Purpose Statement
This article explains how to complete a Multi-Action Medication Event within the Medications module. Multi-Action Workflows allow users to combine supported, related medication actions into a single workflow and complete one final signature process.
A common example is documenting a medication Usage, replenishing the Med Kit through a Transfer or Receive, and ending with a Count when the Med Kit must be physically verified.
Multi-Action Workflows can also help personnel correct an inventory condition created by an earlier action. For example, if a Usage or Remove action reduces inventory below the configured Min, a subsequent Transfer or Receive can replenish the applicable pouch before the workflow is completed.
Background Information
Medication events can be initiated from several areas of the Medications module, including the Dashboard, Med Kits, and Med Supply, depending on the action being performed and the user's permissions.
Supported actions can be added sequentially to create a Multi-Action Workflow. This allows related medication events to remain connected rather than requiring users to complete and sign each action independently.
Common examples include:
- Usage followed by Transfer to replenish a Med Kit.
- Usage followed by Receive when replacement medication is obtained from a Pharmacy vendor.
- Removal followed by Receive or Transfer to replace damaged or expired inventory.
- Receive into Med Supply followed by Transfer into one or more Med Kits.
- Usage, replenishment, and a final Count for a controlled substance Med Kit.
When actions affect a Med Kit, inventory continues to be tracked at the pouch level. If the same Medication Form is configured in multiple pouches, users must select the pouch associated with the physical inventory involved in each action.
Only currently available medication inventory can be selected as source inventory for actions such as Usage, Transfer, or Remove. A configured Medication Form with a current quantity of 0 may remain visible on the Med Kit Overview when Par and/or Min is configured, but there is no physical inventory available to select for those actions. A Receive or applicable Transfer can be used to replenish the Medication Form.
Once a new action is started, the previous action becomes non-editable. Users should verify each action carefully before selecting Continue.
Count is a terminating action. Once Count is added, no additional medication actions can be added afterward.
Custody Exchange is not supported within a Multi-Action Workflow and must be completed through its dedicated custody workflow.
Important Note:
A Multi-Action Workflow represents a sequence of related medication events. Each action should document what physically occurred rather than being added solely to change an inventory status or clear an alert.
Required Permissions
Users need the applicable permissions for each medication action included in the workflow.
Depending on the actions being performed, permissions may include:
- Meds - Usage
- Transfer Medications
- Receive Medications
- Remove Medications
- Count Medications
- Med Kits access
- Med Supply access, when applicable
- Dashboard access, when initiating Usage from the Dashboard
Users can only add actions they have permission to perform.
Signature options and other workflow functionality may vary based on agency configuration.
Video
Medications Par Management
Par management allows medication inventory to be organized and monitored at the pouch level within Med Kits. Multi-Action Workflows are especially useful when one medication action changes a pouch's inventory status and another related action is needed to replenish that inventory.
Par represents the configured stocking level for the Medication Form within the pouch. Min represents the configured minimum inventory threshold.
Medication cards use the current inventory-status logic:
- Red — Restock Needed: Available quantity is below Min.
- Red — Restock Needed at Zero Quantity: When quantity reaches 0 and Par and/or Min is configured, the Medication Form can remain visible on the Med Kit Overview as red Restock Needed.
- Yellow — Monitor: When both Par and Min are configured, available quantity is at or above Min and at or below Par.
- Yellow — Monitor when Min is not configured: Available quantity is at or below Par.
- Light Gray — Well Stocked: When both Par and Min are configured, available quantity is above Par.
- Light Gray — Min only: When Par is not configured, available quantity above Min appears light gray.
- Light Gray — No thresholds configured: When neither Par nor Min is configured, the medication card appears light gray.
Inventory exactly at Min remains yellow when both Par and Min are configured. Red Restock Needed begins only when inventory falls below Min.
If Par and Min are configured to the same value, inventory at that matching value remains yellow. It becomes red only after inventory drops below Min.
A Multi-Action Workflow can address a low-stock condition before the workflow is completed. For example:
- A Usage reduces a pouch from quantity 1 to quantity 0.
- The medication is now below Min and would be in a red Restock Needed condition.
- The user adds a Transfer or Receive action.
- Replacement inventory is placed into the correct pouch.
- The resulting inventory status is based on the final quantity after replenishment.
