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ACP Status Collection in ICU: Difference between revisions

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This article is about collecting the "ACP Status" temp entry.
{{Project
|ProjectActive=legacy
|ProjectProgram=CC
|ProjectRequestor=Critical Care QI Team
|ProjectCollectionStartDate=2015-08-10
|ProjectCollectionStopDate=2016-12-31
|Project=ACP Status Collection in ICU
}}
{{LegacyContent
|explanation=Collection for this project stopped 2016-12-31
|successor=See [[ACP Status Collection over time]] for related collection projects.
|content=
 
This article is about collecting the "ACP Status" (Advanced Care Planning) temp entry.
 
== Start and stop date ==
* First ACP Collection Start Date: 2015-08-10
* Date with complete data across all sites: 2015-09-01
* Date that ACP status documented in chart closest to ICU ADMIT and ICU END.  Start to collect dates on: 2016-04-8
* Revised ACP Collection Start Date: 2016-05-01
* '''Stop Date: 2016-12-31'''
**For patients who have been admitted before or on Dec 31, 2016 and are still in the unit by Jan 2017 and have ACP status data, just email Pagasa the ACP status, ACP source and dates - she will add it in the TMPV2 table of the master database.


== Purpose ==
== Purpose ==
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**** '''ACP M+''' - all medical care given except cardiac resuscitation; intubation either happened or allowed
**** '''ACP M+''' - all medical care given except cardiac resuscitation; intubation either happened or allowed
**** '''ACP M-''' - all medical care given except cardiac resuscitation and intubation; also if ACP M is written without +/-
**** '''ACP M-''' - all medical care given except cardiac resuscitation and intubation; also if ACP M is written without +/-
**** '''[[ACP C]]''' - comfort care
**** '''[[ACP-C]]''' - comfort care
**** '''not documented''' - should be paired with same in ACP Status
**** '''not documented''' - should be paired with same in ACP Status
*** Item one of the following
**** '''Form and Orders '''
*****choose this item if the ACP status and Date are the '''same''' on both the ACP Form and the ICU Admitting Orders (see below for sample forms). Otherwise, enter a new ACP documentation with different ACP status or date.
** Project '''ACP Source'''
** Project '''ACP Source'''
*** Item one of the following
*** Item one of the following:
**** '''Form '''
**** '''Form '''
**** '''Orders '''
**** '''Orders '''
**** '''Other''' - with this option only, put in tmp comment what other place you obtain ACP status and date from is '''none of the above'''.
**** '''Form and Orders '''  
*****I just wanted to check and see what other people are using the "other" option for. If a patient has an ACP status on either the form or the orders, than I do not include an "other" option unless the "other" option occurred prior in the patient's ICU stay. For example: a patient arrived in the ICU, with no other ACP documentation other than a physicians note in the IPN stating "ACP-R", until three days later when the form was filled out. In this case, my first entry would be "ACP-R other", while my second entry would be "ACP-R form". If however, the physicians note and ACP form were filled out on the same day, then I would only have one entry, which would be "ACP-R form". The list of provided examples on WIKI would appear to contradict the way I am collecting, but I feel like it is redundant to enter "other" if the ACP status has been addressed in the orders, or on the ACP form. Any thoughts? [[User:Mlagadi|Mlagadi]] 14:46, 2016 September 6 (CDT)
*****choose this item if the ACP status and Date are the '''same''' on both the ACP Form and the ICU Admitting Orders (see below for sample forms). Otherwise, enter a new ACP documentation with different ACP status or date.
**** '''Other''' - with this option only, put in tmp comment what other place you obtain ACP status and date
**** '''not documented''' - should be paired with same in ACP Source
**** '''not documented''' - should be paired with same in ACP Source
** for both Source and Status:  
** for both Source and Status:  
*** Date: '''date filled out''', or '''check checkbox (column B)''' if '''NO''' DATE
*** Date: '''Same date''' filled out for both Project '''ACP''' and '''ACP Source'''
**** '''Same date''' filled out for both Project '''ACP''' and '''ACP Source'''
**** '''No Date''': check the checkbox for source and status if there is no date
*** '''Integer (column "N"): used to ''pair'' status and source entries; put a number; use the same number for the status and source entry for the same form. e.g. put a "1" for the status and source for the first tmp entry pair, then put a "2" for each of the second. This allows us to pair up entries even if there are more than one for the same date.
*** '''Integer (column "N"): used to ''pair'' status and source entries; put a number; use the same number for the status and source entry for the same form. e.g. put a "1" for the status and source for the first tmp entry pair, then put a "2" for each of the second. This allows us to pair up entries even if there are more than one for the same date.
===Question - Source Others ===


=== Examples ===
=== Examples ===
(needs update, removed link to pdf that is no longer correct)
Some EXAMPLES of pairing ACP status and Source in CCMDB_TMP: [[Media:ACP status collection examples status and source.pdf|CLICK HERE]] to see table of examples.
 
