Pre-admit Inpatient Institution field: Difference between revisions

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''This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear. ''
{{Data_element
 
| field_name = Pre_admit_Inpatient_Institution
The [[Pre-admit Inpatient Institution field]] identifies the '''previous ''inpatient'' location''' of patients who were already '''inpatients''' elsewhere and who have been under medical care continuously before coming to our unit. This does not include patients who just arrived at an ER elsewhere and were not admitted as inpatient there.
| CCMDB_label = Pre-admit Inpatient Institution
 
| CCMDB_tab = Dispo
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]].
| element_description = The most recent '''previous ''inpatient'' location''' of patients who were already '''inpatients''' elsewhere and who have been under medical care continuously before coming to our unit.
| in_table = L_Log table
| data_type = number
| datafield_length = long integer
| program_collecting = Med and CC
| created_raw = Raw
| data_element_start_date = 2016-07-01
| data_element_sort_index = 36
}}


== Collection Instruction ==
== Collection Instruction ==
For each patient,  
* For each patient, enter the most recent '''in-patient''' location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals
* enter the option that most closely matches
** for patients who were accepted by a service at the previous site, but never left the site's ER to get to the ward ("EMIP" concept), consider these in-patients
{{PrePrevDispo listing}}
{{Ex |
*HSC MICU --- family medicine ward at the Vic --- HSC_ER --- STB_ER --- cath lab --- HSC_MICU. 
**Code the Pre-admit Inpatient Institution field as: VIC_Ward}}
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if the situation is unknown, enter '''location missing/unknown'''
* if the situation is unknown, enter '''location missing/unknown'''
* if the patient did not come from an '''in'''patient location, enter "not applicable", for example if they came from home or a clinic. The ER is '''not''' an inpatient location.
* if the patient did not come from an '''in'''patient location, enter "not applicable"  
 
** for example if they came from home or a clinic
If you know how we code 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.
** the ER (at your site or elsewhere) is '''not''' an inpatient location, so enter "not applicable"  


=== Where to find this information ===
=== Where to find this information ===
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.


=== Example ===
=== Ambiguous locations ===
*ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC.
* Day-surgery locations - use "<hosp> ambulatory care"
**The PrevInptLocation field is: VIC_Ward
*The following '''ARE NOT''' considered inpatient locations, enter "NA / not applicable"
** Any PCH (see [[Chronic Health Facility]] for additional instructions)
** Nursing stations - they are not inpatient locations, and Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.  


=== EMIP ===
=== Chronic Care Facilities ===
If pt goes from Medicine [[EMIP]] to an ICU, use the EMIP location in [[Pre-admit Inpatient Institution field]].
They are a changing and complicated case, see [[Chronic Health Facility]].


=== Ambiguous locations ===
=== Intra-facility and inter-facility transfers  ===
The following '''are''' considered inpatient locations in this context:
If a patient gets transferred to another ward in the same or different hospital, enter <site>_Med, <site>_Ward or <site>_CC (as appropriate) as both the [[Previous Location field]] and the [[Pre-admit Inpatient Institution field]].
* day-surgery patients ending up on our unit directly
 
=== Arrivals from a borrowed bed ===
See and follow [[Previous Location field#Borrowed Bed Or Boarding Loc]]


The following are '''not''' considered inpatient locations, enter "NA / not applicable"
=== Several pre-admit locations ===
* care homes, including units with higher levels of care at Deer Lodge or Riverview
If a patient travels through several pre-admit inpatient locations we will only have data on the last one. We understand that. Just to be clear.


=== movement within the same hospital ===
{{Ex |  Pt was on a ward as an inpatient then went to ICU, then was transferred to the ward you are collecting on. Previous location would be ICU and previous inpatient institution would also be ICU.}}
If a patient gets transferred from one ward in a hospital to another ward, enter the previous ward as both the [[Previous Location field]] and the [[Pre-admit Inpatient Institution field]].


=== Cath lab confusion ===
{{Pre-admit, Previous content}}
We did not use to collect cath lab and would instead code the location before, usually ER. We will now allow cath lab. If a patient comes from the cath lab it does not result in any other exceptional collection instructions. If they were an inpatient before, without interruption, code that location as [[Pre-admit Inpatient Institution field]]. If they were not an '''inpatient''' code it as not available.


===Code Readmission from Grace/HSC Nursing Home as NA ===
{{Location dropdown cleanup}}
We consider admissions from there as re-admissions, so would be coded as if they had come from home. Consistent with that we will consider these '''not''' inpatient locations, so code them as "NA / not applicable".
(As per meeting with Dr Roberts 2016-05-05)


== Data Use / Purpose ==
== Data Use / Purpose ==
Line 48: Line 60:
The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.
The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.


== {{CCMDB Data Integrity Checks}} ==
== Cross Checks ==
Can not be blank.
{{Data Integrity Check List}}


== Reports ==
== Reports ==
{{discussion}} Which reports will this be on? Ttenbergen 10:33, 2016 March 22 (CDT)
The information is part of the [[Critical Care Program Quality Indicator Report]] and the [[ICU Interfacility Report]].  Also the information will be useful for research projects where it will mark a patient as inpatient before arrival to the unit or ward.


