Overstay Predictor Project Collection Instructions: Difference between revisions

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Changes coming July 31 2017 - stay tuned.
{{LegacyContent
 
|explanation=we stopped [[Overstay]]
= Instructions for admissions starting Jul 31 2017 =
|successor=
 
|content=
This article documents what data collectors need to do to collect information for the [[Overstay Predictor Project]].  
This article documents what data collectors need to do to collect information for the [[Overstay Predictor Project]].  


'''This project is one of the [[Vacation and staff shortage collection priorities]]!'''
'''This project was one of the Vacation and staff shortage collection priorities!'''
 
No entries are required in the TMP section. (AutoEntry of DPST form in tmp will disappear.)
 
***Trish & Tina...At the task meeting it was mentioned that we are to generate a new colour with every ward move but I don't see instructions reflecting this.--[[User:CMarks|CMarks]] 12:49, 2017 July 20 (CDT)


== In addition to [[Minimal Data Set]] ==
== In addition to [[Minimal Data Set]] ==
Line 15: Line 11:
* [[Date of Birth]]
* [[Date of Birth]]
* [[Province]]
* [[Province]]
* [[Accept DtTm]] if used, else [[Arrive DtTm]]
* "Accept DtTm" if used, else "Arrive DtTm"
* [[Pre-admit Inpatient Institution]]
* [[Pre-admit Inpatient Institution]]
* [[ADL]]
* [[ADL]]
* [[Glasgow Coma Scale]]
* [[Glasgow Coma Scale]]
* '''important:''' [[List of diagnoses affecting Overstay Project]]
* '''important:''' [[List of diagnoses affecting Overstay Project]]
** Will the nurses no longer be completing the DPST form on admission?  Here at the GGH the overstay project has been running the same as it has been from day one, so this is a big change.  We would just like clarity so that we are doing this properly. [[User:Lkaita|Lisa Kaita]] 07:41, 2017 July 20 (CDT)


== Generate colour ==
== Generate colour ==
Line 28: Line 22:
The program will ask you if this is the final colour you will submit. If so, it will be stored and sent. The colour will also be automatically added to the beginning of the Notes field, since most collectors were manually putting it there anyways.  
The program will ask you if this is the final colour you will submit. If so, it will be stored and sent. The colour will also be automatically added to the beginning of the Notes field, since most collectors were manually putting it there anyways.  


* GRAY - if some needed data is missing you will not be able to generate a colour; there will be a specific error, please act on it; there are no gray stickers, gray is just a colour the laptop will give when it gets bad data for the algorithm.  
* '''Red''' - significant risk for discharge delays
* RED - significant risk for discharge delays
** email to notify unit manager - see [[#Notifying_the_Unit_Manager]]
* YELLOW - anyone who is not red
**put red stick on chart - see [[#Red Chart Stickers]]
* '''Yellow''' - anyone who is not red
**no email to manager
**no sticker on chart
* '''Gray''' -  there are no gray stickers, gray is just a colour the laptop will give when it gets bad data for the algorithm.one of two scenarios:
** data needed to generate the colour is missing; you will not be able to generate a colour; there will be a specific error, please act on it
** the patient is transferred from a ward where the colour should have been generated already.


== Red Chart Stickers ==
== Red Chart Stickers ==
If the colour is '''red''' place a 3/4" red round sticker on the spine of the patient chart. {{discussion}} Who is providing the stickers? Or who has in the past? Ttenbergen 14:44, 2017 July 18 (CDT)
If the colour is '''red''' place a 3/4" red round sticker on the spine of the patient chart. Ward clerks will need to order these. Collectors will tell ward clerks when supplies are getting low.  
* At GGH we order them from grand and toy [[User:Lkaita|Lisa Kaita]] 07:33, 2017 July 20 (CDT)
=== Other coloured dots on charts? ===
There is currently a small red dot used to indicate long term chart.
{{discussion}}
* Are these small red dots used at all sites? Ttenbergen 14:44, 2017 July 18 (CDT)
** we don't use them at GGH [[User:Lkaita|Lisa Kaita]] 07:33, 2017 July 20 (CDT)
{{discussion}} *I haven't ever seen small red dots being used at the VIC.[[User:Mlagadi|Mlagadi]] 15:11, 2017 July 19 (CDT)
* Is there any risk of someone confusing these small red dots with our overstay ones? Ttenbergen 14:44, 2017 July 18 (CDT)
 