=== Problem: date required to send, not accepting checkbox instead ===
{{Discussion}}
Please update to include the example of how to enter ACP-no documentation for status or source to reflect recent changes to collection.
*it appears if no status or source date AND Column B (no date)is checked off, CCMDB won't send.
**Julie had mention to Lori P today that should find a date and document best guess closet to ICU admission or if it appears the ACP status was determined closer to end of ICU admission. No blanks dates allowed, is that the rule????[[User:TOstryzniuk|Trish Ostryzniuk]] 11:59, 2016 September 6 (CDT)


=== If care has been discontinued ===
=== If care has been discontinued ===
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== WRHA guidelines / forms ==
== WRHA guidelines / forms ==
*[http://www.wrha.mb.ca/acp/files/Workbook.pdf WRHA ACP Guidelines/workbook]
*[[Media:WRHA ACP form Nov 2013.pdf | Example of WRHA ACP FORM]]
*[http://home.wrha.mb.ca/corp/policy/files/110.000.200.pdf  WRHA Advance Care Policy]
*[[Media:AdmittingOrdersforICU.pdf | Example of Admitting Orders for ICU]]
*[[Media:WRHA ACP form Nov 2013.pdf |Example of WRHA ACP FORM]]
*[[Media:AdmittingOrdersforICU.pdf |Example of Admitting Orders for ICU]]


== Start and stop date ==
== Cross Checks ==
* First ACP Collection Start Date: 2015-AUG-10
* [[Query s tmp ACP]]
* Date with complete data across all sites: 2015-SEP-1
* Date that ACP status documented in chart closest to ICU ADMIT and ICU END.  Start to collect dates on: 2016-APR-8
* Revised ACP Collection Start Date: 2016-May-01
* Stop Date: none
 
== {{CCMDB Data Integrity Checks}} ==
=== Checks at sending time ===
Error triggers if a patient exists who
* pt is ICU pt
* RecordStatus is complete
* one of the following is true
** there is not at least one entry in tmp with project = "ACP Source"
** project = "ACP Source" or "ACP Status" and item = "enter"
** no date or no integer
then won't be able to send anyone.
In normal operation such a patient should not be possible to set to "complete", this is a double-check.
Implemented as query ''s_tmp_ACP'' in [[CCMDB.mdb_Change_Log_2016#2016-May-04]]
 
=== pairs of records ===
If a record does not have a paired partner with same tmp integer there will be an error. Query ''s_tmp_ACP_unpaired''.
 
=== Check at Complete-time ===
Can't check patient complete if the Item for an entry for this project is "enter" or "".
Implemented in VBA in [[CCMDB.mdb_Change_Log_2016#2016-May-04]]
 
==== Incomplete patients ====
* ACP entries must be paired
* there has to be a status entry
* there has to be a source entry
==== Complete patients ====
* unless source item = "not documented" there has to be a date
* unless status item = "not documented" there has to be a date
* source and status items can't be null, "" or "enter"
* source and status integers have to be present


== Data use / Reporting and Analysis ==
== Data use / Reporting and Analysis ==
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* the data are saved in table L_TmpV2 under projects "ACP at admit / ACP at end / ACP Status / ACP Source" of the centralized_data.mdb
* the data are saved in table L_TmpV2 under projects "ACP at admit / ACP at end / ACP Status / ACP Source" of the centralized_data.mdb
* the SAS program that reads the data can be found in X:\Julie\SAS_CFE\CFE_macros\CFE_CC_ACP.sas
* the SAS program that reads the data can be found in {{S:\MED\MED_CCMED}}Julie\SAS_CFE\CFE_macros\CFE_CC_ACP.sas


== Legacy ==
== Legacy ==
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''see [[Comfort Care]] for collection of similar info in Medicine''
''see [[Comfort Care]] for collection of similar info in Medicine''


 
}}
 
[[Category:End-of-life related data]]
[[Category: Critical Care Element]]
[[Category:ACP]]
[[Category: All Projects ICU only]]
[[Category: End-of-life related data]]
[[Category: ACP]]
Retrieved from "https://ccmdb.kuality.ca/index.php?title=ACP_Status_Collection_in_ICU"