Boarding Loc: Difference between revisions

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{{DT | ~~Need~~ to start ~~page~~ about ~~contingency~~ locations as ~~discussed~~ in team ~~meeting~~. ~~To take over from~~ [[Project Borrow arrive]]. }}

{{Project

|ProjectActive=active

|ProjectProgram=CC and Med

|ProjectRequestor=internal

|ProjectCollectionStartDate=2019-Sep-20

|Project=Boarding Loc

}}

This isn't so much a project as way to track how patients physically move around the hospital. See [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]] for information about it and why we needed to change it to this model.

This project tracks where and when a patient '''arrives''' into a new physical location under the Medicine or ICU service.

== Data Collection Instructions ==

=== Sources for Boarding Loc DtTm ===

==== [[CSS]] / [[Cognos2 Unit Starter]] ====

Usually the Cognos Unit start time from [[CSS]] or [[Cognos2 Unit Starter]] can be used as [[Boarding Loc]].

* sometimes the first [[Service tmp entry]] and first and second [[Boarding Loc]] all have the same date and time; see [[#Special Case - Can't have two Boarding Locs with same DtTm]]

==== First set of vital signs for CC ====

[[ICU Curriculum]]: The first set of vital signs is used as [[Boarding Loc]] dttm for arrival on the unit for [[Critical Care program]] admissions, if it is different from the Cognos Unit Start DtTm.

==== Erroneous Unit information in [[CSS]]/[[Cognos2 Unit Starter]] ====

Sometimes the times are not when people really show up at a location. Use what you know to be correct from chart and your knowledge of your hospital.

=== How to enter ===

You can use the [["make loc" button]] to generate and pre-populate these entries.

*Use tmp fields:

** Project: '''{{PAGENAME}}'''

** start_dt and start_tm:

*** enter as per Cognos initially

*** before setting [[RecordStatus]] to complete update the DtTm to comply with [[DtTm for First Boarding Loc and First Service]]

** checkbox: not used for this project

** Item:

*** for the initial unit or ER and each physical move to another unit, enter the location by using the "make loc" button in [[Patient Viewer Tab Cognos ADT2]]

*** if a boarding location appears in COGNOS but the patient does NOT move/arrive to that boarding location, do NOT enter that boarding location. We only capture boarding locations where the patient physically arrives (also see [[Wrong service or unit entries in Cognos]])

**** if the ward is not available in the dropdown, please notify Tina, Lisa, and Julie; Tina/Lisa will add the location to the dropdown and update the wiki as needed

{{Discuss |

**** leave what is in Cognos, the main office doesn't use this part for anything for home locations, but it can be used to crosscheck accuracy.

***** what is this about? [[User:Ttenbergen|Ttenbergen]] 17:42, 19 August 2025 (CDT)

}}

* '''no location entered''' is the default

** that entry will not be allowed in a complete record; it is automatically deleted when by Cognos Make Loc button, but needs to be removed before setting a record to complete if it is still present.

<!--

*emailed to see if this automatic entry is still useful now that things are entered with make loc button [[User:Ttenbergen|Ttenbergen]] 13:05, 2023 January 25 (CST)

** We discussed this and decided to leave for now, as we don't manually delete it is populated by COGNOS when we choose the Make location button [[User:Lkaita|Lisa Kaita]] 13:59, 2023 February 1 (CST) -->

{{Combined instructions for Transfer Ready DtTm and Boarding Loc}}

==== Special Case - Can't have two Boarding Locs with same DtTm ====

* No two different [[Boarding Loc]] records can have same start_dt and start_tm; if two locations have the same Start_DtTm in [[CSS]]/[[Cognos2 Unit Starter]] this is an error.

* The date and time for these entries must be confirmed by looking at the chart, specifically orders, flowsheets, and progress notes

{{DJ | It says:

* Change one to be off by one minute, put a note in [[Notes field]] to check boarding location to confirm the correct date and time for the boarding locations of concern.

