidden by default. What a row offers depends on its status and on whether you may edit:

| Row action              | When it appears                                      |
| ----------------------- | ---------------------------------------------------- |
| **New consultation**    | Status **Pending**, and you may edit                 |
| **View consultation**   | Status **Completed** — shown to everyone             |
| **Update Consultation** | Status **Completed**, and you may edit               |
| **Admit Patient**       | You may edit and the patient is not already admitted |
| **Currently admitted**  | Disabled, when they already have a bed               |

### The chart

Eight tabs, always in this order: **Overview**, **Chart**, **Results**, **Note**, **Orders**, **Vitals**, **History** and **Files**. A new consultation lands on **Note**; viewing or updating one lands on **Results**.

| Tab          | What it holds                                                                                               |
| ------------ | ----------------------------------------------------------------------------------------------------------- |
| **Overview** | The encounter at a glance                                                                                   |
| **Chart**    | Everything previously recorded, filterable. Empty: "Nothing recorded for this patient yet."                 |
| **Results**  | Results against this encounter. On a new one: "Nothing ordered on this encounter yet"                       |
| **Note**     | Your documentation and your diagnoses                                                                       |
| **Orders**   | Medications, labs, imaging and services                                                                     |
| **Vitals**   | **Vital**, **Value**, **Normal range** and **Status**, plus an **Over time** flowsheet of past observations |
| **History**  | Past encounters                                                                                             |
| **Files**    | Documents attached to this patient                                                                          |

The header carries **Back**, **Intakes**, **Upload**, **Check-in**, **Admit patient**, **Sign & lock** (or **Unlock**) and the save button — which names what it will do: **Create consultation**, **Save changes**, or **Save offline**. A lifecycle badge reads **Unsigned**, **Awaiting co-signature**, **Signed** or **Signed & locked**.

Your typing is saved as you go. The chip reads **Saving draft...**, then **Draft saved** — exactly what it is, a draft rather than a signed record — and **Draft not saved — your note is still here** if a save does not land.

## Write the note

The **Note** tab has two sub-tabs, **Documentation** and **Diagnosis** with a count beside it.

* Select **Select template** to insert a template. The popover searches as you type — "Search templates..." — and says "No template found." when nothing matches.
* **Dictate**, with its violet microphone, opens the ambient note taker and turns a recording into structured note text.
* Anything AI wrote carries the banner "AI-generated — review before signing" and a **Mark reviewed** button.
* Use **Collapse all** and **Expand all** to move through a long template; a **Filled** badge marks the sections you have completed.

Diagnoses live here too, not under Orders. Select **Add first diagnosis**, then fill in **Diagnosis description** and "Clinical notes for this diagnosis...". **Add ICD-10** searches the code list, and there is a separate **Clinical impression** field — "Additional clinical notes or impression...".

## Place orders

The **Orders** tab has four sub-tabs, each with a live count: **Medications**, **Labs**, **Imaging** and **Services**.

| Sub-tab         | What you fill in                                                                                                                                                                        |
| --------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Medications** | "Select mode..." (Oral, Tabs, Susp, Syrup, Inhal, Drops and so on), "Select medication...", a dose like `e.g., 500mg`, a frequency, a duration, then "Special instructions or notes..." |
| **Labs**        | "Select lab test...", then "Select parameters...". You will see "Lab test added"                                                                                                        |
| **Imaging**     | "Select test...", an urgency of **Routine**, **Urgent** or **STAT**, "Reason for test..." and "Relevant history..."                                                                     |
| **Services**    | "Select service..." and "Notes for this service...", for billable work done during the encounter                                                                                        |

Urgency is an imaging control only. Orders go straight to the unit that fulfils them — [the laboratory](/hospital/diagnostics/laboratory), [radiology](/hospital/diagnostics/radiology) and [pharmacy](/hospital/pharmacy/prescriptions).

## Admit the patient

Select **Admit patient** to open the admission dialog. Once admitted the button reads **Admitted** and is disabled; everything else on the chart stays usable, so you can carry on documenting. Ward workflow continues in [Admissions](/hospital/inpatient/admissions).

## Sign and lock

Select **Sign & lock** when the encounter is finished. A locked record can be reopened with **Unlock**, and the badge itself is the affordance — its tooltip reads "Unlock this note to edit it".

<Warning>
  **AI-generated sections must be read before you sign.** If any part of the note came from AI, signing is refused with "Review the 3 AI-generated sections before signing." Your signature says a clinician stands behind every word — go through each flagged section, select **Mark reviewed**, and sign only then.
</Warning>

## Working offline

Documentation keeps working without a connection: the save button changes to **Save offline**, and a save toasts **Captured offline** — "It will sync when you are back online." An amber banner explains what is happening, and a running count appears while the queue drains.