{{discussion}}
* Are you talking about the small dots that the ward staff use on the addressograghs?--[[User:CMarks|CMarks]] 12:56, 2013 July 30 (CDT)
** any dots that might be confused with ours, eg by new staff misunderstanding training. Do you think those might be? Ttenbergen 09:44, 2017 July 19 (CDT)
 
==== even at STB? ====
{{discussion}}
*At STB at this time the data collectors do not travel to the ward to review charts as they are able to retrieve all their information from EPR.  Once this change is implemented, do they need to go to the ward every day to put stickers on the charts?  Who will be looking at these stickers which are put on the charts here at STB?  Are all sticker colors essential on the chart spine?  If the unit manager is being notified of red ones perhaps this email notification is sufficient for the purposes of the overstay project? (instead of red sticker).  Just checking to make sure we all understand this new change.  --[[User:LKolesar|LKolesar]] 07:37, 2017 July 19 (CDT)
**At this time the plan would be for all (incl STB) medicine collectors to put dots on physical charts. We discussed only notifying the manager by email with the requestor of the project, but they really want the dots. One thing we considered was the possibility of putting something equivalent to the red dot onto Medworxx. I am looking into that. Ttenbergen 09:44, 2017 July 19 (CDT)


== coordinator binder ==
=== Other coloured dots on charts ===
{{discussion}}
There is currently a small red dot used to indicate long term chart. These are not ours and users of the chart who use these ought to be aware of them.  
*Do the data collectors need to put the "red" patients into the coordinator binder also or is this not needed now?--[[User:LKolesar|LKolesar]] 09:54, 2017 July 19 (CDT)
** The binder won't be needed any more. Were you still putting them in the binder? Ttenbergen 12:22, 2017 July 19 (CDT)
***At STB we have not been putting the reds in the transition coordinator binder for a while now. --[[User:LKolesar|LKolesar]] 13:42, 2017 July 19 (CDT)
****At the VIC, we are still assigning the patients that are "reds" to a member of the allied health team, by writing the patients names into the coordinator binder. We then stamp and give them a "Transition Coordinator Case Notes" form that they are supposed to fill out throughout the patients stay. If I am understanding what I am reading, we will no longer be doing this. The only notification of a "red" patient will be directly to the unit manager via an email. Is this correct?[[User:Mlagadi|Mlagadi]] 07:48, 2017 July 20 (CDT)
*****correct.


== Notifying the Unit Manager ==
== Notifying the Unit Manager ==
If a patient is identified as red, send an email to the unit manager.  
If a patient is identified as red, [[CCMDB.accdb]] will populate an email subject line with the name of the patient and that they have been identified as overstay colour red. The collector must send the email to the unit manager (see [[List of Unit Managers]]). It should not be necessary to add additional information to the body, this way all info is visible when the manager sees the email arrive, and they don't have to open it.  


{{discussion}} We are going to automate that process at least partially, using something similar to the email buttons you already have. Details to come. Ttenbergen 14:44, 2017 July 18 (CDT)
If we find that additional info is required, let's talk about it and add it to the program, rather than add anything manually, so we know this is done consistently.


== Possible Scenarios ==
== Possible Scenarios ==
=== Possible Scenario - Patient transferred from other ward - admit ward was participating ward ===
=== Possible Scenario - Patient transferred from other ward - admit ward was participating ward ===
If the patient was admitted from a another '''medicine''' ward at the same location, and if that ward also participates in the Overstay project, then the original Yellow/Red designation is retained. Ensure that these charts have the appropriate colour dot on them.  
If the patient was admitted from a another '''medicine''' ward at the same location that also participates in the Overstay project, then the original Yellow/Red designation is retained.  
If they were pre-determined to be a "red" then the name and date of the patient transferred in should be written in the transition coordinator binder, indicating that they are a transfer in from another ward.
It will be the responsibility of the manager of the originating ward to notify the manager of the receiving ward of any red patients.  
 
