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Previous Location field: Difference between revisions

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{{DISPLAYTITLE:Previous_Location field}}
{{Data_element
{{Data_element
| field_name = Previous_Location
| field_name = Previous_Location
| CCMDB_label = Previous Location
| CCMDB_label = Previous Location
| CCMDB_tab = Dispo
| CCMDB_tab = Dispo
| element_description = The most recent previous '''physical location''' of a patient before arriving at the collection location.
| element_description = The most recent previous '''physical location''' (with [[#exceptions]]) of a patient before arriving at the collection location.
| in_table = L_Log
| in_table = L_Log table
| data_type = number
| data_type = number
| datafield_length = long integer
| datafield_length = long integer
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| data_element_sort_index = 37
| data_element_sort_index = 37
}}
}}
For exceptions, see
* [[EMIP]]
* [[HSC Community and Clinical Decision Unit (CCDU)]]
* [[Parked in ER]]


== Collection Instruction ==
== Collection Instruction ==
For each patient,  
For each patient,  
* enter the option that most closely matches
* enter the option that most closely matches:
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed''
{{PrePrevDispo listing}}
* if the situation is unknown, enter '''location missing/unknown'''
* if the patient is a direct admission use <site>_UC, <Site>_ER, <site>_ward, <site>_Med, <site>_ICU or temporary location depending on the scenario (see direct admit scenarios below)
 
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
If you know the location exactly, you can type it. Otherwise press the "?" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
* if the situation is unknown, enter '''Not known'''
 
* if the patient is in ER under a service we do not collect ie. cardiology, surgery etc use <site>_ER
For wards where we don't collect, enter e.g. HSC_ward. For wards where we do collect enter the actual ward as available in the dropdown.
{{DL | what is the [[Pre-admit Inpatient Institution]] entry for this case? --[[User:JMojica|JMojica]] 13:37, 29 July 2025 (CDT)
 
* That is what we need to decide we should probably keep it consistent with EMIP concept, however, for SICU we generally disregard the surgical service (when in ER) unless they were truly an inpt on a ward [[User:Lkaita|Lisa Kaita]] 13:59, 30 July 2025 (CDT)}}
=== Example ===
If you know the location exactly, you can type it, otherwise click on the dropdown button to view the options
For example, a patient arriving from Selkirk Hospital via the local ER would have the ER coded in the [[Previous Location field]] and Selkirk coded in the [[Pre-admit Inpatient Institution field]].


=== Where to find this information ===
=== Where to find this information ===
If patient came from a different Winnipeg hospital this should be recorded in the  “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.
If patient came from a different Winnipeg hospital this should be recorded in the  “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.


=== direct transfer ===
=== Borrowed Bed Or Pt Boarding On Other Unit ===
For patients who get [[ICU Var 4 - Parked in ER|parked in the ER]] during a inter-facility transfer, enter the previous ward in [[Pre-admit Inpatient Institution field]] and enter your ER in [[Previous Location field]].
* Use the [[Boarding Loc]] of the service taking care of the patient:<site>_Med, GH-CC, HSC_MICU, HSC_SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU.
(In the past you would have entered the hospital and ward as the "admit from".)
{{Discuss|
 
* for consistency, should this also use the [[Template:PrePrevDispo listing]]? Actually, what does this even mean for previous location? And what do you do if the patient comes from med?
{{discussion}}
}}
There should be a way to distinguish the cases who are from other hospital in Wpg, in other city, province, country, went to ER, assessed at ER and then decision to admit occurred at ER versus those who are direct admits but parked at ER. Suggestions to determine direct admits are 1) add a check box 'Direct Admit' 2)  Visit_admit_DtTm is the same as Accept_DtTm but this does not always happens 3) if the previous service is not 'Emergency Medicine' but there are also other services accepting patients at ER before handling over to Medicine ward/ ICU (e.g. neurology, cardiology, Nephrology). When this issue was presented to the 28Sept2017 Team Meeting, the group finds option 1 to be the clearest data and the easiest to implement for the data collector and for the analysis/reporting purposes. Tina needs to add the check box for 'Direct Admit' in CCMDB. --[[User:JMojica|JMojica]] 10:00, 2017 September 29 (CDT)
 
=== from psych unit ===
Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.
 
=== Dialysis unit as previous location===
For patient from Dialysis unit, use that unit as previous location. [[Pre acute living situation field]] would be the unit they came from right before, if applicable.
{{discussion}}
 
 
=== Heart Cath Lab vs OR as previous location ===
When a procedure (e.g valve replacement) is done in the cath lab before the pt arrives on your unit, enter Cath Lab if done in Cath Lab and put OR if done in OR.
We are aware that this may affect categorization under [[APACHE II]] but will collect like this for now. This will need to be dealt with when we move to [[ICD10]]. {{ICD10}}
 
=== Data collection units that have a '''mix''' of different physician serve types ===
We have a few units in the Region that have a mix of 2 different services (internal medicine, surgical, family medicine etc).
*VIC_S3 - is a mix of family medicine and internal medicine patients
*HSC_B3 - is a mix of day surgery & internal medicine patients
* any others?


