Intended1stSrvc

Projects
Active?:	planned
Program:	CC
Requestor:	Bojan Paunovic
Collection start:
Collection end:

This project is not live yet, do not follow the instructions to stop the old collection yet. I hope to have this set up to start collecting with the new instructions Dec1. For now, continue to use the instructions in ICUotherService. Ttenbergen 14:27, 26 September 2025 (CDT)

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Background

The Critical Care Program Quality Indicator Report

is that the right report? I have added this new data to that report's dependencies. If it's the wrong one it will need to be taken out of there. If other reports also use this, it will need to be added to them. If only that report you can remove this comment. Ttenbergen 15:20, 26 September 2025 (CDT) Yes, the plan is to show them here - the intended 1st service along with the other scenarios which will be presented maybe tabular or graphical (preferably). --JMojica 17:06, 18 December 2025 (CST)

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• This variable essentially replaces ICUotherService
• It is to be used when the ICU service a patients is actually on (MICU, SICU, IICU, ICMS, CICU, Grace ICU) is different from the service the patients should be on. This most common reason for this to happen is bed capacity issues.
  • e.g. patient admitted from ED ventilated with severe pneumonia, should go to MICU but it is full, so goes to SICU and is taken care of by the SICU service. Here Service/Location is SICU and Intended1stSrvc is MICU
  • e.g. patient in ED at Grace and should go to Grace ICU but it's full, so goes to HSC MICU. Here Service/Location is MICU and Intended1stSrvc is Grace ICU. This example shows that the Intended1stSrvc can be at a different hospital altogether.
• This variable should be left BLANK when the ICU service the patient is on is the one they should be on -- i.e. only fill it in when there is an Intended1stSrvc that is different from the first service they are actually on (i.e. what's in Service/Location)
• Along with Boarding Loc, Service Location and Intended1stSrvc allow clear identification of all types of ICU boarding
• As part of this alteration in collection, we will no longer use Service tmp entry for the purpose of identifying actual locations or services. It will ONLY be used for the purpose of keeping track of data collection.
  • those downloaded entries do not actually correspond the the true 6 ICU services that exist (as of 2025) and so are confusing, as they are things like "HSC Critical Care/Medicine A" or "HSC Critical Care/Plastics"
  • as Service tmp entry is downloaded from Cognos, this will no longer occur
• As we create a new ICU profile (record) when the ICU service changes, each time a new ICU profile is created, collectors will need to consider Intended1stSrvc anew
  • although we considered carrying over the prior value of Intended1stSrvc when a patient is transferred ICU-to-ICU, we decided against this as it creates other ambiguities
• Here is the most complex subtlety of this issue of what service a patient "should be on"
  • It can change during the course of the episode of ICU care (across ICUs, or within a single ICU). Sometimes such a change might be clearcut (e.g. due to occurrence of a surgical procedure) but other times the fact that the service the patient should be on changes is just within the heads of the attending physicians. Because of this uncertainty we explicitly decided NOT to try and track the service a patient should be on as time goes by, but only upon initiation of an ICU profile, which is why this variable is called "Intended1stSrvc"

Data Collection Instructions

• Code it as the ICU service that the patient SHOULD HAVE BEEN under upon initial admission to the ICU Service in this hospital, i.e. at the start of this record
  • Leave it blank if the very first day in ICU in that hospital, the patient was, in fact under the "correct" ICU service, i.e. the service that should have been taking care of the patient -- and as this is the majority of all ICU records, this variable will usually be left blank.

Example:

Patient with acute MI admitted via ED. He should have been under the ACCU service in ACCU but ACCU was full. So he was admitted to ICMS instead under the ICMS Service. Thus here Intended1stSrvc = ACCU.

Transfer to Another ICU Service

• This is important regarding this variable as a new ICU database record is created when a patient goes from one ICU service to another, but not if the patient goes from one ICU Boarding Loc to another while staying under the same service.

• Use tmp fields:
• Project: Intended1stSrvc
• Item:

as per JALT Meeting - Rolling Agenda and Minutes 2025#JALT 2025-12-18, needs to be integrated: We agreed that the options for the dropdown listings should all be the same for Boarding Loc, Service/Location, and the new field Intended1stSrvc, and that these will be the same as those currently used for Boarding Loc, i.e: HSC-MICU, HSC-SICU, HSC-IICU, STB-MICU, STB-CICU, STB-ACCU and GH-CC We recognize that these will then be different from the "official" ADT services listings provided to us in Cognos2

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Things to resolve

Things we need to resolve: We need to review anything that links to ICUotherService, and anything that page lists to. The "anything that links there" can be accessed by expanding the "related articles (expand)" at the bottom of ICUotherService. Ttenbergen 10:59, 25 September 2025 (CDT) I have reviewed the links to ICUotherService and changed what needs changing. Ttenbergen 15:05, 26 September 2025 (CDT) We need to move the change-related parts of what Allan wrote in Intended1stSrvc to 2025-05 Revision of concept around ICUotherService to keep this page on target and keep the explanation in one place. Ttenbergen 15:05, 26 September 2025 (CDT) I think I have done that, mostly, but someone should have a look at 2025-05 Revision of concept around ICUotherService to confirm that the change is explained fully enough to make sense of the before and after data Ttenbergen 23:03, 28 September 2025 (CDT). This Intended1stSrvc assumes a whole stay on the borrowed service. How about the case where there is only partial stay being taken care by borrowed service and then the patient now becomes a legit patient of that service. Example, Intended1stSrvc is STB ICSM taken care by ACCU service (May 24,2023 13:17) boarding at ACCU bed , then by May 26,2023 15:40 became an ACCU patient taken care by ACCU in same ACCU bed until discharge to ward June 5,2023 16:22. This is currently just one record. For me to breakdown the days, there is a need to enter the start dttm and/or end dttm aside from the intended unit. OR Should this case be two records, thus there is no need to enter dttm?--JMojica 17:31, 18 December 2025 (CST)

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Log

• 2025-09-25 - change of ICUotherService to this way of coding the concept was first discussed, page generated for Allan to update.
• See 2025-05 Revision of concept around ICUotherService for decisions leading up to implementation

Data Integrity Checks (automatic list)

none found

I don't think any checks are possible for this, or can someone think of one?

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