The completed form, with colour written on it, should arrive on the new unit with the patient. The designated colour should be written on the form.


If the patient is admitted to a participating ward, then transferred to a non-participating ward, and finally back to a participating ward, then use the colour on the original ward.
==== Previous ward's collector ====
When you find out that your patient has been discharged to another ward where we collect please notify that collector. There seem to be different informal methods used by different collectors for this right now. We will test if that is good enough, and only formalize it if there are problems.  


{{discussion}} Need to discuss with [[p:Julie Mojica | Julie]] how this will work. There will no longer be a form to travel along. What would happen if we just generated the colour again and stripped out values for transferred pts later?  Ttenbergen 14:44, 2017 July 18 (CDT)
==== New ward's collector ====
*If generating the color every time will simplify the instructions to the DC, this is fine with me. In the analysis, I will only use the color of the first ward admission and not the succeeding transfers. --[[User:JMojica|JMojica]] 16:15, 2017 July 18 (CDT)
Ensure that these charts have the appropriate colour dot on them as communicated to you.  
** OK, will take out these instructions when I clean up since it will now be simply matter of generating a colour in every case. Ttenbergen 09:59, 2017 July 19 (CDT)


{{discussion}}
Enter the patient as normal and click the overstay button. It will give you a message ''"Patient comes from participating ward, use their overstay colour on charts. CCMDB will list gray."''. We will match the data to the original ward behind the scenes.
* Tina, is it possible to have an article in  WIKI about the Overstay model and the cut-off value that designate color? Thanks. --[[User:JMojica|JMojica]] 16:15, 2017 July 18 (CDT)
** added: [[Overstay Predictor Project Algorithm]] Ttenbergen 09:59, 2017 July 19 (CDT)


=== Possible Scenario - Patient transferred from other ward - admit ward was '''NON'''-participating ward ===
=== Possible Scenario - Patient transferred from other ward - admit ward was '''NON'''-participating ward ===
Line 87: Line 60:


=== Possible Scenario - colour change due to data entry error ===
=== Possible Scenario - colour change due to data entry error ===
After 24 hours all information required to make the assessment as to if the patient is at risk should be available (or not known to the nurse within the first 24 hours and thus considered a risk). The only case where the colour should be changed is if the data-collector knew they had made an error on data entry. In that case, click the button again and answer "yes" to the question whether this is the final entry; this will overwrite the previous entry in the tmp table, and it will add the new entry to the beginning of the Notes field. This means you may have multiple colours in notes, the first one being the current one.
'''The only case where the colour should be changed is if the data-collector made a error on data entry. We don't want you to change colour because data becomes available after the initial assessment window.'''
It is '''not be necessary to document''' when a sticker colour changes. Just change the colour.
 
If you realize you made a data entry error and you have fixed it, you can click the Overstay button again. It will ask you again if this is final, and if you click yes the original entry will be '''overwritten''' and the new colour be added to the beginning of the Notes field. This means you may have multiple colours in notes, the first one being the current one.


{{discussion}}
It is '''not necessary to document''' when a colour changes. Just change the colour.
*Tina, how are these color changes being handled when sending the data - which color appears in the table L_TmpV2?  Can we assume that the last color entry is the final color?  [[User:JMojica|JMojica]] 11:33, 2015 April 30 (CDT) {{discussion}}
** I will need to review in the CCMDB.mdb... Ttenbergen 11:33, 2015 May 1 (CDT)
*** I still need to review... Ttenbergen 14:44, 2017 July 18 (CDT)


=== Possible Scenario - Patient died/discharged before data collection ===
=== Possible Scenario - Patient died/discharged before data collection ===
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=== Possible Scenario - Off ward patients ===
=== Possible Scenario - Off ward patients ===
For patients with [[Off ward field]] = true, Enter anyway and generate colour.  
Almost all of these will be [[#Possible Scenario - Patient transferred from other ward - admit ward was participating ward]], so use those collection instructions. It will be the responsibility of that manager to notify the next manager.
{{discussion}}  
 
Which unit manager do we contact? Ttenbergen 14:44, 2017 July 18 (CDT)
For the rare patient admitted to an off-ward location without hitting one of our regular wards first, generate a colour and put it on the chart, but don't worry about contacting a manager. This was discussed as a special case not worth following up on. It Is OK.
*email to MALynch. [[User:TOstryzniuk|Trish Ostryzniuk]]
 
== Start/Stop/Site participation ==
see [[Overstay Project Start Stop dates]]
 
{{Data Integrity Check List}}
 
= Clarification of difference to previous process=
The following documentation is relevant to pre-empt questions only until the transition to the new process is complete.
 
