Previous Location 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. ''
{{DISPLAYTITLE:Previous_Location field}}
 
{{Data_element
The [[Previous Location field]] contains the most recent previous '''physical location''' of a patient before arriving at the collection location. (exception, see [[#EMIP]], [[bed borrow]])
| field_name = Previous_Location
 
| CCMDB_label = Previous Location
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]].
| CCMDB_tab = Dispo
| element_description = The most recent previous '''physical location''' (with [[#exceptions]]) of a patient before arriving at the collection location.
| 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 = 37
}}


== Collection Instruction ==
== Collection Instruction ==
For each patient,  
For each patient,  
* enter the option that most closely matches
* enter the option that most closely matches:
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed''
{{PrePrevDispo listing}}
* if the situation is unknown, enter '''location missing/unknown'''
* if the patient is a direct admission use <site>_UC, <Site>_ER, <site>_ward, <site>_Med, <site>_ICU or temporary location depending on the scenario (see direct admit scenarios below)
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if the situation is unknown, enter '''Not known'''
* if the patient is in ER under a service we do not collect ie. cardiology, surgery etc use <site>_ER


If you know the location exactly, you can type it. Otherwise press the "?" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
If you know the location exactly, you can type it, otherwise click on the dropdown button to view the options
 
For wards where we don't collect, enter e.g. HSC_ward. For wards where we do collect enter the actual ward as available in the dropdown.


=== Where to find this information ===
=== Where to find this information ===
If patient came from a different Winnipeg hospital this should be recorded in the  “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.
If patient came from a different Winnipeg hospital this should be recorded in the  “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.


=== Cath Lab Question ===
=== Borrowed Bed Or Pt Boarding On Other Unit ===
{{Discussion}}
* Use the [[Boarding Loc]] of the service taking care of the patient:<site>_Med, GH-CC, HSC_MICU, HSC_SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU.
*Need clarification of "cath lab" which is listed for STB and HSC hospitals.  Gail already asked this question and we need clarification for both hospitals.  Is this just the heart cath lab??--[[User:LKolesar|LKolesar]] 13:13, 2016 May 27 (CDT)
** Yes, my understanding is Cardiac cath lab.  But if there are other type, does it matter? Will the previous service or pre-admit inpatient institution become a problem? [[User:JMojica|JMojica]] 13:22, 2016 May 31 (CDT)
*** This question was raised again today at the collector meeting, still outstanding. Ttenbergen 16:02, 2016 June 8 (CDT)


=== direct transfer ===
=== Direct Admit Scenarios ===  
For patients who get [[ICU Var 4 - Parked in ER|parked in the ER]] during a inter-facility transfer, enter the previous ward in [[Pre-admit Inpatient Institution field]] and enter your ER in [[Previous Location field]].
*inpatients from CON, OAK, VIC who are direct transfers to HSC/STB/GRA, the [[Pre-admit Inpatient Institution]] and [[Previous Location]] will be <site>_ward, even if the patient spends time in that site's UC prior to transfer. If not yet an inpatient from CON/OAK/VIC and transfer is from their UC, then previous location is the <site>_UC. 
(In the past you would have entered the hospital and ward as the admit from.)
*For direct transfers from HSC/STB/GRA, if an inpatient, and no in-between temporary location, the [[Pre-admit Inpatient Institution]] is the same as [[Previous Location]] (e.g. GH_med, or HSC_MICU)
**if there is a temporary location in-between, then [[Previous Location]] is equal to the temporary location (e.g. OR, RR, Cath Lab, Dialysis, IR or Other procedure location) and [[Pre-admit Inpatient Institution]] would be the previous <site>_inpatient location
**If not yet an inpatient from HSC/STB/GRA and coming from <other site> ER then previous location is <other site> ER, and the [[Pre-admit Inpatient Institution]] would be not applicable
*If a homeless patient is admitted directly then code them as admitted from home.
*If a patient is admitted directly from prison, jail or a correctional institution, code this as an admission from '''"Institution NOS"'''. See [[Prison / Jail / Correctional Institution]] for additional info.