** how does that fit in with reviewing reality in the chart?

** I don't know what you mean by this? It means you double check the correct first service and first and second boarding loc dttm [[User:Lkaita|Lisa Kaita]] 21:14, 6 September 2025 (CDT)

*** Well, it seems like this triggers an error check, so you pull the times a minute apart to overcome the error check and put a note to remind you to check later. So either the check should run later (on complete or send) or we shouldn't have it at all. But a check that just gets you to "tweak" the data to make it go away isn't a good idea.

* sure if you can have the cross check on completion that would be better, the prior scenario is almost always for SICU admissions from ER [[User:Lkaita|Lisa Kaita]] 15:51, 26 November 2025 (CST)

** Julie, do you use Boarding Loc info on incomplete charts? Would either the current collection practice, or delaying the check, mess with measures or indicators? [[User:Ttenbergen|Ttenbergen]] 22:09, 26 November 2025 (CST)

}}

* This case is especially common in the context of [[DtTm for First Boarding Loc and First Service]]

{{Ex |

* Example: Not infrequently, the COGNOS data for HSC_SICU patients coming from the ER will show the first service, first boarding location (ER) and the second boarding location (SICU) as all having the same start_DtTm. Our solution for this is to change the second boarding location (SICU) to be off by one minute.

}}

==== Special Case - GRA MICU boarding in GH-Emergency ====

''This is a case of [[Patients who appear to transfer from in-patient situation to Emergency Room]], see there for more info.

* Grace ICU boarding in ER choose Boarding Location GH-Emergency

* Grace Main ICU choose Boarding Location and GH-Intensive Care

* Grace Recovery Room (ICU) choose Boarding Location and [[GH-Recovery Room]] and enter comment Covid+ICU

* For External(SDC/NFA) ICU beds choose Boarding Loc and GH-External ICU and enter exact location in comments

* The [[Previous Location]] and [[Pre-admit Inpatient Institution]] would be <site>_med or <site>_ward

=== Special Case - Cross-program boarding ===

If a patient is accepted by one of our services, and is on an off-service ward, enter a [[Boarding Loc]] entry for that period.

'''For medicine pts boarding in ICU''' you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc.

{{DJ|

what is this sentence telling me, can I not use the specific medicine entry? Why/how? What would a new collector need to know?

* I have no idea, I suppose this can happen although I have not ever seen this at any of the facilities, I believe you were the original author of this so feel free to do what you want with this [[User:Lkaita|Lisa Kaita]] 13:46, 6 August 2025 (CDT)

** Julie, do you know what this is about? If the same applies for Med as for ICU in this, then lets get rid of the confusing entry. [[User:Ttenbergen|Ttenbergen]] 17:23, 6 August 2025 (CDT)

*** we have one case S4_STB_Med-2892 where first3 days at SBGH ICMS then transferred to SBGH-L2CC.--[[User:JMojica|JMojica]] 16:42, 18 August 2025 (CDT)

**** What else would they use? The entry would come from Cognos, no? It's entered by drop-down, so I don't think they could enter anything but the actual entry. Is this stated here really as a reminder for you, in case this happens again? If so, would it be better to store it in L_Problems table? If it is an instruction to collectors, would you explain further what you actually intend? [[User:Ttenbergen|Ttenbergen]] 17:33, 19 August 2025 (CDT)

}}

'''For CC patients boarding on a Med ward where we collect''', enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only for [[Critical Care program]] admissions.

{{Ex | This could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med" "<Site>_Med" (ie [[GRA_Med]], [[HSC_Med]], [[STB_Med]]) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are.}}

=== Special Case - [[Visits to temporary locations]] that happen to be Boarding Locs ===

Occasionally a patient may be transferred to a location that is normally a [[Boarding Loc]] that we would enter or discharge to, however that location may be used as a temporary boarding location for a procedure. If after reading through the chart this is in fact the case, that [[Boarding Loc]] should not be entered, as it should be regarded as though the patient were going for any procedure and then back to their home ward location.

