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Previous Service field: Difference between revisions

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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]].
}}
}}


== Collection Instruction ==
== Collection Instruction ==
For each patient,
*For each patient enter the option that most closely matches
* enter the option that most closely matches
** For medicine ward-to-ward moves, code "medicine" as previous service  
** for medicine ward-to-ward moves, code "medicine" as previous service  
** For ICU-to-ICU moves, code "Critical Care" if no other specific service is documented
** for ICU-to-ICU moves, code "Critical Care" if no other specific service is documented
** For pt from ER, code "Emergency Medicine" unless a different service had accepted them and is handing them off to Medicine
** for pt from ER, code "Emergency Medicine" unless a different service had accepted them and is handing them off to Medicine
** For pt direct from '''ambulatory''' not via ER, code "not applicable" if no other specific service is documented
* 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:
* if the service is not listed, code "other (known but not on list)"
**Such procedures include outpatient:  GI endoscopy, bronchoscopy, cardiac cath, invasive radiology, procedures done at surgicentres, etc.
** in these cases we don't care about the details; if we see too many others we may add additional options in future
**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)


===From HD / From hemodialysis===
===From HD / From hemodialysis===
*Patient admitted from outpatient HD to ward/ICU - code HD as Previous Location, and '''Nephrology''' as Previous Service.
* Came to dialysis from being an outpatient: 
*Patient transferred from ER to HD, then to ward/ICU - code HD as Previous Location, and '''Nephrology''' as Previous Service.
** [[Previous Location]] =dialysis 
*Patient admitted to medicine ward, goes to HD for dialysis, then is transferred to another ward/ICU - code HD as previous location, and '''Medicine service''' as Previous Service.
** [[Previous Service]]=Nephrology
{{Discuss |
** [[Pre-admit Inpatient Institution]]=n.a.
* As per [[Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2019#ICU_Database_Task_Group_Meeting_.E2.80.93_June_26.2C_2019 | last Task Meeting (item 1j)]] and then again [[Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2019#ICU_Database_Task_Group_Meeting_.E2.80.93_July_3.2C_2019 | last Task Meeting (item 7)]] - is this correct or do we need to discuss further? --[[User:Jvelasco|Jvelasco]] 14:39, 2019 June 26 (CDT)
* Came to dialysis from ED:
** Good question. 6 months later, what do people think?
** [[Previous Location]]=dialysis
*** The last relevant Task meeting entry there was as per below this discussion
** [[Previous Service]]=ED  
}}
** [[Pre-admit Inpatient Institution]]=n.a.
Comment from Task meeting, needs to either be integrated or can be removed if already consistent:
* Came to dialysis from a prior, different, inpatient location:  
*    Came to dialysis from being an outpatient: Previous Location=dialysis; Previous Service=Nephrology; Prior Inpatient Location=n.a.
** [[Previous Location]]=dialysis
*   Came to dialysis from ED: Previous Location=dialysis; Previous Service=ED; Prior Inpatient Location=n.a.
** [[Previous Service]]=service of that prior inpatient location
*   Came to dialysis from a prior, different, inpatient location: Previous Location=dialysis; Previous Service=service of that prior inpatient location; Prior Inpatient Location=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]]
[[Category:Data Collection Guide]]
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