=== [[EMIP]]/[[Bed borrow]] ===
=== Exceptions ===
see those articles
*We have a few units in the Region that have a mix of different services (internal medicine, surgical, family medicine etc). For patients from these units:
** If patient was under internal medicine service, enter <site>_Med
** If '''not''' under internal medicine service, enter the <site>_Ward
*for Riverview and Deer Lodge, see [[Chronic Health Facility]] see [[Pre-admit Inpatient Institution field]] or the various wards that are considered an inpatient location
*patients from POU (psych evaluation unit @ HSC) as "HSC ambulatory care" - This is not an inpatient ward.
*patients admitted from day surgery units, enter <site>_ambulatory care, e.g. this is not considered to be an inpatient location see [[Pre-admit Inpatient Institution field]]


=== from psych unit ===
==== Temporary locations ====  
Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.  
*for patients from the Dialysis unit, use that <site>_Dialysis as previous location. [[Pre-admit Inpatient Institution]] would be the unit they came from right before, if applicable.
*patients from the cardiac cath lab, enter STB Cardiac Cath Lab, [[Pre-admit Inpatient Institution]] would be the unit they came from right before, if applicable.
*<site>_Interventional Radiology, [[Pre-admit Inpatient Institution]] would be the unit they came from right before, if applicable.
*<site>_OR, [[Pre-admit Inpatient Institution]] would be the unit they came from right before, if applicable.
*<site>_recovery (PACU),  [[Pre-admit Inpatient Institution]] would be the unit they came from right before, if applicable.
*Other procedure location, eg. misericordia eye clinic for procedure, [[Pre-admit Inpatient Institution]] would be the unit they came from right before, if applicable.  
* see also [[Visits to temporary locations]] for more coding instructions


=== Example: transfer from out-of-town ER ===
{{Location dropdown cleanup}}
Pt was examined & treated in the Selkirk ER (but not admitted as an in pt.) & then sent as a direct admit to HSC but stopped in HSC ER & was treated there till a ward bed was ready. Code as
* [[Previous Location field]]: HSC ER
* [[Previous Service field]]: Emergency Medicine
* [[Pre-admit Inpatient Institution field]]: NA / not applicable
* yes, the Selkirk ER would not be reflected in collection


== Data Use ==
== Data Use ==
This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.  
This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.  


== {{CCMDB Data Integrity Checks}} ==
== Cross Checks ==
Implemented:
{{Data Integrity Check List}}
* Can not be blank
* previous_NE_Location() - [[Previous Location field]] can't be same as [[Service/Location field]]
 
Following might still need to be implemented:
* [[Check ORDx]]; or not? Would have to be done for ICD10, so can it wait? Ttenbergen 16:26, 2016 May 25 (CDT) 
** discussing with Julie, she seems open to waiting, told her I am starting [[:Category:ICD10]] and [[:Template:ICD10]] for stuff like this. Ttenbergen 10:56, 2016 June 2 (CDT)
{{ICD10}}


== Implementation ==
== Implementation ==
Line 64: Line 74:
* [[Hospital previous]]
* [[Hospital previous]]
* [[Var 1 - Admit-from Ward]]
* [[Var 1 - Admit-from Ward]]
== Related articles ==
{{Related Articles}}


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

Latest revision as of 17:52, 10 March 2025


Data Element (edit)
Field Name: Previous_Location
CCMDB Label: Previous Location
CCMDB tab: Dispo
Table: L_Log table
Data type: number
Length: long integer
Program: Med and CC
Created/Raw: Raw
Start Date: 2016-07-01
End Date: 2300-01-01
Sort Index: 37

The most recent previous physical location (with #exceptions) of a patient before arriving at the collection location.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


Collection Instruction

For each patient,

  • enter the option that most closely matches:
  • if the patient is a direct admission use <site>_UC, <Site>_ER, <site>_ward, <site>_Med, <site>_ICU or temporary location depending on the scenario (see direct admit scenarios below)
  • if you know the situation but nothing on the list matches closely, enter other - known but not listed
  • if the situation is unknown, enter Not known
  • if the patient is in ER under a service we do not collect ie. cardiology, surgery etc use <site>_ER

If you know the location exactly, you can type it, otherwise click on the dropdown button to view the options

Where to find this information

If patient came from a different Winnipeg hospital this should be recorded in the “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.

