Deceased patients: Difference between revisions

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This page ties together the different types of information we collect about deceased patients. Additional info might be in [[Category:End-of-life related data]] but not integrated here yet.  
This page ties together the different types of information we collect about deceased patients. Additional info might be in [[Category:End-of-life related data]] but not integrated here yet.  
{{DT | need to include [[LOS]] (sp exclude dead people) and [[Brain death]] (sp time used) in this. And [[Bed occupancy]]; LOS will not include brain deads, but bed occ. would.}}
{{DA | [[Dispo]] needs to be tweaked to
* Death - to OR
* Death - to ICU
* Death - to morgue
}}


== General instructions for deceased patients ==
== General instructions for deceased patients ==
* there might or might not be one of the [[:Category:Diagnosis implying death]]
*We always know that a patient died by virtue of the [[Dispo field]].  And data collectors record all diagnoses relevant to the admission.  Thus beyond those 2 items, we have no specific need to record death as a diagnosis EXCEPT for brain death in which the patient becomes an organ donor.
*There might or might not be one of the [[:Category:Diagnosis implying death]]
{{ListICD10Category | categoryName = Diagnosis implying death}}
{{ListICD10Category | categoryName = Diagnosis implying death}}
* the patient might become a [[Organ donor (organ/tissue donation by the donor)]]
* if the patient had been sent to a temporary location and was expected to return to the unit after the procedure, then the '''dispo is death'''.  If the person was NOT expected to return to the unit after the procedure, then the dispo is transfer to the procedure area, resp the next ward.


=== NOT organ donor ===
=== NOT organ donor ===
*'''[[Dispo]]''':  "Died - NOT organ donor"
*'''[[Dispo]]''':  "Died - to morgue"
*'''[[Dispo DtTm]]''': ''' time of death  
*'''[[Dispo DtTm]]''': ''' date and time of death''' - info is found in '''[[Patient Viewer Tab Cognos ADT2]] '''


=== organ donor ===
=== organ donor ===
*'''[[Dispo]]''':  "Died - organ donor"
See [[Guideline for coding organ donation after death]]
** ie don't code that pt was discharged to the OR or another ICU
<!-- as discussed ICU Database Task Group Meeting – April 9, 2019 -->
 
*'''[[Dispo DtTm]]''': '''sent from ICU to the operating room or to another ICU'''
** ie don't code the time of death
{{DA |
* Is that really what we want? It will give occupancy but miss actual time of death. }}


==== Organ donors moving between sites ====
=== Death at temporary location ===
Our data structure allows us either to know that a pt died or that they went to e.g. the OR. What do we want to know more. As of 2019-04-10, we code that they are dead, but not where they went.
See [[Visits to temporary locations]]
* presumably organ donation always happens in an OR. So, pt would always have [[Dispo]] OR when sent for organ donation. But if that's true, then when do we ever use [[Dispo]] = "Died - organ donor"? The way I read [[Dispo_field#deceased_patients]] we would not code the OR/ICU, but the desire for this cross-check makes me wonder if we are all on the same page about this. Collectors, do you ever code OR/ICU as dispo for a brain dead organ donor? Julie, do you ''expect'' to see them coded as that? (emailed Julie and collectors) Ttenbergen 16:45, 2018 November 24 (CST)
** After our discussion in the office about this, one option to capture both deaths and transfers is to add  "Died organ donor - to OR" and "Died organ donor - to ICU" to the [[Dispo_field]] and  remove the "Died - organ donor" - are there any other locations need to be added where organ donor goes to? Then the [[Dispo_DtTm]] = date and time left the unit or ward. In this way, the mortality counts can be made without looking at the ICD10 diagnosis; the linking or flow of transfers can be done with correct dispo location; the occupancy will be correct.  For these cases, [[Dispo_DtTm]] does not necessarily mean death date.  But this is fine since we are working to get the data of death dates from the  project 'Data Sharing  with WRHA'.  We thought of bringing this to Task but I think this option is workable for every one. --[[User:JMojica|JMojica]] 15:22, 2018 November 28 (CST)
*** Allan is fine with this. Ttenbergen 10:16, 2018 December 28 (CST)
*When there is a braindead patient waiting for transplant we always put dispo to OR once they go there.  Putting the time of death as the time of braindeath will not work because we continue to look after the patient for quite a while after the pronouncement  of braindeath (even for 1 or 2 days or more).  The tiss extends longer and there are interventions that we code after braindeath.  If we put died: organ donor for these patients, what time would we put there as the actual time of death?? --[[User:LKolesar|LKolesar]] 05:31, 2018 November 26 (CST)
*I have been following the instruction on the [[Organ Donor]] page, so the dispo location is "died - organ donor" and the date/time is when the patient leaves to the OR. For these patients I don't put the actual time of death, but in ICD10 we can put the date for [[Brain death]] and [[Sudden cardiac death (and died)]]  --[[User:Jvelasco|Jvelasco]] 08:29, 2018 November 26 (CST)
* If we don't need the actual time when all organs stop working (whole body death), then this will work but I would suggest the wording for dispo be only "organ donation" and take out the word "died".  The death does not actually happen in the unit but it happens during the harvest of organs in the OR. Putting death as the time to the OR is not accurate as the time of death. The OR probably documents the time of actual death although I am not sure of this. --[[User:LKolesar|LKolesar]] 13:51, 2018 November 28 (CST)
*  I also use the dispo location "died - organ donor" when pt leaves to OR using that time as time of death.  Pts can be in ICU for days after brain death is declared. --[[User:Llovell|Llovell]] 11:03, 2018 November 26 (CST)
* We don't often see this at the Grace because they are transferred out to another facility if they are an organ donor, but I do not code the braindeath as the time of disposition, I would code it as a complication and the disposition date and time would be the transfer to another facility [[User:Lkaita|Lisa Kaita]] 10:15, 2018 November 27 (CST)


