Intended1stSrvc: Difference between revisions
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=== Examples === | === Examples === | ||
*Example#1: Patient admitted from HSC ED with severe pneumonia, is still on ED service in ED. She/he should go to MICU but it is full, so goes to SICU and is taken care of by the SICU service. Here [[Service/Location]]=SICU, [[Intended1stSrvc]]=MICU, [[Boarding Loc]]=SICU. | *Example#1: Patient admitted from HSC ED with severe pneumonia, is still on ED service in ED. She/he should go to MICU but it is full, so goes to SICU and is taken care of by the SICU service. Here [[Service/Location]]=SICU, [[Intended1stSrvc]]=MICU, [[Boarding Loc]]=SICU. | ||
*Example#2: Patient admitted from HSC ED with severe pneumonia, and while in ED is officially admitted to MICU service (i.e. is ECIP). So this initial ICU record has: [[Service/Location]]=MICU, [[Intended1stSrvc]]= | *Example#2: Patient admitted from HSC ED with severe pneumonia, and while in ED is officially admitted to MICU service (i.e. is ECIP). So this initial ICU record has: [[Service/Location]]=MICU, [[Intended1stSrvc]]=left blank as it doesn't apply for direct ICU service-to-ICU service transfers, [[Boarding Loc]]=HSC ED. But MICU but it is full, so decision is made for patient to go from ED (having already been admitted to the MICU service) to SICU on SICU service. For the SICU service record, [[Service/Location]]=SICU, [[Intended1stSrvc]]=left blank since it doesn't apply to direct ICU service-to-ICU service transfers, [[Boarding Loc]]=SICU, plus [[Transfer for bed management]] as an [[Admit Diagnosis]]. The earlier MICU service record should have [[Transfer for bed management]] as an [[Acquired Diagnosis]]. | ||
*Example#3: Patient in ED at Grace still on the ED service. Should go to Grace ICU but it's full, so is instead initially admitted to HSC MICU, upon which [[Service/Location]]=MICU, [[Intended1stSrvc]]= | *Example#3: Patient in ED at Grace still on the ED service. Should go to Grace ICU but it's full, so is instead initially admitted to HSC MICU, upon which [[Service/Location]]=MICU, [[Intended1stSrvc]]=GGH ICU, [[Boarding Loc]]=MICU. This example shows that the [[Intended1stSrvc]] can be at a different hospital altogether. | ||
*Example#4: Patient in ED at Grace but has been officially admitted to the Grace ICU service. So, for that Grace ICU record [[Service/Location]]=Grace ICU, [[Intended1stSrvc]]=Grace ICU, [[Boarding Loc]]=Grace ED . But Grace ICU is full, so decision is made for patient to go to HSC MICU. Upon admission to HSC MICU, that record has [[Service/Location]]=MICU, [[Intended1stSrvc]]=left blank since it doesn't apply to direct ICU service-to-ICU service transfers, [[Boarding Loc]]=MICU, and [[Transfer for bed management]] coded as [[Admit Diagnosis]]. The earlier Grace ICU service record should have [[Transfer for bed management]] as an [[Acquired Diagnosis]]. | *Example#4: Patient in ED at Grace but has been officially admitted to the Grace ICU service. So, for that Grace ICU record [[Service/Location]]=Grace ICU, [[Intended1stSrvc]]=Grace ICU, [[Boarding Loc]]=Grace ED . But Grace ICU is full, so decision is made for patient to go to HSC MICU. Upon admission to HSC MICU, that record has [[Service/Location]]=MICU, [[Intended1stSrvc]]=left blank since it doesn't apply to direct ICU service-to-ICU service transfers, [[Boarding Loc]]=MICU, and [[Transfer for bed management]] coded as [[Admit Diagnosis]]. The earlier Grace ICU service record should have [[Transfer for bed management]] as an [[Acquired Diagnosis]]. | ||
