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Minutes from [[Team Meeting June 19, 2013]].
Minutes from [[Team Meeting June 19, 2013]].
#The plan for September collection meeting is to have [[p:Dr. Allan Garland]] to present general plans to database structure changes program has been working on.  Collectors are noting some small changes in their [[CCMDB.mdb]] and they are not sure why they are being done.
#The plan for September collection meeting is to have [[p:Dr. Allan Garland]] to present general plans to database structure changes program has been working on.  Collectors are noting some small changes in their [[CCMDB.accdb]] and they are not sure why they are being done.
===[[Central_Line_Related_Blood_stream_Infection_(CLR-BSI)]] Data Collection Criteria 2 issue===
===[[Central_Line_Related_Blood_stream_Infection_(CLR-BSI)]] Data Collection Criteria 2 issue===
# [[Central_Line_Related_Blood_stream_Infection_(CLR-BSI)]]
# [[Central_Line_Related_Blood_stream_Infection_(CLR-BSI)]]
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#*'''PLAN 1''':
#*'''PLAN 1''':
#**Take topic to ICU database Task team.
#**Take topic to ICU database Task team.
#**one '''SUGGESTION''': June 21.13; Trish has sent out an email to data collectors (including [[p:Dr. Allan Garland]] and Kendiss) to review and proposed we use the SAME wording for Criteria 2, make a 3rd criteria so wording is CLEARER for [[Central_Line_Related_Blood_stream_Infection_(CLR-BSI)| CLR_BSI]] as the [[CCVSM general information | Cross Canada Critical Care Vital Sign Montoring Project]].
#**one '''SUGGESTION''': June 21.13; Trish has sent out an email to data collectors (including [[p:Dr. Allan Garland]] and Kendiss) to review and proposed we use the SAME wording for Criteria 2, make a 3rd criteria so wording is CLEARER for [[Central_Line_Related_Blood_stream_Infection_(CLR-BSI)| CLR_BSI]] as the [[Critical Care Vital Signs Monitoring]].
#***'''Criteria 2'''  
#***'''Criteria 2'''  
#****One of:
#****One of:
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===TISS28 items 46-49 - 2300 hrs items===
===TISS28 items 46-49 - 2300 hrs items===
#[[:Category: TISS28 | TISS28]] is not only used to monitor bedside nurse workload trends, by administration and management, it is also used by [[CCVSM general information | CCVSM]] and ICU Quality Improvement team for research and monitoring for quality of patient care.
#[[:Category: TISS28 | TISS28]] is not only used to monitor bedside nurse workload trends, by administration and management, it is also used by [[Critical Care Vital Signs Monitoring]] and ICU Quality Improvement team for research and monitoring for quality of patient care.
#every 3-4 month the data collectors are asked to provide a summary of observed issues with completion of TISS forms.  This information feed back to ICU Nursing Director [[p:Jodi Walker Tweed]], review with the QI officer [[p:Basil Evan]], ICU managers in the region. Manager then review with their staff and QI Officer review with Nursing Educators.  
#every 3-4 month the data collectors are asked to provide a summary of observed issues with completion of TISS forms.  This information feed back to ICU Nursing Director [[p:Jodi Walker Tweed]], review with the QI officer [[p:Basil Evan]], ICU managers in the region. Manager then review with their staff and QI Officer review with Nursing Educators.  
#[[p:Julie Mojica]] presented a brief '''Comparative Analysis of TISS28 items 46-49 vs CRN Data collection'''  
#[[p:Julie Mojica]] presented a brief '''Comparative Analysis of TISS28 items 46-49 vs CRN Data collection'''  
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#*data collector at a site will be notificed not to edit or add to TISS28 for items 46-49 for a specific date by Trish.
#*data collector at a site will be notificed not to edit or add to TISS28 for items 46-49 for a specific date by Trish.
#Quality control of TISS data provided by bedside nurses continues to be a significant burden of workload on the data collector at each site.  The degree and amount of edits, additions, correction etc., varies from site to site.  Some collectors do a high degree of quality control on each TISS, others do minimal corrections. The degree of quality control required has not been specified therefore, not consistent, and is dependant on the collector who does it.
#Quality control of TISS data provided by bedside nurses continues to be a significant burden of workload on the data collector at each site.  The degree and amount of edits, additions, correction etc., varies from site to site.  Some collectors do a high degree of quality control on each TISS, others do minimal corrections. The degree of quality control required has not been specified therefore, not consistent, and is dependant on the collector who does it.
#RE: Long stay patient and turning in TISS form after second page is started: CCVSM and ICU QI team is wanting data sooner rather than later, particularily related to certain items on TISS.  There has been a request that collector not hold on to all the TISS forms until patient is discharged from unit if LOS is 10 days or more.  For some units this has been challenging that they are not able to do weekly QA check of TISS before submitting.  IF the ICU starts to accept TISS AS IS with missing days and incomplete data we would need a way on form and in TISS database tag this.   
#RE: Long stay patient and turning in TISS form after second page is started: [[Critical Care Vital Signs Monitoring]] and ICU QI team is wanting data sooner rather than later, particularily related to certain items on TISS.  There has been a request that collector not hold on to all the TISS forms until patient is discharged from unit if LOS is 10 days or more.  For some units this has been challenging that they are not able to do weekly QA check of TISS before submitting.  IF the ICU starts to accept TISS AS IS with missing days and incomplete data we would need a way on form and in TISS database tag this.   
#*'''Plan'''
#*'''Plan'''
#*discuss at ICU database Task meeting what should be the minimal standards of quality control on TISS forms?
#*discuss at ICU database Task meeting what should be the minimal standards of quality control on TISS forms?
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#**the independant TISS audit started in June 2013, to be reported and reviewed by Steering Commitee when it is completed.
#**the independant TISS audit started in June 2013, to be reported and reviewed by Steering Commitee when it is completed.