Agencies may configure a Critical Low Stock notification. This condition applies when medication inventory drops below the configured Min and the low-stock condition is not corrected as part of the applicable workflow.
Tip:
When replenishing within a Multi-Action Workflow, verify the specific destination pouch rather than relying on the Med Kit's overall medication quantity. The same Medication Form can be stocked in multiple pouches with separate inventory and threshold values.
Step-by-Step Guide
1. Start a Supported Medication Event
Open the Medications module and begin one of the supported starting actions.
Depending on the action and location, a workflow can be initiated from:
- Dashboard
- Med Kits
- Med Supply
Supported starting actions include:
- Usage
- Transfer
- Receive
- Remove
Important Note:
A Count cannot begin a Multi-Action Workflow because Count is a terminating action.
Custody Exchange cannot be included in a Multi-Action Workflow and must be completed through its dedicated custody process.
From the Medications Dashboard
From Med Kits - Controlled Substance Kits
From Med Kits - Non-Controlled Substance Kits
From Med Supply
2. Complete the First Medication Action
Complete the required fields for the selected medication event.
Depending on the action, this may include:
- Source or destination
- Med Kit
- Pouch
- Medication Form
- Quantity
- Expiration date
- Lot number
- Serial number
- Incident or patient information
- Removal reason
- Other action-specific documentation
Verify all information before adding another action.
When selecting existing medication inventory for Usage, Transfer, or Remove, only available inventory can be acted upon. A Medication Form at quantity 0 may remain visible on the Med Kit Overview but is unavailable as source inventory.
3. Review the Result of the Current Action
Before adding another action, consider how the current event affects the Med Kit's inventory.
For example, a Usage or Remove can reduce a pouch:
- From above Par into the yellow monitoring range.
- To exactly Min, which remains yellow.
- Below Min, which creates red Restock Needed.
- To quantity 0, which can remain visible on the Med Kit Overview as red Restock Needed when Par and/or Min is configured.
If replacement inventory is part of the same operational event, add the applicable Transfer or Receive before finalizing the workflow.
Important Note:
Do not create an additional medication event solely to manipulate the displayed inventory status. Each action should correspond to an actual medication transaction.
4. Select Add Action
When the current action is complete, select Add Action.
Choose the next supported medication action required for the workflow.
Available actions depend on the current workflow and the user's permissions.
Tip:
Use a Multi-Action Workflow when the medication events are directly related. For example, document a Usage and then replenish that same Med Kit through a Transfer or Receive action.
5. Review the Multi-Action Confirmation
After selecting the next action, the system identifies that you are creating a Multi-Action Workflow.
Review the current action before continuing.
Select Continue to proceed to the next action.
After selecting Continue, the previous medication action is locked and cannot be edited.
Verify before continuing:
- Medication
- Quantity
- Source and destination
- Source pouch
- Destination pouch
- Expiration date
- Lot number
- Serial number
- Patient or incident information, when applicable
- Other action-specific documentation
6. Complete the Next Action
Complete the required information for the newly added action.
For example, after documenting a Usage, a user may:
- Transfer replacement medication from Med Supply or another applicable location into the Med Kit.
- Receive replacement medication from a Pharmacy vendor.
- Remove another medication that is physically being taken out of service.
When transferring or receiving medication into a Med Kit, verify the destination pouch and resulting Par and Min status.
A Transfer or Receive can also replenish a Medication Form that reached quantity 0 during an earlier action.
7. Remove the Current Action if Needed
If the newly selected action is incorrect, select Remove Action from this Flow before completing it.
A confirmation message appears.
Select Remove to delete the active action.
Previously completed actions remain locked. You can then select another supported action or complete the workflow using the actions already documented.
Important Note:
Remove Action from this Flow applies to the currently active action. It does not reopen or remove previously completed actions that were locked when you continued.
8. Continue Adding Supported Actions as Needed
Continue using Add Action when additional related medication events are required.
Each completed action becomes non-editable when the next action begins.
Supported actions can include:
- Usage
- Transfer
- Receive
- Remove
- Count as the final action
Avoid adding unrelated actions simply to reduce the number of signature processes. A Multi-Action Workflow should represent medication events that are operationally connected.
9. End with a Count for a Sealed Med Kit When Required
When a Count is required after the preceding medication actions, select Count as the final action.
