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Pre-admit Inpatient Institution field: Difference between revisions

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''This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear. ''
{{Data_element
 
| field_name = Pre_admit_Inpatient_Institution
The [[Pre-admit Inpatient Institution field]] identifies the '''previous inpatient location''' of patients who were already '''inpatients''' elsewhere before coming to our unit '''from a [[Previous Location field | Previous location]] that is temporary'''(such as an ER). This does not include patients who just arrived at an ER elsewhere and were not admitted as inpatient there.
| CCMDB_label = Pre-admit Inpatient Institution
 
| CCMDB_tab = Dispo
For example, a patient arriving from Selkirk Hospital via the local ER would have the ER coded in the [[Previous Location field]] and Selkirk coded in the [[Pre-admit Inpatient Institution field]].
| element_description = The most recent '''previous ''inpatient'' location''' of patients who were already '''inpatients''' elsewhere and who have been under medical care continuously before coming to our unit.
| in_table = L_Log table
| data_type = number
| datafield_length = long integer
| program_collecting = Med and CC
| created_raw = Raw
| data_element_start_date = 2016-07-01
| data_element_sort_index = 36
}}


== Collection Instruction ==
== Collection Instruction ==
If the [[Previous Location field]] '''contains a "temporary" location''' like an ER, OR or Cath Lab you will need to enter this field. In that case, for each patient,
* For each patient, enter the most recent '''in-patient''' location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals
* enter the option that most closely matches
** for patients who were accepted by a service at the previous site, but never left the site's ER to get to the ward ("EMIP" concept), consider these in-patients
{{PrePrevDispo listing}}
{{Ex |
*HSC MICU --- family medicine ward at the Vic --- HSC_ER --- STB_ER --- cath lab --- HSC_MICU.
**Code the Pre-admit Inpatient Institution field as: VIC_Ward}}
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if the situation is unknown, enter '''location missing/unknown'''
* if the situation is unknown, enter '''location missing/unknown'''
 
* if the patient did not come from an '''in'''patient location, enter "not applicable"  
If the [[Previous Location field]] does '''not contain a "temporary" location'''
** for example if they came from home or a clinic
* enter "not applicable"
** the ER (at your site or elsewhere) is '''not''' an inpatient location, so enter "not applicable"  
 
If you know how we code the location exactly, you can type it. Otherwise press the "magic wand" button to take you to the [[S dispo chooser‎]] to help filter options if desired.


=== Where to find this information ===
=== Where to find this information ===
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.


=== Example ===
=== Ambiguous locations ===
*ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC.
* Day-surgery locations - use "<hosp> ambulatory care"
**The PrevInptLocation field is: VIC_Ward
*The following '''ARE NOT''' considered inpatient locations, enter "NA / not applicable"
** Any PCH (see [[Chronic Health Facility]] for additional instructions)
** Nursing stations - they are not inpatient locations, and Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.  


==Questions==
=== Chronic Care Facilities ===
=== how about nursing stations? ===
They are a changing and complicated case, see [[Chronic Health Facility]].
*We used to collect nursing stations in [[hospital previous]] but would not include them under the new scheme because they are not inpatient locations.  
We are planning a meeting with Randy Martin to discuss. For now you can't enter nursing stations here, so, don't. Ttenbergen 18:16, 2016 April 28 (CDT)


=== ER -> cath lab -> ward scenario ===
=== Intra-facility and inter-facility transfers  ===
*If the previous location is the heart cath lab (which is a temporary location), then I should add a pre-admit inpatient institution.  However, if the patient comes to the cath lab from ER, I cannot put this location because it also is a temporary location. Currently we do not put in the heart cath lab as a place to admit from, instead we use where they were located just prior to the cath lab  (ER in this example). I thought that Julie tracked Winnipeg hospital use of ER's for Randy so if we will no longer be able to put that the pt came from ER in this setting, then this will be entirely missed.  Just checking!  --[[User:LKolesar|LKolesar]] 14:21, 2016 April 14 (CDT)
If a patient gets transferred to another ward in the same or different hospital, enter <site>_Med, <site>_Ward or <site>_CC (as appropriate) as both the [[Previous Location field]] and the [[Pre-admit Inpatient Institution field]].