===[[:Category: OverstayProject | Overstay Project]] Bed day reduction in medicine program ===
=== Overstay Project Bed day reduction in medicine program ===
#Presented by [[Linda Hathout]]
#Presented by [[Linda Hathout]]
#approximate decrease in mean LOS of 2.1 days
#approximate decrease in mean LOS of 2.1 days
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#**ownership of problem and increase accountablity (transition coordinator)
#**ownership of problem and increase accountablity (transition coordinator)
#**excellent support from data collector at each site!
#**excellent support from data collector at each site!
#**reduction of panelling from hospitals and increase panelling from Home.  Better for patient to be panelled from home
#**reduction of [[paneling]] from hospitals and increase [[paneling]] from Home.  Better for patient to be panelled from home
#**increase supports as needed to enable patient to return to home
#**increase supports as needed to enable patient to return to home
#**reduction in number of unnecessary consults for home care and increase in number of appropriate consults
#**reduction in number of unnecessary consults for home care and increase in number of appropriate consults
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#[[p:Debbie Page-Newton]] Requested to have the stats for the number of bed days/beds saved as a result of the [[:Category:OverstayProject | OverstayProject]]. It would also be beneficial if someone could figure out what that translates to in terms of actual dollars and cents saved. I think that generally people can relate to, and are more impressed by the amount of money saved.
#[[p:Debbie Page-Newton]] Requested to have the stats for the number of bed days/beds saved as a result of the [[:Category:OverstayProject | OverstayProject]]. It would also be beneficial if someone could figure out what that translates to in terms of actual dollars and cents saved. I think that generally people can relate to, and are more impressed by the amount of money saved.


===[[Palliative Care]] ===
=== [[Palliative care]] ===
#as per [[Linda Hathout]] & [[p:Dr. Dan Roberts]] the [[Media:Discharge Planning Screening Tool.pdf | DPST]], should done for palliative care patients, and a color should be generated. (not sure what the final color was decided if GREEN or YELLOW?  It was Green by [[p:Dr. Dan Roberts]] first email.
#as per [[Linda Hathout]] & [[p:Dr. Dan Roberts]] the [[Media:Discharge Planning Screening Tool.pdf | DPST]], should done for palliative care patients, and a color should be generated. (not sure what the final color was decided if GREEN or YELLOW?  It was Green by [[p:Dr. Dan Roberts]] first email.
#*I could be wrong; my understanding is the color could be either green or yellow and coded according to the color generated by the algorithm.--[[User: Ppiche | Pamela Piche]]   
#*I could be wrong; my understanding is the color could be either green or yellow and coded according to the color generated by the algorithm.--[[User: Ppiche | Pamela Piche]]   
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#**'''EXCEPTION: Palliative care and DC TX:  if demise is imminent and anticipated within 24-36 hrs of unit admission then DO NOT complete''' the [[Media:Discharge Planning Screening Tool.pdf | DPST]].
#**'''EXCEPTION: Palliative care and DC TX:  if demise is imminent and anticipated within 24-36 hrs of unit admission then DO NOT complete''' the [[Media:Discharge Planning Screening Tool.pdf | DPST]].
#***one cannot estimate or make a judgement that a patient will for certain, die within 24-36 hrs, therefore fill out form as best you can if not certain.  If died and form was filled out, patient will be excluded from analysis and any work associated with discharge planning; well, there won't be any.   
#***one cannot estimate or make a judgement that a patient will for certain, die within 24-36 hrs, therefore fill out form as best you can if not certain.  If died and form was filled out, patient will be excluded from analysis and any work associated with discharge planning; well, there won't be any.   
#*PROPOSED: Add a '''subcode''' to code 90400 [[Palliative Care]]
#*PROPOSED: Add a '''subcode''' to code 90400 [[Palliative care]]
#**90401 Palliative Care - demise imminent within 24-36 hrs
#**90401 Palliative Care - demise imminent within 24-36 hrs
#*Collector must make sure that any patient admitted as Palliative or becomes Palliative after being admitted to your unit, you must include this code in your DX slots in [[CCMDB.mdb]] where appropriate.
#*Collector must make sure that any patient admitted as Palliative or becomes Palliative after being admitted to your unit, you must include this code in your DX slots in [[CCMDB.accdb]] where appropriate.


===Sending and copying DPST forms===
===Sending and copying DPST forms===
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[[Category: Minutes 2013]]
[[Category:Minutes 2013]]
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