*Sometimes [[Visits to temporary locations]] may look like boarding locations. See that page for info on making the distinction.

{{Ex|

Medicine patient is transferred to ICMS for a scope and is not admitted under critical care -> don't enter a [[Boarding Loc]] for ICMS

}}

=== Special Case - parked in ER ===

For further information please see

* [[Parked in ER]]

== Start/End Dates of collection ==

*CC Start: 2018-July-19 as [[Project Borrow arrive]] and has been renamed and continued as Boarding Loc starting 2019-Sep-01

*Med Start: 2019-Sep-01: new admissions on and after this date.

*CC and Med Start Oct,1 2020 : modified according to [[PatientFollow Project]] to include ER as boarding loc.

* 2020-12-16: [[Change of GRA location names from "our" names to EPR/Cognos names]]

* 2022-01-01: [[Change of remaining location names from "our" names to EPR/Cognos names]]

*End: there is no planned end date

== Data Use ==

Critical care and Medicine programs want to know this to better understand patient flow and bed utilization.

=== SAS Program ===

The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.

::Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time

::: where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.

The SAS program is saved in S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas.

*the specific macros are %BoardingLoc, %ACCUBorrow, %ICUOtherService

== Background ==

See [[Bed borrow]] as aggregator page for other boarding and borrow related concepts.

The concept of [[EMIP]]s which was similar from [[Bed borrow]] and collected separately before are now collected as part of [[Boarding Loc]]. See [[EMIP#Legacy information]] information for how they were collected before/

==Related articles ==

[[Category:L TmpV2 Data]]

[[Category:Project]]

[[Category:Overflow]]

[[Category:EMIP]]

[[Category:PatientFollow Project]]

[[Category:Admit/Discharge]]

