CCMDB Wiki

Dispo field: Difference between revisions

← Older edit
No edit summary
 
(126 intermediate revisions by 11 users not shown)
Line 13: Line 13:
|element_description=The Dispo field contains information about what happens to the patient at the end of their admission.
|element_description=The Dispo field contains information about what happens to the patient at the end of their admission.
}}
}}
== Collection Instruction ==
== Collection Instruction ==
If you know the location exactly, you can type it. Otherwise press the "?" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
=== surviving patients ===
* Enter:
{{PrePrevDispo listing}}
* see [[Visits to temporary locations]] for dispo to temporary locations, ie. OR, dialysis, procedure suites of all types, imaging suites/radiology
* [[HSC Stepdown Units]]
* [[AMA]] see also [[BedHeldEnd DtTm]]
 
====Home====
* Includes:
** hotel
** rooming house
** boarding home
 
===== Additional options similar to "Home" =====
We have several "Home" like discharge options that may appear in [[Cognos2 Unit Starter]]. If the entry from ADT doesn't align with what is found in the chart then correct the entry to what you think is correct:
* '''Home with Support Services''' - Discharged to a private residence or apartment with support from the community at home or referred to services.  example home care, [[Alternative Integrated Accommodation (AIA) | AIA]].  '''Note''' a patient with instructions to return for follow-up or referral to a specialist (as part of a routine discharge order) is '''NOT''' considered discharge home with support service/referral
** includes people on Home O2, for every admission as long as they still require home O2, they are part of the Home Oxygen home care program
** includes CIVP
** includes private nursing care
** includes dc to virtual wards
 
** excludes: GPAT/GMAT assessments
 
* '''TRSF Group/Supportive housing'''
** includes group home
** excludes [[Assisted Living]] facilities
 
 
 
 
{{DiscussTask | JALT
I thought we had decided at [[JALT Meeting - Rolling Agenda and Minutes 2025#JALT 2025-03-11 |JALT]] to collect this as presented by EPR... do I remember this wrong? I had already added it in [[CCMDB.accdb Change Log 2025#2025-03-11-1]]. [[User:Ttenbergen|Ttenbergen]] 22:52, 11 March 2025 (CDT)
* Yes, I saw that, come to think of it I don't think we decided, not in my notes, but we can use it and I will change the wiki instructions [[User:Lkaita|Lisa Kaita]] 11:25, 13 March 2025 (CDT)
* If we are going to collect this detail for dispo, should we consider whether or not to also look at SH in preadmit living situation?, currently lumped with community facility with support. [[User:Lkaita|Lisa Kaita]] 14:45, 16 April 2025 (CDT)
* The entry name includes "TRSF" - is the entry for the previous location equivalent in EPR? [[User:Ttenbergen|Ttenbergen]] 23:30, 16 April 2025 (CDT)
* no because the previous location would usually be <site>_ER [[User:Lkaita|Lisa Kaita]] 09:53, 28 May 2025 (CDT)
** Sorry, I should have asked about "pre-hospital location in ADT". [[User:Ttenbergen|Ttenbergen]] 16:21, 28 May 2025 (CDT)
}}
* '''TRSF to Residential Care'''- Includes transfer to long-term care home (24 hour nursing), mental health and/or addiction treatment center or hospice/palliative care facility. 
** for PCH use [[Dispo]] PCH options
** for hospice, see [[Hospice]]
** for palliative care use the appropriate palliative care options
** for mental health or addiction treatment center use [[Dispo]] '''Home with Support Services'''
{{DL |
That more detailed info included things like [[HSC Lennox Bell]]; we discussed whether or not we need to document the details of this. If so, the following is likely a starting point:
* Institution NOS
* TRSF Group/Supportive housing
* TRSF to Correctional Facility
* any [[Hospice]]s
* GH-Transitional care
* HSC - Transitional care
* Misericordia  - Transitional care
* STB - Transitional care
* VIC - Transitional care
* HSC Lennox Bell
* Manitoba Adolescent Treatment Center - unknown/other
** what is this about again? we already collect these with the exception of the transitional care units, which don't exist, at GH, HSC, SBGH and VIC, but there is a TCU at Miseri and DLC [[User:Lkaita|Lisa Kaita]] 21:18, 6 September 2025 (CDT)
*** we discussed whether we should shift to EPR's "TRSF to Residential Care" and decided not to because our data is more granular. But we should be able to compare to their TRSF, so should understand which of our data would compare to theirs, and how. I ''think'' the above is a list of what  we have in dispo, so which of those correspond do what listing in EPR? [[User:Ttenbergen|Ttenbergen]] 10:31, 8 September 2025 (CDT)
* I think these are covered in the instructions above can we remove this discussion? [[User:Lkaita|Lisa Kaita]] 20:32, 9 March 2026 (CDT)
** Many are, Lennox is not. Not sure which others we would want someone to code when Cognos says "trsf to residential". [[User:Ttenbergen|Ttenbergen]] 02:10, 11 March 2026 (CDT)
}}


