Previous Location field: Difference between revisions

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→from a unit that is partly collected by us, and partly not: Units that have 2 different service type - what do you do for Previous Location and Previous Service fields.
 
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<onlyinclude>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]]) </onlyinclude>
{{DISPLAYTITLE:Previous_Location field}}
{{Data_element
| field_name = Previous_Location
| CCMDB_label = Previous Location
| 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.
 
=== Example ===
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]].


=== 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.


=== direct transfer ===
=== Borrowed Bed Or Pt Boarding On Other Unit ===
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]].
* 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.
(In the past you would have entered the hospital and ward as the "admit from".)


=== [[EMIP]]/[[Bed borrow]] ===
=== Direct Admit Scenarios ===
see those articles
*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.


=== from psych unit ===
=== Exceptions ===
Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.
*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]]


=== Data collection units that have a '''mix''' of different physician serve types ===
==== Temporary locations ====  
We have a few units in the Region that have a mix of 2 different services (internal medicine, surgical, family medicine etc).  
*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.
*VIC_S3 - is a mix of family medicine and internal medicine patients
*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.
*HSC_B3 - is a mix of day surgery & internal medicine patients
*<site>_Interventional Radiology, [[Pre-admit Inpatient Institution]] would be the unit they came from right before, if applicable.
* any others?
*<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


For patients on these units:
{{Location dropdown cleanup}}
* If patient is an internal medicine patient: enter the unit name (eg. VIC_S3)
* If patient is '''not''' a internal medicine patient, enter the generic hospital ward (e.g. VIC Ward); this will allow you to enter the [[Previous Service field]] with a physician service other than "Medicine".
 
=== Example: transfer from out-of-town ER ===
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
 
=== See also ===
* [[Operating room visits]]
 
=== Question: from day surgery or From Family Medicine ===
{{discussion}}
*Just wondering what people are selecting in the '''previous location field''' for patients who come from a day surgery unit (ex. '''B3 day surgery''' at HSC)... Right now we only have ambulatory care or interventional radiology to choose from. Do we need to add a "day surgery" option in the drop down menu? Or "other ward"?--[[User:Jvelasco|Jvelasco]] 12:07, 2016 August 2 (CDT)
**Previous Location - HSC Ward. 
**Previous Service - General Surgery (or other surgical service listed in drop down.
***I have struggled with this as well, but usually my same day patients are coming directly from the OR, or Recovery Room, so I just enter this in my previous location field, and put n/a for my pre-admit inpatient institution. If they came from a same day surgical area, then I would probably enter "ambulatory care" for my previous location.[[User:Mlagadi|Mlagadi]] 09:20, 2016 August 3
***I am trying to complete a profile that was sent to MICU from S3 at the VIC, and it won’t let me check off “complete” for my registration section. The problem seems to be that the system wants me to enter medicine as a sending service, but in reality this patient is on S3 under family medicine. My only other option would be to check off the more generic “Vic ward” instead of “VIC S3”. This patient is not on the S3 data base, because we don’t admit any of the patients on S3 that are under family medicine.  Let me know if you want to change things on your end, or if you want me to change my previous location.[[User:Mlagadi|Mlagadi]] 2016 Sept 19.
****In this case, even though the patient is physically in S3, she should enter the generic '''VIC Ward''' as '''previous location'''.  We would like to be specific in the ward  for previous location and dispo fields when it is the Med ward we are collecting or when these  wards are of interest to the users (e.g. step down wards, long term vent wards).  Put '''Family Medicine''' as '''previous service'''.  Putting VIC S3 as previous location will only create a question  ‘why there is no record of this patient in VIC S3 ?”  [[Julie Mojica]] 2016-Sept-19


== 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]]
* Patients with [[Previous Location field]] critical care must have [[Previous Service field]] critical care, and patients from medicine must have previous service medicine.
 
* query check_prev_pre-admit_consistent: for inpatient transfers within the region, [[Previous Location field]] and [[Pre-admit Inpatient Institution field]] should be same.
 
* query check_previous_location_vs_service_inconsistent: patients with [[Previous Location field]] in medicine must have [[Previous Service field]] medicine; patients from ICU (except CCU) must have previous service "critical care".
 
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 84: 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: Registry Data]]
[[Category: L Log table]]
[[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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