This may apply when a controlled substance Med Kit has been opened and its physical inventory must be verified according to the applicable Med Kit configuration or agency procedure.
Complete the physical medication count according to the standard Count workflow.
Only medication with current physical inventory is presented during the Count. A configured Medication Form that is already recorded at quantity 0 may remain visible on the Med Kit Overview but does not appear during the Count because there is no physical inventory to verify.
Warning:
Count must be the final action. Once Count is selected, no additional medication actions can be added.
If another medication action is still required, complete that action before adding Count.
For sealed Med Kits, the Count may also require a new seal number before the workflow can be finalized.
10. Address a Count Discrepancy, if Identified
During the final Count, compare the physical medication inventory with the inventory recorded in First Due.
A discrepancy exists when the recorded inventory and physical observation differ.
A Medication Form that First Due already records at quantity 0 is not automatically a discrepancy simply because it does not appear during the Count.
If a discrepancy is identified, document the actual physical observation and follow the applicable Count and agency procedures.
11. Save the Count as a Draft if Necessary
If the final action is a Count and the workflow must be interrupted, Save as Draft may be available.
When the Med Kit uses seals, the count workflow may require the user to:
- Enter a new seal number, or
- Select Skip Seal and provide a reason.
Use Save as Draft only when necessary and follow the standard Medication Count process when resuming the count.
12. Sign & Finish or Complete and Sign Later (If Available)
Select Sign and Finish to finalize the Multi-Action Workflow.
If the final action is a Count for a sealed Med Kit, enter the required new seal number or numbers before continuing when applicable.
Complete the agency's configured signature process.
All supported actions included in the Multi-Action Workflow are finalized through the single final signature process.
Tip:
See Completing Medication Signatures for additional information about PINs, saved signatures, multiple signers, and Pending Signatures.
Depending on the workflow, permissions, and agency configuration, Complete and Sign Later may be available.
Selecting Complete and Sign Later completes the documented medication actions and applies the associated inventory changes immediately.
The completed event is then added to Pending Signatures for later signature completion.
If the completed actions affect Par or Min status, the resulting inventory status is also reflected immediately.
Warning:
Complete and Sign Later does not delay the medication transactions or inventory changes. It leaves the configured signature requirement outstanding.
Best Practices
- Use Multi-Action Workflows when medication actions are directly related and represent one operational sequence.
- Complete and verify each action before selecting Continue because previous actions become non-editable.
- Verify the specific pouch involved whenever an action affects Med Kit inventory.
- Use Usage followed by Transfer or Receive when replacement inventory is actually being replenished as part of the same workflow.
- Review the resulting Par and Min status after inventory-changing actions.
- Remember that inventory at Min remains yellow when both thresholds are configured. Red Restock Needed begins only when inventory falls below Min.
- When inventory reaches quantity 0, remember that the Medication Form may remain visible on the Med Kit Overview but is unavailable as existing source inventory.
- Use Receive or Transfer, as applicable, to replenish zero or low inventory.
- Correct a below-Min condition during the same workflow when replacement inventory is part of the actual medication transaction.
- Do not add an action solely to clear an inventory status or notification; document only medication transactions that actually occurred.
- Add Count last when physical inventory verification is required.
- Remember that zero-quantity Medication Forms do not appear during Count because there is no physical inventory to verify.
- Do not select Count until all other required medication actions are complete.
- Do not attempt to include Custody Exchange in a Multi-Action Workflow.
- Remove an incorrectly selected active action before continuing; previously locked actions cannot be reopened through Remove Action from this Flow.
- Distinguish Save as Draft from Complete and Sign Later. A draft preserves an unfinished Count, while Complete and Sign Later completes the applicable transaction and leaves the signature outstanding.
- Resolve Pending Signatures according to agency documentation policies.
- Verify the final workflow reflects the actual sequence and physical movement of medication before signing.
Troubleshooting & FAQs
Where can I start a Multi-Action Medication Event?
Supported workflows can be initiated from the Dashboard, Med Kits, or Med Supply, depending on the first action being performed and the user's permissions.
Which actions can start a Multi-Action Workflow?
Supported starting actions include Usage, Transfer, Receive, and Remove, depending on the workflow context and permissions.
Which actions can be combined in a Multi-Action Workflow?
Supported medication actions include Usage, Transfer, Receive, Remove, and a final Count, depending on permissions and workflow context.