{{DT|
=== Entries in [[CSS]]/[[Using Cognos2 to keep track of patients]] ===
* once addressed we need to change [[Check dx implying death must be dispo deceased]]   }}
* deceased
{{DT |
* "ED Death after Arrival" for [[EMIP]]s
* [[Correcting suspect links]] also needs to be dealt with when this is done. And needs to be documented.}}


== Data prior to death (even if pt did not die on our ward) ==
== Data prior to death (even if pt did not die on our ward) ==
=== Decisions about end of life care ===
=== Decisions about end of life care ===
* [[ACP C]]
* [[ACP-C]]


=== End of life care ===
=== End of life care ===
* [[Comfort Care]]
* [[DC Treatment]]
* [[DC Treatment]]
* [[Hospice]]
* [[Hospice]]
* [[Palliative care]]
{{palliative patient}}


=== MAID ===
=== MAID ===
Line 60: Line 34:
== Data about patients who did die ==
== Data about patients who did die ==
* [[APACHE physiological variable collection#Patient DIED shortly after arriving in unit]]
* [[APACHE physiological variable collection#Patient DIED shortly after arriving in unit]]
=== Not organ donors ===
* [[Dispo DtTm field]]
* [[Dispo DtTm field]]
* [[Dispo field]]
* [[Dispo field]]
** entries "Died - NOT organ donor" or "Died - organ donor"


=== Organ Donation ===
=== Organ donors ===
* Possibly but not always (could be live donor): [[Organ donor (organ/tissue donation by the donor)]]
* see [[Guideline for coding organ donation after death]]


=== [[:Category:Diagnosis implying death]] ===
=== [[:Category:Diagnosis implying death]] ===
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always = click expand to see legacy info
always = click expand to see legacy info
| full =  
| full =  
* [[ACP Status collection in ICU]]
* [[ACP Status Collection in ICU]]
* [[Palliative Service]]
* [[Palliative Service]]
* [[Medical Assistance In Dying (old)]]
* [[Medical Assistance In Dying (old)]]

Latest revision as of 12:08, 7 August 2025

This page ties together the different types of information we collect about deceased patients. Additional info might be in but not integrated here yet.

General instructions for deceased patients

  • We always know that a patient died by virtue of the Dispo field. And data collectors record all diagnoses relevant to the admission. Thus beyond those 2 items, we have no specific need to record death as a diagnosis EXCEPT for brain death in which the patient becomes an organ donor.
  • There might or might not be one of the Category:Diagnosis implying death
Diagnosis implying death codes:

NOT organ donor

organ donor

See Guideline for coding organ donation after death

Death at temporary location

See Visits to temporary locations

Entries in CSS/Using Cognos2 to keep track of patients

  • deceased
  • "ED Death after Arrival" for EMIPs

Data prior to death (even if pt did not die on our ward)

Decisions about end of life care

End of life care

MAID

Data about patients who did die

Not organ donors

Organ donors

Category:Diagnosis implying death

Diagnosis implying death codes:

Data Integrity Checks (automatic list)

 AppStatus
Query check ICD10 dx implying death must have appropriate dispoCCMDB.accdbimplemented
Query NDC dx implying death across encountersCentralized data front end.accdbimplemented
Link suspect dead then alive queryCentralized data front end.accdbimplemented

Legacy info

click expand to see legacy info   
Related articles:
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