A power outage leaves a patient on portable oxygen with a finite supply. In hospice and home health, the useful question in that hour is how many minutes remain, and whether a delivery will arrive before the tanks run out.

I built the Power Outages list in Safety for the calls that come in one patient at a time. Each row is that patient’s outage, kept separate from a full emergency occurrence. The row stays on the active list until a staff member resolves it. An expired oxygen timer remains there until then.

Remaining oxygen

Remaining oxygen starts from the chart. DigiDoc uses the prescribed flow and the E-tank count already on the record, and counts down from the time the outage was reported. The Remaining column stays live: comfortable time, caution under two hours, an urgent mark under 30 minutes, and Expired at zero.

When tanks are dropped off, staff record the count, the drop-off time, and an optional note. That delivery starts a new clock from the drop-off, so a long outage can be replenished more than once. A chart change to flow, tank count, or oxygen status updates the active outage. A resolved outage stays as the historical snapshot.

A reminder when a delivery is needed

Every five minutes, DigiDoc checks active outages. When remaining oxygen reaches the 30-minute mark, or the supply has already run out, one urgent inbox message goes to each person on the emergency command team. The message states the minutes left, says a delivery is needed, and links back to Power Outages.

That reminder is sent once for the current supply. A new drop-off starts a new cycle, so the next 30-minute mark reminds the team again. A patient already covered by an open emergency occurrence is reminded from that occurrence.

What QAPI surveillance keeps

Logging the outage opens one linked QAPI incident in the Power Outage category. Severity is High when the patient is on oxygen and Medium otherwise. Monthly surveillance counts that category as events per 1,000 patient-days against the agency goal, which defaults to 8.0 or fewer. A rate over the goal asks for a performance improvement project, or a documented reason for declining one.

Surveillance counts how often outages occur. The oxygen outcome measures score what happened to the supply:

  • How many patients on oxygen never ran out.
  • Whether each replenishment cycle was replaced before the tanks depleted, including a long outage with more than one delivery.
  • Whether a low-oxygen alert was followed by an on-time delivery. A patient who never reached 30 minutes still counts as a successful delivery opportunity.

The outage log, the delivery reminder, and the QAPI record are the same event. Staff see the minutes left while the power is out. The command team hears when a delivery is due. The surveillance record later shows both the incidence and whether the oxygen lasted.

For the regulatory frame around the QAPI program, see the hospice QAPI guide. For how an emergency preparedness program covers events such as power outages, see compliance operations.

Cary Stewart, MD, PhD
Founder, DigiDoc LLC
Hospice Medical Director & Administrator