== even at STB ==
For a while STB medicine collectors stopped putting red dots on the charts. They will now be required to put dots on the charts again. We discussed only notifying the manager by email with the requestor of the project, but they really want the dots. One thing we considered was the possibility of putting something equivalent to the red dot onto [[Medworxx]]. I am looking into that.


=== Chart binders - what happens with chart binders when pt moves from one war to another at your site?==
== DPST form - STOP July 31.17 ==
*HSC-Med- Con M-binder goes to receiving unit and traded for empty one
Collectors will '''no longer''':
*Gra_-Med - Allyson - binder goes to receiving unit and traded for empty one
*collect any information from the DPST forms or be responsible for them  (tmp file for the questions will be gone)
**Gra-ICU - keeps binder and only send paper from chart.
*post information in the Transition Coordinator binders or
*STB-Med -
*notify and assign allied Health.  
**STB-MICU - keep binder and only send paper from chart.


==RED DOT stickers needed or not?==
Collectors can ignore the form and just collect the minimal data set outlined above to generate a colour.
{{Discussion}}
*wards may continue to fill out the DPST form at admission ''For their own purposes.''   
*'''who needs 3/4" red dots stickers?'''
==Yes==
**DPN - STB E6 (ward clerks would order)
**EN - STB D5-5B
**VP - HSC -H4


==No==
== Transition Coordinator Binder - Stop July 31.17 ==
**LL - HSC B3/D5 (has from previous)
Collectors will '''no longer''':
**SK - VIC - N5, S4, S5 (ward clerk would order as per SK)
*post any kind of information in the Transition Coordinator binder 
**LK - GRA    (order themselves from G&T)
*notify and assign reds to allied Health team 


= Instructions admissions before Jul 30 2017 =
= Instructions admissions before Jul 30 2017 =
see [[Pre-2017-07-30 Overstay Predictor Project Collection Instructions]]
see [[Pre-2017-07-30 Overstay Predictor Project Collection Instructions]]
* All reds generated prior to July 31st are already in our data, just leave them as they were.
}}


 
[[Category: OverstayProject| *]]
[[Category: OverstayProject|*]]
[[Category: Dispo]]
[[Category: All Projects Medicine Only]]

Latest revision as of 13:16, 2022 April 19

Legacy Content

This page contains Legacy Content.
  • Explanation: we stopped Overstay
  • Successor:

Click Expand to show legacy content.

This article documents what data collectors need to do to collect information for the Overstay Predictor Project.

This project was one of the Vacation and staff shortage collection priorities!

In addition to Minimal Data Set

The following items need to be entered before the generation of the chart colour in the next step because the algorithm uses this data:

Generate colour

Once the required information has been entered click the "Overstay" button on the patient viewer screen next to the Notes field and it will turn a colour based on an algorithm.

The program will ask you if this is the final colour you will submit. If so, it will be stored and sent. The colour will also be automatically added to the beginning of the Notes field, since most collectors were manually putting it there anyways.

  • Red - significant risk for discharge delays
  • Yellow - anyone who is not red
    • no email to manager
    • no sticker on chart
  • Gray - there are no gray stickers, gray is just a colour the laptop will give when it gets bad data for the algorithm.one of two scenarios:
    • data needed to generate the colour is missing; you will not be able to generate a colour; there will be a specific error, please act on it
    • the patient is transferred from a ward where the colour should have been generated already.

Red Chart Stickers

If the colour is red place a 3/4" red round sticker on the spine of the patient chart. Ward clerks will need to order these. Collectors will tell ward clerks when supplies are getting low.

