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2020-05 HSC COVID unit transition: Difference between revisions

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== Background ==
== Background ==
=== Dates ===
=== Dates ===
**'''May 12.20 - "HSC D2 C" will now be ortho patients'''.   
*'''May 12.20 - "HSC D2 C" will now be ortho patients'''.   
* '''??  .20''' - '''H7''' (H7 and H733 old CCU)  will be additional 17 beds for ICU ([[HSC_MICU]] and/or [[HSC_SICU]])
*'''May 12, 2020 "HSC D2 C" converted back to ortho and [[HSC D4 C]] is now a mixed unit of COVID positive and suspect patients
** it is not yet clear if this ward is allocated for MICU only or SICU only or both - waiting for the decision.  
*'''May 26th.20''' D4 started transitioning to accept all D medicine patients, no longer a dedicated COVID positive or suspect ward. By '''May 28th''', this transition was completed, and all patients from D5 were moved back to D4.
* '''??  .20''' - '''A7''' will be additional 14 beds for ICU ([[HSC_MICU]] and/or [[HSC_SICU]]) 
*'''2020-03-20''' to '''2020-05-25''' - [[HSC D4 C]] is the designated COVID positive ward.
** it is not yet clear if this ward is allocated for MICU only or SICU only or both - waiting for the decision.
*'''July 27.21''' - '''B2B''' only COVID ward open at HSC
 
* '''May 12, 2020 "HSC D2 C" converted back to ortho and [[HSC D4 C]] is now a mixed unit of COVID positive and suspect patients


=== Medicine specifics ===
=== Medicine specifics ===
{{Discuss |* Julie wrote - We should have a cut-off date for the additional covid ward D2 and MS3.  As I understand these new wards are for  covid positives. Once dates are confirmed, then we start collecting at D2 and MS3.
*'''May 12.20 D2 C is no longer suspect ward.  will now be ortho pts.  D4 will house both suspect and +ve covid'''
** Currently D2 is still a suspect ward, D4 is still our only COVID + ward [[User:Lkaita|Lisa Kaita]] 17:01, 2020 April 16 (CDT)
*'''May 26th.20''' D4 started transitioning to accept all D medicine patients, no longer a dedicated COVID positive or suspect ward. By '''May 28th''', this transition was completed, and all patients from D5 were moved back to D4.
***'''May 12.20 D2 C is no longer suspect ward.  will now be ortho pts.  D4 will house both suspect and +ve covid'''
***'''May 26th.20''' D4 started transitioning to accept all D medicine patients, no longer a dedicated COVID positive or suspect ward. By '''May 28th''', this transition was completed, and all patients from D5 were moved back to D4. }} 
If all the covid wards are operational,  how to handle the case where the patient stayed in 2 official covid wards consecutively - 1) separate records or 2)one continuous record?  I think we should consider (2) as continuous.


=== ICU specifics ===
=== ICU specifics ===
{{Discuss| what is STB ICU doing for suspect or positive covid patients? Will they be in the ICMS along with nocovid?[[User:TOstryzniuk|Trish Ostryzniuk]] 17:27, 2020 May 7 (CDT)
*Suspects are on units ICSM, ICCS and ACCU.  COVID+ are in ICMS together with the nonCovid as shown in the database.--[[User:JMojica|JMojica]] 10:33, 2020 June 11 (CDT)  
*Suspects are on units ICSM, ICCS and ACCU.  COVID+ are in ICMS together with the nonCovid as shown in the database.--[[User:JMojica|JMojica]] 10:33, 2020 June 11 (CDT) }}
 
* April 2020 HSC_MICU will admitted both SICU and MICU physician Service patients that are either suspect or confirmed COVID patients.  No suspect or positive covid will be admitted to HSC SICU.  Though MICU is a close unit the SICU patient in this unit will be under the SICU attending service physician.  Depending on skill set required, sometime may be a SICU nurse or just MICU nurse. The nurse bit we will not be able to track.   
**This scenario can be handled by the tmp boarding loc. Say an SICU physician service patient with COVID using HSC MICU bed will have SICU as service and boarding loc at MICU. OR vice versa, no covid MICU physician Service patients using SICU bed will have service MICU and boarding loc at SICU.


{{Discuss|* April 2020 HSC_MICU will admitted both SICU and MICU physician Service patients that are either suspect or confirmed COVID patients.  No suspect or positive covid will be admitted to HSC SICU.  Though MICU is a close unit the SICU patient in this unit will be under the SICU attending service physician.  Depending on skill set required, sometime may be a SICU nurse or just MICU nurse. The nurse bit we will not be able to track.    We need to ask Randy and Bojan how they want this tracked in Database in terms of service occupancy. Put service Loc as HSC SICU and tag in TMP as boarding location?  Julie would some of the logic applied to bed board apply to how we tag this.}}


Wards involved:  
Wards involved:  
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** HSC_D4_P  
** HSC_D4_P  
** HSC_H4H
** HSC_H4H
{{Discuss |
*Does that mean all those should be removed as [[s_dispo table]] entries? If we keep them in both linking will mess up.
** are you using the tmp entries in linking? I use the s_dispo when I do linking. I use the tmp entries to calculate time spent in each boarding loc and home ward.  --[[User:JMojica|JMojica]] 11:03, 2020 April 15 (CDT)
*** No, not using tmp entries for linking, but if info is kept in tmp instead of new record added then the dispo entry in previous record or previous entry in next record may not match with the service location. }}


