2020-04 HSC COVID unit transition: Difference between revisions

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This page is about the '''April''' transition of collection units at HSC to accommodate the new COVID unit. See [[2020-03 HSC COVID unit transition]] about earlier transitions in March.  
This page is about the '''April''' transition of collection units at HSC to accommodate the new COVID unit. See [[2020-03 HSC COVID unit transition]] about earlier transitions and [[2020-05 HSC COVID unit transition]] about later ones.


== Background ==
== Background ==
{Discuss |* Lisa asked - Patient x under A goes to A4 then becomes suspect and moves to D2 then becomes positive and moves to D4 but stays under A the whole time, do we make a new profile for each move?  Or keep as one profile?
=== Dates ===
* Julie wrote - We should have a cut-off date for the additional covid ward D2 and MS3.  As I understand these new wards are for  covid positives. Once dates are confirmed, then we start collecting at D2 and WS3.
* '''Wednesday April 1'''- [[HSC_H4]] patients moved to HSC D4 as suspect COVID cases ([[HSC_H4]] closed for terminal clean)
** '''all''' [[HSC_H4]]  patients were moved to [[HSC_D4_C]] and were all considered as covid suspects.  and  they are the ones who were now labeled as D4 suspects who later move to "HSC D2 C" in Apr 3. the ones left at [[HSC_D4_C]] are all COVID+. HSC_H4 is vacant from April 1 forward
* '''Friday April 3''' - D4 Suspect patients moved to D2 Covid Suspect ward (D4-C is now the COVID positive ward)
* '''Tuesday April 7''' - [[Boarding Loc]] beds HSC B2B moved to HSC WRS2
* '''Tuesday April 7''' - '''"HSC D2 C"''' opened as COVID-19 suspect ward
* '''Tuesday April 14.20''' – patients in [[HSC_H4H]] (GH7 HOBS) moved to [[HSC_B2]]
* '''Wednesday April 15''' -[[HSC_H4]] reopened
*'''July 27.21''' - '''B2B''' only COVID ward open at HSC


For Lisa's example,  there can be 3 options assuming no official date yet for D2 as COVID positive ward :
=== Medicine specifics ===
1) A4, D2 together  and new record D4
==== Cut-off dates ====
2) A4 one record, D4 new record – drop D2 (suspect only) because we don’t collect on that ward
* Julie wrote - We should have a cut-off date for the additional covid ward D2 and MS3. As I understand these new wards are for  covid positives. Once dates are confirmed, then we start collecting at D2 and MS3.
3) A4 as one record  and  D2,D4 together as new record
** Currently D2 is still a suspect ward, D4 is still our only COVID + ward [[User:Lkaita|Lisa Kaita]] 17:01, 2020 April 16 (CDT)
Which one? not sure, I have to think. Maybe option (2). 
***update There are no COVID specific suspect or positive wards as of May 27, 2020 [[User:Lkaita|Lisa Kaita]] 13:49, 2020 June 11 (CDT)
 
==== multiple wards ====
* If all the covid wards are operational,  how to handle the case where the patient stayed in 2 official covid wards consecutively - 1) separate records or 2)one continuous record? I think we should consider (2) as continuous. (who asked?)
** what was the decision? Ttenbergen 10:31, 2020 May 14 (CDT)
** Did not happen at all.  we can ignore this scenario.  --[[User:JMojica|JMojica]] 10:00, 2020 June 12 (CDT)}}


If all the covid wards are operational,  how to  handle the case where the patient stayed in 2 official covid wards consecutively - 1) separate records or 2)one continuous record?  I think we should consider (2) as continuous.
=== ICU specifics ===
Any thoughts?
April 2020 HSC_MICU will admitted both SICU and MICU physician Service patients that are either suspect or confirmed COVID patients.  No suspect or positive covid will be admitted to HSC SICU.  Though MICU is a close unit the SICU patient in this unit will be under the SICU attending service physician. Depending on skill set required, sometime may be a SICU nurse or just MICU nurse. The nurse bit we will not be able to track.   
* Tina commented - Keep in mind with all this that having a single record is maybe less work, but having multiple might actually make it more straighfwd to track all this. Also, how collectors get this out of EPR might be easier if we do it one way than another.
*This scenario can be handled by our tmp boarding loc. Say an SICU physician service patient with COVID using HSC MICU bed will have SICU as service and boarding loc at MICU. OR vice versa, no covid MICU physician Service patients using SICU bed will have service MICU and boarding loc at SICU.  
**So far, I have been using option one. We have had a lot of admissions to D2 over the weekend, and I have been entering them as though they are an off ward D5 patient. I don't think option 2 would work, because these are medicine patients admitted under our services, so ignoring that part of their stay wouldn't make sense. I'm happy to change this, but we should decide soon before this gets too complicated.[[User:Mlagadi|Mlagadi]] 15:07, 2020 April 14 (CDT)
***if D2 is under Medicine service, then D2 can be consider as an off ward - I agree this makes sense.  --[[User:JMojica|JMojica]] 15:22, 2020 April 14 (CDT)
**** Should I remove D2 from service_location dropdown then? Or how will we use this? If we are not consistent about this we will have errors in linking, which needs to be able to match a dispo with a location and a location with a previous. Ttenbergen 20:40, 2020 April 14 (CDT)}}
 