@@ Line 1: / Line 1: @@
-{{DT | Need to start page about contingency locations as discussed in team meeting. To take over from [[Project Borrow arrive]]. }}
+{{Project
+|ProjectActive=active
+|ProjectProgram=CC and Med
+|ProjectRequestor=internal
+|ProjectCollectionStartDate=2019-Sep-20
+|Project=Boarding Loc
+}}
+This isn't so much a project as way to track how patients physically move around the hospital. See [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]] for information about it and why we needed to change it to this model.
+This project tracks where and when a patient '''arrives''' into a new physical location under the Medicine or ICU service.
+== Data Collection Instructions ==
+=== Sources for Boarding Loc DtTm ===
+==== [[CSS]] / [[Cognos2 Unit Starter]] ====
+Usually the Cognos Unit start time from [[CSS]] or [[Cognos2 Unit Starter]] can be used as [[Boarding Loc]].
+* sometimes the first [[Service tmp entry]] and first and second [[Boarding Loc]] all have the same date and time; see [[#Special Case - Can't have two Boarding Locs with same DtTm]]
+==== First set of vital signs for CC ====
+[[ICU Curriculum]]: The first set of vital signs is used as [[Boarding Loc]] dttm for arrival on the unit for [[Critical Care program]] admissions, if it is different from the Cognos Unit Start DtTm.
+==== Erroneous Unit information in [[CSS]]/[[Cognos2 Unit Starter]] ====
+Sometimes the times are not when people really show up at a location. Use what you know to be correct from chart and your knowledge of your hospital.
+=== How to enter ===
+You can use the [["make loc" button]] to generate and pre-populate these entries.
+*Use tmp fields:
+** Project: '''{{PAGENAME}}'''
+** start_dt and start_tm:
+*** enter as per Cognos initially
+*** before setting [[RecordStatus]] to complete update the DtTm to comply with [[DtTm for First Boarding Loc and First Service]]
+** checkbox: not used for this project <!-- was used for [[cross check]]s in data before 2020-10-15 -->
+** Item:
+*** for the initial unit or ER and each physical move to another unit, enter the location by using the "make loc" button in [[Patient Viewer Tab Cognos ADT2]]
+*** if a boarding location appears in COGNOS but the patient does NOT move/arrive to that boarding location, do NOT enter that boarding location.  We only capture boarding locations where the patient physically arrives (also see [[Wrong service or unit entries in Cognos]])
+**** if the ward is not available in the dropdown, please notify Tina, Lisa, and Julie; Tina/Lisa will add the location to the dropdown and update the wiki as needed
+{{Discuss |
+**** leave what is in Cognos, the main office doesn't use this part for anything for home locations, but it can be used to crosscheck accuracy.
+***** what is this about? [[User:Ttenbergen|Ttenbergen]] 17:42, 19 August 2025 (CDT)
+}}
+* '''no location entered''' is the default
+** that entry will not be allowed in a complete record; it is automatically deleted when by Cognos Make Loc button, but needs to be removed before setting a record to complete if it is still present.
+<!--
+*emailed to see if this automatic entry is still useful now that things are entered with make loc button [[User:Ttenbergen|Ttenbergen]] 13:05, 2023 January 25 (CST)
+** We discussed this and decided to leave for now, as we don't manually delete it is populated by COGNOS when we choose the Make location button [[User:Lkaita|Lisa Kaita]] 13:59, 2023 February 1 (CST) -->
+{{Combined instructions for Transfer Ready DtTm and Boarding Loc}}
+<!-- the above are general instructions, put any special case info below here -->
+==== Special Case - Can't have two Boarding Locs with same DtTm ====
+* No two different [[Boarding Loc]] records can have same start_dt and start_tm; if two locations have the same Start_DtTm in [[CSS]]/[[Cognos2 Unit Starter]] this is an error.
+* The date and time for these entries must be confirmed by looking at the chart, specifically orders, flowsheets, and progress notes
+{{DJ | It says:
+* Change one to be off by one minute, put a note in [[Notes field]] to check boarding location to confirm the correct date and time for the boarding locations of concern.
+** how does that fit in with reviewing reality in the chart?
+** I don't know what you mean by this?  It means you double check the correct first service and first and second boarding loc dttm [[User:Lkaita|Lisa Kaita]] 21:14, 6 September 2025 (CDT)
+*** Well, it seems like this triggers an error check, so you pull the times a minute apart to overcome the error check and put a note to remind you to check later. So either the check should run later (on complete or send) or we shouldn't have it at all. But a check that just gets you to "tweak" the data to make it go away isn't a good idea.
+* sure if you can have the cross check on completion that would be better, the prior scenario is almost always for SICU admissions from ER [[User:Lkaita|Lisa Kaita]] 15:51, 26 November 2025 (CST)
+** Julie, do you use Boarding Loc info on incomplete charts? Would either the current collection practice, or delaying the check, mess with measures or indicators? [[User:Ttenbergen|Ttenbergen]] 22:09, 26 November 2025 (CST)
+}}
+* This case is especially common in the context of [[DtTm for First Boarding Loc and First Service]]
