EMIP: Difference between revisions

EMIP stands for '''E'''mergency '''M'''edicine "'''I'''n" '''P'''atient. It is used for patients who are admitted to our internal medicine service and spend their entire '''admission under one of the medicine services we follow''' in the ER (emergency department).  

==Definition of EMIP==  

An EMIP is a Patient who has a record in [[EPR]]/[[Cognos Report Integrator]] for a [[Service tmp entry | Service]] we collect while in ER, and who does not then end up on one of the wards/units that correspond with that service, regardless where they go instead.

 

# Pt has an order or some entry that medicine has accepted the patient while still in ER.

#* the patient is transferred '''within the hospital to any service''' because the [[Medicine program]] decides that they will not take the pt but the patient needs different care or

#** this could include a [[Critical Care program]] admission we would collect, see [[#Collecting an EMIP who has been transferred to the Critical Care program]]

#* [[Deceased patients|dies]] in ER ("ED Death after Arrival" in [[Cognos]]) [[Category:End-of-life related data]]

 

Our definition of EMIP includes only patients that were followed by one of '''''our''''' services. So, patients who were followed by Family Medicine or Trauma while still in the ER are '''not EMIPs'''.

 

 

There has been some discussion whether or not a patient accepted by our service but still in ER when Cognos first lists them should actually be entered then, or only after they either leave from ER or become an inpatient. People have been leaving these un-entered both out of old habit (when EMIPs were entered following different rules you first had to know if a pt would need to be entered as EMIP or as regular) and to be able to enter the unit at the same time, rather than having to remember to go back to the record later to enter the unit. There really is no longer a reason to delay these, especially starting with [[Using Cognos2 to keep track of patients]], instead they become something for which we would need to add tools to CSS to identify them. Please enter them as they show up on [[Cognos2 Service Starter]]o.

 

* [[Service/Location field]] - your Generic [[HSC_Med]], [[GRA_Med]], [[STB_Med]]

'''Follow the instructions in [[Boarding Loc]], [[Service tmp entry]], [[Transfer Ready DtTm tmp entry]]; if you do, none of the old special instructions for EMIPs should be required.'''

=== Collecting an EMIP who has been transferred to the [[Critical Care program]] ===

EMIPs include patients who are discharged to another service in the hospital. (eg [[Medicine program]] to [[Critical Care program]] or [[Critical Care program]] to [[Medicine program]])

*if an EMIP patient is transferred to an ICU, that ICU would use e.g. [[GRA_Med]] as [[Previous Location]]

** For [[Pre-admit Inpatient Institution field | Pre-admit Inpatient Institution]] = GRA_Med for the new scheme. Before start date of new scheme,[[Previous Location]] is '''site_EMIP'''

*If a pt who starts out on the EMIP track turns into a medicine [[Boarding Loc]] patient, collect them as you would any other [[Boarding Loc]] patient.  

* In ER under '''Medicine service''' and left your hospital to Home or died in ER

* In ER under '''Medicine service''' and transferred to other locations under '''different''' service in your hospital  

* In ER under '''Medicine service''' and discharged to other locations in another hospital

* In ER under '''Medicine service''' and then moved to a '''Medicine service''' ward  (i.e. a regular Medicine admission)

* In ER under '''Medicine service''' and then moved to other ward but under '''Medicine service''' (i.e. a case of [[Off_ward_field|off ward patients]]).

 

*(1) Internal Med answered consult but deferred and admitted under Critical Care service. Consults do not count as admissions, the patient has to be accepted to Internal med service, and in this scenario would be considered an admission to Critical care only.

*(2) Rural Patient accepted by Internal Med service but deteriorated enroute to Winnipeg. Transport team transferred to ER resus room and Critical care consulted, admitted, and assumed care of the patient. This should only be collected as a Critical care service profile, as the patient was assumed by CC service upon arrival at the hospital. (Just as we would not collect for any other patient who died before they ever made it to the hospital).

== Legacy information ==

* [[VIC_EMIP]], [[GRA_EMIP]], [[STB_EMIP]] and [[HSC_EMIP]] used to be [[Service/Location field]] entries in the Medicine database until [[2020-10 EMIP changes]] / [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]]  

* there used to not be a [[Critical Care program]] counterpart, see [[ECIP]] for more info

* since the concept only applied to Med pts and we didn't collect those at CON and OAK, patients in Concordia ER or Oaks ER could not become EMIPs

* Before start date of new scheme, a second service in the hospital for an EMIP would have used [[Previous Location]] is '''site_EMIP'''

== Related articles ==  

[[Category:Overflow]]

[[Category:EMIP| *]]