IICU consult

Projects
Active?:	planned
Program:	CC
Requestor:	Bojan P / Jodi / Adrian
Collection start:
Collection end:

Purpose

To capture the number of patient days waiting for transfer from acute ICU bed to IICU bed

Data Collection

For every Critical Care patient who has a consult to IICU, obtain the date and time order was written by ICU requesting IICU consult.

How to code

requested

• Project: IICU consult
• Item: consult request written
• Date (Column E): consult dt
• Time (Column M): consult tm
• Checkbox: dt missing
• Integer: not used
• Real: not used
• Comment: not used

accepted

• Project: IICU consult
• Item:
  • consult accepted by IICU
  • consult rejected by IICU
• Date (Column E): response dt
• Time (Column M): response tm
• Checkbox: dt missing
• Integer: not used
• Real: not used
• Comment: not used

Out of province patients

• Template:Discussion
• HSC IICU collectors - when a patient comes from another site outside province, would you be able to see in chart when consult was requested by the other ICU and when IICU service accepted? Trish Ostryzniuk 11:35, 2018 November 14 (CST)
  • I have never had this case before, but I think it all depends on what is photocopied and sent with the patient from the referring facility.--Jvelasco 12:13, 2018 November 14 (CST)

Patients from STB

• Template:Discussion At STB we currently have a patient waiting for an IICU bed. I can easily see when the original consult was written by the STB staff, however I do not know where the reply from HSC IICU people is written. Please advise where I would find this information. Is it written on EPR and if so where on EPR is it written. I spoke with our CRN today about this and she said that the IICU doctors come to see the patient only about 24 hours before they actually go to IICU, once a bed is about to clear there. She did not know where their "acceptance" would be charted or even it is charted. She thought it might just be done verbally. I cannot say myself because we have never had to collect this information before. Please advise how to obtain the "acceptance" part of this tmp request. --LKolesar 10:29, 2018 November 14 (CST)
  • Stb is a different, given it is mostly EPR. The IICU docs rarely, if ever, write into EPR.
  • For this pt, just track from day of IICU consult request written and then we can figure out what his/her ultimate disposition is
  • I am not so much looking to track when consults filled as much as what pt disposition is ultimately…Bojan Paunovic 1130, 2018 Nov 14.
• to have clear and clean data - I suggest to add another item 'Unknown' --JMojica 11:40, 2018 November 14 (CST)
  • Julie's idea might also solve the problem where only having one record from STB would break cross check Query s tmp IICU consult not paired. Ttenbergen 16:24, 2018 November 14 (CST)

Questions

Template:Discussion Any other questions? Ttenbergen 16:24, 2018 November 14 (CST)

Sources

• physician orders
• consult form
• IPN (integrated progress notes)

Special Cases

IICU Consulted but pt deteriorates before transfer

• How do you want us to handle cases where IICU has been consulted and accepted but then the patient's condition deteriorates prior to getting a bed in IICU and is no longer a candidate for IICU? Lisa Kaita 09:06, 2018 November 8 (CST)
  • leave original consult & accept date. Note fields to be used to comment about this. Trish Ostryzniuk 11:04, 2018 November 13 (CST)

Why not put this in Transfer Ready DtTm?

• Why do we need a project to determine the patient days waiting for transfer when we already put in the Transfer Ready DtTm? I suggest we just put another option in the drop down for transfer ready which would read "waiting for IICU bed" and then you would have the information you need without a new tmp item. --LKolesar 07:59, 2018 November 6 (CST)
  • The definition for Transfer Ready DtTm says to enter the first time they are transfer ready. This may not be the first time. Also, we prefer not to add temporary data to existing fields because it would change their definition with special cases, and mess with cross-checks that are based on those fields. Ttenbergen 10:52, 2018 November 6 (CST)

how about the date/time responded

We do not need the date when IICU doc answered consult at this time.

Data use

validating resource use and need.

Study Run Times

• start date: 2018-11-12
• projected end date: 2019-06-30

Consistency Checks

<Any? Might want to wait for first bit of collection so that special cases don't stop collection or cause maladaptive data.>

Data Integrity Checks (automatic list)

	App	Status
Query s tmp IICU consult dispo to IICU but no tmp	CCMDB.accdb	implemented
Query s tmp IICU consult DtTm	CCMDB.accdb	retired

Related articles

Polling for ease of ID'ing Date and Time of consult

Can the collectors easily find in the chart when a consult for IICU or order for IICU consult is made?Trish Ostryzniuk 18:43, 2018 October 31 (CDT)

• would you be able to find DATE and TIME consult was ordered? Trish Ostryzniuk 11:35, 2018 November 2 (CDT)
  • OAK: I have not seen a consult at Oaks for IICU but it would be easily identified in the consults, notes and or orders;
  • GRA: it is easily identified in the orders, consult and or notes Lisa Kaita 21:06, 2018 October 31 (CDT)
  • STB: the orders including consults are all electronic so it would be easy to obtain this data. --LKolesar 18:30, 2018 November 1 (CDT)
  • HSC: we can usually find something in the orders, consults and/or IPN about the intention to send someone to IICU.