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| Some sites use swap locations as entries in [[EPR]]. | | Some sites use swap locations as entries in [[EPR]]. |
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| When patients need to switch locations due to medical reasons, patient swap locations can be performed in the ADT EPR. For example, patient A and patient B need to switch locations. Patient A is in a private room and patient B is in a semi-private room. Both patients could be transferred into the swap location or non-census location, freeing up both of the unit beds. Then both Patient A and Patient B can be transferred into the correct unit and room/bed. | | When patients need to switch locations, patient swap locations can be performed in the ADT EPR. |
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| {{Ex |
| | * Ex 1: For example, patient A and patient B need to switch locations. Patient A is in a private room and patient B is in a semi-private room. Both patients could be transferred into the swap location or non-census location, freeing up both of the unit beds. Then both Patient A and Patient B can be transferred into the correct unit and room/bed. |
| A patient was in a swing bed from 0243 until 0405 that is the actual arrival time to the unit. | | * Ex 2: A patient was in a swing bed from 0243 until 0405 that is the actual arrival time to the unit. |
| The patient remained in ER until 0405 but MR staff had to electronically enter/place the patient somewhere. | | The patient remained in ER until 0405 but MR staff had to electronically enter/place the patient somewhere. |
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| == The problem == | | == The problem == |
| Swing or swap locations are not real locations. While listed as in a swap location, the pt might still be in the old location or already be in a new location that gets entered after. Collectors seem to review the chart, make sense of what actually happened, and enter accordingly.
| | * We need to ensure this is dealt with consistently in the context of [[Using Cognos2 to keep track of patients]] and [[Cognos2 Unit Starter]]. [[CUS]] lists when someone arrives on a '''''unit''''', not in a bed. So, for [[GH-SWAP Location]]s it is immediately visible that pt is there, but for [[SBGH Swing Beds]] it is not. |
| | | * Since EPR/Cognos lists these patients as being physically on the unit already (just in a swing bed) and we list them (correctly) as still being in the ER, this could result in discrepancy between our reports and other hospital reports. This can't be fixed, but is good to know if we are ever asked about reasons for discrepancies. |
| <quote>...because cognos Is often using the swing bed as a legitimate date and time, we are getting incorrect information. I find that more often than not (not necessarily every single time), the swing bed entry is usually when the patient is still physically located in er, and has not yet, actually physically been moved up to the ward. The er needs to use that location to admit another patient. Therefore, they will put a “swing bed” entry in. because the swing bed entry is listed right after the er entry, cognos picks that up, and uses that as the admit to unit start date and time. This date and time, is, in actual fact wrong. The actual ward unit start time, is the next entry in the location history that does not have the swing bed tag as the location. (Debbie)</quote>
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| Clarifications:
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| * The entry is picked up by Cognos ''"because the swing bed entry is listed right after the er entry"'', it is picked up because it is a unit entry during the timeframe of a service admission.
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| * The swing bed is associated with whichever location it is a swing bed for. So, if the ER uses a ward swing bed, then maybe the real problem is that they should be using an ER swing bed? If they did, the pt would be correctly still listed as an ER
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| *Not necessarily, swing bed entries are not specific to ER only, and ER occasionally uses ambiguous locations for swing bed entries that are picked up by cognos resulting in a false positive (exclusion patient) showing on cognos.
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| {{Discuss |
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| * Debbie: When you say ''"the next entry in the location history"'', you mean the history on the EPR, right? [[User:Ttenbergen|Ttenbergen]] 09:26, 2020 December 3 (CST)Yes, the location history in the epr. Each scenario with a swing bed entry can be different, and needs to be reviewed to ascertain the true and correct information. [[User:DPageNewton|DPageNewton]] 09:45, 2020 December 3 (CST)
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| {{DA |
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| * Would it make sense to talk to STB about how the swing beds are used by ER? | |
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| {{Discuss | Is there ever "room for interpretation" where both collectors would still consider the pt on their unit, or where both would consider them already/still on the other unit? If not, how and why?