== Transition plan ==
== Transition plan ==
# There is no transition plan for the new COVID wards and the additional ICUs. Just need to add in the [[s_dispo table]]
# There is no transition plan for the new COVID wards and the additional ICUs. Just need to add in the [[s_dispo table]]
# This transition plan is only for the patients in H4H who were moved to HSC_B2  
# This transition plan is only for the patients in H4H who were moved to HSC_B2  
#* "HSC_H4H" needs to be added to [[s_tmp]] of Project BoardingLoc
#* "HSC_H4H" needs to be added to [[s_tmp table]] of Project BoardingLoc


=== collector instructions ===
=== collector instructions ===
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===D2 COVID Suspect Ward "HSC D2 C"===
===D2 COVID Suspect Ward "HSC D2 C"===
{{Discuss| what needs to change on laptops? [[User:TOstryzniuk|Trish Ostryzniuk]] 18:00, 2020 May 12 (CDT)}}
*Stopped May 12.20.  will be Ortho.
*Stopped May 12.20.  will be Ortho.
This ward is a mix of different medicine patients ie. H, D, A, unkknown, and nephrology patients, therefore each data collector will enter their own patients
This ward is a mix of different medicine patients ie. H, D, A, unkknown, and nephrology patients, therefore each data collector will enter their own patients
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# For D4_C start with serial number 150
# For D4_C start with serial number 150


=== data processor instructions ===
{{Discuss | Depending on how we do this with tmp vs service location we may end up with linking issues and orphans; need to review. }}


== Reporting ==
== Reporting ==
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* service location [[HSC_H4H]] before April 14,2020 and [[HSC_B2]] can be together.
* service location [[HSC_H4H]] before April 14,2020 and [[HSC_B2]] can be together.
* all COVID wards namely [[HSC_D4_C]], "HSC D2 C", HSC_MS3 can be together.
* all COVID wards namely [[HSC_D4_C]], "HSC D2 C", HSC_MS3 can be together.
* [[HSC_MICU]], [[HSC_A7_MI]], [[HSC_H7_MI]] can be together.
* [[HSC_MICU]], HSC_A7_MI, HSC_H7_MI can be together.
* [[HSC_SICU]], [[HSC_A7_SI]], [[HSC_H7_SI]] can be together.
* [[HSC_SICU]], HSC_A7_SI, HSC_H7_SI can be together.


== Transition plan B ==
== Transition plan B ==
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# For patients discharged on or after ?? 2020, change the Service/Location from [[HSC WRS3]] to [[HSC D5 P]]  and in tmp, add the "HSC- boarding" and 'WRS3' in comment (or "HSC_WRS3" if available), date/time the patient arrived in WRS3 and the line for "HSC - Home medicine ward" with the time that the patient was actually moved to D5
# For patients discharged on or after ?? 2020, change the Service/Location from [[HSC WRS3]] to [[HSC D5 P]]  and in tmp, add the "HSC- boarding" and 'WRS3' in comment (or "HSC_WRS3" if available), date/time the patient arrived in WRS3 and the line for "HSC - Home medicine ward" with the time that the patient was actually moved to D5
# After the last D service patient  from D5 has been completed and submitted to the master database and the label for HSC D5 has been changed from [[HSC D5]] to [[HSC D5 D]],the label pre-COVID [[HSC D5 P]] will be restored back to [[HSC D5]]. This change will create orphans to the master database which will be deleted by the Data Processor.
# After the last D service patient  from D5 has been completed and submitted to the master database and the label for HSC D5 has been changed from [[HSC D5]] to [[HSC D5 D]],the label pre-COVID [[HSC D5 P]] will be restored back to [[HSC D5]]. This change will create orphans to the master database which will be deleted by the Data Processor.
== Cross checks ==
{{Discuss |
* We have no [[CCMDB.accdb Data Integrity Checks]] yet for [[Boarding Loc]] , so that won’t limit our options. Is this the time to add cross-checks?
**Yes, I think we need to add now the integrity checks. See below and check if I have missed anything:
***1. Date_var and Time_var must not be before Accept DtTm/Arrive DtTm
***2. Date_var and Time_var must not be on or after Dispo DtTm
***3. Item should not be the same as the service_location for Medicine profile
***4. Item should be either ‘no borrow’ or with boarding item  but must not have  both
***5. When having a boarding location, both date and time must be present.  Should not have missing time.
---[[User:JMojica|JMojica]] 08:52, 2020 May 28 (CDT)
}}
{{Discuss |
* Have not yet checked how this will impact [[CFE Data Integrity Checks]]. Pagasa, of the top of your head which would be impacted and how? 
}}


== Related articles ==  
== Related articles ==  
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[[Category: 2020 COVID unit transition ]]
[[Category:2020 COVID unit transition ]]
[[Category: Legacy Data Collection]]
[[Category:Legacy Data Collection]]
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