Minutes Team Meeting 12 June 2008: Difference between revisions
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== Agenda for [[Team Meeting 12 June 2008]] == | == Agenda for [[Team Meeting 12 June 2008]] == | ||
* Discuss how the [[ | * Discuss how the [[ALERT Scale]] is being collected - Trish or Linda | ||
* What the [[ | * What the [[ALERT Scale]] is used for - Dr. Roberts | ||
* Discuss discharges to ER – Julie | * Discuss discharges to ER – Julie | ||
* Review Vital Signs project – Julie | * Review Vital Signs project – Julie | ||
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==Questions/Concerns Submitted== | ==Questions/Concerns Submitted== | ||
1. Clarify definition for '''[[Hypotension NYD]]'''- it says not due to shock or post-op in the code book we don't know when to use this. Why can't we just have [[Hypotension NYD]] for a code? In other words if patients don't meet the specific criteria for [[Septic Shock]] or [[Hypovolemic Shock]] or [[Cardiogenic Shock]] it would be [[NYD]]. | 1. Clarify definition for '''[[Hypotension NYD (not due to shock or post op)]]'''- it says not due to shock or post-op in the code book we don't know when to use this. Why can't we just have [[Hypotension NYD (not due to shock or post op)]] for a code? In other words if patients don't meet the specific criteria for [[Septic Shock]] or [[Hypovolemic Shock]] or [[Cardiogenic Shock]] it would be [[NYD]]. | ||
2.Clarify definition '''[[Septic Shock]]'''. (Criteria are in DX code guide for [[Septic Shock]]. The exact question here according to Gail Hall was as follows: if a patient doesn't meet the criteria for [[Septic Shock]] as outline in the Diagnosis code criteria for [[Septic Shock]], for example is hypothermic instead of hyperthermic, yet the physician is calling it [[Septic Shock]], what is the collector suppose to do: | 2.Clarify definition '''[[Septic Shock]]'''. (Criteria are in DX code guide for [[Septic Shock]]. The exact question here according to Gail Hall was as follows: if a patient doesn't meet the criteria for [[Septic Shock]] as outline in the Diagnosis code criteria for [[Septic Shock]], for example is hypothermic instead of hyperthermic, yet the physician is calling it [[Septic Shock]], what is the collector suppose to do: | ||
*a. follow the criteria and if they are NOT met then don't code a [[Septic Shock]] or | *a. follow the criteria and if they are NOT met then don't code a [[Septic Shock]] or | ||
*b. If physician DX is the working DX and that is what they are treating, then code as [[Septic Shock]] or | *b. If physician DX is the working DX and that is what they are treating, then code as [[Septic Shock]] or | ||
*c. Use the [[Hypotension NYD]] code. | *c. Use the [[Hypotension NYD (not due to shock or post op)]] code. | ||
**NEEDS FURTHER FOLLOW-UP'' | **NEEDS FURTHER FOLLOW-UP'' | ||
***[[User:TOstryzniuk|TOstryzniuk]] 17:06, 29 July 2008 (CDT) | ***[[User:TOstryzniuk|TOstryzniuk]] 17:06, 29 July 2008 (CDT) | ||
3. Clarify definition '''[[Cardiogenic Shock]]''' | 3. Clarify definition '''[[Cardiogenic Shock]]''' | ||
''*there are criteria to follow in diagnosis code guideline therefore I am not sure what the exact question is here?[''[User:TOstryzniuk|TOstryzniuk]] 17:06, 29 July 2008 (CDT) | ''*there are criteria to follow in diagnosis code guideline therefore I am not sure what the exact question is here?[''[User:TOstryzniuk|TOstryzniuk]] 17:06, 29 July 2008 (CDT) | ||
4. Clarify definition '''Cardiac [[:Category: Arrest | Arrest]]'''-It's impossible to see how many occur right before admission to Medicine as some patients are admitted to medicine bypassing ICU. | 4. Clarify definition '''Cardiac [[:Category: Arrest (old)| Arrest]]'''-It's impossible to see how many occur right before admission to Medicine as some patients are admitted to medicine bypassing ICU. | ||
''*Not sure what the question is here?''[[User:TOstryzniuk|TOstryzniuk]] 17:06, 29 July 2008 (CDT) | ''*Not sure what the question is here?''[[User:TOstryzniuk|TOstryzniuk]] 17:06, 29 July 2008 (CDT) | ||
