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| <onlyinclude>The [[Admit date and time]] for critical care designates the time the patient arrives on the unit, the one for medicine when the patient was accepted to the medicine service.</onlyinclude> IMPORTANT NOTE: The Admit date and time field is current used '''differently''' for Medicine and ICU. See below
| | The concept of "Admit date and time" is not as simple as it might seem due to the way we use it in reporting, and how it has been stored over time. |
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| We track '''Admit date and time''' for patients as part of our [[Minimal Data Set]], i.e. this his high-priority data that needs to be collected ASAP. You will not be able to send any records (even correct ones) if it is not filled out for any patient.
| | == Current definition as of 2021-04-21 == |
| | The most recent version is [[Admit DtTm]] as derived by [[Created_AdmitDtTm query]] |
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| === Definition for Critical Care (ICU's) === | | == Previous definitions == |
| *See [[Arrive DtTm field]]
| | {{LegacyContent |
| | |explanation=[[Created_AdmitDtTm query]] |
| | |successor=[[Created_AdmitDtTm query]] |
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| This field designates the '''date/time''' the patient '''PHYSICALLY ARRIVES''' on the unit.
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| For the ICU's the most accurate place to find this information is where the nurse first charted first vital signs on admission to the unit.
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| * If the admission time is 24:00/midnight use 00:01 hours as the admit time. (This is a change from the previous rule of using 23:59 hours as the admit time. The change corresponds with the transition to [[TISS28]] which does not have a 2 hour rule--change is effective 24:00 hours December 31, 2012) [[User:Mlaporte|Mlaporte]] 13:39, 2012 December 9 (EST)
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| * see [[Transfer time rule]] for info on expected differences between admit and previous discharge times when transferring
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| {{discussion}}
| | ''Arrive DtTm'' and ''Accept DtTm'' |
| ICU
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| *I often have patients who are in PACU when accepted by SICU but have to stay in PACU as overflow. I had been told when oriented to consider the time accepted by SICU as the admit time & [[Arrive DtTm field]] in these cases. Should I be changing my practice to the time the patient actually comes to SICU, this sometimes never occurs as the bed space may never be found before the patient is discharged to the ward.--[[User:Jpeterson|Jpeterson]] 11:19, 2012 December 10 (EST)
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| **There apparently is a discrepancy between some of the data collectors for the discharge/admit time of a patient who has a code on the ward and then admitted to the ICU. After a discussion with Trish, the time of admission to the ICU should be when the patient arrives in the ICU after the code.--[[User:Jpeterson|Jpeterson]] 13:03, 2016 May 13 (CDT)
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| ***That is the way I have always done it, usually first vital signs unless clear charting otherwise.[[User:GHall|GHall]] 13:44, 2016 May 13 (CDT)
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| ****now that we have an [[Accept DtTm field]], in the EPR, if you are able to find documentation when an ICU service accepted the patient prior to arrival to your unit, then you can fill in this field. If there is no clear ICU acceptance date/time ''OR'' the patient stayed for example: in the PACU under ICU physican's care, but never moved into the ICU, then the '''Admit Data and time field''' + ([[Accept DtTm field]] + [[Arrive DtTm field]] will all be the SAME.--[[User:TOstryzniuk|Trish Ostryzniuk]] 14:57, 2016 May 13 (CDT)
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| *****great input everyone![[User:TOstryzniuk|Trish Ostryzniuk]] 14:57, 2016 May 13 (CDT)
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| === Definition for Medicine ===
| | The [[Admit date and time]] used to designate the time a patient was admitted to the ward/unit. For critical care it designated the time the patient physically arrived on the unit, the one for medicine when the patient was accepted to the medicine service. |
| This field designated the '''date/time''' that the patient was '''ACCEPTED TO''' the medicine physician service.
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| *see [[ER Wait]] to see where to enter Medicine ward actual physical arrival date/time.
