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{{Data_element
Collection stopping as per [[Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2022#ICU_Database_Task_Group_Meeting_%E2%80%93_August_24,_2022]]. [[User:Ttenbergen|Ttenbergen]] 16:00, 2022 September 7 (CDT)
| field_name = Previous_Service
 
| CCMDB_label = Previous Service
{{Data element
| CCMDB_tab = Dispo
|field_name=Previous_Service
| element_description = The most recent "originating service" which sends the patients to their [[Service/Location field| current service location]].
|CCMDB_label=Previous Service
| in_table = L_Log table
|CCMDB_tab=Dispo
| data_type = number
|in_table=L_Log table
| datafield_length = long integer
|data_type=number
| program_collecting = Med and CC
|datafield_length=long integer
| created_raw = Raw
|program_collecting=Med and CC
| data_element_start_date = 2016-07-01
|created_raw=Raw
| data_element_sort_index = 38
|data_element_start_date=2016-07-01
|data_element_end_date=2022-09-07
|data_element_sort_index=38
|element_description=The most recent "originating service" which sends the patients to their [[Service/Location field| current service location]].
}}
}}


{{DiscussTask | The patient type field was replaced by the previous service field, how will the patient types be derived from the previous service field? the table s_previous_service must have a column defining the patient type.
== Collection Instruction ==
* Patient Type is Surgical if previous service is Cardiac Surgery, General surgery ,etc.,  
*For each patient enter the option that most closely matches
* Patient type is Cardiac if previous service is Cardiology,  
** For medicine ward-to-ward moves, code "medicine" as previous service  
* what about Patient type Medical? if Ob/Gyne or Emergency Medicine, is it Medical type? how about critical care?
** For ICU-to-ICU moves, code "Critical Care" if no other specific service is documented
*It was also mentioned earlier to use the diagnosis instead, can we begin working on this?
** For pt from ER, code "Emergency Medicine" unless a different service had accepted them and is handing them off to Medicine
--[[User:JMojica|JMojica]] 15:48, 2019 May 21 (CDT)}}
** For pt direct from '''ambulatory''' not via ER, code "not applicable" if no other specific service is documented
* Patients admitted after having a problem during an outpatient procedure are more complicated:
**Such procedures include outpatient:  GI endoscopy, bronchoscopy, cardiac cath, invasive radiology, procedures done at surgicentres, etc.
**If the patient goes DIRECTLY from the outpatient procedure area to a Medicine ward or an ICU, then code the type of physician who was doing the procedure:
***if, for example, it was a GI endoscopy, then the previous service was "GI", but as GI is not specifically listed in the dropdown list of services, then list it as "other"
**If before being admitted to hospital the patient was sent from the procedure area to the ED:
***if the patient was actually an ED patient (under the care of the ED docs) then code "Emergency Medicine"
***if, for example, it was a GI endoscopy and the patient was not actually under ED care, but instead was directly admitted to the ED on the Medicine ward service, then the previous service was "Medicine"
* If the service is not listed, code "other (known but not on list)"
** in these cases we don't care about the details; if we see too many others we may add additional options in future (as of January 2022 we checked and these account for <1% of all previous services)


== Collection Instruction ==
===From HD / From hemodialysis===
For each patient,
* Came to dialysis from being an outpatient: 
* enter the option that most closely matches
** [[Previous Location]] =dialysis 
** for medicine ward-to-ward moves, code "medicine" as previous service
** [[Previous Service]]=Nephrology
** for ICU-to-ICU moves, code "Critical Care" if no other specific service is documented
** [[Pre-admit Inpatient Institution]]=n.a.
** for pt from ER, code "Emergency Medicine" unless a different service had accepted them and is handing them off to Medicine
* Came to dialysis from ED: 
* for pt direct from '''ambulatory''' not via ER, code "not applicable" if no other specific service is documented
** [[Previous Location]]=dialysis
* if the service is not listed, code "other (known but not on list)"
** [[Previous Service]]=ED
** in these cases we don't care about the details; if we see too many others we may add additional options in future
** [[Pre-admit Inpatient Institution]]=n.a.
* Came to dialysis from a prior, different, inpatient location:
** [[Previous Location]]=dialysis
** [[Previous Service]]=service of that prior inpatient location
** [[Pre-admit Inpatient Institution]]=that prior inpatient location


===From Cardiac Cath Lab===
===From Cardiac Cath Lab===
*A patient goes to emergency, then is sent to the cardiac cath lab for an angiogram. Julie would like the sending service to be Emergency Medicine in these cases (not cardiology).   Discussed at the task group meeting on July 20, 2017.
*A patient goes to emergency, then is sent to the cardiac cath lab for an angiogram. Julie would like the sending service to be Emergency Medicine in these cases (not cardiology). Discussed at the task group meeting on July 20, 2017.
*Most patients come to CCU or ICU via the heart cath as a code stemi, in which case the previous service is cardiology because they bypass ER and go direct to the heart cath lab.  
*Most patients come to CCU or ICU via the heart cath as a code stemi, in which case the previous service is cardiology because they bypass ER and go direct to the heart cath lab.  
    
    
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We treat patients that went through the HSC/GRA Nursing Home as having been discharged. So, admission from there should be as if admitted from home, so put "not applicable" into the [[Previous Service field]].  
We treat patients that went through the HSC/GRA Nursing Home as having been discharged. So, admission from there should be as if admitted from home, so put "not applicable" into the [[Previous Service field]].  
This does not affect the [[Visit Admit DtTm field]] definition - remember, that is defined by EPR entry.
This does not affect the [[Visit Admit DtTm field]] definition - remember, that is defined by EPR entry.
===Admit from home===
===Admit from home===
For an admission directly from home bypassing the ER enter Previous Service = 'Not applicable'.
For an admission directly from home bypassing the ER enter Previous Service = 'Not applicable'.
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=== admission from a nursing station ===
=== admission from a nursing station ===
*For direct admission from a nursing station, put "other (known, but not on list)".  
*For a direct admission to a collection unit from nursing stations, put "other (known, but not on list)".  
*If from a nursing station, patient dropped by ER , put "Emergency Medicine".
*If from a nursing station, patient dropped by ER , put "Emergency Medicine".


=== [[Parked in ER]] ===
=== Direct admit ===
If a pt is physically in ER and officially under the care of primary service eg Neurology, then code [[Previous Service]] as Neurology.
For a direct admit via the ER, the [[Previous Service]] will be the primary service looking after the patient, prior to admission at your facility. 
 
{{Ex|
If pt was not yet accepted, code [[Previous Service]] as Emergency Medicine.
* direct admit from Steinbach ER, [[Previous Service]] = emergency
* direct admit from Steinbach ward, [[Previous Service]] = medicine or family medicine
}}


=== Urgent Care ===
=== Urgent Care ===
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*see updated minutes dated August 24, 2017.
*see updated minutes dated August 24, 2017.


== Related articles ==
{{Related Articles}}




[[Category: 2016 Time and Place changes]]
[[Category:2016 Time and Place changes]]
[[Category: Admit/Discharge]]
[[Category:Admit/Discharge]]
[[Category:Data Collection Guide]]
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