Three actions are deliberately switched off, each stating why. **Sign & lock** and co-signing say "Signing needs a connection". **Admit patient** says "Admission needs a connection — a bed is a shared resource", with the fuller reason in the banner: "two clinicians admitting offline would allocate the same one". Everything you typed is still there when you reconnect. See [Working offline](/platform/apps/offline).

## Who can do this

| Action                          | Who by default                                     | Permission                         |
| ------------------------------- | -------------------------------------------------- | ---------------------------------- |
| Open the queue and view a chart | Any clinical role the Outpatient group is shown to | Role Navigation                    |
| Write and save a consultation   | Owner, doctor, physiotherapist, manager            | Role — no slug                     |
| Sign and lock it                | Those who may edit                                 | **Sign and lock a consultation**   |
| Countersign a colleague's work  | Supervisors                                        | **Countersign a colleague's note** |
| Admit a patient to a ward       | Those who may edit                                 | **Admit a patient to a ward**      |

Anyone else opens the chart **read-only with no message** — no save button, no autosave chip, and every field disabled. That silence surprises people; if the chart will not take your typing, your role is the first thing to check.

Two behaviours worth stating. Permission enforcement is **opt-in per person**: someone never saved in the permissions sheet is unrestricted, and the sheet warns **"Saving starts enforcing"**. And a denied action is recorded in the audit log while an allowed one is not — hiding a module in [Role Navigation](/hospital/settings/role-navigation) is a convenience, not a security boundary. See [Permissions](/platform/team/permissions).

A signed note is read-only for everyone, whatever their role, until it is unlocked.

## Check it worked

* The encounter shows as **Completed** in the queue.
* The lifecycle badge reads **Signed & locked** and the save button has gone.
* The counts on the **Orders** sub-tabs match what you entered, and each order is visible to the unit that must fulfil it.
* An admitted patient shows **Admitted** on the header and a bed on [Admissions](/hospital/inpatient/admissions).

<AuditNote action="Opening a consultation record" />

## Common issues

<AccordionGroup>
  <Accordion title="Every field is read-only and nothing explains why">
    Editing needs the owner, a doctor, a physiotherapist or a manager. Everyone else opens the chart in view mode silently. Check your role in [Roles](/platform/team/roles) — or the note may already be signed, which locks it for everybody.
  </Accordion>

  <Accordion title="The patient is not in the queue">
    Consultation queues are filled by triage. Either they were never triaged into your department, or it happened more than 48 hours ago — look on [Consultation history](/hospital/outpatient/consultation-history).
  </Accordion>

  <Accordion title="Sign & lock will not do anything">
    Two causes. The note still has AI-generated sections you have not reviewed, and the stated reason says how many; or you are offline, and the button says "Signing needs a connection".
  </Accordion>

  <Accordion title="Admit patient is greyed out">
    Either the patient is already admitted — the button then reads **Admitted** — or you are offline. Beds are shared across the hospital, so a bed is never allocated from a device that cannot see the ward.
  </Accordion>

  <Accordion title="I chose the wrong department and cannot get back">
    Select **Back** to return to **Select a Department**. The department picker is a filter on the queue, not something written on the encounter.
  </Accordion>

  <Accordion title="A previously placed order has vanished from Results">
    Results shows what was ordered on **this** encounter. Earlier investigations sit in their own section further down the same tab, and everything the patient has ever had is on **Chart**.
  </Accordion>
</AccordionGroup>

## FAQ

<AccordionGroup>
  <Accordion title="Can I edit a signed consultation?">
    Only after unlocking it. Select **Unlock**, make the correction, then sign again. Both the unlock and the re-signature are recorded, so amend rather than working around it.
  </Accordion>

  <Accordion title="Does 'Draft saved' mean the record is filed?">
    No, and that is why it says draft. Your typing is preserved so nothing is lost, but the encounter is not a finished clinical record until you **Sign & lock** it.
  </Accordion>

  <Accordion title="Do orders need to be saved separately?">
    No. An order is placed the moment you add it — "Lab test added" — and reaches the fulfilling unit straight away, which is why the counts on the sub-tabs update live.
  </Accordion>

  <Accordion title="Where do vitals on the chart come from?">
    From [triage](/hospital/outpatient/triage) and from any ward observations. The **Vitals** tab reads them; it is not where they are entered.
  </Accordion>

  <Accordion title="Does admitting a patient close the consultation?">
    No. Admission allocates a bed and opens a ward record; the consultation stays open and editable so you can finish documenting and sign it properly.
  </Accordion>
</AccordionGroup>

<StillStuck topic="consultations" />