Can I start a Multi-Action Workflow with Count?
No. Count is a terminating action and cannot begin a Multi-Action Workflow.
Can I add another action after Count?
No. Once Count is added, no additional medication actions can be added afterward.
Why isn't Count available as my first action for a Multi-Action Workflow?
Count is designed as the terminating action. Begin with the applicable Usage, Transfer, Receive, or Remove action, then add Count last when needed.
Can Custody Exchange be included in a Multi-Action Workflow?
No. Custody Exchange uses its dedicated custody workflow and is not supported as part of a Multi-Action Medication Event.
Why can't I edit the previous action?
Once you select Continue and begin the next action, the previous action becomes locked and non-editable. Review each action carefully before continuing.
What should I do if I selected the wrong next action?
Select Remove Action from this Flow while working in the active action, then confirm the removal. You can then select another supported action.
Can Remove Action from this Flow remove an earlier action?
No. It removes the currently active action. Previously completed actions that were locked when you continued remain non-editable.
Can I use multiple actions to replenish medication after Usage?
Yes. When replacement medication is part of the same operational sequence, document the Usage and then add an applicable Transfer or Receive action to replenish the correct Med Kit and pouch.
What happens if Usage or Remove reduces inventory exactly to Min?
When both Par and Min are configured, inventory exactly at Min remains yellow Monitor. Red Restock Needed begins only when inventory drops below Min.
What happens if an action reduces inventory below Min?
The medication enters the red Restock Needed condition. If replacement inventory is part of the same Multi-Action Workflow, an applicable Transfer or Receive can replenish the medication before the workflow is completed.
When can a Critical Low Stock notification occur?
The Critical Low Stock condition applies when inventory drops below the configured Min and the low-stock condition is not corrected as part of the applicable workflow.
Can replenishing inventory during the same Multi-Action Workflow prevent the low-stock condition from remaining when I finish?
Yes. When an applicable Receive or Transfer replenishes the medication before the workflow is completed, the resulting inventory status is based on the replenished quantity. The Critical Low Stock condition applies when inventory remains below Min rather than being corrected as part of the applicable workflow.
What happens if an action reduces a Medication Form to quantity 0?
When Par and/or Min is configured, the Medication Form may remain visible on the Med Kit Overview as red Restock Needed. However, there is no physical inventory available for Usage, Transfer, Remove, or other actions that require existing medication.
How do I replenish a Medication Form at quantity 0?
Use an applicable Receive or Transfer action to add inventory to the correct Med Kit and pouch.
Why doesn't a zero-quantity Medication Form appear during the final Count?
Counts display inventory that is physically present for verification. A Medication Form already recorded at quantity 0 may remain visible on the Med Kit Overview, but it does not appear during Count because there is no physical inventory to count.
Is a zero-quantity Medication Form automatically a Count discrepancy?
No. If First Due already records the quantity as 0, its absence from the physical inventory is not itself a discrepancy. A discrepancy occurs when the system-recorded inventory and physical observation differ.
Why should I end a sealed Med Kit workflow with Count?
When physical inventory verification and resealing are required by the applicable Med Kit configuration or agency procedure, Count must be added last because no additional actions can follow it.
Can I save the final Count as a draft?
Yes, when the Count workflow provides Save as Draft. Follow the standard Count workflow for seal requirements and resume the unfinished Count later using Resume Count.
Does saving the final Count as a draft create a Pending Signature?
No. A saved-draft Count remains unfinished and is resumed through Resume Count. Pending Signatures are associated with supported completed events that still require signature completion.
What happens when I select Complete and Sign Later?
The supported medication actions are completed and applicable inventory changes take effect immediately. The signature remains outstanding and the event is added to Pending Signatures.
Does Complete and Sign Later delay Par or Min status changes?
No. Because the medication transactions are completed immediately, the resulting pouch quantities and applicable Par and Min statuses are also updated immediately.
What is the difference between Save as Draft and Complete and Sign Later?
Save as Draft preserves an unfinished Count so it can be resumed. Complete and Sign Later completes the supported medication transaction and applies its inventory changes while leaving the configured signature requirement outstanding.
How many times do I sign a Multi-Action Workflow?
The supported medication actions included in the Multi-Action Workflow are finalized through one final signature process.