{{Discuss | Related to ICU, how will the patient originally at HSC_MICU then move to either H7 or A7 under the care of MICU be collected - will the move to H7/A7 be a new record or continuation?}}
 
The dates are not yet finalized
* '''Tuesday April 14.20''' – patients in [[HSC_H4H]] (GH7 HOBS)  will be moving to [[HSC_B2]]
* '''?? April .20''' - '''MS3''' will be another new COVID-19 ward ([[HSC_MS3]]) with 29 adult beds
* '''?? April .20''' - '''D2''' will be another new COVID-19 ward ([[HSC_D2_C]]) with 32 adult beds
* '''??  .20''' - '''H7''' (H7 and H733 old CCU) will be additional 17 beds for ICU ([[HSC_MICU]] and/or [[HSC_SICU]])
** it is not yet clear if this ward is allocated for MICU only or SICU only or both - waiting for the decision.
* '''??  .20''' - '''A7''' will be additional 14 beds for ICU ([[HSC_MICU]] and/or [[HSC_SICU]]) 
** it is not yet clear if this ward is allocated for MICU only or SICU only or both - waiting for the decision.


Wards involved:  
Wards involved:  
** [[HSC_D2_C]]
** "HSC D2 C" - stopped May 12.20
** [[HSC_B2]]
** [[HSC_B2]]
** [[HSC_MS3]]
** HSC_MS3
** [[HSC_A7_MI]]
** HSC_A7_MI
** [[HSC_A7_SI]]
** HSC_A7_SI
** [[HSC_H7_MI]]
** HSC_H7_MI
** [[HSC_H7_SI]]
** HSC_H7_SI


originals:  
originals:  
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* [[HSC_SICU]]
* [[HSC_SICU]]
* [[HSC_IICU]]
* [[HSC_IICU]]
{{Discuss | *
 
Were there more? Pls add... Ttenbergen 20:29, 2020 April 14 (CDT) }}
==== Multiple Units ====
Related to ICU, how will the patient originally at HSC_MICU then move to either H7 or A7 under the care of MICU  be collected - will the move to H7/A7 be a new record or continuation?
* the move will be considered as a continuation of HSC MICU profile and H7 or A7 is noted as a second record in tmp boarding loc.


== Service Locations ==
== Service Locations ==


== Tmp entries ==
== Tmp entries ==
{{Discuss | Do we need any? }}
*The following should be added to Tmp entries :
** HSC_D5_P
** HSC_D4_P
** HSC_H4H
 
== Transition plan ==
== Transition plan ==
# There is no transition plan for the new COVID wards and the additional ICUs. Just need to add in the [[s_dispo table]]
# There is no transition plan for the new COVID wards and the additional ICUs. Just need to add in the [[s_dispo table]]
# This transition plan is only for the patients in H4H who were moved to HSC_B2  
# This transition plan is only for the patients in H4H who were moved to HSC_B2  
#* "HSC_H4H" needs to be added to [[s_tmp]] of Project BoardingLoc
#* "HSC_H4H" needs to be added to [[s_tmp table]] of Project BoardingLoc
 
