CCMDB Wiki

Boarding Loc: Difference between revisions

← Older edit
Surbanski (talk | contribs)
CCMDB_legit
87 edits
 
(171 intermediate revisions by 10 users not shown)
Line 9: Line 9:
This isn't so much a project as way to track how patients physically move around the hospital. See [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]] for information about it and why we needed to change it to this model.  
This isn't so much a project as way to track how patients physically move around the hospital. See [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]] for information about it and why we needed to change it to this model.  


This project tracks where and when a patient '''arrives''' into a new physical location.  
This project tracks where and when a patient '''arrives''' into a new physical location under the Medicine or ICU service.  


== Data Collection Instructions ==
== Data Collection Instructions ==
{{Discuss |
=== Sources for Boarding Loc DtTm ===
* and this is where I realized we may need to do this for CC and Med, rather than just cc. Sent out email for input... }}
==== [[CSS]] / [[Cognos2 Unit Starter]] ====
Usually the Cognos Unit start time from [[CSS]] or [[Cognos2 Unit Starter]] can be used as [[Boarding Loc]].
* sometimes the first [[Service tmp entry]] and first and second [[Boarding Loc]] all have the same date and time; see [[#Special Case - Can't have two Boarding Locs with same DtTm]]


In [[L TmpV2 table |TMP]], a "no borrow" entry will automatically be added to every new Critical Care or Medicine patient's record.  
==== First set of vital signs for CC ====
[[ICU Curriculum]]: The first set of vital signs is used as [[Boarding Loc]] dttm for arrival on the unit for [[Critical Care program]] admissions, if it is different from the Cognos Unit Start DtTm.


If the patient never ends up in a "borrowed bed" during their stay then, leave the default in Item as ''no borrow'' and also put a check mark in the checkbox. (this is to verify that there was no bed borrow, otherwise no one is sure is missed or not).
==== Erroneous Unit information in [[CSS]]/[[Cognos2 Unit Starter]] ====
If the patient does end up in a "borrowed bed", change the item to the location of the borrow and enter the rest as per below: [[#How to enter this]].  
Sometimes the times are not when people really show up at a location. Use what you know to be correct from chart and your knowledge of your hospital.


Add a new tmp entry for every additional move/borrow within your centre that a patient makes during their stay at your '''[[Service/Location]]'''; including moves from borrowed location to your actual unit.
=== How to enter ===
 
You can use the [["make loc" button]] to generate and pre-populate these entries.
=== How to enter this ===
*Use tmp fields:
*Use tmp fields:
** Project: '''{{PAGENAME}}'''
** Project: '''{{PAGENAME}}'''
** Item: '''no location entered''' is the default (that entry will not be allowed in a complete record)
** start_dt and start_tm:  
*** change the original entry to the first location the patient was during the admission in this record, e.g. ER, specific medicine ward etc
*** enter as per Cognos initially
*** for any physical move to another unit, enter an additional boarding loc entry
*** before setting [[RecordStatus]] to complete update the DtTm to comply with [[DtTm for First Boarding Loc and First Service]]
** Enter start_dt: '''arrival date at borrowed bed''', under column E.
** checkbox: not used for this project <!-- was used for [[cross check]]s in data before 2020-10-15 -->
** Enter start_tm: '''arrival time at borrowed bed''', under column M.
** Item:  
** checkbox: not used for this project <!-- was used for cross checks in data before 2020-10-15 -->
*** for the initial unit or ER and each physical move to another unit, enter the location by using the "make loc" button in [[Patient Viewer Tab Cognos ADT2]]
** comment field:  
*** if a boarding location appears in COGNOS but the patient does NOT move/arrive to that boarding location, do NOT enter that boarding location.  We only capture boarding locations where the patient physically arrives (also see [[Wrong service or unit entries in Cognos]])
*** see [[#Special Case - moving from one borrowed ward bed to another]]
**** if the ward is not available in the dropdown, please notify Tina, Lisa, and Julie; Tina/Lisa will add the location to the dropdown and update the wiki as needed
*** There are now additional circumstances where we use comment field for Borrow Loc, to do with COVID moves. Documented in pages in [[:Category:2020 COVID unit transition]] and some info below in [[#COVID]]
{{Discuss |
**** leave what is in Cognos, the main office doesn't use this part for anything for home locations, but it can be used to crosscheck accuracy.
***** what is this about? [[User:Ttenbergen|Ttenbergen]] 17:42, 19 August 2025 (CDT)
}}
* '''no location entered''' is the default
** that entry will not be allowed in a complete record; it is automatically deleted when by Cognos Make Loc button, but needs to be removed before setting a record to complete if it is still present.
<!--
*emailed to see if this automatic entry is still useful now that things are entered with make loc button [[User:Ttenbergen|Ttenbergen]] 13:05, 2023 January 25 (CST)
** We discussed this and decided to leave for now, as we don't manually delete it is populated by COGNOS when we choose the Make location button [[User:Lkaita|Lisa Kaita]] 13:59, 2023 February 1 (CST) -->


