IICU consult: Difference between revisions

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{{LegacyContent
|explanation=project ended
|content=
{{Project
{{Project
| Project = {{PAGENAME}}
|ProjectActive=legacy
| ProjectActive = planned
|ProjectProgram=CC
| ProjectProgram = CC
|ProjectRequestor=Bojan P / Jodi / Adrian
| ProjectRequestor = Bojan P / Jodi / Adrian
|ProjectCollectionStartDate=2018-11-12
}}  
|ProjectCollectionStopDate=2020-01-01
 
}}
==Purpose==   
==Purpose==   
To capture the number of patient days waiting for transfer from acute ICU bed to IICU bed
To capture the number of patient days waiting for transfer from acute ICU bed to [[HSC IICU]] bed.


== Data Collection ==
== Data Collection ==
For every Critical Care patient who has a consult to IICU, obtain the date and time order was written by ICU requesting IICU consult.  
For every Critical Care patient who has a consult to IICU, obtain the date and time order was written by ICU requesting IICU consult. This info goes into the temp file of the patient waiting for an IICU bed (ie. the sending profile).


{{Discussion}}
=== How to code ===
*My experience has been that these consults often do not have a time vs the usual transfer ready dates in the doctor's orders. In these situations, I have made an educated guess.--[[User:Jpeterson|Jpeterson]] 08:11, 2018 November 7 (CST)
==== requested ====
 
* '''Project:''' IICU consult
(We do not need the date when IICU doc answered consult at this time. Bojan. 2018_Nov_2.)
* '''Item:''' consult request written
* '''Date (Column E)''': consult Dt
=== How to code ===  
* '''Time (Column M)''': consult Tm
* Project: [[HasTmpEntry::IICU consult]]
* '''Checkbox:''' check box if Date (Dt) and/or Time (Tm) are missing
* Item: request written by ICU
* '''Comment''': (example):
* Date (Column E): Date request for consult was written
**No documented request
* Time (Column M): Time request for consult was written
* Integer: not used
* Integer: not used
* Real: not used
* Real: not used
* Checkbox: not used
* Comment: not used


==Sources==
=== Consult Unknown ===
If you can't find any documentation of when a consult was made, enter "consult unknown" and check the checkbox for  dt missing. 
 
Background: Especially at STB, given it is mostly EPR, the IICU docs rarely, if ever, write into EPR.
We are not so much looking to track when consults filled as much as what pt disposition is ultimately.
 
=== IICU Consulted but pt deteriorates before transfer  ===
If IICU has been consulted and accepted but then the patient's condition deteriorates prior to getting a bed in IICU and is no longer a candidate for IICU then '''leave original consult & accept date and use the [[Notes field]] to provide further info.
 
===Sources===
*physician orders
*physician orders
*consult form  
*consult form  
*IPN (integrated progress notes)
*IPN (integrated progress notes)


==== <details?> ====
=== Out of province patients ===
<clarifications, usually come up during first few days of collection>
*HSC IICU collectors - when a patient comes from another site outside province, would you be able to see in chart when consult was requested by the other ICU and when IICU service accepted?  [[User:TOstryzniuk|Trish Ostryzniuk]] 11:35, 2018 November 14 (CST)
 
** I have never had this case before, but I think it all depends on what is photocopied and sent with the patient from the referring facility.--[[User:Jvelasco|Jvelasco]] 12:13, 2018 November 14 (CST)
==== Special Cases  ====
<clarifications, usually come up during first few days of collection>.