=== collector instructions ===
=== collector instructions ===
# change the [[Service/Location]] of the record to the new location (ie from [[HSC_H4H]] to [[HSC_B2]] )
# change the [[Service/Location]] of the record to the new location (ie from [[HSC_H4H]] to [[HSC_B2]] )
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#** add a line for "HSC - Home medicine ward" with the time that the patient was actually moved
#** add a line for "HSC - Home medicine ward" with the time that the patient was actually moved
#* if there were patients who actually were in a borrow location during the transition, let's talk about how we would enter those
#* if there were patients who actually were in a borrow location during the transition, let's talk about how we would enter those
#**The move from H4H to B2 happened April 14th.
===D2 COVID Suspect Ward "HSC D2 C"===
*Stopped May 12.20.  will be Ortho.
This ward is a mix of different medicine patients ie. H, D, A, unkknown, and nephrology patients, therefore each data collector will enter their own patients
# the [[Service/Location]] will be your home ward location
# in the tmp the [[Boarding Loc]] will be generic boarding and in Q column enter D2
#  if the patient's result is negative and they are moved back to their home ward then enter [[Boarding Loc]] HSC home medicine ward with the date and time they are transferred back
#  if the patient's result is positive, create a new profile using D4_C or whichever COVID + ward they are transferred to, if they remain on D2 no changes are required
===Special Circumstances===
When Reviewing a chart in MR and you find a COVID positive or  COVID suspect patient that occurred BEFORE the new COVID positive/suspect wards were opened, use [[Service Location]] home ward location and use the appropriate [[COVID-19 (SARS-COV-2)]] or [[Observation for suspected infection NOS]] code.
When reviewing a chart in MR and you find a COVID suspect patient on your home ward and the patient is transferred to another location where the diagnosis of COVID positive is made, check the date/time the swab was sent.  If it was sent less than 48 hours after admission code this as an [[Admit Diagnosis]], if the swab was sent greater than 48 hours after admission code this as an [[Acquired Diagnosis]]
=== Serial Number===
# For transition units ie. D5 to WRS3, D4 to D5, H4H to B2,  use your continuous serial numbers
# For D4_C start with serial number 150


=== data processor instructions ===
{{Discuss | Depending on how we do this with tmp vs service location we may end up with linking issues and orphans; need to review. }}


== Reporting ==
== Reporting ==
* service location [[HSC_H4H]] before April 14,2020 and [[HSC_B2]] can be together.
* service location [[HSC_H4H]] before April 14,2020 and [[HSC_B2]] can be together.
* all COVID wards namely [[HSC_D4_C]], [[HSC_D2_C]], [[HSC_MS3]] can be together.
* all COVID wards namely [[HSC_D4_C]], "HSC D2 C", HSC_MS3 can be together.
* [[HSC_MICU]], [[HSC_A7_MI]], [[HSC_H7_MI]] can be together.
* [[HSC_MICU]], HSC_A7_MI, HSC_H7_MI can be together.
* [[HSC_SICU]], [[HSC_A7_SI]], [[HSC_H7_SI]] can be together.
* [[HSC_SICU]], HSC_A7_SI, HSC_H7_SI can be together.


== Cross checks ==
== Cross checks ==
{{Discuss |
* [[CCMDB.accdb Data Integrity Checks]] for [[Boarding Loc]] have been set up. Ttenbergen 10:26, 2020 June 25 (CDT)
* We have no [[CCMDB.accdb Data Integrity Checks]] yet for [[Boarding Loc]] , so that won’t limit our options. Is this the time to add cross-checks?
}}
 
{{Discuss |
* Have not yet checked how this will impact [[CFE Data Integrity Checks]]. Pagasa, of the top of your head which would be impacted and how? 
}}


== Related articles ==  
== Related articles ==  
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[[Category: 2020 COVID unit transition ]]
[[Category:2020 COVID unit transition ]]
[[Category: Legacy Data Collection]]
[[Category:Legacy Data Collection]]

Latest revision as of 11:29, 30 July 2025

This page is about the April transition of collection units at HSC to accommodate the new COVID unit. See 2020-03 HSC COVID unit transition about earlier transitions and 2020-05 HSC COVID unit transition about later ones.

Background

Dates

  • Wednesday April 1- HSC_H4 patients moved to HSC D4 as suspect COVID cases (HSC_H4 closed for terminal clean)
    • all HSC_H4 patients were moved to HSC_D4_C and were all considered as covid suspects. and they are the ones who were now labeled as D4 suspects who later move to "HSC D2 C" in Apr 3. the ones left at HSC_D4_C are all COVID+. HSC_H4 is vacant from April 1 forward
  • Friday April 3 - D4 Suspect patients moved to D2 Covid Suspect ward (D4-C is now the COVID positive ward)
  • Tuesday April 7 - Boarding Loc beds HSC B2B moved to HSC WRS2
  • Tuesday April 7 - "HSC D2 C" opened as COVID-19 suspect ward
  • Tuesday April 14.20 – patients in HSC_H4H (GH7 HOBS) moved to HSC_B2
  • Wednesday April 15 -HSC_H4 reopened
  • July 27.21 - B2B only COVID ward open at HSC

Medicine specifics

Cut-off dates

  • Julie wrote - We should have a cut-off date for the additional covid ward D2 and MS3. As I understand these new wards are for covid positives. Once dates are confirmed, then we start collecting at D2 and MS3.
    • Currently D2 is still a suspect ward, D4 is still our only COVID + ward Lisa Kaita 17:01, 2020 April 16 (CDT)
      • update There are no COVID specific suspect or positive wards as of May 27, 2020 Lisa Kaita 13:49, 2020 June 11 (CDT)

multiple wards

  • If all the covid wards are operational, how to handle the case where the patient stayed in 2 official covid wards consecutively - 1) separate records or 2)one continuous record? I think we should consider (2) as continuous. (who asked?)
    • what was the decision? Ttenbergen 10:31, 2020 May 14 (CDT)
    • Did not happen at all. we can ignore this scenario. --JMojica 10:00, 2020 June 12 (CDT)}}

