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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
{{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. 
*The following '''ARE NOT''' considered inpatient locations, enter "NA / not applicable"
**The PrevInptLocation field is: VIC_Ward
** Any PCH (see [[Chronic Health Facility]] for additional instructions)
** [[Grace Nursing Home Ward]] - We consider admissions from there as [[readmission]]s, so would be coded as if they had come from home. Consistent with that we will consider these '''not''' inpatient locations, so code them as "NA / not applicable". (As per meeting with Dr Roberts 2016-05-05)
** Day-surgery locations - use "<hosp> ambulatory care"


=== EMIP ===
=== Chronic Care Facilities ===
If pt goes from Medicine [[EMIP]] to an ICU, use the EMIP location in [[Pre-admit Inpatient Institution field]].
They are a changing and complicated case, see [[Chronic Health Facility]].
 
=== Ambiguous locations ===
The following '''are''' considered inpatient locations in this context:
* day-surgery patients ending up on our unit directly


The following are '''not''' considered inpatient locations, enter "NA / not applicable"
=== Intra-facility and inter-facility transfers  ===
* care homes, including units with higher levels of care at Deer Lodge or Riverview
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]].


=== movement within the same hospital ===
=== Arrivals from a borrowed bed ===
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]].
See and follow [[Previous Location field#Borrowed Bed Or Boarding Loc]]


=== Cath lab confusion ===
=== Several pre-admit locations ===
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.  
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.


==Questions==
{{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.}}


===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 ==
Can not be blank.
{{Data Integrity Check List}}


== Reports ==
== Reports ==
{{discussion}} Which reports will this be on? Ttenbergen 10:33, 2016 March 22 (CDT)
*The information will be part of the Inter-facility transfer report (i.e. inpatients coming from other facility outside the region or within the region).  Also the information will be useful for research projects where a patient will be tagged if already an inpatient before arrival to the unit or ward.  [[User:JMojica|JMojica]] 11:45, 2016 June 6 (CDT)


== Implementation ==
== Implementation ==
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We used to collect nursing stations in [[hospital previous]] but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.   
We used to collect nursing stations in [[hospital previous]] but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.   


== 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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