Operations

A.1 What an Operations doctor / nurse owns

A.2 What they cannot do

The Operations shell is intentionally narrow — kiosk-style, like ICU / Maternity / Emergency:

• No sidebar, no global navigation, no dashboard.
• No access to lab, pharmacy, radiology, billing, HR, or admissions screens.
• No access to other wards (ICU, Maternity, Emergency) — only Transfer to Ward for downstream recovery.
• No access to patients who are not on the operations board.

Forbidden URLs land on the standard Forbidden page.

A.3 What the screen looks like

When an operations doctor or nurse logs in:

┌──────────────────────────────────────────────────────────────────────────────┐
│ M  Mando · Operations    [ Operations ]            🔔   Dr. Tarek Younes ┄    │
├──────────────────────────────────────────────────────────────────────────────┤
│                                                                              │
│   ⚙ Operations & Surgery                            + Schedule Operation    │
│   3 total procedures scheduled or completed                                  │
│                                                                              │
│   ┌ All (3) ┐ ┌ Pre-Op (1) ┐ ┌ In Surgery (1) ┐ ┌ Post-Op (1) ┐             │
│                                                                              │
│   ┌ pre-op ─ Anna Taylor — Appendectomy ─ Surgeon: Dr. Tarek Y ─ [ pre-op ] ┐│
│   │ Scheduled: 2026-04-26 09:30   OR-1   Anesthesia: general (Dr. Khaled)  ││
│   │ Pre-Op Diagnosis: Acute appendicitis                                    ││
│   │ Pre-Op Instructions: NPO since 22:00, IV access, consent signed         ││
│   │ ─────────────────────────────────────────  [+ Order] [Edit] [🗑]         ││
│   └────────────────────────────────────────────────────────────────────────┘│
└──────────────────────────────────────────────────────────────────────────────┘

Top bar: brand → single static tab “Operations” → notification bell → user pill → Sign out.

A.4 The day, end to end

1. Sign in. The system bounces them straight to /operations. No dashboard.
2. Read the board. Four status cards across the top (All / Pre-Op / In-Surgery / Post-Op). Filter the list by clicking one.
3. Schedule a new operation. Click + Schedule Operation → modal opens with admitted-patient picker, surgery type (elective / urgent / emergency), procedure name, anaesthesia type & anaesthesiologist, scheduled date/time, OR, pre-op diagnosis & instructions. Save.
4. Click the patient name. The chart popup opens with 11 cards: Operation, Vitals, Allergies, Conditions, Nursing Assess., Medications, Lab Orders, Imaging Orders, Results, Care Plans, Consents. Each card shows a count.
5. Click “Operation”. Read-only snapshot: procedure, surgery type, OR, scheduled date/time, duration, anaesthesia & anaesthesiologist, pre-op diagnosis & instructions, post-op notes, complications, status. Banner highlights complications (red) or urgent/emergency surgery (orange). The chart’s bottom hint reminds the user that editing the operation record happens on the board (Edit / Transfer to Ward).
6. Click “Vitals” → + Add. Form has seven chips: BP, HR, Temp, SpO2, RR, EtCO2, Pain. Click a chip → fields pre-fill → type the value → Save. Useful both intraoperatively (anaesthesia monitoring) and in PACU.
7. Click “Allergies / Conditions / Nursing Assess.” → + Add. Same flow. The Nursing Assess. dropdown adds OR-specific types (Aldrete, Apfel, Wound check) alongside the shared ones.
8. Place an order. Close the chart, click + Order on the row. Three tabs: Prescription, Lab, Imaging. Submit → Pharmacy / Lab / Radiology gets the alert.
9. Move the case along. Click Edit to bump status (pre-op → in-surgery → post-op → recovered), record duration, post-op notes, complications.
10. Transfer to Ward. When status is post-op or recovered and the patient is still admitted, Transfer to Ward appears on the row → handoff form (wing, room, ward type, bed, attending nurse, post-op care plan, notes). Submit → ward gets the alert; the operations row is closed out from the OR’s perspective.

A.5 Notifications

Inbound (the bell flashes):

• Patient transferred from Emergency for emergency surgery — fired by ER’s “To Operation” handoff.
• Surgical admission landed on the wing — fired by Reception with admission_type = surgery.
• Stat lab or imaging result finalised on one of their surgical patients (planned).

Outbound (they create them implicitly):

• Placing a Lab order → Laboratory.
• Placing an Imaging order → Radiology.
• New prescription → MAR / pharmacy queue.
• Transfer to Ward → ward charge nurse for post-op care.

A.6 Common pitfalls

• “I want to update post-op notes from the chart.” The Operation card is read-only. Close the chart, click Edit on the row, record post-op notes there. (Use the Vitals card for intraop / PACU vitals.)
• “Transfer to Ward isn’t showing up.” It only appears once the operation is post-op or recovered AND the underlying admission is still active. Bump the status via Edit first.
• “I can’t find the patient I want to schedule.” They aren’t admitted as a surgery/operation admission. Reception creates that admission first; until then the picker on + Schedule Operation won’t list them.
• “I tried to open the lab page and got Forbidden.” Correct — Operations staff place orders but never browse lab/pharmacy/radiology. Use + Order on the row.
• “The patient just had emergency surgery — where do I see them?” ER’s “To Operation” transfer creates the operation_details record automatically. They should be on the board with status pre-op or in-surgery.