ICU specifics

April 2020 HSC_MICU will admitted both SICU and MICU physician Service patients that are either suspect or confirmed COVID patients. No suspect or positive covid will be admitted to HSC SICU. Though MICU is a close unit the SICU patient in this unit will be under the SICU attending service physician. Depending on skill set required, sometime may be a SICU nurse or just MICU nurse. The nurse bit we will not be able to track.

  • This scenario can be handled by our tmp boarding loc. Say an SICU physician service patient with COVID using HSC MICU bed will have SICU as service and boarding loc at MICU. OR vice versa, no covid MICU physician Service patients using SICU bed will have service MICU and boarding loc at SICU.

Wards involved:

    • "HSC D2 C" - stopped May 12.20
    • HSC_B2
    • HSC_MS3
    • HSC_A7_MI
    • HSC_A7_SI
    • HSC_H7_MI
    • HSC_H7_SI

originals:

Multiple Units

Related to ICU, how will the patient originally at HSC_MICU then move to either H7 or A7 under the care of MICU be collected - will the move to H7/A7 be a new record or continuation?

  • the move will be considered as a continuation of HSC MICU profile and H7 or A7 is noted as a second record in tmp boarding loc.

Service Locations

Tmp entries

  • The following should be added to Tmp entries :
    • HSC_D5_P
    • HSC_D4_P
    • HSC_H4H

Transition plan

  1. There is no transition plan for the new COVID wards and the additional ICUs. Just need to add in the s_dispo table
  2. This transition plan is only for the patients in H4H who were moved to HSC_B2
    • "HSC_H4H" needs to be added to s_tmp table of Project BoardingLoc

collector instructions

  1. change the Service/Location of the record to the new location (ie from HSC_H4H to HSC_B2 )
    • Multi DC are collecting the H4H patients
      • HSC_H4H_a to HSC_B2
      • HSC_H4H_b to HSC_B2
      • HSC_H4H_d to HSC_B2
      • HSC_H4H_h to HSC_B2
    • the new ward B2 does not need a subscript anymore because the Laptop identifier replaces it.
  2. enter the actual location as part of Boarding Loc:
    • for patients who had no location borrowing during transition:
      • change the "no borrow" line to "HSC_H4H" and enter the time the patient arrived in H4H
      • add a line for "HSC - Home medicine ward" with the time that the patient was actually moved
    • if there were patients who actually were in a borrow location during the transition, let's talk about how we would enter those
      • The move from H4H to B2 happened April 14th.

D2 COVID Suspect Ward "HSC D2 C"

  • Stopped May 12.20. will be Ortho.

This ward is a mix of different medicine patients ie. H, D, A, unkknown, and nephrology patients, therefore each data collector will enter their own patients

  1. the Service/Location will be your home ward location
  2. in the tmp the Boarding Loc will be generic boarding and in Q column enter D2
  3. if the patient's result is negative and they are moved back to their home ward then enter Boarding Loc HSC home medicine ward with the date and time they are transferred back
  4. if the patient's result is positive, create a new profile using D4_C or whichever COVID + ward they are transferred to, if they remain on D2 no changes are required

Special Circumstances

When Reviewing a chart in MR and you find a COVID positive or COVID suspect patient that occurred BEFORE the new COVID positive/suspect wards were opened, use Service Location home ward location and use the appropriate COVID-19 (SARS-COV-2) or Observation for suspected infection NOS code.

When reviewing a chart in MR and you find a COVID suspect patient on your home ward and the patient is transferred to another location where the diagnosis of COVID positive is made, check the date/time the swab was sent. If it was sent less than 48 hours after admission code this as an Admit Diagnosis, if the swab was sent greater than 48 hours after admission code this as an Acquired Diagnosis

Serial Number

  1. For transition units ie. D5 to WRS3, D4 to D5, H4H to B2, use your continuous serial numbers
  2. For D4_C start with serial number 150


Reporting

  • service location HSC_H4H before April 14,2020 and HSC_B2 can be together.
  • all COVID wards namely HSC_D4_C, "HSC D2 C", HSC_MS3 can be together.
  • HSC_MICU, HSC_A7_MI, HSC_H7_MI can be together.
  • HSC_SICU, HSC_A7_SI, HSC_H7_SI can be together.

Cross checks

Related articles

Related articles:
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