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| Sometimes currently admitted patients are sent to the local or other ER, often with the intention to go on to ICU. Right now we can't discharge to ER, so there are work-arounds. Different things are documented in different places. Starting this article after discussion with Trish and Julie to consolidate. Collectors, please get involved early if we are missing something.
| | {{LegacyContent |
| | |explanation=This is no longer collected as a tmp entry, see [[Parked in ER]] |
| | |successor=[[Parked in ER]] |
| | |content= |
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| Possible scenarios:
| | {{Project |
| * ward/unit -> ER -> home
| | |ProjectActive=legacy |
| * ward/unit -> ER -> died
| | |ProjectProgram=CC and Med |
| * ward/unit -> ER -> ward/unit at same site
| | |ProjectCollectionStartDate=Oct 10, 2017 |
| * ward/unit -> ER -> ward/unit at different site
| | |ProjectCollectionStopDate=2020-10-16 |
| * different site ER -> ER -> ward/unit at this site
| | |Project=Parked in ER |
| * different site ward/unit -> ER -> ward/unit at this site
| | }} |
| | This tmp entry was replaced by [[Parked in ER]] as part of [[Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry]] |
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| == from [[VIC ICU Collection Guide]] == | | == collection instructions == |
| See also [[Dispo_field#Discharge_to_ER]]
| | === for patient arriving at a ward/unit via parked in ER === |
| * On rare occasions, a patient who has become unstable/codes on the ward will be transferred to the ER if a bed is not yet available in the ICU. If these patients have been accepted by MICU attending, then these patients should be entered into the ICU computer, with an admit location from the ward that they came from, and an admit time of when they arrived in the ER from the ward. These patients are transferred to the ICU once a bed is available. If patient dies prior to arriving in the ICU, they should still be entered into the database. Document in the notes field time of transfer from the ER to the ICU.
| | * [[Previous Location field]], enter one of |
| {{Discussion}}
| | **HSC - ER (parked) |
| At the Concordia the patients will occasionally go from a ward to emergency because they are unstable and then are admitted to ICU. There often is no real documentation the the ICU doctor accepted the patient prior to the physical arrival in ER or ICU. Times of arrival to ER from the ward are in EPR but may not be accurate. Other recorded times may not be available. What do you want collectors do do? Are we supposed to guess, or just use what is in the EPR as an arrival time to emerg as our admit time to ICU? [[User:GHall|GHall]] 07:48, 2016 November 10 (CST)
| | **GRA - ER (parked) |
| | **STB - ER (parked) |
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| == from [[Pre-admit Inpatient Institution field]] about [[OAK_MICU]] ==
| | * [[Previous Service field]], enter the accepting service, otherwise enter ''Unknown'' |
| {{discussion}}
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| *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.
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| The question to other data collectors is: is this only a SOGH phenomenom?
| | Example: Patient in Thompson ER accepted by medicine prior to their arrival at HSC ER, previous service=medicine |
| If it is occurring 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)
| | * For these patients the [[Visit Admit DtTm field]] and the ''Accept DtTm field'' will be the same |
| *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)
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| ** 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)
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| == from [[Dispo]] ==
| | Old discussion: |
| If a patient is discharged to another ER, put discharge to home. '''Then email Pagasa to tell her which ER the pt was discharged to.'''
| | * Lisa, you changed this from "the service at the sending facility". I think the new definition is inconsistent with what is said in [[Previous Service field]] which seems to say to enter "Not Applicable". Am I missing something? Ttenbergen 10:43, 2020 July 9 (CDT) |
| We don't want ER to be available in the dropdown because it had been mistakenly entered a number of times. If it turns out there are a lot of legitimate discharges to ER we will make the option available. (discussed with Julie and Trish)
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| == from [[Previous Location field]] ==
| | * '''For an INPATIENT direct admit:''' |
| 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
| | **[[Pre-admit Inpatient Institution field]], enter the other site/unit/ward (including the HSC/STB/GRA [[EMIP]]s) they were last sent from |
| * [[Previous Location field]]: HSC ER
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| * [[Previous Service field]]: Emergency Medicine | |
| * [[Pre-admit Inpatient Institution field]]: NA / not applicable | |
| * yes, the Selkirk ER would not be reflected in collection
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| | * '''For a NON INPATIENT direct admit:''' |
| | ** go to '''Tmp Project,''' '''[[Accept_Loc_Park]]''' |
| | **follow the instruction on how to enter the non inpatient location they were last sent from |
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| == related concepts == | | === for patient leaving a ward/unit via parked in ER === |
| * [[Off ward field]]
| | Into [[Dispo]], enter the new ward that the patient will go to. The option ER (parked) will not be available. |
| * [[:Category:Overflow]]
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| * [[EMIP]]
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| * [[ECIP]]
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| [[Category: Collection Location]] | | == [[Media:DirectAdmit2.ppt | Direct Admit Process-POWER POINT presentation]] == |
| [[Category: Overflow]] | | *collection details and process change present by [[p:Julie Mojica]] at collection Collector meeting 2017_Nov_30. |
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| | == Related articles == |
| | {{Related Articles}} |
| | |
| | [[Category:Admit/Discharge]] |
| | [[Category:Overflow]] |
| | }} |