==== Why not put this in Transfer Ready DtTm? ====
=== Why not put this in [[Transfer Ready DtTm]]? ===
* Why do we need a project to determine the patient days waiting for transfer when we already put in the [[Transfer Ready DtTm]]? I suggest we just put another option in the drop down for transfer ready which would read "waiting for IICU bed" and then you would have the information you need without a new tmp item.  --[[User:LKolesar|LKolesar]] 07:59, 2018 November 6 (CST)
* Why do we need a project to determine the patient days waiting for transfer when we already put in the [[Transfer Ready DtTm]]? I suggest we just put another option in the drop down for transfer ready which would read "waiting for IICU bed" and then you would have the information you need without a new tmp item.  --[[User:LKolesar|LKolesar]] 07:59, 2018 November 6 (CST)
** The definition for [[Transfer Ready DtTm]] says to enter the first time they are transfer ready. This may not be the first time. Also, we prefer not to add temporary data to existing fields because it would change their definition with special cases, and mess with cross-checks that are based on those fields. Ttenbergen 10:52, 2018 November 6 (CST)
** The definition for [[Transfer Ready DtTm]] says to enter the first time they are transfer ready. This may not be the first time. Also, we prefer not to add temporary data to existing fields because it would change their definition with special cases, and mess with cross-checks that are based on those fields. Ttenbergen 10:52, 2018 November 6 (CST)
=== how about the date/time responded ===
We do not need the date when IICU doc answered consult at this time. <!-- as per Bojan. 2018_Nov_2. -->
=== Multiple Consults ===
Only collect '''the first''' consult date.
<!-- Allan confirmed this with Bojan 2019-03 -->


==Data use==
==Data use==
Line 47: Line 62:
== Study Run Times ==
== Study Run Times ==
* start date: 2018-11-12
* start date: 2018-11-12
* projected end date: 2019-06-30
* 2019-06-30: projected end date - Data provided to ICU directors
* 2019-10-29:  Update - continued.  Data provided to ICU directors
* stop date: 2020-01-01
* 2020-06-09: entry removed from [[s_tmp table]]
{{Data Integrity Check List}}


== Consistency Checks ==
== Evolution and rework throughout project ==
<Any? Might want to wait for first bit of collection so that special cases don't stop collection or cause maladaptive data.>
=== accepted - collection of this part stopped 2019-03-09 ===
* '''Project:''' IICU consult
* '''Item:'''
** consult accepted by IICU
** consult rejected by IICU
** [[#Consult_Unknown | consult unknown]]
* '''Date (Column E):''' response dt
* '''Time (Column M):''' response tm
* '''Checkbox:''' dt and/or time missing
* '''Comment''': any observation (some examples):
** consult was only accepted when bed was available
** no documented reply & pt went to off ward bed (RR)
** no documented reply & pt died waiting
* Integer: not used
* Real: not used


== Related articles ==
===Polling for ease of ID'ing Date and Time of consult===
{{Related Articles}}
 
 
==Polling for ease of ID'ing Date and Time of consult==
Can the collectors easily find in the chart when a consult for IICU or order for IICU consult is made?[[User:TOstryzniuk|Trish Ostryzniuk]] 18:43, 2018 October 31 (CDT)
Can the collectors easily find in the chart when a consult for IICU or order for IICU consult is made?[[User:TOstryzniuk|Trish Ostryzniuk]] 18:43, 2018 October 31 (CDT)
*would you be able to find DATE and TIME consult was ordered? [[User:TOstryzniuk|Trish Ostryzniuk]] 11:35, 2018 November 2 (CDT)
*would you be able to find DATE and TIME consult was ordered? [[User:TOstryzniuk|Trish Ostryzniuk]] 11:35, 2018 November 2 (CDT)
Line 63: Line 92:
**'''STB''': the orders including consults are all electronic so it would be easy to obtain this data. --[[User:LKolesar|LKolesar]] 18:30, 2018 November 1 (CDT)
**'''STB''': the orders including consults are all electronic so it would be easy to obtain this data. --[[User:LKolesar|LKolesar]] 18:30, 2018 November 1 (CDT)
**'''HSC''': we can usually find something in the orders, consults and/or IPN about the intention to send someone to IICU.
**'''HSC''': we can usually find something in the orders, consults and/or IPN about the intention to send someone to IICU.
== Related articles ==
{{Related Articles}}


[[Category: L_TmpV2 Data]]
[[Category: L_TmpV2 Data]]
[[Category: QA]]
[[Category: QA]]
[[Category: All Projects ICU only]]
}}

Latest revision as of 08:19, 2021 May 5

Legacy Content

This page contains Legacy Content.
  • Explanation: project ended
  • Successor: No successor was entered

Click Expand to show legacy content.

Projects
Active?: legacy
Program: CC
Requestor: Bojan P / Jodi / Adrian
Collection start: 2018-11-12
Collection end: 2020-01-01

Purpose

To capture the number of patient days waiting for transfer from acute ICU bed to HSC IICU bed.