5. Clarify definition '''[[Violent | 5. Clarify definition '''[[Violent 2nd to dementia]]''' code - supposed to be 2nd to [[Dementia]] but is used for anyone who is violent. (note: not just tagging general bad moods here). | ||
*Violent behavior secondary to "dementia" it the only "specific" reason we are tracking violent behavior. We will not change this until we go to ICU10. As discussed with Dr. Allan Garland. Trish Ostryzniuk 12:13, 2012 July 16 (CDT) | |||
6. Clarify definition '''[[Panelling or Discharge Planning]]''' why does it say in the code book primary reason for admission to ward bed? | 6. Clarify definition '''[[Panelling or Discharge Planning]]''' why does it say in the code book primary reason for admission to ward bed? | ||
''*the reason for adding this patient status code (it is not a DX code), was to try and track those patients whose primary reason for moving to a medicine ward bed was no longer due to an acute disease process however they were waiting for other services or nursing home placement and that is the primary reason why they are still in an acute care med bed. | ''*the reason for adding this patient status code (it is not a DX code), was to try and track those patients whose primary reason for moving to a medicine ward bed was no longer due to an acute disease process however they were waiting for other services or nursing home placement and that is the primary reason why they are still in an acute care med bed. | ||
*discussion about these patients was that they had chronic disease condition ([[: | *discussion about these patients was that they had chronic disease condition ([[:Category: Comorbid | Comorbid]] condition) and that was the reason why they were still in med ward beds and not sent home. Many of these patient have multiple chronic underlying diseases ([[:Category: Comorbid |Comorbid]] conditions) and the question was, how do we then decide which one was the primary one that was still keeping them in a med ward be''d? | ||
*.............''more to be added here later''..............```` | *.............''more to be added here later''..............```` | ||
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''*we are not wanting to tag every patient who is being treated for pain. | ''*we are not wanting to tag every patient who is being treated for pain. | ||
*use this code only if the reason for ICU or ward admission is due to '''severe out of control pain''' that is a primary reason for admission is for the management of severe out of control pain. | *use this code only if the reason for ICU or ward admission is due to '''severe out of control pain''' that is a primary reason for admission is for the management of severe out of control pain. | ||
*example is Cancer patients who primary reason for admission to medicine ward is pain management''. [[User:TOstryzniuk|TOstryzniuk]] 18:08, 29 July 2008 (CDT) | |||
9. Clarify definition '''[[Pain Control - post op]]''' - we feel it is highly overused. | 9. Clarify definition '''[[Pain Control - post op]]''' - we feel it is highly overused. | ||
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*the reason for having this code was that there were many patients being admitted from the recovery room who's primary reason to ICU was purely pain control and nothing else that warranted ICU admission.''[[User:TOstryzniuk|TOstryzniuk]] 18:08, 29 July 2008 (CDT) | *the reason for having this code was that there were many patients being admitted from the recovery room who's primary reason to ICU was purely pain control and nothing else that warranted ICU admission.''[[User:TOstryzniuk|TOstryzniuk]] 18:08, 29 July 2008 (CDT) | ||
10. Clarify definition '''[[Palliative | 10. Clarify definition '''[[Palliative care]]''' - need further criteria to code correctly. | ||
*''see ''[[ | *''see ''[[Palliative care]] ''article for updated information''. | ||
''*Work in progress which looks like it is getting there. | ''*Work in progress which looks like it is getting there. | ||
*[[Data Collector]] contribution is encouraged''.[[User:TOstryzniuk|TOstryzniuk]] 18:08, 29 July 2008 (CDT) | *[[Data Collector]] contribution is encouraged''.[[User:TOstryzniuk|TOstryzniuk]] 18:08, 29 July 2008 (CDT) | ||
