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{{Project
{{Project
| Project = {{PAGENAME}}
|ProjectActive=active
| ProjectActive = planned
|ProjectProgram=Med
| ProjectProgram = Med
|ProjectRequestor=Dan Roberts
| ProjectRequestor = Dan Roberts
|ProjectCollectionStartDate=2025-07-02
| ProjectCollectionStartDate = '''within the next few weeks'''
|ProjectCollectionStopDate=continuous
| ProjectCollectionStopDate = continuous
|Project={{PAGENAME}}
}}  
}}
''' Not live yet! '''
Currently only active at GRA
 
This page contains the collection instructions and the data description for the Overstay2 project. For other information, see [[Overstay2 Overview]].
This project is one of the [[Vacation and staff shortage collection priorities]].


== Data Collection ==
== Data Collection ==
For any medicine record, enter the [[Minimal dataset]] +  
=== Sticker ===
* ADLs ([[ADL General Collection Information]])
* The colour generated in this process is communicated with the ward
* [[Pre acute living situation]] (re nursing home)
** an "overstay sticker" on the paper name insert of the chart located within the spine sleeve of the patient's chart
* [[Province]] (although we could use the [[Postal Code]] instead)
** on the [[DPST]] form
* The ward clerk will have stickers "top drawer" and will provide them to collectors on request
* When I talked with Andrea Thiessen at implementation time she said there was no SOP for the clerk yet, but that she would add this when they set it up. Until we hear it's set up it might be good to flag when you run low on the stickers.
 
=== Regular data required in addition to Minimal Data Set ===
For each [[Definition of a Medicine Program Admission|Medicine Program Admission]], enter the [[Minimal dataset]] +  
* [[ADL General Collection Information|ADLs ]]
* [[Pre acute living situation]] - to know if they came from a ([[Personal Care Home]] or [[Chronic Health Facility]]) or [[Homeless]]
{{DJ|
* We have had patients admitted from the chronic care unit at DLC (they live there) the nurses check off PCH for where they reside (on DPST), for [[Pre acute living situation field]] we enter [[Chronic Health Facility]] and for dispo we enter [[Deer Lodge (DLC)|Deer Lodge]], should we be considering this a PCH? as per instructions on DPST they do not continue the DPST form [[User:Lkaita|Lisa Kaita]] 12:35, 24 November 2025 (CST)
** [[Data definition for factor candidates for the Overstay2 project]] shows we are using PCH and Chronic Care as a group, they contribute equally to the score. The entry for [[Deer Lodge (DLC)]] in [[s_dispo table]] has [[s_dispo.loc_type]] "PCH", so entering Deer Lodge will also group this consistently. I am not sure that answers your question, though... should we consider it PCH for collection or data use purposes? If it is always clear when a patient comes from the Chronic Care part of DLC then maybe we should break this out? [[User:Ttenbergen|Ttenbergen]] 22:25, 26 November 2025 (CST)
* yes that answers my question, for the most part we can figure it out through the notes, lets leave collection as is.  If you are ok with this lets take it off the JALT list [[User:Lkaita|Lisa Kaita]] 09:06, 17 December 2025 (CST)
* Agreed it doesn't need to be on JALT. I will keep it around as a comment because it's part of the whole [[Chronic Health Facility]] issue. [[User:Ttenbergen|Ttenbergen]] 11:44, 17 December 2025 (CST)
}}
* [[Previous Location]]
* [[Glasgow Coma Scale]]
* [[Glasgow Coma Scale]]
* any [[Admit Diagnoses]] contributing to the [[Charlson ...]] of
* Any [[Admit Diagnosis]], [[Comorbid Diagnosis]] or [[CCI]] codes
* Charlson dxs in "Chronic pulmonary disease", "Congestive heart failure", "Rheumatic disease", "Renal disease"
 