Borrowed Bed Or Pt Boarding On Other Unit

  • Use the Boarding Loc of the service taking care of the patient:<site>_Med, GH-CC, HSC_MICU, HSC_SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU.

Direct Admit Scenarios

  • inpatients from CON, OAK, VIC who are direct transfers to HSC/STB/GRA, the Pre-admit Inpatient Institution and Previous Location will be <site>_ward, even if the patient spends time in that site's UC prior to transfer. If not yet an inpatient from CON/OAK/VIC and transfer is from their UC, then previous location is the <site>_UC.
  • For direct transfers from HSC/STB/GRA, if an inpatient, and no in-between temporary location, the Pre-admit Inpatient Institution is the same as Previous Location (e.g. GH_med, or HSC_MICU)
    • if there is a temporary location in-between, then Previous Location is equal to the temporary location (e.g. OR, RR, Cath Lab, Dialysis, IR or Other procedure location) and Pre-admit Inpatient Institution would be the previous <site>_inpatient location
    • If not yet an inpatient from HSC/STB/GRA and coming from <other site> ER then previous location is <other site> ER, and the Pre-admit Inpatient Institution would be not applicable
  • If a homeless patient is admitted directly then code them as admitted from home.
  • If a patient is admitted directly from prison, jail or a correctional institution, code this as an admission from "Institution NOS". See Prison / Jail / Correctional Institution for additional info.

Exceptions

  • We have a few units in the Region that have a mix of different services (internal medicine, surgical, family medicine etc). For patients from these units:
    • If patient was under internal medicine service, enter <site>_Med
    • If not under internal medicine service, enter the <site>_Ward
  • for Riverview and Deer Lodge, see Chronic Health Facility see Pre-admit Inpatient Institution field or the various wards that are considered an inpatient location
  • patients from POU (psych evaluation unit @ HSC) as "HSC ambulatory care" - This is not an inpatient ward.
  • patients admitted from day surgery units, enter <site>_ambulatory care, e.g. this is not considered to be an inpatient location see Pre-admit Inpatient Institution field

Temporary locations

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

SQL query of what is currently available    
SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo
FROM s_dispo
WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));
  • query of what is currently used: query z_s_dispo_inactivatable

Data Use

This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.

Cross Checks

Data Integrity Checks (automatic list)

 AppStatus
Check pre acute consistentCCMDB.accdbdeclined
Query check tmp ER Boarding Loc should exist if from ERCCMDB.accdbdeclined
Function Validate Previous LocationCCMDB.accdbimplemented
Query check prev pre-admit consistentCCMDB.accdbimplemented
Check function previous NE LocationCCMDB.accdbimplemented
Query check CCI from OR no CCICCMDB.accdbimplemented
Query check pt from ERCCMDB.accdbimplemented
Query check previous location vs service inconsistentCCMDB.accdbretired
Check Accept Loc ParkCCMDB.accdbretired
Query check VAP admit must be from ICUCCMDB.accdbretired
Link suspect mismatch from ours incomplete queryCentralized data front end.accdbimplemented
Link_suspect_not_same_visitAdmitDtTm queryCentralized data front end.accdbimplemented
Query cardiac arrest throughout admissionCentralized data front end.accdbneeds review
Link_suspect_visitAdmitDtTm_mult_to-from-home queryCentralized data front end.accdbready to implement

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes.

It a combination of our previous

Related articles

Related articles:
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