Data Collection

For every Critical Care patient who has a consult to IICU, obtain the date and time order was written by ICU requesting IICU consult. This info goes into the temp file of the patient waiting for an IICU bed (ie. the sending profile).

How to code

requested

  • Project: IICU consult
  • Item: consult request written
  • Date (Column E): consult Dt
  • Time (Column M): consult Tm
  • Checkbox: check box if Date (Dt) and/or Time (Tm) are missing
  • Comment: (example):
    • No documented request
  • Integer: not used
  • Real: not used

Consult Unknown

If you can't find any documentation of when a consult was made, enter "consult unknown" and check the checkbox for dt missing.

Background: Especially at STB, given it is mostly EPR, the IICU docs rarely, if ever, write into EPR. We are not so much looking to track when consults filled as much as what pt disposition is ultimately.

IICU Consulted but pt deteriorates before transfer

If IICU has been consulted and accepted but then the patient's condition deteriorates prior to getting a bed in IICU and is no longer a candidate for IICU then leave original consult & accept date and use the Notes field to provide further info.

Sources

  • physician orders
  • consult form
  • IPN (integrated progress notes)

Out of province patients

  • HSC IICU collectors - when a patient comes from another site outside province, would you be able to see in chart when consult was requested by the other ICU and when IICU service accepted? Trish Ostryzniuk 11:35, 2018 November 14 (CST)
    • I have never had this case before, but I think it all depends on what is photocopied and sent with the patient from the referring facility.--Jvelasco 12:13, 2018 November 14 (CST)

Why not put this in Transfer Ready DtTm?

  • Why do we need a project to determine the patient days waiting for transfer when we already put in the Transfer Ready DtTm? I suggest we just put another option in the drop down for transfer ready which would read "waiting for IICU bed" and then you would have the information you need without a new tmp item. --LKolesar 07:59, 2018 November 6 (CST)
    • The definition for Transfer Ready DtTm says to enter the first time they are transfer ready. This may not be the first time. Also, we prefer not to add temporary data to existing fields because it would change their definition with special cases, and mess with cross-checks that are based on those fields. Ttenbergen 10:52, 2018 November 6 (CST)

how about the date/time responded

We do not need the date when IICU doc answered consult at this time.

Multiple Consults

Only collect the first consult date.

Data use

validating resource use and need.

Study Run Times

  • start date: 2018-11-12
  • 2019-06-30: projected end date - Data provided to ICU directors
  • 2019-10-29: Update - continued. Data provided to ICU directors
  • stop date: 2020-01-01
  • 2020-06-09: entry removed from s_tmp table

Data Integrity Checks (automatic list)

 AppStatus
Query s tmp IICU consult dispo to IICU but no tmpCCMDB.accdbimplemented
Query s tmp IICU consult DtTmCCMDB.accdbretired

Evolution and rework throughout project

accepted - collection of this part stopped 2019-03-09

  • Project: IICU consult
  • Item:
  • Date (Column E): response dt
  • Time (Column M): response tm
  • Checkbox: dt and/or time missing
  • Comment: any observation (some examples):
    • consult was only accepted when bed was available
    • no documented reply & pt went to off ward bed (RR)
    • no documented reply & pt died waiting
  • Integer: not used
  • Real: not used

Polling for ease of ID'ing Date and Time of consult

Can the collectors easily find in the chart when a consult for IICU or order for IICU consult is made?Trish Ostryzniuk 18:43, 2018 October 31 (CDT)

  • would you be able to find DATE and TIME consult was ordered? Trish Ostryzniuk 11:35, 2018 November 2 (CDT)
    • OAK: I have not seen a consult at Oaks for IICU but it would be easily identified in the consults, notes and or orders;
    • GRA: it is easily identified in the orders, consult and or notes Lisa Kaita 21:06, 2018 October 31 (CDT)
    • STB: the orders including consults are all electronic so it would be easy to obtain this data. --LKolesar 18:30, 2018 November 1 (CDT)
    • HSC: we can usually find something in the orders, consults and/or IPN about the intention to send someone to IICU.

Related articles

Related articles:
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