Deceased patients: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
← Older edit
m →Organ donors moving between sites: Moved concern about how this would affect TISS to Guideline for coding organ donation after death; cleared out current state info on how people code pt transferred to other site for donation.
 
(23 intermediate revisions by 4 users not shown)
Line 1: Line 1:
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 | [[Dispo]] needs to be tweaked to
* Death - to OR
* Death - to other ICU
* Death - to morgue
}}
{{DA|
* What about the tiss score sheet, it extends beyond LOS then in these cases?  There are significant interventions done by the nurses after braindeath, hopefully we can complete the tiss to the end of bed occupancy? Just checking.--[[User:LKolesar|LKolesar]] 14:06, 2019 May 2 (CDT)
** AKA [[Query TISS Errors NrTISSDays NE LOS]]; [[Query TISS Errors missing days]]; [[Query TISS Errors TISS date out of admission]] }}
== New Rules (as of April 2019) Regarding Brain death and Organ Donation ==
*For a patient who develops [[Brain death]] in location A, and then transfers to location B for further evaluation for organ donation
**In location A the patient will have an acquired diagnosis of [[Brain death]], and their dispo will be '''Death with transfer to another ICU'''.  The [[LOS]] in location A will be time from admit to [[Brain death]].  Any time spent in location A after [[Brain death]] will be counted towards occupancy but not [[LOS]].
**In location B the patient will have admit diagnosis of [[Brain death]], and their dispo will be '''Death with transfer to OR for organ donation''' IF they go for donation and '''Death with transfer to morgue''' if not.  While all of this time will be included in occupancy, none of it will be included in [[LOS]] (since the person was not alive). 
**In the unusual situation where the patient goes directly from location A (an ICU) to the OR of another/different hospital for organ harvesting, the dispo for location A will be '''Death with transfer to OR for organ donation'''
**Regarding death rates in these records
***It’s necessary to avoid double counting the death in location A and location B.
*For a patient who is not yet brain dead in location A and then transfers to location B with expectation of near-future [[Brain death]] or Donation after Cardiac Death (DCD)
**In location A the dispo will be transfer to location B.  The record in location B will have admit diagnoses of whatever is present.  IF that person develops [[Brain death]] in location B, then that will be coded as an acquired diagnosis.
**If the patient develops [[Brain death]] in location B, then the [[LOS]] in location B will only be the time from admit to [[Brain death]].  For calculating this patient’s total [[LOS]], it will be the entire time in location A + the time in location B until [[Brain death]]. 
*For a patient who is in one location (e.g. MICU), where he develops [[Brain death]], and then stays in that location to be evaluated/optimized for being an organ donor
**[[Brain death]] will be an acquired diagnosis.  [[LOS]] will only be the time from admit to [[Brain death]].  Time after [[Brain death]] will be counted towards occupancy but not [[LOS]]. 
**The dispo will be '''Death with transfer to OR''' for organ donation IF they go for donation and '''Death with transfer to morgue''' if not.


== 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]]''':  "Death - to morgue"
*'''[[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 ===
See [[Guideline for coding organ donation after death]]
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 [[EMIP]]s


== 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 70: Line 50:
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 11:08, 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
Link suspect dead then alive queryCentralized data front end.accdbimplemented
Query NDC dx implying death across encountersCentralized data front end.accdbimplemented

Legacy info

click expand to see legacy info   

Related articles

Related articles:
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Deceased_patients&oldid=167311"