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Note Locks, Doc Alert Recovery, and Chart Addendums

After sign-off, charts lock. Correct with late entries, addendums, or amendments—not by editing the original. Admin reset/unlock when the form must reopen.

Written by Jonathan Marbutt

This article covers chart documents that offer an Addendums panel. The Visit Record's individual note locks and ultrasound Doc Alert recovery are separate.

After a chart is fully signed off, CoolFocus locks it so the original clinical record stays intact. You do not rewrite signed fields in place. Corrections go through the Addendums section as a late entry, addendum, or amendment.

Looking for how to set up reviewers or Send for Review? See Doc Alert and Chart Sign-Off: Setup, Review, and Reminders. This article is about what happens after sign-off.


First identify what is locked

  • Visit note: a note lock makes that note read-only. It may be set automatically on save or by a permitted staff action. Use the note's available lock/unlock action or ask an administrator. This does not sign a document.

  • Ultrasound Doc Alert: sending it protects the ultrasound's review content. Open Workspace → Ultrasound → Info to check Doc Alert state. Reset Doc Alert is administrator-only after the alert has been sent or reviewed; resetting a signed alert requires another review.

  • Signed chart document: use the document's Addendums panel when offered. The instructions below apply to that panel.

If you do not see Addendums, do not keep looking for a chart-document action on a different surface. Ask support or your administrator to confirm the record type and current review state.


When a chart document locks

A chart locks when review finishes and the chart is signed. Typical path:

1. Staff complete the chart and Send for Review (or complete it when the chart type starts review automatically).

2. The reviewer approves (or finishes the last step on a custom approval chain).

3. CoolFocus marks the chart signed and applies a lock.

Some built-in charts, such as Counseling and Vitals, do not go through review at all. Marking one of these Completed locks it the same way sign-off locks a reviewed chart, and Addendums becomes the correction path right away.

While a chart is In Review (before final sign-off), the chart content is already protected from normal edits; notes may still be allowed. After sign-off, the permanent correction path is addendums.

You may also see a lock while a workflow is in progress (for example when a chart was sent for review). The message on the chart explains the lock reason when one is stored.


What staff see on a locked chart

Open the chart document from the visit's Workspace document list or the chart record. On a signed chart you will typically see:

  • Fields that no longer save as normal edits

  • Guidance to use Addendums for corrections (for example Add corrections in Addendums)

  • An Addendums panel with history and Add addendum

Trying to change locked fields returns an error that the record is locked and to use the addendum system instead.

Signed custom chart entries also cannot be deleted from the visit; use addendums for corrections.


Addendum types (pick the right one)

In the Addendums panel, choose Add addendum, then pick a type:

  • Late Entry — Information that should have been documented earlier, added after lock. Enter a reason (required) and content (required).

  • Addendum — Extra clinical information that does not replace a specific field value. Enter a reason (required) and content (required).

  • Amendment — A specific field value needs a documented correction. Enter a reason (required) and field name (required). You can also record the original value and the corrected value.

Every addendum needs a reason. CoolFocus keeps the original signed content and stores your addendum as a separate, permanent note.


How to add an addendum

1. Open the signed chart on the visit.

2. Go to the Addendums section.

3. Choose Add addendum.

4. Select Late Entry, Addendum, or Amendment.

5. Fill in the required fields (reason always; content for Late Entry/Addendum; field name for Amendment).

6. Choose Save addendum.

7. Confirm your identity when CoolFocus asks you to re-verify (this is required for compliance-sensitive chart corrections).

You should see a success message and the new item in the history list.

Who can add

Addendums are for people who are allowed to correct that chart in your organization (typically reviewers / clinical staff with access to the chart). On some review surfaces, people who only submitted the chart may see history only and cannot add new addendums there.

Important limits

  • The chart must be currently locked to add a new addendum. If the lock is not active, Add addendum stays unavailable until the chart is locked again (or use an admin path below when appropriate).

  • Once saved, an addendum cannot be edited or deleted. If you need another correction, add another addendum.

  • Addendums do not silently overwrite the original field values on the chart form; they are the official correction trail.


Correction history

The same Addendums panel shows history in time order, including:

  • Each late entry, addendum, or amendment (type, who, when, reason, and content or field change)

  • Unlocked by admin events when an administrator unlocked the record (with reason)

Printed chart PDFs can include lock history and amendments as well. See Managing Chart Templates.

Clinical timeline notes may also record that an addendum was added (staff-facing activity, not Client Portal).


Admin-only: reopen a signed chart document

For a chart document that offers this panel, normal staff should correct with addendums. Administrators have two stronger options when the signed chart must be reopened rather than only annotated.

Reset to draft (admin)

On the chart’s Addendums panel, admins can use Reset to draft (admin).

  • Requires a reason

  • Requires identity re-verification

  • Voids the physician signature — the chart must go through review/sign-off again

  • Keeps prior signature, addenda, and lock history; it reopens the chart for editing

Use this only when reopening the original form is truly needed (not for routine “I forgot a sentence” notes — use an addendum for those).

Unlock (admin)

Administrators can unlock a locked record with a required reason. Unlock events appear in the correction history as Unlocked by admin. Unlocking is an override of the normal addendum-only model; prefer addendums or Reset to draft when those match the need.


Good habits

  • Prefer an addendum over asking an admin to reopen a signed chart.

  • Write a clear reason (what was wrong or missing, and why).

  • For a wrong value on a named field, use Amendment and name the field.

  • Do not rely on old checkbox-style “reviewed” markers as a substitute for real sign-off and lock.

  • After an admin Reset to draft, send the chart for review again before treating it as final.


Troubleshooting

  • Cannot edit chart fields after sign-off — Expected. Use Addendums.

  • Add addendum is grayed out — Chart may not be locked right now, or you only have history access. Refresh; confirm the chart is signed/locked; ask a reviewer or admin if needed.

  • “Addendums can only be added to locked entities” — The record is not locked. Finish sign-off/lock first, or have an admin resolve lock state.

  • Need to change original values on a chart document — ask an administrator about Reset to draft when offered, then re-review. For the Visit Record's ultrasound, use the separate Doc Alert recovery path.

  • Need a printed record of corrections — Print/PDF the chart; amendments and lock history can appear on the clinical PDF.


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