=== APACHE ===
{{Combined instructions for Transfer Ready DtTm and Boarding Loc}}
The APACHE elements time frame will start in the off-ward bed location.
<!-- the above are general instructions, put any special case info below here -->
{{Discuss |
* Does it really start in ER? since that's now one off-ward location? In any case, we should really only link to the definition in APACHE from here so this doesn't become inconsistent. If someone knows where that's documented, can you please confirm and fix? Ttenbergen 00:36, 2020 October 16 (CDT)}}


=== TISS ===
==== Special Case - Can't have two Boarding Locs with same DtTm ====
TISS starts from the off-ward bed.
* No two different [[Boarding Loc]] records can have same start_dt and start_tm; if two locations have the same Start_DtTm in [[CSS]]/[[Cognos2 Unit Starter]] this is an error.  
{{Discuss |  
* The date and time for these entries must be confirmed by looking at the chart, specifically orders, flowsheets, and progress notes
* This would now mean TISS starts in ER if the pt is in ER long enough. We discussed that a while ago and I can't remember the outcome. This might need to be updated to correspond to that. Or rather, this should only be a link to that so it doesn't go inconsistent in the future. If some one knows what was decided, can you please fix this? Ttenbergen 00:36, 2020 October 16 (CDT)}}
{{DL | It says:
* Change one to be off by one minute, put a note in [[Notes field]] to check boarding location to confirm the correct date and time for the boarding locations of concern.
** how does that fit in with reviewing reality in the chart?
** I don't know what you mean by this?  It means you double check the correct first service and first and second boarding loc dttm [[User:Lkaita|Lisa Kaita]] 21:14, 6 September 2025 (CDT)
*** Well, it seems like this triggers an error check, so you pull the times a minute apart to overcome the error check and put a note to remind you to check later. So either the check should run later (on complete or send) or we shouldn't have it at all. But a check that just gets you to "tweak" the data to make it go away isn't a good idea.
}}


=== Special Case - Parked ===
* This case is especially common in the context of [[DtTm for First Boarding Loc and First Service]]
{{Discuss |
{{Ex |
* There was talk about changing the [[Parked in ER]] to use [[Boarding Loc]] scheme instead; I can't remember details, if someone else can, could you please update here and remove the old instruction below?Ttenbergen 00:36, 2020 October 16 (CDT)
* Example: Not infrequently, the COGNOS data for HSC_SICU patients coming from the ER  will show the first service, first boarding location (ER) and the second boarding location (SICU) as all having the same start_DtTm. Our solution for this is to change the second boarding location (SICU) to be off by one minute.
}}
}}
*For patients who are [[Parked in ER]], no need an entry for these, since the ER delay will take care of them.