{{#ask: [[-Has subobject::Charlson Comorbidities in ICD10 codes]][[Charlson_component::Chronic pulmonary disease||Congestive heart failure||Rheumatic disease||Renal disease]]
=== The {{DPST form}} ===
|?Charlson_ICD10Code=ICD10 code
Ward staff has a full 24 hours to complete the {{DPST form}} as part of [[Overstay2 Overview#Patient Admission]], '''before the 24 hours are up the {{DPST form}} may be incomplete and should not be scored yet'''. They will file it in the '''Legal Section behind the pink Patient Demographics Sheet''' of the chart and put a ''green'' [[#sticker]] if the answers to the 6 main questions are all "yes".  
|?Charlson_ICD10Description=Diagnosis description
 
|?Charlson_component=Charlson component
Data collectors will assess the {{DPST form}} {{Overstay2 data collector timeline}} and generate an [[Overstay2 colour]] according to these instructions.
|sort=Charlson_component, Charlson_ICD10Code
 
|order=ascending
There will be one {{DPST form}} for the record per hospitalization and the unit will make sure the colour is re-applied.  
|format=table
 
|limit=500
==== Data Entry Instructions ==== 
|mainlabel=-
* A line is automatically created for [[medicine program]] admission at [[#Dates | a site where this project is active]] for ''Overstay2 DPST'' with Item "not yet entered". Update that line as follows:
}}
** '''Project''': '''Overstay2 DPST'''
** '''Item''':
*** '''green''' - enter if there is a green [[#sticker]]
*** '''green problem''' - 6xyes but missing sticker, date or name; if it's clear it should be green use this, else use the ''problem'' entry; also see ''comment'' entry
**** this was initially coded differently, see [[#data interpretation]]
*** '''non-green''' - enter if you check the [[File:DPST GGH.pdf]] and it filled out appropriately (not a ''problem'' entry) but has at least one "no" and is therefore an appropriate non-green
*** '''continued''' - not first medicine admission, so DPST and colour from first admission stay
*** '''problem''' - any '''one''' of the following is true; also see ''comment'' entry
**** missing {{DPST form}} '''after 24 hrs'''
**** {{DPST form}} with any of the 6 questions not filled as y/n (incl. if one of the answers is "n", ie this takes precedent over ''non-green''
**** all other scenarios
**** we don't expect collectors to fix this, and the algorithm will treat "problem" like "non-green" to generate a yellow or red [[Overstay2 colour]]
** '''Date''': Date on the {{DPST form}}, or best guess if missing
** '''comment''': if ''problem'' or ''green problem'' put short cue what was wrong, eg. no sticker, incomplete etc
** time, integer, real, checkbox not used
 
== Generating the [[Overstay2 colour]] ==
* Once the above data has been entered, click the "OS" button on the [[Patient Viewer]]. This will run [[Overstay2 module | the colour generator]]. The button will change colour, or there will be an error.
** If any of the [[Data definition for factor candidates for the Overstay2 project|patient conditions]] that are [[Overstay2 scoring models|parameters of the model]] change after admission, '''do not generate a new colour''', only the initial conditions are relevant for this project.
*  Put a ''yellow'' or ''red'' [[#sticker]]
* For those profiles that were entered as a problem because the only error was missing a green sticker, the algorithm will generate a different color, but place a green [[#sticker]] on the spine of the chart
 
== [[Overstay2 Screening Reports]] ==
See  [[Overstay2 Screening Reports]]
 
== Special Cases  ==
=== Possible Scenario - colour change due to data entry error ===
'''The only case where the colour should be changed is if the data-collector made a error on data entry. Don't change colour because data becomes available after the initial assessment window.'''
 
If you realize you made a data entry error and you have fixed it, you can click the Overstay button again. It will ask you again if this is final, and if you click yes the original entry will be '''overwritten''' and the new colour be added to the beginning of the Notes field. This means you may have multiple colours in notes, the first one being the current one.
 
It is '''not necessary to document''' when a colour changes. Just change the colour.
 
=== Possible Scenario - Patient died/discharged before DPST form filled out ===
Enter with "green problem" and generate colour.
 
=== Possible Scenario - [[EMIP]] patient that never made it to the ward ===
Enter with "green problem" and generate colour.


{{collapsable|always=click to see list
=== Possible Scenario - DPST missing or not filled yet when collector starts record '''earlier than 24 hrs after admission''' ===
|full=
The unit has 24 hours upon admission to fill the form. If the collector starts collection before then (as they ideally might, based on [[Using Cognos2 to keep track of patients]]). So, the collector would need to return to that chart at a later time and add the project data.
}}
The colour generating code adds the colour to the beginning of the [[Notes field]], which causes it to be listed in the [[Patient List]], so collectors can see which records will need to be reviewed again.


