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Note countersign queue

A note written by a trainee is not yet final documentation. The countersign queue gathers such notes in one place and lets you approve them.

Required permissions:
Clinic AdminPractitioner
Reviewed: 2026-08-24

A note written by someone with the Trainee role is marked by Heltio as Pending countersign and is not treated as final documentation until a supervisor approves it. The Countersign queue is the list of all such notes at the facility.

The requirement follows from the author's role at the moment of writing, not from the content of the note — the role description says so outright: Documents care; notes require countersign before finalisation. Changing the author's role later does not retroactively approve notes already waiting.

Open the countersign queue

How to do it

01

Open the queue

In the side menu: Hospital → Countersign queue. The entry appears only to people entitled to countersign, and carries a counter when notes are waiting. The screen header says: Review and approve pending trainee notes.

02

Look through the list

The table has the columns Author, Patient, Type, Date, View and Actions, sorted newest first. Next to the author sits a Trainee note marker. The View column shows the beginning of the content, and the patient's name is a link to the patient record. The list is paginated at 20 entries.

An empty queue is Nothing to countersign — and that is the desired state, not an error.

03

Approve a note

The Countersign button opens the Countersign note dialog with a preview: the note type, the author, the date and the beginning of the content. The dialog warns: You are about to countersign this note, making it final clinical documentation. This action cannot be undone.

You confirm with Countersign; Heltio acknowledges with Note countersigned and takes the entry off the queue.

04

Check a note's state outside the queue

A note carries its state on the patient record and on the timeline too: Pending countersign before approval, and after it Countersigned by together with a name and a date. You do not have to come back to the queue to check.

What countersigning changes

  • The note stops being a supervised draft and becomes final documentation.
  • The action goes into the audit log together with who approved it and when.
  • The approval cannot be undone or repeated — a second attempt is refused.

When something goes wrong

Error

You cannot countersign your own note

What this means: The note was written by the same person who is trying to approve it. A countersignature is by definition a second pair of eyes, so no permission gets around it.

What to do: Ask another person entitled to countersign — a coordinator, a senior therapist, an administrator or the owner.
Warning

This note is already countersigned

What this means: Somebody approved this note in the meantime — or the click went through twice.

What to do: Refresh the queue. The entry will disappear from the list; you can check the note's state on the patient record.
Info

Available for hospital facilities

What this means: The queue works only at facilities of type Hospital. At other practices the screen is visible but greyed out, with a **Hospital feature** banner.

What to do: Contact Heltio support if the facility should have the hospital line enabled.
Warning

Something went wrong. Please try again.

What this means: The list did not load.

What to do: Click **Try again** next to the message.

Who has access

Clinic Admin Practitioner

Four roles can countersign: Owner, Admin, Coordinator and Senior therapist. The role descriptions say so outright — a coordinator is a Department head — manages structure & teams, may countersign notes, and a senior therapist is a Supervising therapist — countersigns notes, plans treatment series.

Someone with the Trainee role may write notes but does not see the queue and approves nothing — not even other people's notes. If an otherwise entitled person opens the screen at a hospital facility without that right, they see a message instead of the table.

In the mobile app the queue is called To countersign and works the same way, with one limitation: Countersigning is only available when online.

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