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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. 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 ==
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", for example if they came from home or a clinic. The ER is '''not''' an inpatient location.
* if the patient did not come from an '''in'''patient location, enter "not applicable"  
 
** for example if they came from home or a clinic
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.
** the ER (at your site or elsewhere) is '''not''' an inpatient location, so enter "not applicable"  


=== 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.
 
=== Chronic Care Facilities ===
They are a changing and complicated case, see [[Chronic Health Facility]].
 
=== Intra-facility and inter-facility transfers ===
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]].


=== Ambiguous locations ===
=== Arrivals from a borrowed bed ===
The following are considered inpatient locations in this context:
See and follow [[Previous Location field#Borrowed Bed Or Boarding Loc]]
* [[EMIP]]s are considered
* day-surgery patients ending up on our unit directly
The following are '''not''' considered inpatient locations, enter "NA / not applicable"
* care homes


=== movement within the same hospital ===
=== Several pre-admit locations ===
If a patient gets transferred from one ward in a hospital to another ward, enter the previous ward as both the [[Previous Location field]] and the [[Pre-admit Inpatient Institution field]].
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.


=== Cath lab confusion ===
{{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.}}
We did not use to collect cath lab and would instead code the location before, usually ER. We will now allow cath lab. If a patient comes from the cath lab it does not result in any other exceptional collection instructions. If they were an inpatient before, without interruption, code that location as [[Pre-admit Inpatient Institution field]]. If they were not an '''inpatient''' code it as not available.  


==Questions==
{{Pre-admit, Previous content}}
=== how about nursing stations? ===
*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)
*** Nursing stations are not ''in''patient locations, so don't code these. Treat as you would any external doctor's office: code NA. Ttenbergen 12:58, 2016 May 9 (CDT)


===Readmission from Grace/HSC Nursing Home===
{{Location dropdown cleanup}}
*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]]
** We treat these nursing home wards as inpatient locations for at least some scenarios.  We will treat them as inpatient locations for this.
**E.G.code Grace Nursing Home as [[Previous Location field]] and code Grace Ward (or e.g. VIC_S5 if known) as [[Pre-admit Inpatient Institution field]].
** [[Visit Admit DtTm field]] is the original hospital admit DtTm.


== 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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