== Implementation ==
== Implementation ==
Line 58: Line 70:


== Legacy ==
== Legacy ==
This field is part of the [[2016 Time and Place changes]] and did not previously exist.
This field is part of the [[2016 Time and Place changes]]. Some of the data previously existed in [[hospital previous]] but it is not a 1-to-1 mapping.
 
=== Nursing stations ===
We used to collect nursing stations in [[hospital previous]] but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.


== 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]]

Latest revision as of 22:58, 30 July 2025

Data Element (edit)
Field Name: Pre_admit_Inpatient_Institution
CCMDB Label: Pre-admit Inpatient Institution
CCMDB tab: Dispo
Table: L_Log table
Data type: number
Length: long integer
Program: Med and CC
Created/Raw: Raw
Start Date: 2016-07-01
End Date: 2300-01-01
Sort Index: 36
Data Dependencies(Reports/Indicators/Data Elements):

The most recent previous inpatient location of patients who were already inpatients elsewhere and who have been under medical care continuously before coming to our unit.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


Collection Instruction

  • For each patient, enter the most recent in-patient location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals
    • for patients who were accepted by a service at the previous site, but never left the site's ER to get to the ward ("EMIP" concept), consider these in-patients
    • for places where we collect, use the Service/Location used by the counterpart admission: <site>_Med, GH-CC, HSC MICU , HSC SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU
    • for wards where we don't collect: <site>_Ward or other external entry e.g. home
Example:   
  • HSC MICU --- family medicine ward at the Vic --- HSC_ER --- STB_ER --- cath lab --- HSC_MICU.
    • Code the Pre-admit Inpatient Institution field as: VIC_Ward
  • if you know the situation but nothing on the list matches closely, enter other - known but not listed
  • if the situation is unknown, enter location missing/unknown
  • if the patient did not come from an inpatient location, enter "not applicable"
    • for example if they came from home or a clinic
    • the ER (at your site or elsewhere) is not an inpatient location, so enter "not applicable"

Where to find this information

If patient came from a different Winnipeg hospital this will be recorded in the “Visit History” on the EPR.

Ambiguous locations

  • Day-surgery locations - use "<hosp> ambulatory care"
  • The following ARE NOT considered inpatient locations, enter "NA / not applicable"
    • Any PCH (see Chronic Health Facility for additional instructions)
    • Nursing stations - they are not inpatient locations, and Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.

Chronic Care Facilities

They are a changing and complicated case, see Chronic Health Facility.

Intra-facility and inter-facility transfers

If a patient gets transferred to another ward in the same or different hospital, enter <site>_Med, <site>_Ward or <site>_CC (as appropriate) as both the Previous Location field and the Pre-admit Inpatient Institution field.

Arrivals from a borrowed bed

See and follow Previous Location field#Borrowed Bed Or Boarding Loc

Several pre-admit locations

If a patient travels through several pre-admit inpatient locations we will only have data on the last one. We understand that. Just to be clear.

Example:    
 Pt was on a ward as an inpatient then went to ICU, then was transferred to the ward you are collecting on. Previous location would be ICU and previous inpatient institution would also be ICU.

Instructions that apply to both Pre-admit Inpatient Institution and Previous Location

Special Case - Temporary locations

Special Case - ... what is the case?

  • direct admissions to the ER that are under a service that we do not collect, and then are admitted to either an ICU or medicine service, while still physically in the ER

the Previous Location: <site>_ward; Pre-admit Inpatient Institution would also be <site>_ward

  • for EMIP or ECIP follow instructions on those wiki pages


I can not remember which particular data collection instruction applies only to those two that is related to sending someone to the ED, but then, my brain is full. This template was to contain the instructions collectors need to enter this, and then link to an index page with reasons, implications and decision point info. That page is Patients who appear to transfer from in-patient situation to Emergency Room.

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

SQL query of what is currently available    
SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo
FROM s_dispo
WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));
  • query of what is currently used: query z_s_dispo_inactivatable

Data Use / Purpose

To document where those patients who were inpatients immediately before arriving on our ward/unit came from.

The detailed information will allow us also to distinguish between patients who were or were not inpatients before arrival. This is relevant to a patient's risk of bad outcomes.

The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.

Cross Checks

Data Integrity Checks (automatic list)

 AppStatus
Query check prev pre-admit consistentCCMDB.accdbimplemented
Function Validate Pre admit Inpatient InstitutionCCMDB.accdbimplemented
Check function preAdmit NE LocationCCMDB.accdbimplemented
Check Accept Loc ParkCCMDB.accdbretired
Link suspect mismatch pre inpt ours incomplete queryCentralized data front end.accdbimplemented
Link_suspect_not_same_visitAdmitDtTm queryCentralized data front end.accdbimplemented

Reports

The information is part of the Critical Care Program Quality Indicator Report and the ICU Interfacility Report. Also the information will be useful for research projects where it will mark a patient as inpatient before arrival to the unit or ward.

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes. Some of the data previously existed in hospital previous but it is not a 1-to-1 mapping.

Related articles

Related articles:
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