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| * another question here :
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| I supposed this swing bed is already happening in the past, before we have this COGNOS admitter. How it is handle? 1) is it included – such that the accept date is taken from that line of swing bed or 2) excluded and the next line where the Accommodation has an entry is the one chosen? I think we need to decide first if to include or not before solving the exclusion process. who to ask? --[[User:JMojica|JMojica]] 16:02, 2020 December 2 (CST)
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| The use of swap or swing locations makes it hard to follow patients in [[Cognos Report Integrator]], so we need to find out more about how these are used.
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| === possible solution: list all bed dttms instead of all unit dttms ===
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| If we listed all bed dttms instead of all unit dttms the collectors would be able to pick the actual physical move dttms from that and exclude any irrelevant bed moves (eg during an admission). This would increase the noise collectors need to wade through. We would ''not'' be able to just exclude the swap locations from such a list because that would result in a gap between the previous location and the next, and gaps should at least be transparent (ie you can see why they are there).
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| I think this would show the collector all the info they need to make their admit decisions. It would create more frequent listings in [[CUS]] (i.e. one for each bed move). It would also require more columns in the unit section of [[Patient Viewer Tab Cognos ADT2]] since bed name and bed start and end dttm would also need to be listed.
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| {{Discuss |
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| * Collectors: Do you think this would work?
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| === possible solution: exclude by filter ===
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| {{Discuss |
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| * One option would be to omit lines with current unit is a swap location from the cognos data via filter automatically, but it's not clear if this will result in the previous and subsequent records having non-matching next locations and previous locations. Can we just delete these lines from Cognos? Ttenbergen 14:03, 2020 August 28 (CDT)
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| {{Discuss |
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| One problem with filtering these out would be that, I ''think'', the '''unit''' record for a swap location might be the same as the unit record for a successive stay in that unit; ie. the bed entry chagnes, but the unit remains the same. So, the unit start dttm and unit end dttm don't care if part of the unit stay was in a swap location. Is that not true? If it is true, then how would we filter these out? if I eliminate every line that has a swap/swing bed (which I can do) then we will not get any line for those pts who never get into a real bed on that unit (which may be good), but we would still get the ''same'' line with unit start and end times including the swap/swing time for patients who eventually get into a bed on that unit. [[User:Ttenbergen|Ttenbergen]] 12:07, 2020 December 2 (CST)
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| For these reasons all swing bed entries should be filtered out if possible.
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| === possible solution: exclude by manual exclude ===
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| {{Discuss |
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| * Another option, and this seems to be what is being done now, is for collectors to "exclude" unit lines from Cognos that list "wrong" start or end times because part of the time is in a swap location.
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| This will not exclude the record from [[Cognos2 Ender]] since that is based on service rather than unit.
| | == The solution == |
| | We considered whether there are ways to deal with these in the data/filters/programs, but since the scenarios when and how these would be used aren't entirely predictable it was decided to keep these a manual process. See [[SBGH Swing Beds]] and [[GH-SWAP Location]] for details. |
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| == Location specific info == | | == Location specific info == |
| === "Swing beds" at STB === | | === "Swing beds" at STB === |
| {{Discuss |
| | See [[SBGH Swing Beds]] |
| Are the following the STB ones?
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| AsgnBed_Current
| | === "Swap locations" at GRA === |
| * SBGH-A6CM-A6CSWG-01
| | See [[GH-SWAP Location]] |
| * SBGH-ICCS-CR5SWG-01
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| * BGH-ICCS-CR5SWG-02
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| * SBGH-ICCS-CR5SWG-03
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| * SBGH-ICCS-CR5SWG-04
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| * SBGH-ICCS-CR5SWG-05
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| * SBGH-ICCS-CR5SWG-06
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| * SBGH-ICMS-E2SWG-01
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| * SBGH-L2ME-L2SWG-01
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| {{TT |
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| * Whenever this gets finalized we need to also update [[STB CICU Collection Guide]] to make sure it's consistent. }}
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| === ??? at HSC === | | === HSC === |
| {{Discuss |
| | According to [[Chastity]] there is no such thing at HSC. |
| * Do these exist at HSC and what are they called? I didn't see any bed names that made me think "swing" or "swap".
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| === "Swap locations" at GRA ===
| | Except, on 2021-02-12 we saw a unit "HSC-HOLD", and it wasn't clear what that was about. |
| These show up in the AsgnBed_Current as:
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| * GH-SWAP Location
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| == Related articles == | | == Related articles == |