=== Special Case - EMIP/ECIP ===
==== Special Case - GRA MICU boarding in GH-Emergency ====
See [[2020-10 EMIP changes]]
''This is a case of [[Patients who appear to transfer from in-patient situation to Emergency Room]], see there for more info.
* Grace ICU boarding in ER choose Boarding Location GH-Emergency
* Grace Main ICU choose Boarding Location and GH-Intensive Care
* Grace Recovery Room (ICU) choose Boarding Location and [[GH-Recovery Room]] and enter comment Covid+ICU
* For External(SDC/NFA) ICU beds choose Boarding Loc and GH-External ICU and enter exact location in comments
* The [[Previous Location]] and [[Pre-admit Inpatient Institution]] would be <site>_med or <site>_ward


=== Special Case - CAU ===
=== Special Case - Cross-program boarding ===
{{Guideline CAU vs Boarding Loc vs EMIP}}
If a patient is accepted by one of our services, and is on an off-service ward, enter a [[Boarding Loc]] entry for that period.


{{Discuss|If the patient ends up moving to a ward from CAU, why would we treat the CAU as a boarding loc? We don’t collect data on CAU patients so wouldn’t it be a new profile? I know at one time the CAU was considered an extension of the ER, but I believe that may have changed now, as I believe all of the CAU’s are located away from the ER’s and are considered an inpatient location, under family medicine service. e.g at HSC the CAU is now located on WRS3, At Grace it is located in the old ER and are under a grace HMO. At SBGH I think CAU is located on 6AS.  I will double check with our admitting girls.  If it is an inpatient location then this would not be an EMIP
'''For medicine pts boarding in ICU''' you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc.
*I can only speak to what I've seen at the Grace - it seems our CAU is intended to be a brief stay. Like they need a little more time/care than can be given in ER, but won't need a prolonged admission. If after a couple days the patient isn't improving and will need to be admitted they'll be taken over by medicine and get admitted to the ward. We've never treated CAU as a boarding loc, and my understanding the only Accept Time that we enter (and track) is the ER to ward times. [[User:Surbanski|Surbanski]] 08:19, 2020 October 16 (CDT)}}
{{DJ|
what is this sentence telling me, can I not use the specific medicine entry? Why/how? What would a new collector need to know?  
* I have no idea, I suppose this can happen although I have not ever seen this at any of the facilities, I believe you were the original author of this so feel free to do what you want with this [[User:Lkaita|Lisa Kaita]] 13:46, 6 August 2025 (CDT)
** Julie, do you know what this is about? If the same applies for Med as for ICU in this, then lets get rid of the confusing entry. [[User:Ttenbergen|Ttenbergen]] 17:23, 6 August 2025 (CDT)
*** we have one  case S4_STB_Med-2892 where first3 days at SBGH ICMS then transferred to SBGH-L2CC.--[[User:JMojica|JMojica]] 16:42, 18 August 2025 (CDT)
**** What else would they use? The entry would come from Cognos, no? It's entered by drop-down, so I don't think they could enter anything but the actual entry. Is this stated here really as a reminder for you, in case this happens again? If so, would it be better to store it in L_Problems table? If it is an instruction to collectors, would you explain further what you actually intend?  [[User:Ttenbergen|Ttenbergen]] 17:33, 19 August 2025 (CDT)
}}
 
'''For CC patients boarding on a Med ward where we collect''', enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only for [[Critical Care program]] admissions.


