View source for Boarding Loc

{{Project
|ProjectActive=active
|ProjectProgram=CC and Med
|ProjectRequestor=internal
|ProjectCollectionStartDate=2019-Sep-20
|Project=Boarding Loc
}}

This isn't so much a project as way to track how patients physically move around the hospital. See [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]] for information about it and why we needed to change it to this model. 

This project tracks where and when a patient '''arrives''' into a new physical location. 

== Data Collection Instructions ==
{{Discuss | 
* and this is where I realized we may need to do this for CC and Med, rather than just cc. Sent out email for input... }}

In [[L TmpV2 table |TMP]], a "no borrow" entry will automatically be added to every new Critical Care or Medicine patient's record. 

If the patient never ends up in a "borrowed bed" during their stay then, leave the default in Item as ''no borrow'' and also put a check mark in the checkbox. (this is to verify that there was no bed borrow, otherwise no one is sure is missed or not).
If the patient does end up in a "borrowed bed", change the item to the location of the borrow and enter the rest as per below: [[#How to enter this]]. 

Add a new tmp entry for every additional move/borrow within your centre that a patient makes during their stay at your '''[[Service/Location]]'''; including moves from borrowed location to your actual unit.

=== How to enter this ===
*Use tmp fields:
** Project: '''{{PAGENAME}}'''
** Item: '''no location entered''' is the default (that entry will not be allowed in a complete record)
*** change the original entry to the first location the patient was during the admission in this record, e.g. ER, specific medicine ward etc
*** for any physical move to another unit, enter an additional boarding loc entry
** Enter start_dt: '''arrival date at borrowed bed''', under column E.
** Enter start_tm: '''arrival time at borrowed bed''', under column M.
** checkbox: not used for this project <!-- was used for cross checks in data before 2020-10-15 -->
** comment field: 
*** see [[#Special Case - moving from one borrowed ward bed to another]]
*** There are now additional circumstances where we use comment field for Borrow Loc, to do with COVID moves. Documented in pages in [[:Category:2020 COVID unit transition]] and some info below in [[#COVID]]

=== APACHE ===
The APACHE elements time frame will start in the off-ward bed location. 
{{Discuss | 
* Does it really start in ER? since that's now one off-ward location? In any case, we should really only link to the definition in APACHE from here so this doesn't become inconsistent. If someone knows where that's documented, can you please confirm and fix? Ttenbergen 00:36, 2020 October 16 (CDT)}}

=== TISS ===
TISS starts from the off-ward bed.
{{Discuss | 
* This would now mean TISS starts in ER if the pt is in ER long enough. We discussed that a while ago and I can't remember the outcome. This might need to be updated to correspond to that. Or rather, this should only be a link to that so it doesn't go inconsistent in the future. If some one knows what was decided, can you please fix this? Ttenbergen 00:36, 2020 October 16 (CDT)}}

=== Special Case - Parked ===
{{Discuss | 
* There was talk about changing the [[Parked in ER]] to use [[Boarding Loc]] scheme instead; I can't remember details, if someone else can, could you please update here and remove the old instruction below?Ttenbergen 00:36, 2020 October 16 (CDT)
}}
*For patients who are [[Parked in ER]], no need an entry for these, since the ER delay will take care of them.

=== Special Case - EMIP/ECIP ===
See [[2020-10 EMIP changes]]

=== Special Case - CAU ===
{{Guideline CAU vs Boarding Loc vs EMIP}}

{{Discuss|If the patient ends up moving to a ward from CAU, why would we treat the CAU as a boarding loc?  We don’t collect data on CAU patients so wouldn’t it be a new profile? I know at one time the CAU was considered an extension of the ER, but I believe that may have changed now, as I believe all of the CAU’s are located away from the ER’s and are considered an inpatient location, under family medicine service. e.g at HSC the CAU is now located on WRS3, At Grace it is located in the old ER and are under a grace HMO. At SBGH I think CAU is located on 6AS.   I will double check with our admitting girls.  If it is an inpatient location then this would not be an EMIP 
*I can only speak to what I've seen at the Grace - it seems our CAU is intended to be a brief stay. Like they need a little more time/care than can be given in ER, but won't need a prolonged admission. If after a couple days the patient isn't improving and will need to be admitted they'll be taken over by medicine and get admitted to the ward. We've never treated CAU as a boarding loc, and my understanding the only Accept Time that we enter (and track) is the ER to ward times. [[User:Surbanski|Surbanski]] 08:19, 2020 October 16 (CDT)}}

=== Special Case - COVID ===
See [[2020-10 COVID unit collection]]. 
{{Collapsable 
| always= earlier info
| full=  
During the [[COVID-19 (SARS-COV-2)|COVID-19]] pandemic there were a lot of movements of entire wards (see [[:Category:2020 COVID unit transition]] for related pages). The {{PAGENAME}} project was a convenient place to store this information, so we added some specific locations for this purpose: 
* HSC_D4_P
* HSC_D5
* HSC_D5_p
* HSC_H4H
* STB_E6_B
* GRA_5N
}}

== Start/End Dates ==
*Start: 2019-Sep-01: new admissions on and after this date. 
*End: there is no planned end date

== Loose ends ==
{{Discuss | 
* we have two entries "GRA_ER" and "GRA - ER". The "- ER" one is same format as the STB and HSC ones. We should probably consolidate the GRA_ER entry into GRA - ER. For now, collectors please use "GRA - ER", and when the last "GRA_ER" is gone I will get rid of the option and we can consolidate them. Ttenbergen 19:26, 2020 October 15 (CDT)
** we have two 5N entries as well: GRA - N5 and GRA_5N. As previously discussed we've been using GRA - N5 but let us know if that changes [[User:Surbanski|Surbanski]] 08:23, 2020 October 16 (CDT)
}}

{{DT | 
* [[Query ''check ER Delay not too big'']] needs to be changed to include the new [[Boarding Loc]] schema . }}

{{Discuss |
Which if any of [[Project_Borrow_arrive#Data_Integrity_Checks_.28SMW.29]] will need to be moved over to this instead? }}

{{Data Integrity Check List}}

== Data Use ==
Critical care and Medicine programs want to know this to better understand patient flow and bed utilization.

=== SAS Program ===
The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.

::Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time
::: where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time. 

The SAS program is saved in X:\Julie\SAS_CFE\CFE_macros\Bed_Borrow.sas

== Background ==
See [[Bed borrow]] as aggregator page for other boarding and borrow related concepts.

The concept is similar to [[EMIP]]s but we will keep the EMIP separate from this project. The current EMIP will stay the same.--[[User:JMojica|JMojica]] 10:37, 2019 September 20 (CDT)

==Related articles ==
{{Related Articles}}

[[Category:L TmpV2 Data]]
[[Category:Project]]
[[Category:Overflow]]
[[Category:EMIP]]
[[Category:PatientFollow Project]]