Previous Location field: Difference between revisions

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{{DISPLAYTITLE:Previous_Location field}}
{{Data_element
{{Data_element
| field_name = Previous_Location
| field_name = Previous_Location
| CCMDB_label = Previous Location
| CCMDB_label = Previous Location
| CCMDB_tab = Dispo
| CCMDB_tab = Dispo
| element_description = The most recent previous '''physical location''' of a patient before arriving at the collection location.
| element_description = The most recent previous '''physical location''' (with [[#exceptions]]) of a patient before arriving at the collection location.
| in_table = L_Log
| in_table = L_Log table
| data_type = number
| data_type = number
| datafield_length = long integer
| datafield_length = long integer
Line 12: Line 13:
| data_element_sort_index = 37
| data_element_sort_index = 37
}}
}}
For exceptions, see
* [[EMIP]]
* [[HSC Community and Clinical Decision Unit (CCDU)]]
* [[Parked in ER]]


== 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".)
 
=== from psych unit ===
Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.
 
== Question about Dialysis unit as previous location==
{{discussion}}
*Since now we have the Dialysis unit as an option for previous location, should we always be using this even if the pt is a ward patient that just happens to be transferred from the dialysis unit to the ICU as the last place they were located having their treatment?  I thought that was what was wanted.  Just checking because at the team meeting there was some discussion about a pt having gone to dialysis between transfers and that affecting their EPR arrival time on a given ward.  This can apply to Previous location and to dispo. If we use the option of Dialysis unit it is still clear that they were a ward patient because you would still enter the ward in the previous inpatient location field.  Using dialysis unit as a place would make transfers much more accurate so I think that this would prevent any problem using EPR times regarding transfers when dialysis is done before or after a transfer.  Just bringing this up because of the question that was brought up in the team meeting so we can clarify this.  Thanks.--[[User:LKolesar|LKolesar]] 07:37, 2017 March 13 (CDT)
**Yes the location Dialysis Unit will be used in the [[Previous Location]] and [[Dispo]] if applicable, similar to 'Cardiac Cath Lab'.  If already an inpatient, enter the location in the [[Pre-admit Inpatient Institution]]. [[User:JMojica|JMojica]] 13:47, 2017 March 14 (CDT)
***This is not presently an option at HSC-with medicine transfers-the transferring ward /medicine group continues to manage patient until they arrive on the next unit-then orders etc are processed and admission is completed.Our arrival to ward time then becomes our coordinated transfer time/s.--[[User:Llemoine|Llemoine]] 08:02, 2017 March 15 (CDT)
 
==Question about Heart Cath Lab as previous location==
{{discussion}}
*When a valve replacement is done in the cath lab (TAVI) should we put the CATH lab in previous location or OR?  Do we have to put all surgical procedures from the OR?  Just making sure this will not conflict with anything.  Just checking because Lois had this question. 
**yes this will affect the score of the APACHE II Diagnosis categories where the nonoperative and operative patients have to be defined by using the previous location (i.e. operative if coming from OR/RR).  Can we keep the previous location = Operating Room until we move to ICD10 coding which will consequently require the changing of the program for the APACHE II Diagnosis categories. [[User:JMojica|JMojica]] 14:26, 2017 March 14 (CDT)


=== 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.


=== Data collection units that have a '''mix''' of different physician serve types ===
=== Exceptions ===
We have a few units in the Region that have a mix of 2 different services (internal medicine, surgical, family medicine etc).  
*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:
*VIC_S3 - is a mix of family medicine and internal medicine patients
** If patient was under internal medicine service, enter <site>_Med
*HSC_B3 - is a mix of day surgery & internal medicine patients
** If '''not''' under internal medicine service, enter the <site>_Ward
* any others?
*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]]


For patients from these units:
==== Temporary locations ====
* If patient is an internal medicine patient: enter the unit name (eg. VIC_S3)
*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.
* 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".
*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


=== Patients from day surgery===
{{Location dropdown cleanup}}
For patients admitted from day surgery units, enter:
*Previous Location - <your hospital> Ward, e.g. HSC Ward
*[[Previous Service]] - General Surgery (or other surgical service listed in drop down.


== 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 96: 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]]
[[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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