*Example#5: Patient with pneumonia was admitted from ED to HSC MICU, so [[Service/Location]]=MICU, [[Intended1stSrvc]]=left blank because this patient WAS admitted to the intended first service, [[Boarding Loc]]=MICU. Due to bed issues in MICU, later on the day of that initial MICU admission, patient is transferred to SICU on SICU service. For the SICU record, [[Service/Location]]=SICU, [[Intended1stSrvc]]=left blank since this is a direct transfer not an initial admission to an ICU, [[Boarding Loc]]=SICU, [[Transfer for bed management]] as an [[Admit Diagnosis]]. The earlier MICU service record should have [[Transfer for bed management]] as an [[Acquired Diagnosis]]. | *Example#5: Patient with pneumonia was admitted from ED to HSC MICU, so [[Service/Location]]=MICU, [[Intended1stSrvc]]=left blank because this patient WAS admitted to the intended first service, [[Boarding Loc]]=MICU. Due to bed issues in MICU, later on the day of that initial MICU admission, patient is transferred to SICU on SICU service. For the SICU record, [[Service/Location]]=SICU, [[Intended1stSrvc]]=left blank since this is a direct transfer not an initial admission to an ICU, [[Boarding Loc]]=SICU, [[Transfer for bed management]] as an [[Admit Diagnosis]]. The earlier MICU service record should have [[Transfer for bed management]] as an [[Acquired Diagnosis]]. | ||
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**For the MICU service record: [[Service/Location]]=MICU, [[Intended1stSrvc]]=blank as it doesn't apply to direct ICU transfers, [[Boarding Loc]]=MICU. Here the transfer was judged to be for medical necessity, so no [[Transfer for bed management]] -- and the same would be the case if the patient had gone to STB-ICMS instead of HSC MICU. | **For the MICU service record: [[Service/Location]]=MICU, [[Intended1stSrvc]]=blank as it doesn't apply to direct ICU transfers, [[Boarding Loc]]=MICU. Here the transfer was judged to be for medical necessity, so no [[Transfer for bed management]] -- and the same would be the case if the patient had gone to STB-ICMS instead of HSC MICU. | ||
**For the IICU service record: [[Service/Location]]=IICU, [[Intended1stSrvc]]=blank as it doesn't apply to direct ICU transfers, [[Boarding Loc]]=IICU. Here [[Transfer for bed management]] doesn't apply since IICU is a lower level than MICU and (except for ward to LAU transfers) it only applies to service transfers at the SAME level. | **For the IICU service record: [[Service/Location]]=IICU, [[Intended1stSrvc]]=blank as it doesn't apply to direct ICU transfers, [[Boarding Loc]]=IICU. Here [[Transfer for bed management]] doesn't apply since IICU is a lower level than MICU and (except for ward to LAU transfers) it only applies to service transfers at the SAME level. | ||
*Example#10: Patient with severe pneumonia admitted from Grace ED to SICU service in SICU because both Grace ICU and MICU are full. A few days later patient remains physically in SICU but care is taken over by MICU service. Initial SICU service record: [[Service/Location]]=SICU, [[Intended1stSrvc]]=MICU, [[Boarding Loc]]=SICU Subsequent MICU service record: [[Service/Location]]=MICU, [[Intended1stSrvc]]=left blank, [[Boarding Loc]]=SICU. | |||
*Example#11: Grace ICU patient goes to MICU for an EEG, with an official transfer from Grace ICU service to MICU service for this relatively brief interval. This is a transfer for medical necessity, and MICU service record has: [[Service/Location]]=MICU, [[Intended1stSrvc]]=left blank, [[Boarding Loc]]=MICU. For the transfer back to Grace ICU, this is a [[Transfer for bed management]] with [[Service/Location]]=Grace ICU, [[Intended1stSrvc]]=left blank, [[Boarding Loc]]=Grace ICU. | |||
=== Data Entry Instructions === | === Data Entry Instructions === | ||
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=== Terminology for services inconsistent with [[EPR]] === | === Terminology for services inconsistent with [[EPR]] === | ||
*We recognize that the drop-downs we chose are different from the standardized terms in [[EPR]]; it was decided that this is OK because the perception is that our terms are what leadership actually wants | *We recognize that the drop-downs we chose are different from the standardized terms in [[EPR]]; it was decided that this is OK because the perception is that our terms are what leadership actually wants | ||
== Left to resolve == | == Left to resolve == | ||
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{{DJ | | {{DJ | | ||