=== surviving patients ===
For each patient,
* enter the location that most closely matches
** for wards where we don't collect, enter e.g. HSC_ward
** for wards where we do collect enter the actual ward as available in the dropdown
* consider [[bed borrow]]s
**If you discharge a patient to a bed borrow location, code in Dispo field the home location (i.e. wards where we do collect), not the bed borrow location.


==== [[AMA]] ====
Enter "AMA (left against medical advice)" for patients who leave against medical advice (type "AMA" to open up drop down).


AMA is used as follows:
# AMA is being excluded in the  calculation of Readmission rate.
# AMA is being counted as HOME in reporting for the location the patient went after discharge. 
# AMA as itself for specific request. 


AMA should be entered whether the patient follows the WRHA AMA process (signing form etc) or just goes AWOL. This will lead to proper reporting for the first two points, and it will allow a chart review to exclude AWOL person depending on the data requirements in the third case.


==== [[Homeless]] patients ====
==== [[Homeless]] patients ====
If a homeless patient is discharged, either to a place like Siloam Mission or even without a specific plan, then code them as discharged to '''home'''. Consider whether they might have left [[AMA]].
*If a homeless patient is discharged, either to a place like Siloam Mission, shelter or even without a specific plan, then code them as discharged to '''home'''. Consider whether they might have left [[AMA]].
* If discharged to an [[Alternative Integrated Accommodation (AIA)|Alternative Integrated Accommodation]] with services use '''home with support services'''
*{{Discuss | if on admission a patient is coming from Siloam Mission housing (Roblin Blvd)complex, is this still considered homelessness? }}


==== [[Prison / Jail / Correctional Institution]] ====
==== [[Prison / Jail / Correctional Institution]] ====
If a patient is '''discharged to prison, jail or a correctional institution''', code this as a '''Institution NOS'''.
If a patient is '''discharged to prison, jail or a correctional institution''', code this as "TRSF to Correctional Facility" as dispo to be consistent with EPR
*[[Pre acute living situation field]] should be coded as:  Jail/correctional institution.
 
See [[Prison / Jail / Correctional Institution]] for additional coding instructions that may apply.
 
==== [[Chronic Health Facility]] ====
This is somewhat messy and fluid, so see [[Chronic Health Facility]]
 
==== Transfer to different in-patient location ====
* We generally break institutions down to special locations like ER OR or simply "ward"
* We break some wards/units out separately when we care about details of a unit:
** [[LAU]] (low acuity units)
** [[Geri Rehab]]
** [[HSC_H6]]
* When the transfer is for bed management reasons only, also code the dx [[Transfer for bed management]]
 
====== Discharged to ER or [[Urgent Care]] ======
This is a case of [[Patients who appear to transfer from in-patient situation to Emergency Room]].  


