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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).
 
=== How to code ===   
=== How to code ===   
==== requested ====  
==== requested ====  
* '''Project:''' [[HasTmpEntry::IICU consult]]
* '''Project:''' IICU consult
* '''Item:''' consult request written
* '''Item:''' consult request written
* '''Date (Column E)''': consult dt
* '''Date (Column E)''': consult Dt
* '''Time (Column M)''': consult tm
* '''Time (Column M)''': consult Tm
* '''Checkbox:''' dt missing
* '''Checkbox:''' check box if Date (Dt) and/or Time (Tm) are missing
* '''Comment''': (example):
**No documented request
* Integer: not used
* Integer: not used
* Real: not used
* Real: not used
* Comment: not used


==== accepted ====
=== Consult Unknown ===
* '''Project:''' [[HasTmpEntry::IICU consult]]
If you can't find any documentation of when a consult was made, enter "consult unknown" and check the checkbox for  dt missing. 
* '''Item:'''
 
** consult accepted by IICU
Background: Especially at STB, given it is mostly EPR, the IICU docs rarely, if ever, write into EPR.
** consult rejected by IICU
We are not so much looking to track when consults filled as much as what pt disposition is ultimately.
* '''Date (Column E):''' response dt
* '''Time (Column M):''' response tm
* '''Checkbox:''' dt missing
* Integer: not used
* Real: not used
* Comment: not used


==Questions==
=== IICU Consulted but pt deteriorates before transfer  ===
*{{Discussion}}
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.
*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)


**{{Discussion}}  At STB we currently have a patient waiting for an IICU bed.  I can easily see when the original consult was written by the STB staff, however I do not know where the reply from HSC IICU people is written.  Please advise where I would find this information. Is it written on EPR and if so where on EPR is it written.  I spoke with our CRN today about this and she said that the IICU doctors come to see the patient only about 24 hours before they actually go to IICU, once a bed is about to clear there.  She did not know where their "acceptance" would be charted or even it is charted.  She thought it might just be done verbally.  I cannot say myself because we have never had to collect this information before.  Please advise how to obtain the "acceptance" part of this tmp request. --[[User:LKolesar|LKolesar]] 10:29, 2018 November 14 (CST)
***Stb is a different, given it is mostly EPR.  The IICU docs rarely, if ever, write into EPR.
***For this pt, just track from day of IICU consult request written and then we can figure out what his/her ultimate disposition is
***I am not so much looking to track when consults filled as much as what pt disposition is ultimately…Bojan Paunovic  1130, 2018 Nov 14.
** to have clear and clean data - I suggest to add another item 'Unknown' --[[User:JMojica|JMojica]] 11:40, 2018 November 14 (CST)
===Sources===
===Sources===
*physician orders
*physician orders
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*IPN (integrated progress notes)
*IPN (integrated progress notes)


=== Special Cases ===
=== Out of province patients ===
==== IICU Consulted but pt deteriorates before transfer  ====
*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)
*How do you want us to handle cases where 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? [[User:Lkaita|Lisa Kaita]] 09:06, 2018 November 8 (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)
**leave original consult & accept date.  Note fields to be used to comment about this. [[User:TOstryzniuk|Trish Ostryzniuk]] 11:04, 2018 November 13 (CST)


=== 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)
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=== how about the date/time responded ===
=== 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. -->
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==
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== 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
== Consistency Checks ==
* stop date: 2020-01-01
<Any? Might want to wait for first bit of collection so that special cases don't stop collection or cause maladaptive data.>
* 2020-06-09: entry removed from [[s_tmp table]]
 
{{Data Integrity Check List}}
{{Data Integrity Check List}}


== Related articles ==
== Evolution and rework throughout project ==
{{Related Articles}}
=== 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


==Polling for ease of ID'ing Date and Time of consult==
===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)
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**'''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.


[[Category: L_TmpV2 Data]]
== Related articles ==
[[Category: QA]]
{{Related Articles}}
[[Category: All Projects ICU only]]
 
[[Category:L_TmpV2 Data]]
[[Category:QA]]
[[Category:Consult]]
}}
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