When a computer problem hits a nursing home at 2 a.m., the person on duty needs to know three things: who to call, what to say and what to do while waiting. Without a clear policy, people call whoever they know, send an email nobody reads, or give up and work around the problem. Workarounds on a care floor can include writing passwords on paper or using someone else's login, both of which create risk.
An escalation policy is a short document that answers these questions in advance. It does not need to be elaborate. It needs to be clear, posted where staff will see it and tested.
Escalation is the process of moving a problem up to higher levels of expertise or authority when it is not resolved within an expected time, or when its severity demands it. In a managed IT arrangement, it usually looks like this:
Level 1: The helpdesk takes the call, resolves common problems and gathers details.
Level 2: A more experienced technician handles issues Level 1 cannot fix.
Level 3: Specialists, engineers or the software vendor handle complex problems.
Management: Leadership at your IT provider and your facility is notified when an issue is serious or prolonged.
Use plain language that clinical and administrative staff can apply without technical knowledge.
Resident safety is or could be affected
The whole building or a major system is down
A suspected security incident, such as ransomware
Target: Immediate response by phone, with updates every 30 to 60 minutes
A department or unit cannot do its work
A key system is slow or partially unavailable
Target: Response within one to two hours
One person is affected, and a workaround exists
Target: Response within one business day
Requests, questions and improvements
Target: Scheduled according to priority
Agree on these targets with your IT provider and put them in your service agreement.
List actual names and numbers for each level, including after hours.
Helpdesk phone number and email
After-hours emergency number
Your internal point of contact, such as the administrator or business office manager
Backup contact if the primary is unavailable
Key vendors, such as your EHR support line
Print this on a card or poster at every nurses' station, and keep a copy in the downtime kit. Do not rely only on the intranet, since it may be unavailable during an outage.
Decide how long an issue can remain unresolved before it is moved up.
If a Severity 1 issue has no progress after 30 minutes, notify IT management and your administrator.
If a Severity 2 issue is not resolved in four hours, escalate to Level 2 or 3.
If a ticket is reopened more than once, review the root cause.
Automatic escalation rules in a ticketing system can enforce these.
Give simple guidance for common situations:
Switch to downtime procedures for charting or medications
Use another workstation or device
Do not share passwords or use another person's account
Tell the charge nurse so that care can be adjusted
Document the issue and the time it started
Make it unmistakable that suspected security incidents are always Severity 1. Staff should know to disconnect from the network if directed, avoid deleting anything, and call rather than email. Include an instruction for reporting lost or stolen devices, since time matters for locking and wiping them.
Decide who updates staff and leadership, how often and through what channel. Some facilities designate a single person to relay information so that nurses are not interrupted repeatedly. Plan for communication when email or phones are down, such as overhead announcements or a phone tree.
After any Severity 1 or 2 incident, hold a brief review. What happened, how long did it take, what slowed us down and what should change? Update the policy at least once a year, and whenever contacts or systems change.
Using technical language only IT staff understand
Listing contacts who have left
Not testing the after-hours number
Setting response targets the provider never agreed to
Forgetting weekends and holidays
UnityCare IT provides helpdesk and escalation procedures designed for 24-hour care environments. If you would like help drafting or testing yours, we are happy to work with your team.
Call or text: 405-285-3845
New customers: start@unitycareit.com
Existing customers: support@unitycareit.com
Address: UnityCare Technologies, 2524 N Broadway Ste 554, PMB 947974, Edmond, Oklahoma 73034-4172