Bug #15

Patients Stuck in 'Reassessment Required' State After Resus Changes

Status:	Released
Priority:	Critical
Added by:	grave2.2 on September 24, '26
Assigned to:	grave2.2
Due date:
Reported for:	v1.2.0-beta.2

Steps to Reproduce

1. Run the simulation under significant pressure.
2. Allow RED/Resus patients to progress through treatment.
3. Allow the Resus escalation/reassessment system to activate.
4. Monitor patients entering "Reassessment required".
5. Continue the simulation for several hours.
6. Observe that affected patients remain in the same state rather than being reassessed and progressed.

Explanation

A large number of patients are becoming stuck indefinitely in the "Reassessment required" state.

This appears particularly noticeable following the Resus capacity/escalation changes, where patients may require reassessment to determine whether they still require Resus-level care or can safely be stepped down.

The intended flow appears to be:

1. Patient requires reassessment.
2. Patient is clinically reassessed.
3. Their current condition/observations are reviewed.
4. If they still require their current level of care, they remain there and continue through the appropriate pathway.
5. If they are stable enough to step down, they can be moved to an appropriate area such as Majors, Minors, Paediatrics, Observation or another suitable clinical area.
6. If a disposition/admission decision is appropriate, they should continue towards a ward or discharge rather than remaining in reassessment.

Instead, patients are reaching "Reassessment required" and then apparently never leaving that state.

This is not limited to one clinical area. Affected patients can be found in:

• Resus
• Resus surge
• Majors
• Paediatrics
• Ambulance Handover
• Mental Health Assessment
• Waiting Room

Some patients have remained in "Reassessment required" for hundreds of simulated hours.

This suggests the reassessment event may either:

• not be getting scheduled,
• not be processed,
• require a clinician/state that can never become available,
• be repeatedly deferred,
• or complete without transitioning the patient into their next valid state.

It may also be interacting with the new Resus escalation/step-down protocol. If Resus patients are intentionally placed into reassessment before determining whether they can be stepped down, that reassessment needs to actually complete so Resus capacity can turn over.

Expected behaviour:

• REASSESSMENT_REQUIRED should always have a valid route forward.
• A reassessment should occur when resus is at capacity and every few hours but not all at once.
• A suitable clinician should eventually perform the reassessment.
• Stable Resus patients should be considered for step-down where clinically appropriate.
• Patients who still require Resus should remain there but should not remain permanently stuck in the reassessment state.
• Patients ready for admission/discharge should continue through disposition.
• Reassessment should not permanently block patient progression.
• No patient should remain in this state for hundreds of simulated hours.

Actual behaviour:

Large numbers of patients accumulate in "Reassessment required" and appear to remain there indefinitely, preventing normal patient progression and potentially blocking clinical capacity.

This appears capable of creating a major downstream flow problem because patients occupying Resus/Majors/Paediatrics beds never complete their pathway, reducing available capacity and potentially causing further queues elsewhere.

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