The Care Signals (Smart Notes) feature provides automated analysis of shift notes and form responses, helping you identify potential risks and incidents that might otherwise go unnoticed.
The system scans form responses and event notes (such as progress notes, feedback, and injury notes) and flags concerning entries based on customisable rules.
This feature utilises Artificial Intelligence (AI) to analyse notes and generate text. While designed to be highly accurate, AI can occasionally misinterpret context or make mistakes. Always review all flagged content and verify any AI-generated details before confirming or clearing an incident.
How Smart Notes Works
When staff members submit or update notes via the web or mobile app, the system scans the text in the background.
If a concern is detected, the note is flagged and assigned a severity level and a confidence percentage:
High (Red): Incident/Emergency, Injury/Fall, Aggression/Violence, Medication Error, Self-Harm, Safeguarding, Staff Injury.
Moderate (Orange): Behavioural Concern, Damage/Maintenance, Medication Concern, Safety Hazard, Transport Issue, Client Distress, Health Concern, Injury Signs, Fall Risk, Empty Mandatory Section*, Insufficient Detail*.
Low (Green): Missing Items, Shift Issue, Equipment Issue, Refusal of Care, Admin Issue, Environmental Concern, Health, Generic/Templated Content*.
*In addition to detecting risks, the AI also checks shift notes for completeness. It cross-references the carer's note against the client's profile data (like care plans, medications, and support needs). If the AI notices that crucial expected information is missing, it will flag it as a documentation gap.
Note: If a staff member edits a previously flagged note to remove the concerning text, the system will re-scan it and automatically remove the flag from your queue.
This feature ensures that important details buried in long progress notes or critical gaps in reporting are brought to the immediate attention of your admin team, even if a formal incident report was not raised.
Reviewing Flagged Notes
To view notes flagged by the system, navigate to Care Signals from the sidebar menu. The number displayed in the menu indicates the total number of high and moderate risk notes.
The dashboard features three summary cards at the top displaying your total High, Moderate, and Low risk flags.
Below this, a detailed table lists each flagged entry, including its severity, category, source type, client and staff details, a preview, and the confidence score. You can use the Actions column to quickly clear the flag or confirm it as an incident.
The table is divided into three tabs:
Open: Flags awaiting admin review.
Cleared: Flags that an admin has reviewed and cleared.
Incidents: Flags that an admin has confirmed and converted into an Incident Ticket.
Filtering the List
You can filter your Open notes list using the summary cards at the top of the dashboard. Clicking the High Risk, Moderate Risk, or Low Risk cards will filter the list by severity.
You can also click 'Filters' to filter the list by specific date ranges, severity levels, source types, categories, staff members, clients, teams, facilities, and locations.
Managing Flagged Notes
Click on any item in the list to view its details. The detail view will show the AI's reasoning for the flag.
If the source was a Shift Note, you will see the full text content.
If the source was a Form, you will see the specific Question and Answer pairs that triggered the flag.
You can click 'View Original Content' to open the actual shift note or form response page.
You have two primary options:
If the flag was a false positive or requires no action, select 'Clear Flag'. The flag will move to the Cleared tab.
If the note describes an issue that requires formal tracking, clicking 'Confirm as Incident' will convert the flag directly into a new Incident Ticket. Incident Management is a Premium feature. If you are on a standard plan, confirming an incident will open an upgrade modal.
You can also bulk-clear multiple flags using the checkboxes in the list and clicking 'Bulk Actions'.
Customising Detection Rules
The system uses a set of predefined rules to determine what qualifies as a risk. You can customise these rules by clicking 'Configure Flags' to better suit your organisation's needs.
Here are the various customisations you can perform on this page.
Enable/Disable Flag Rules: Toggle specific rules On or Off. (Note: Disabling a rule prevents that category from being flagged in future scans, but existing flags are unaffected).