For patients from these units:
=== Direct Admit Scenarios ===
* If patient is an internal medicine patient: enter the unit name (eg. VIC_S3)  
*inpatients from CON, OAK, VIC who are direct transfers to HSC/STB/GRA, the [[Pre-admit Inpatient Institution]] and [[Previous Location]] will be <site>_ward, even if the patient spends time in that site's UC prior to transfer. If not yet an inpatient from CON/OAK/VIC and transfer is from their UC, then previous location is the <site>_UC. 
* If patient is '''not''' a internal medicine patient, enter the generic hospital ward (e.g. VIC Ward); this will allow you to enter the [[Previous Service field]] with a physician service other than "Medicine".
*For direct transfers from HSC/STB/GRA, if an inpatient, and no in-between temporary location, the [[Pre-admit Inpatient Institution]] is the same as [[Previous Location]] (e.g. GH_med, or HSC_MICU)  
**if there is a temporary location in-between, then [[Previous Location]] is equal to the temporary location (e.g. OR, RR, Cath Lab, Dialysis, IR or Other procedure location) and [[Pre-admit Inpatient Institution]] would be the previous <site>_inpatient location
**If not yet an inpatient from HSC/STB/GRA and coming from <other site> ER then previous location is <other site> ER, and the [[Pre-admit Inpatient Institution]] would be not applicable
*If a [[homeless]] patient is admitted directly then code them as admitted from home.
*If a patient is admitted directly from prison, jail or a correctional institution, code this as an admission from '''"Institution NOS"'''. See [[Prison / Jail / Correctional Institution]] for additional info.


=== Patients from day surgery===
=== Exceptions ===
For patients admitted from day surgery units, enter:
*We have a few units in the Region that have a mix of different services (internal medicine, surgical, family medicine etc). For patients from these units:
*Previous Location - <your hospital> Ward, e.g. HSC Ward
** If patient was under internal medicine service, enter <site>_Med
*[[Previous Service]] - General Surgery (or other surgical service listed in drop down.
** If '''not''' under internal medicine service, enter the <site>_Ward
*for Riverview and [[Deer Lodge (DLC)]], see [[Chronic Health Facility]] see [[Pre-admit Inpatient Institution field]] or the various wards that are considered an inpatient location
*patients from POU (psych evaluation unit @ HSC) as "HSC ambulatory care" - This is not an inpatient ward.
*patients admitted from day surgery units, enter <site>_ambulatory care, e.g. this is not considered to be an inpatient location see [[Pre-admit Inpatient Institution field]]


=== [[Homeless]] Patients ===
{{Pre-admit, Previous content}}
If a homeless patient is admitted directly then code them as admitted from home. Usually they would be via ER, of course, and you'd code them as that.


=== [[Prison / Jail / Correctional Institution]] ===
{{Location dropdown cleanup}}
If a patient is admitted from prison, jail or a correctional institution, under the circumstances that would qualify as an admission from home, code this as an admission from home.


== Data Use ==
== Data Use ==
This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.  
This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.  


== {{CCMDB Data Integrity Checks}} ==
== Cross Checks ==
Implemented:
{{Data Integrity Check List}}
* Can not be blank
* previous_NE_Location() - [[Previous Location field]] can't be same as [[Service/Location field]]
* Patients with [[Previous Location field]] critical care must have [[Previous Service field]] critical care, and patients from medicine must have previous service medicine.
 
* query check_prev_pre-admit_consistent: for inpatient transfers within the region, [[Previous Location field]] and [[Pre-admit Inpatient Institution field]] should be same.
 
* query check_previous_location_vs_service_inconsistent: patients with [[Previous Location field]] in medicine must have [[Previous Service field]] medicine; patients from ICU (except CCU) must have previous service "critical care".
 
Following might still need to be implemented:
* [[Check ORDx]]; or not? Would have to be done for ICD10, so can it wait? Ttenbergen 16:26, 2016 May 25 (CDT) 
** discussing with Julie, she seems open to waiting, told her I am starting [[:Category:ICD10]] and [[:Template:ICD10]] for stuff like this. Ttenbergen 10:56, 2016 June 2 (CDT)
{{ICD10}}


== Implementation ==
== Implementation ==
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== Legacy ==
== Legacy ==
{{Change to collecting prison as "Institution NOS"}}
=== pre-2016 ===
This field is part of the [[2016 Time and Place changes]].
This field is part of the [[2016 Time and Place changes]].


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* [[Var 1 - Admit-from Ward]]
* [[Var 1 - Admit-from Ward]]


[[Category: 2016 Time and Place changes]]
== Related articles ==
[[Category: Admit/Discharge]]
{{Related Articles}}
[[Category: Registry Data]]
 
[[Category: L Log]]
[[Category:2016 Time and Place changes]]
[[Category:Admit/Discharge]]
[[Category:Registry Data]]
[[Category:Data Collection Guide]]
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