=== Special Case - COVID ===
See [[2020-10 COVID unit collection]].
{{Collapsable
| always= earlier info
| full= 
During the [[COVID-19 (SARS-COV-2)|COVID-19]] pandemic there were a lot of movements of entire wards (see [[:Category:2020 COVID unit transition]] for related pages). The {{PAGENAME}} project was a convenient place to store this information, so we added some specific locations for this purpose:
* HSC_D4_P
* HSC_D5
* HSC_D5_p
* HSC_H4H
* STB_E6_B
* GRA_5N
}}


== Start/End Dates ==
{{Ex | This could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med"  "<Site>_Med" (ie [[GRA_Med]], [[HSC_Med]], [[STB_Med]]) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are.}}
*Start: 2019-Sep-01: new admissions on and after this date.  
*End: there is no planned end date


== Loose ends ==
=== Special Case - [[Visits to temporary locations]] that happen to be Boarding Locs ===
{{Discuss |
Occasionally a patient may be transferred to a location that is normally a [[Boarding Loc]] that we would enter or discharge to, however that location may be used as a temporary boarding location for a procedure. If after reading through the chart this is in fact the case, that [[Boarding Loc]] should not be entered, as it should be regarded as though the patient were going for any procedure and then back to their home ward location.
* we have two entries "GRA_ER" and "GRA - ER". The "- ER" one is same format as the STB and HSC ones. We should probably consolidate the GRA_ER entry into GRA - ER. For now, collectors please use "GRA - ER", and when the last "GRA_ER" is gone I will get rid of the option and we can consolidate them. Ttenbergen 19:26, 2020 October 15 (CDT)
*Sometimes [[Visits to temporary locations]] may look like boarding locations. See that page for info on making the distinction.
** we have two 5N entries as well: GRA - N5 and GRA_5N. As previously discussed we've been using GRA - N5 but let us know if that changes [[User:Surbanski|Surbanski]] 08:23, 2020 October 16 (CDT)
{{Ex|
Medicine patient is transferred to ICMS for a scope and is not admitted under critical care -> don't enter a [[Boarding Loc]] for ICMS
}}
}}


{{DT |
=== Special Case - parked in ER ===
* [[Query ''check ER Delay not too big'']] needs to be changed to include the new [[Boarding Loc]] schema . }}
For further information please see
* [[Parked in ER]]


{{Discuss |
{{Boarding Loc, Service content}}
Which if any of [[Project_Borrow_arrive#Data_Integrity_Checks_.28SMW.29]] will need to be moved over to this instead? }}
 
== Start/End Dates of collection ==
*CC Start: 2018-July-19 as [[Project Borrow arrive]] and has been renamed and continued as Boarding Loc starting 2019-Sep-01
*Med Start: 2019-Sep-01: new admissions on and after this date.  
*CC and Med Start Oct,1 2020 : modified according to [[PatientFollow Project]]  to include ER as boarding loc.
* 2020-12-16: [[Change of GRA location names from "our" names to EPR/Cognos names]]
* 2022-01-01: [[Change of remaining location names from "our" names to EPR/Cognos names]]
*End: there is no planned end date


{{Data Integrity Check List}}
{{Data Integrity Check List}}
Line 101: Line 121:
::: where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.  
::: where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.  


The SAS program is saved in X:\Julie\SAS_CFE\CFE_macros\Bed_Borrow.sas
The SAS program is saved in S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas.
*the specific macros are %BoardingLoc, %ACCUBorrow, %ICUOtherService


== Background ==
== Background ==
See [[Bed borrow]] as aggregator page for other boarding and borrow related concepts.
See [[Bed borrow]] as aggregator page for other boarding and borrow related concepts.


The concept is similar to [[EMIP]]s but we will keep the EMIP separate from this project. The current EMIP will stay the same.--[[User:JMojica|JMojica]] 10:37, 2019 September 20 (CDT)
The concept of  [[EMIP]]s which  was similar from [[Bed borrow]] and collected separately before are now collected as part of [[Boarding Loc]]. See [[EMIP#Legacy information]] information for how they were collected before/


==Related articles ==
==Related articles ==
Line 116: Line 137:
[[Category:EMIP]]
[[Category:EMIP]]
[[Category:PatientFollow Project]]
[[Category:PatientFollow Project]]
[[Category:Admit/Discharge]]
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Boarding_Loc"