Edit Rule Descriptions: You can edit the text description of each rule (up to 500 characters) to tell the AI exactly what to look for. If you make a mistake while editing a rule description, you can revert it to the original ShiftCare phrasing by clicking 'Restore to default description'.
Adjust Detection Sensitivity: You can set how strict the AI should be. Setting a higher threshold means only very high-confidence matches will create a flag.
Sensitive: Detect more possible cases
Balanced: Recommended default
Strict: Only strong matches
Custom Keywords (English and Spanish): Add or disable specific keywords for the AI to scan.
Add Actions: Select actions that are automatically triggered when this flag is detected.
Customise Settings: Select the risk severity of this flag, add a description, and select specific roles that will be notified when this flag is detected.
All changes made to these rules are tracked in an audit log, so you can always see which Admin made a change and when.
Tip: If you are unsure how to write an effective AI prompt, it is best to leave the rule descriptions on their default settings.
Generating an Incident Ticket
If you are using the Care Signals feature, you can create an incident ticket directly from a flagged note in your list.
Click on a pending note and select 'Confirm as Incident', or you can directly click 'Confirm as Incident' from the Care Signals dashboard.
An incident creation modal will open. The AI will read the original shift note and automatically populate the new Incident Ticket with the following information:
Status: Open
Client and Staff Member
Priority Level
Category
Ticket Name
Description (including the specific flags, confidence percentages, and the contents of the note)
Select the assignee, due date, and attach the associated form and any attachments if needed. Private mode is enabled by default, which can be disabled.
Once you confirm the flag as an incident, you can only attach an answered form. You cannot attach a blank or unanswered form.
Click 'Enhance with AI' to improve the ticket name and description (formatting it cleanly with structured sections: What Happened, Who was involved, Context, and Actions Taken). All prefilled fields remain fully editable. If you are not satisfied with the AI-generated text, click 'Undo' on the AI banner to revert all fields to their original blank state.
Click 'Save' to create an incident ticket and trigger the Incident Report process.
The original flag will move to the Incidents tab on your Care Signals dashboard. If your account has Incident Management enabled (Premium only), you can click 'Manage Incident' to open the new ticket.
Please always review the AI's output and manually add or modify any missing details before saving the ticket.
Notifications
You will receive an email notification when a note is flagged. Notifications are only sent for Risk flags, not Completeness flags.
You can opt out of receiving email notifications by unchecking 'Care Signal Alerts' in your Subscribed Email Categories (staff details page). Read this guide for in-depth instructions.
You can also choose to receive an instant message via chat by toggling on 'Send Care Signal Alerts via Chat' in Account > Feature Settings.
Stream Chat alerts include a 'View Care Signal' link, allowing you to jump straight to the flag detail page from your messages. Notifications are only sent for Risk flags, not Completeness flags.
You can disable the Care Signals feature at any time in Account > AI Settings. Please read this in-depth guide for more information.
Frequently Asked Questions
Can I enable Smart Notes for just one client or staff member?
No. The feature is account-wide. All notes matching the scanned categories are processed.
Does clearing a flag delete it?
No. Clearing a flag simply moves it to the Cleared tab, and it remains in the database for audit purposes.
Can a flag be reopened after being cleared?
Not currently. Once marked as cleared, it stays in the Cleared tab. However, flagged notes in the Cleared tab can still be confirmed as incidents.
What happens if I edit a note that was already flagged?
The note is automatically re-scanned. If the updated text still contains risk indicators, the existing flag is updated. If the risk content was removed, the flag is deleted and disappears from your list.
Are notes from the mobile app also scanned?
Yes. Any note created or updated through the web or mobile app that belongs to the scanned categories (progress notes, enquiry, feedback, injury, incident) is processed.
Which roles have access to the Care Signals Feature?
Currently, only users with the Admin role can access and manage the Care Signals feature (no custom permissions yet).
For further assistance with Care Signals: AI Smart Note Review, please contact our Support team using online chat when you're logged into ShiftCare or email our Support team at support@shiftcare.com.