* which additional values?
=== Possible Scenario - DPST missing or not filled '''later than 24 hrs after admission''' ===
* the diagnoses constituting Charlson...
We want to make sure both the colour, and the fact that is was generated without data from the DPST form, is documented on the chart. This is both to be clear and transparent about the time the form was scored without DPST, and to make sure there is fall-back documentation of the colour if something goes wrong with the sticker.
* [[Admit Diagnosis]] or [[Comorbid Diagnosis]] of Dementia
* bring along print-outs of [[File:DPST GGH.pdf]] and keep track and update our copy of this if we are notified of a change to the form
* [[Previous Location]] if that is still what we want to use for "from out of town" now that we have [[Postal Code]].
* If you find a '''DPST form missing''':
**In the generation of data, I have used the following:
** add a DPST form to the usual place in the chart
**ADL score - I have used the 0,3,6  values (same ADL as in ALERT score)
** fill in the patient name, no need to fill in all details
**OutsideWPG - I have used [[Previous Location]] because Leigh Anne specified the patient came from a facility outside of Winnipeg.
* If you find a '''DPST form with Section 1 empty''' (incl one you added because it was missing)
**MB - I would think Leigh Anne had used the [[Province]] because the data set  has no [[Postal Code]]  yet
** cross out the section 1 questions to make it very clear that this is not a usual form
**Charlson categories are provided but the CCMDB Script model  only includes MI, Pulmonary, Connective, Renal
** write "no DPST form found" or "Section 1 empty" near there
**NH (Nursing Home) - these data are from the tmp Overstay and the NH start dates from Manitoba Health which DR Roberts requested. we do not have the [[Pre acute living situation]] at that time but I agree just to use the [[Pre acute living situation]] . When I Have looked at the CCMDB script I noticed that NH includes PCH and Chronic Health Facility, is this correct?
** Document the form as “form missing” in our database as per our "problem" collection in [[#Data Entry Instructions]]
** ADLmean_nh - in the CCMDB Script it is written -- Adlmean_nh = (ADLScore - 12)*(from a nursing home),  what does 12 mean?
** continue as usual to generate the colour, add it to the DPST form and chart and date the colour generation
** same with Adlmean_age = (ADLScore - 12)*(age), what does 12 mean?
** Charlson_nh = (Charlson score)*(from a nursing home)  -- this is clear. --[[User:JMojica|JMojica]] 13:53, 24 January 2025 (CST)
=== Data Entry Instructions === 
''will add these as we come closer to implementing, but it will be a button again''


==== Sources ====
=== Possible Scenario - Off ward patients ===
* for green, a form TBD
For the rare patient admitted directly to an off-ward / boarding location without hitting one of our regular wards first, we will expect that there will be no DPST form, since the process to fill it isn't specified on those wards. With that in mind, still follow our normal process: if there happens to be a form, use what is on it. If there is no form, collect as [[#Possible Scenario - DPST missing or not filled later than 24 hrs after admission]].
* rest: as usual


==== <details?> ====
As per {{DPST SOP}} 4.4.1 the Utilization Coordinator will follow up on these.
<clarifications, usually come up during first few days of collection>


==== Special Cases  ====
== Dates ==
* GGH - 2025-07-02
* HSC - start date not planned yet, possibly Q3 2025
* STB - start date not planned yet, possibly Q3 2025


== Data Use ==
== Data Use ==
This data is being collected as for [[Project Overstay2]].
See [[Overstay2 Overview]]


== Consistency Checks ==
== Legacy / data interpretation ==
* we will need to re-apply what was set up before or set up new ones.  
* 2025-09-19 - finally added option for the "green problem" entry
* 2025-09-16 - finally added option for the "continued" entry
* 2025-07-24 - added entries
** "green problem" - previously missing sticker, date, name would have led to a "problem" entry, project team decided that getting a "green" designation was more important.  
** "continued" - got confirmation that we only want one DPST per admission so added this to allow entry


{{Data Integrity Check List|}} <!-- this will populate automatically from the cross-checks -->
{{Data Integrity Check List|}} <!-- this will populate automatically from the cross-checks -->
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== Related articles ==
== Related articles ==
{{Related Articles}}
{{Related Articles}}
[[Category:Overstay2]]
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