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'''Trish:''' | '''Trish:''' | ||
Discussed how the MOST score elements were to be collected as of December 2007 at which time some of the old vital sign data fields were removed and clear guidelines were provided for the collection of the ADL and the other MOST score elements which started January 1, 2007. This information can be found | Discussed how the MOST score elements were to be collected as of December 2007 at which time some of the old vital sign data fields were removed and clear guidelines were provided for the collection of the ADL and the other MOST score elements which started January 1, 2007. This information can be found in [[ALERT Scale]]. | ||
Trish clarified that it is '''not''' supposed to be the worst assessment values observed prior to a patient being admitted to a ward rather the value '''closest to the decision to accept to medicine service.''' If there were no score documented 48 hours prior to admissions then it should be the closed score post admission. If no assessment value was recored withing 48 hours pre admission or 48 hours post than the data collector should assume normal. | Trish clarified that it is '''not''' supposed to be the worst assessment values observed prior to a patient being admitted to a ward rather the value '''closest to the decision to accept to medicine service.''' If there were no score documented 48 hours prior to admissions then it should be the closed score post admission. If no assessment value was recored withing 48 hours pre admission or 48 hours post than the data collector should assume normal. | ||
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# Clarify definition ''[[Septic Shock]]'' | # Clarify definition ''[[Septic Shock]]'' | ||
# Clarify definition ''[[Cardiogenic Shock]]'' | # Clarify definition ''[[Cardiogenic Shock]]'' | ||
# Clarify definition ''[[:Category:Arrest | Arrests]]''s-It's impossible to see how many occur right before admission to Medicine as some patients are admitted to medicine bypassing ICU | # Clarify definition ''[[:Category:Arrest (old)| Arrests]]''s-It's impossible to see how many occur right before admission to Medicine as some patients are admitted to medicine bypassing ICU | ||
# Clarify definition ''[[Violent | # Clarify definition ''[[Violent 2nd to dementia]]'' code - supposed to be 2nd to dementia but is used for anyone who is violent | ||
# Clarify definition ''[[Panelling or Discharge Planning]]'' why does it say in the code book primary reason for admission to ward bed? | # Clarify definition ''[[Panelling or Discharge Planning]]'' why does it say in the code book primary reason for admission to ward bed? | ||
# Clarify definition | # Clarify definition | ||
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#* ''[[Pain Control - non post op]]'' | #* ''[[Pain Control - non post op]]'' | ||
#* ''[[Pain Control - post op]]'' - we feel it is highly overused | #* ''[[Pain Control - post op]]'' - we feel it is highly overused | ||
# Clarify definition [[Palliative | # Clarify definition [[Palliative care]] - need criteria to follow | ||
# ''[[Acute coronary insufficiency]]'' and ''[[Unstable angina]]'' (151, 152) - description in code book should be reversed | # ''[[Acute coronary insufficiency]]'' and ''[[Unstable angina]]'' (151, 152) - description in code book should be reversed | ||
# There currently is no codes for: '''hematuria'''-we have lots of people who are getting CBI for hematuria NYD. Hematuria is a symptom not a diagnosis[[User:TOstryzniuk|TOstryzniuk]] 19:12, 24 June 2008 (CDT). | # There currently is no codes for: '''hematuria'''-we have lots of people who are getting CBI for hematuria NYD. Hematuria is a symptom not a diagnosis[[User:TOstryzniuk|TOstryzniuk]] 19:12, 24 June 2008 (CDT). | ||
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# Possible impacts of the new Code Blue policy at HSC | # Possible impacts of the new Code Blue policy at HSC | ||
[[Category: Minutes]] | [[Category: Minutes 2008]] | ||