=== are EMIPs inpatients? ===
=== Arrivals from a borrowed bed ===
*GRA_emip is not a pre admit location
See and follow [[Previous Location field#Borrowed Bed Or Boarding Loc]]
** Or are they? their name would suggest they are. Emailing Julie for answer. Ttenbergen 18:16, 2016 April 28 (CDT)
** Good question. I would consider EMIPS as in-patient and therefore STB, VIC and GRA ER should be included in the downlist of PRE-admit location (not HSC,CON,OAK ER). [[User:JMojica|JMojica]] 10:01, 2016 April 29 (CDT)


=== Grace changes requested ===
=== Several pre-admit locations ===
* Missing from Grace: S2, S4, S5 (unless we just put GRA_ward for all units that we currently don't collect on)
If a patient travels through several pre-admit inpatient locations we will only have data on the last one. We understand that. Just to be clear.
** changed, Grace collecors, please delete when you have seen


* Can we change W3 to S3 as it is no longer called W3 (unit was expanded)?[[User:Mschaffer|Mschaffer]]
{{Ex |  Pt was on a ward as an inpatient then went to ICU, then was transferred to the ward you are collecting on. Previous location would be ICU and previous inpatient institution would also be ICU.}}
** changed, Grace collecors, please delete when you have seen


=== intra-hospital transfers ===
{{Pre-admit, Previous content}}
{{discussion}}
 
*When we have patients moving from ward to ward, we normally do not go back to their original admission date to gather data especially as some patients have been admitted for over a year. Will it be acceptable to continue this practice?--[[User:CMarks|CMarks]] 12:39, 2016 April 11 (CDT)
{{Location dropdown cleanup}}
** For intra-hospital transfer, code Pre-admit Inpatient Institution field as "not applicable" (I still have to make that available) Ttenbergen 11:41, 2016 April 27 (CDT)
===readmission from Grace Nursing Home===
*currently discharges to and admissions from Grace Nursing Home are treated as new admissions (with the exception of the Discharge Screening Tool which is labelled 'transferred form').  Technically, though, this is an interhospital transfer, and the hospital treats it as a continuous admission.  Will this require a previous Inpatient Institution entry? And will the visit admission date then be the original admission date, or the date transferred from one ward to the other? [[User:SCortilet|SCortilet]]


== Data Use / Purpose ==
== Data Use / Purpose ==
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The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.
The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.


== {{CCMDB Data Integrity Checks}} ==
== Cross Checks ==
* Records for all [[Admit from]]s in [[#Temporary locations]] need to have an entry (possibly "none")
{{Data Integrity Check List}}
* Records for all [[Admit from]]s ''not'' in [[#Temporary locations]] need to '''not''' have an entry
Not yet implemented Ttenbergen 14:11, 2015 May 27 (CDT)
*{{discussion}} do these make sense?  (old q from Tina)
**YES.  if these are done, you may delete the ones I wrote above.  [[User:JMojica|JMojica]] 12:31, 2015 May 28 (CDT)


== Reports ==
== Reports ==
{{discussion}} Which reports will this be on? Ttenbergen 10:33, 2016 March 22 (CDT)
The information is part of the [[Critical Care Program Quality Indicator Report]] and the [[ICU Interfacility Report]].  Also the information will be useful for research projects where it will mark a patient as inpatient before arrival to the unit or ward.


== Implementation ==
== Implementation ==
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== Legacy ==
== Legacy ==
This field is part of the [[2016 Time and Place changes]] and did not previously exist.
This field is part of the [[2016 Time and Place changes]]. Some of the data previously existed in [[hospital previous]] but it is not a 1-to-1 mapping.
 
== Related articles ==
{{Related Articles}}


[[Category: 2016 Time and Place changes]]
[[Category:2016 Time and Place changes]]
[[Category: Admit/Discharge]]
[[Category:Admit/Discharge]]
[[Category:Data Collection Guide]]
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