Dispo field: Difference between revisions

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|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 ===
=== surviving patients ===
For each patient,
* Enter:
* enter the location that most closely matches
{{PrePrevDispo listing}}
** for wards where we don't collect, enter e.g. HSC_ward
* see [[Visits to temporary locations]] for dispo to temporary locations, ie. OR, dialysis, procedure suites of all types, imaging suites/radiology
** for wards where we do collect enter the actual ward as available in the dropdown
*[[HSC Stepdown Units]]
* consider [[bed borrow]]s
 
==== [[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]] see also [[BedHeldEnd DtTm]]
# 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]].


==== [[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 a '''Institution NOS'''.
*[[Pre acute living situation field]] should be coded as:  Jail/correctional institution.
*[[Pre acute living situation field]] should be coded as:  Jail/correctional institution.
===[[Chronic Health Facility]] ===
* use <site>_ward e.g. Riverview stroke rehab, Oaks ward
* If the patient is discharged to the PCH portion of Deer Lodge or Riverview use '''Winnipeg PCH'''
{{DL|
* you removed <nowiki>{{PCH Riverview Deer Lodge}}</nowiki>; that template is also linked from [[Chronic Health Facility]]. The two will now show inconsistent content. When content is driven by a template like that it is always so it stays consistent across the wiki. Pls have a look at [[Template:PCH Riverview Deer Lodge]] and [[Chronic Health Facility]] to consider if (a) the two should really be inconsistent now or (b) we should re-instate the template and fix its content. Catch me on teams if you want more information or help with this. [[User:Ttenbergen|Ttenbergen]] 14:05, 2024 October 16 (CDT)
*Lets set up a time to discuss this, I don't think I knew they were templates, I thought I was editing an article [[User:Lkaita|Lisa Kaita]] 13:16, 2024 October 31 (CDT)
* we have pts discharged to AIA (alternative integrated accommodation) located at 698portage ave, opened April 15, 2024, should we add this as an option to the dispo dropdown? [[User:Lkaita|Lisa Kaita]] 08:39, 2024 December 17 (CST)}}


==== Discharged to ER or [[Urgent Care]] ====
==== Discharged to ER or [[Urgent Care]] ====
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:
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 '''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.)
* 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.)
* 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.


==== [[Operating room visits]] ====
===Manitoba Nursing Station===
* use outside city -unknown/other


=== [[Deceased patients]] ===
=== [[Deceased patients]] ===
* for patients who expire, see [[Deceased patients]] for more info. Enter one of
See
** "Died - Organ Donor"
* [[Deceased patients#General instructions for deceased patients]]
** "Died - NOT Organ Donor"
* [[Guideline for coding organ donation after death]]
* [[Visits to temporary locations]]


See also: [[Deceased patients#General instructions for deceased patients]]
{{Location dropdown cleanup}}


== Data Use ==
== Data Use ==
* Mortality Rate
* [[Unit Mortality]]
* Intra or Inter Transfer Rate
* Intra or Inter Transfer Rate
* Discharges out of hospital
* Discharges out of hospital
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== Legacy ==
== Legacy ==
This field is part of the [[2016 Time and Place changes]].
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  
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[[Category:Registry Data]]
[[Category:Registry Data]]
[[Category:Dispo]]
[[Category:Dispo]]
[[Category:Data Collection Guide]]
[[Category:End-of-life related data]]

Latest revision as of 08:39, 17 December 2024

Data Element (edit)
Field Name: dispo
CCMDB Label: Dispo
CCMDB tab: Dispo
Table: L Log table
Data type: number
Length: long
Program: Med and CC
Created/Raw: Raw
Start Date: 2016-07-01
End Date: 2300-01-01
Sort Index: 41

The Dispo field contains information about what happens to the patient at the end of their admission.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


Collection Instruction

surviving patients

Homeless patients

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.

Prison / Jail / Correctional Institution

If a patient is discharged to prison, jail or a correctional institution, code this as a Institution NOS.

Chronic Health Facility

  • use <site>_ward e.g. Riverview stroke rehab, Oaks ward
  • If the patient is discharged to the PCH portion of Deer Lodge or Riverview use Winnipeg PCH


  • you removed {{PCH Riverview Deer Lodge}}; that template is also linked from Chronic Health Facility. The two will now show inconsistent content. When content is driven by a template like that it is always so it stays consistent across the wiki. Pls have a look at Template:PCH Riverview Deer Lodge and Chronic Health Facility to consider if (a) the two should really be inconsistent now or (b) we should re-instate the template and fix its content. Catch me on teams if you want more information or help with this. Ttenbergen 14:05, 2024 October 16 (CDT)
  • Lets set up a time to discuss this, I don't think I knew they were templates, I thought I was editing an article Lisa Kaita 13:16, 2024 October 31 (CDT)
  • we have pts discharged to AIA (alternative integrated accommodation) located at 698portage ave, opened April 15, 2024, should we add this as an option to the dispo dropdown? Lisa Kaita 08:39, 2024 December 17 (CST)
  • SMW


  • Cargo


  • Categories

Discharged to ER or Urgent Care

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.)
  • 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.

Manitoba Nursing Station

  • use outside city -unknown/other

Deceased patients

See

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

query of what is currently available

SQL   
SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo
FROM s_dispo
WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));

Query of what is currently used

query z_s_dispo_inactivatable

Data Use

  • Unit Mortality
  • Intra or Inter Transfer Rate
  • Discharges out of hospital
  • Organ donor rate
  • AMA Rate
  • Linking admissions

Cross checks

Data Integrity Checks (automatic list)

 AppStatus
Check pre acute consistentCCMDB.accdbdeclined
Function Validate DispoCCMDB.accdbimplemented
Check function location NE dispoCCMDB.accdbimplemented
Query check ICD10 dx implying death must have appropriate dispoCCMDB.accdbimplemented
Query check dispo lower acuity than locationCCMDB.accdbretired
Link suspect dead then alive queryCentralized data front end.accdbimplemented
Link suspect mismatch to ours incomplete queryCentralized data front end.accdbimplemented
Link suspect not same visitAdmitDtTm queryCentralized data front end.accdbimplemented
Query cardiac arrest throughout admissionCentralized data front end.accdbneeds review

Implementation

The field is populated with options from the s dispo table.

Related Articles

Related articles:

Legacy

This field is part of the 2016 Time and Place changes and was affected by the PatientFollow_Project.

It a combination of our previous

Data from these fields has been back-populated to the this field so data is available from the beginning of the database.

Related articles:

Very early missing Discharge-tos

There were 6762 very old ICU records who are listed as survived but didn’t have a discharge-to. This is from HSC-only days when there simply were no checks.

When data was brought across from the old discharge to field the dispo fields of these records were set to 'survive(Legacy)'.