Other coloured dots on charts

There is currently a small red dot used to indicate long term chart. These are not ours and users of the chart who use these ought to be aware of them.

Notifying the Unit Manager

If a patient is identified as red, CCMDB.accdb will populate an email subject line with the name of the patient and that they have been identified as overstay colour red. The collector must send the email to the unit manager (see List of Unit Managers). It should not be necessary to add additional information to the body, this way all info is visible when the manager sees the email arrive, and they don't have to open it.

If we find that additional info is required, let's talk about it and add it to the program, rather than add anything manually, so we know this is done consistently.

Possible Scenarios

Possible Scenario - Patient transferred from other ward - admit ward was participating ward

If the patient was admitted from a another medicine ward at the same location that also participates in the Overstay project, then the original Yellow/Red designation is retained. It will be the responsibility of the manager of the originating ward to notify the manager of the receiving ward of any red patients.

Previous ward's collector

When you find out that your patient has been discharged to another ward where we collect please notify that collector. There seem to be different informal methods used by different collectors for this right now. We will test if that is good enough, and only formalize it if there are problems.

New ward's collector

Ensure that these charts have the appropriate colour dot on them as communicated to you.

Enter the patient as normal and click the overstay button. It will give you a message "Patient comes from participating ward, use their overstay colour on charts. CCMDB will list gray.". We will match the data to the original ward behind the scenes.

Possible Scenario - Patient transferred from other ward - admit ward was NON-participating ward

If the patient is transferred either from or via any unit not participating in the Overstay project (e.g. an ICU) generate a colour.

Possible Scenario - colour change due to data entry error

The only case where the colour should be changed is if the data-collector made a error on data entry. We don't want you to change colour because data becomes available after the initial assessment window.

If you realize you made a data entry error and you have fixed it, you can click the Overstay button again. It will ask you again if this is final, and if you click yes the original entry will be overwritten and the new colour be added to the beginning of the Notes field. This means you may have multiple colours in notes, the first one being the current one.

It is not necessary to document when a colour changes. Just change the colour.

Possible Scenario - Patient died/discharged before data collection

Enter anyway and generate colour. Do not contact Unit Manager.

Possible Scenario - EMIP patient that never made it to the ward

Enter anyway and generate colour. Do not contact Unit Manager.

Possible Scenario - Off ward patients

Almost all of these will be #Possible Scenario - Patient transferred from other ward - admit ward was participating ward, so use those collection instructions. It will be the responsibility of that manager to notify the next manager.

For the rare patient admitted to an off-ward location without hitting one of our regular wards first, generate a colour and put it on the chart, but don't worry about contacting a manager. This was discussed as a special case not worth following up on. It Is OK.

Start/Stop/Site participation

see Overstay Project Start Stop dates

Data Integrity Checks (automatic list)

 AppStatus
Query check tmp generate allowedCCMDB.accdbimplemented
Query check overstay no colourCCMDB.accdbretired
Query check overstay pt from our medCCMDB.accdbretired
Query check overstay not enteredCCMDB.accdbretired

Clarification of difference to previous process

The following documentation is relevant to pre-empt questions only until the transition to the new process is complete.

even at STB

For a while STB medicine collectors stopped putting red dots on the charts. They will now be required to put dots on the charts again. We discussed only notifying the manager by email with the requestor of the project, but they really want the dots. One thing we considered was the possibility of putting something equivalent to the red dot onto Medworxx. I am looking into that.

DPST form - STOP July 31.17

Collectors will no longer:

  • collect any information from the DPST forms or be responsible for them (tmp file for the questions will be gone)
  • post information in the Transition Coordinator binders or
  • notify and assign allied Health.

Collectors can ignore the form and just collect the minimal data set outlined above to generate a colour.

  • wards may continue to fill out the DPST form at admission For their own purposes.

Transition Coordinator Binder - Stop July 31.17

Collectors will no longer:

  • post any kind of information in the Transition Coordinator binder
  • notify and assign reds to allied Health team

Instructions admissions before Jul 30 2017

see Pre-2017-07-30 Overstay Predictor Project Collection Instructions

  • All reds generated prior to July 31st are already in our data, just leave them as they were.