+{{Ex |
+* Example: Not infrequently, the COGNOS data for HSC_SICU patients coming from the ER  will show the first service, first boarding location (ER) and the second boarding location (SICU) as all having the same start_DtTm. Our solution for this is to change the second boarding location (SICU) to be off by one minute.
+}}
+==== Special Case - GRA MICU boarding in GH-Emergency ====
+''This is a case of [[Patients who appear to transfer from in-patient situation to Emergency Room]], see there for more info.
+* Grace ICU boarding in ER choose Boarding Location GH-Emergency
+* Grace Main ICU choose Boarding Location and GH-Intensive Care
+* Grace Recovery Room (ICU) choose Boarding Location and [[GH-Recovery Room]] and enter comment Covid+ICU
+* For External(SDC/NFA) ICU beds choose Boarding Loc and GH-External ICU and enter exact location in comments
+* The [[Previous Location]] and [[Pre-admit Inpatient Institution]] would be <site>_med or <site>_ward
+=== Special Case - Cross-program boarding ===
+If a patient is accepted by one of our services, and is on an off-service ward, enter a [[Boarding Loc]] entry for that period.
+'''For medicine pts boarding in ICU''' you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc.
+{{DJ|
+what is this sentence telling me, can I not use the specific medicine entry? Why/how? What would a new collector need to know?
+* I have no idea, I suppose this can happen although I have not ever seen this at any of the facilities, I believe you were the original author of this so feel free to do what you want with this [[User:Lkaita|Lisa Kaita]] 13:46, 6 August 2025 (CDT)
+** Julie, do you know what this is about? If the same applies for Med as for ICU in this, then lets get rid of the confusing entry. [[User:Ttenbergen|Ttenbergen]] 17:23, 6 August 2025 (CDT)
+*** we have one  case S4_STB_Med-2892 where first3 days at SBGH ICMS then transferred to SBGH-L2CC.--[[User:JMojica|JMojica]] 16:42, 18 August 2025 (CDT)
+**** What else would they use? The entry would come from Cognos, no? It's entered by drop-down, so I don't think they could enter anything but the actual entry. Is this stated here really as a reminder for you, in case this happens again? If so, would it be better to store it in L_Problems table? If it is an instruction to collectors, would you explain further what you actually intend?  [[User:Ttenbergen|Ttenbergen]] 17:33, 19 August 2025 (CDT)
+}}
+'''For CC patients boarding on a Med ward where we collect''', enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only for [[Critical Care program]] admissions.
+{{Ex | This could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med"  "<Site>_Med" (ie [[GRA_Med]], [[HSC_Med]], [[STB_Med]]) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are.}}
+=== Special Case - [[Visits to temporary locations]] that happen to be Boarding Locs ===
+Occasionally a patient may be transferred to a location that is normally a [[Boarding Loc]] that we would enter or discharge to, however that location may be used as a temporary boarding location for a procedure.  If after reading through the chart this is in fact the case, that [[Boarding Loc]] should not be entered, as it should be regarded as though the patient were going for any procedure and then back to their home ward location.
+*Sometimes [[Visits to temporary locations]] may look like boarding locations. See that page for info on making the distinction.
+{{Ex|
+Medicine patient is transferred to ICMS for a scope and is not admitted under critical care -> don't enter a [[Boarding Loc]] for ICMS
+}}
+=== Special Case - parked in ER ===
+For further information please see
+* [[Parked in ER]]
+{{Boarding Loc, Service content}}
+== Start/End Dates of collection ==
+*CC Start: 2018-July-19 as [[Project Borrow arrive]] and has been renamed and continued as Boarding Loc starting 2019-Sep-01
+*Med Start: 2019-Sep-01: new admissions on and after this date.
+*CC and Med Start Oct,1 2020 : modified according to [[PatientFollow Project]]  to include ER as boarding loc.
+* 2020-12-16: [[Change of GRA location names from "our" names to EPR/Cognos names]]
+* 2022-01-01: [[Change of remaining location names from "our" names to EPR/Cognos names]]
+*End: there is no planned end date
+{{Data Integrity Check List}}
+== Data Use ==
+Critical care and Medicine programs want to know this to better understand patient flow and bed utilization.
+=== SAS Program ===
+The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.
+::Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time
+::: where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.
+The SAS program is saved in S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas.
+*the specific macros are %BoardingLoc, %ACCUBorrow, %ICUOtherService
+== Background ==
+See [[Bed borrow]] as aggregator page for other boarding and borrow related concepts.
+The concept of  [[EMIP]]s  which  was similar from [[Bed borrow]] and collected separately before are now collected as part of [[Boarding Loc]]. See [[EMIP#Legacy information]] information for how they were collected before/
+==Related articles ==
+{{Related Articles}}
+[[Category:L TmpV2 Data]]
+[[Category:Project]]
+[[Category:Overflow]]
+[[Category:EMIP]]
+[[Category:PatientFollow Project]]
+[[Category:Admit/Discharge]]