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Pre-admit Inpatient Institution field: Difference between revisions

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{{Data_element
{{Data_element
| field_name = Pre_admit_Inpatient_Institution
| field_name = Pre_admit_Inpatient_Institution
 
| CCMDB_label = Pre-admit Inpatient Institution
| element_description = The Pre-admit Inpatient Institution field identifies the '''previous ''inpatient'' location''' of patients who were already '''inpatients''' elsewhere and who have been under medical care continuously 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_tab = Dispo
*NOTE: if the previous location is already an inpatient location, then the pre admit inpatient institution will be the same the previous location.
| 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
| in_table = L_Log table  
| data_type = number
 
| datafield_length = long integer
| data_type = integer
 
| datafield_length = long
 
| program_collecting = Med and CC
| program_collecting = Med and CC
 
| created_raw = Raw
| created_raw = raw
| data_element_start_date = 2016-07-01
 
| data_element_sort_index = 36
}}  
}}
 
For example, a patient arriving from Selkirk Hospital ward via the local ER would have the ER coded in the [[Previous Location field]] and Selkirk ward coded in the [[Pre-admit Inpatient Institution field]].


== 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 most recent '''in-patient''' location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals.
** 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 "?" 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.
=== [[EMIP]]/[[Bed borrow]] ===
see those articles


=== Ambiguous locations ===
=== Ambiguous locations ===
The following '''are''' considered inpatient locations in this context:
* Day-surgery locations - use "<hosp> ambulatory care"
* day-surgery patients ending up on our unit directly
*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.


The following are '''not''' considered inpatient locations, enter "NA / not applicable"
=== Chronic Care Facilities ===
* care homes, including units with higher levels of care at any [[Chronic Health Facility]]
They are a changing and complicated case, see [[Chronic Health Facility]].


=== intra-facility and inter-facility transfers  ===
=== Intra-facility and inter-facility transfers  ===
If a patient gets transferred to another ward in the same or different hospital, enter the '''previous ward''' as both the [[Previous Location field]] and the [[Pre-admit Inpatient Institution field]].
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]].


=== patients discharged to Oaks ER ===
=== Arrivals from a borrowed bed ===
{{discussion}}
See and follow [[Previous Location field#Borrowed Bed Or Boarding Loc]]
*Patients that are admitted to a ward at SOGH and become unstable may be transferred to the SOGH ER for determination of problem and disposition. If they are deemed critically ill and are an ICU candidate, they are then admitted from the ER to SOGH ICU. This is not a consistent practice but does occur on a regular basis. Main office notes that my pre-admit inpatient field is Oak-Ward but my previous location is Oak-ER and is an outlier compared to everyone else.


The question to other data collectors is: is this only a SOGH phenomenom?
=== Several pre-admit locations ===
If it is occuring at your facility, does it occur only rarely which is why the data has not shown this elsewhere? Or is your coding different in these cases? --[[User:Lpruden2|Lpruden2]] 14:37, 2016 October 13 (CDT)
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.
*At the VIC, the only reason that I have seen patients making a stop in the ER is when they have been accepted to the ICU, but the bed is not yet available. They sometimes will be cared for in the ER until the ICU bed is ready. This is a rare occurrence-I would estimate that it only happens once or twice a year. [[User:Mlagadi|Mlagadi]] 10:05, 2016 October 17 (CDT)
** It looks like what Lorri describes only happens at the Oaks, then. How should we code it there? I have added a link from [[Oaks_ICU_Collection_Guide#Data_Collection]] to this article to make sure a visiting collector can find this. Ttenbergen 10:40, 2016 October 20 (CDT)
**The same thing happens at Concordia that Lori described for SOGH. Patients go to the ER from the ward for treatment and assessment then to ICU.[[User:GHall|GHall]] 17:19, 2016 October 20 (CDT)
 
===Code Readmission from Grace/HSC Nursing Home as NA ===
We consider admissions from there as re-admissions, 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)


=== Example ===
{{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.}}
*ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC.
**The PrevInptLocation field is: VIC_Ward


=== several pre-admit locations ===
{{Pre-admit, Previous content}}
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.


Example: 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.
{{Location dropdown cleanup}}


== 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}}
* preAdmit_NE_Location() - [[Pre-admit Inpatient Institution field]] can't be same as [[Service/Location field]]
 
* query check_prev_pre-admit_consistent: for inpatient transfers within the region, [[Previous Location field]] and [[Pre-admit Inpatient Institution field]] should be same.


== Reports ==
== Reports ==
*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)
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 ==
Line 88: Line 70:


== 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.
 
=== 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. 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: OverstayProject]]
[[Category:Data Collection Guide]]
[[Category: L_Log table]]
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