==== Discharged to ER or [[Urgent Care]] ====
If a patient is discharged to the ER or Urgent Care at your own site you can't enter this in the dispo field. The reason is that this should not happen. If it really does happen:
If you discharge a patient to the ER or Urgent Care, you can't enter this in the dispo field. The reason is that this should not happen. If it really does happen:
* enter '''Not Canada or USA - unknown/other''' (this is a very rare entry so when we see it, we can question it. Put a note in to the [[Notes field]] so Pagasa can check there first.)
* enter '''Other Continents - unknown/other''' (this is a very rare entry so when we see it, we can question it. Put a note in to the [[Notes field]] so Pagasa can check there first.)
* email Pagasa so she can enter your ER / Urgent Care location as dispo.
* email Pagasa so she can enter your ER / Urgent Care location as dispo.


We don't want ER to be available in the dropdown because it had been mistakenly entered a number of times. If it turns out there are a lot of legitimate ''discharges'' to ER we will make the option available.
We don't want ER to be available in the dropdown because it had been mistakenly entered a number of times. If it turns out there are a lot of legitimate ''discharges'' to ER we will make the option available.
 
These patients might become [[Parked in ER]] at the next location.


==== [[Visits to temporary locations]] ====
======Manitoba Nursing Station======
* use ''"Outside City - unknown/other"''
{{Discuss | If this is actually done then why don't we just make the nursing stations available? We already have [[s_dispo table]] entries for them. 35 entries since 2016, 6 in the last 12 months. Are there other things for which this entry is used? Checked for reasons for this decision but they don't appear documented [[User:Ttenbergen|Ttenbergen]] 19:42, 13 March 2025 (CDT)
}}


=== [[Deceased patients]] ===
=== [[Deceased patients]] ===
Line 58: Line 122:
* [[Visits to temporary locations]]
* [[Visits to temporary locations]]


== Data Use ==
{{Location dropdown cleanup}}
* [[ICU Mortality]]
 
* Intra or Inter Transfer Rate
== Data Use / [[Indicators]] ==
* [[Unit Mortality]]
* [[ICU Interfacility Transfer]]/[[Length of Time for Transfer from ED to ICU within same facility]]/[[Transfer Delay (Critical Care)]]/[[Transfer Delay (Medicine)]]
* Discharges out of hospital
* Discharges out of hospital
* Organ donor rate
* Organ donor rate
* AMA Rate  
* AMA Rate  
* Linking admissions
* Linking admissions
* [[Readmission Rate to ICU]]/[[Readmission to MedWard]]


== Cross checks ==
== Cross checks ==
Line 75: Line 142:
{{Related Articles}}
{{Related Articles}}


== Legacy ==
== Log/Legacy ==
This field is part of the [[2016 Time and Place changes]].
Also see info in the various [[CCMDB.accdb_Change_Log]]s over time.
* [[CCMDB.accdb_Change_Log_2025#2025-03-11-1 | 2025-03-11]]
** added granularity Discharged to community: "TRSF Group/Supportive housing", "TRSF to Correctional Facility", "Home with Support Services"
*** one other option in EPR for discharge to was "TRSF to Residential Care"; discussed adding and decided not to switch to this because we currently record more detailed information
** added locations for [[LAU Collection Project]]: VGH_LAU, VGH_Geriatrics, COH_LAU, SOH_LAU, SOH_Geriatrics
 
* 2025-03-07
** started to collect "TRSF to Correctional Facility" as dispo to be consistent with EPR; for [[Previous Location]] continue to use the old entry "Institution, NOS"
 
{{Change to collecting prison as "Institution NOS"}}
 
=== earlier legacy info ===
This field is part of the [[2016 Time and Place changes]] and was affected by the [[PatientFollow_Project]].


It a combination of our previous  
It a combination of our previous  
Line 97: Line 176:
[[Category:Registry Data]]
[[Category:Registry Data]]
[[Category:Dispo]]
[[Category:Dispo]]
[[Category:Data Collection Guide]]
[[Category:End-of-life related data]]
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Dispo_field"