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Level of care hierarchy: Difference between revisions

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== Levels of Care ==
== Levels of Care ==
*The list of  levels of care from highest to lowest are:
*The list of  levels of care from highest to lowest are:
**WRHA ICU, same level of care includes: MICU, SICU, CICU, ACCU, CCU (also for PACU or OR)
**WRHA ICU, same level of care includes: MICU, SICU, CICU, ACCU, CCU, Brandon ICU (also for PACU or OR)
**Other MB RHA ICU or Other Province ICU <!--(confirmed by Dr. Allan Garland 2Oct2017)-->
**Other MB RHA ICU or Other Province ICU <!--(confirmed by Dr. Allan Garland 2Oct2017)-->
**WRHA IICU
**WRHA IICU
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**PCH or home
**PCH or home
=== level of care of the ED ===
=== level of care of the ED ===
'''We consider the ER to be at the standard level of care for the [[Service tmp entry | Service]] taking care of the patient''' i.e. regular med ward for Medicine service patients, and regular ICU (ie not IICU)
'''We consider the ER to be at the standard level of care for the [[Service tmp entry | Service]] taking care of the patient''' i.e. regular med ward for Medicine (not HOBS) and regular ICU (not IICU).


These definition is relevant for decisions about the [[Transfer Ready DtTm tmp entry]] and consequently about reporting [[Transfer Delay]].
This definition is relevant for decisions about the [[Transfer Ready DtTm tmp entry]] and consequently about reporting [[Transfer Delay]].


{{Discuss | JALT
Rationale for Medicine - ER will be treated as regular ward because the intention to where to transfer the patient is usually unknown or not documented. Thus, any delay in transfer from ER is treated as a bed wasted to regular ward. If it happens that the patient with transfer ready at  ER went to HOBS, the TR Dttm until the start dttm at HOBS is bed wasted '''regular ward'''. If at HOBS, patient becomes transfer ready, it is  '''bed wasted to HOBS'''  until  the start of the different level of care.  This case will have two wasted bed - one regular and one HOBS.
* We had discussed making this "the level of care of where the pt goes" but the problem in this definition is pts who are discharged or AMA from or die in ER. So I have instead made it about the patient's service. Would that work as a definition? This would also remove the concept of "where the patient actually went" from the definition and might finally eliminate some of the confusion that comes from that. [[User:Ttenbergen|Ttenbergen]] 12:37, 2022 August 3 (CDT)
}}


=== When to use the Levels of Care ===
=== When to use the Levels of Care ===
When the intent is to move the patient from a higher level of care to a lower level of care, transfer ready date and time has to be entered corresponding to the physical location where the decision was made. The entries are done following the guidelines in the [[Boarding Loc]] and [[Transfer Ready DtTm tmp entry]].
When the intent is to move the patient from a higher level of care to a lower level of care, transfer ready date and time has to be entered corresponding to the physical location where the decision was made. The entries are done following the guidelines in the [[Boarding Loc]] and [[Transfer Ready DtTm tmp entry]].


=== Actual listing of care levels for different [[Boarding Loc]]s ===
The level of care of [[Boarding Loc]]s that a patient is actually on is used to aggregate [[Transfer Delay (Medicine)]].
The [[s_level_of_care table]] in [[CCMDB.accdb]] (and automatically linked into [[CFE]] contains a mapping of our Boarding Locs to their level of care.
 
=== Data for levels of care ===
This was implemented one way before [[PatientFollow Project]] and is set up differently now:
* Before: the 'acuity_level' column in [[s_dispo table]] maps the [[Service/Location]] in [[L_Log table]] to level of care in single digits
* Now: the [[s_level_of_care table]] in [[CCMDB.accdb]] maps the 'item' in [[Boarding Loc]] to level of care in double digits


=== Why are some non-med locations considered "lower" ===
=== Why are some non-med locations considered "lower" ===
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