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| | Collection instructions for this article were transferred to ''Arrive DtTm'' and ''Accept DtTm'' as appropriate and deleted from here to prevent accidental use of outdated information. See 2016-07-03 history of the article for old instructions, such as when this was encoded as field ''R_AdmDate''. |
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| Get the "accept to Medicine date/time" from one of the following in this order of preference:
| | == CCMDB Data Integrity Checks == |
| #physician's note accepting patient to their Service
| | * Minimal_Data_Set#CCDMB_Data_Integrity_Checks for patients with Dispo DtTm before 2016-07-01 |
| #from the hospital admission sheet (e.g the white admission separation?/triage sheet at HSC)
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| #Often the actual time of admission is documented in the IPN (integrated progress note)) which is a hand written admission note by the nurse. We at HSC in medicine use this.--[[User:CMarks|CMarks]] 08:10, 26 January 2012 (CST)
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| ** New form "Admission Request Form From Emergency Department" first line has Admit Order Written followed by date and time which is accurate.--[[User:CMarks|CMarks]] 08:54, 2015 January 29 (CST)
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| *** is this form used across the region? If not, this info should go into [[HSC Medicine Collection Guide]] resp [[HSC General Collection Guide]] instead. Ttenbergen 16:41, 2015 January 29 (CST) {{discussion}}
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| *FOR THOSE PATIENTS ADMITTED FROM E.R: use the date and time from the "accepted to service" on the [[EPR]] orders. i.e. in the epr, click on orders, then highlight the order that says "admit to inpatient-medicine-medical service". Right click on that order. Scroll down to view, then across to history, then across to status. Click on status. Use the date and time as listed in the top "new" order. This is the date and time the patient is accepted to medical service.
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| *FOR THOSE PATIENTS ADMITTED FROM ANOTHER WARD: use the date and time plus five minutes from the discharge date and time of the sending ward. [[User:DPageNewton|DPageNewton]] 15:17, 20 June 2011 (CDT)
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| * FROM ICU WITH A STOP IN DIALYSIS FOR TREATMENT: use the time they left ICU plus five minutes as the admit time to medicine. This was decided at the April 4,2013 task meeting.
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| ====Source for this information - STB Medicine====
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| *For Acute Care Medicine patients at STB - use the Doctors orders on the [[EPR]] as date/time accepted to Medicine Service.
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| *for Non Acute Care (C service) medicine patients at STB - use [[EPR]]'s registration tab/visit location/location history, for date/time accepted to medicine service.
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| ==== For admissions from: '''ICU''', '''ambulatory''' or other '''medicine wards''' ====
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| For patients admitted directly from an ICU, ambulatory care or other wards the admission date/time is the date/time that they actually arrive to the medicine ward.(exception is if they have dialysis see above)
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| Also consider the [[Transfer time rule]].
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| == See also [[ER Wait]] ==
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| == {{CCMDB Data Integrity Checks}} ==
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| *[[Minimal_Data_Set#CCDMB_Data_Integrity_Checks]] | |
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| == Date and time formats == | | == Date and time formats == |
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| == Data use == | | == Data use == |
| Among other things, the times are used to generate statistics about | | Among other things, the times are used to generate statistics about |
| * [[:Category: Length of stay | LOS]] | | * [[LOS]] |
| * [[Multiple Encounter]] | | * [[Multiple Encounter]] |
| * [[Transfer Delay]] | | * [[Transfer Delay]] |
| * [[bed occupancy]] | | * [[Bed occupancy]] |
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| == See Also ==
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| *[[Admit date and time]]
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| *[[Discharge date and time]]
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| *[[Transfer Ready date and time]]
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| == Legacy == | | == See also == |
| This article was spun out from [[Interrelation between Admit, Discharge and Transfer Ready date and time]], see that article for any history missing from here.
| | * [[Admit date and time]] |
| | * [[Discharge date and time]] |
| | * [[Transfer Ready date and time]] |
| | * [[Minimum data set]] |
| | * [[ER Wait]] |
| | }} |
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| [[Category: Admit/Discharge]]
| | [[Category:Data structure]] |
| [[Category: Data Collection Guide]] | | [[Category:Legacy Data structure]] |
| [[Category: Registry Data]] | |
| [[Category: L_Log table]]
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| [[Category: 1Main table]]
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