Dispo field

Data Element (edit)
Field Name:	dispo
CCMDB Label:	Dispo
CCMDB tab:	Dispo
Table:	L Log table
Data type:	number
Length:	long
Program:	Med and CC
Created/Raw:	Raw
Start Date:	2016-07-01
End Date:	2300-01-01
Sort Index:	41

The Dispo field contains information about what happens to the patient at the end of their admission.

• SMW

Legacy implementation right in the table

• Cargo

• Categories

• Forms

Collection Instruction

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.

Misericordia Transitional Care Unit?

I had a discharge to Misercordia Hospital yesterday, and the notes indicated that it was a “transitional care unit”. My only options from the Dispo drop down would be “Institution, NOS”, or “Winnipeg PCH”. I usually put PCH for all of my transfers to Misericordia, but I’m not sure this is the most accurate in this situation. The patient did not have a paneling code, nor was paneling ever mentioned. --Michelle - May 2.19

• SMW

• Cargo

• Categories

surviving patients

For each patient,

• enter the location that most closely matches
  • 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
• consider bed borrows

AMA

Enter "AMA (left against medical advice)" for patients who leave against medical advice (type "AMA" to open up drop down).

AMA is used as follows:

1. AMA is being excluded in the calculation of Readmission rate.
2. AMA is being counted as HOME in reporting for the location the patient went after discharge.
3. AMA as itself for specific request.

AMA should be entered whether the patient follows the WRHA AMA process (signing form etc) or just goes AWOL. This will lead to proper reporting for the first two points, and it will allow a chart review to exclude AWOL person depending on the data requirements in the third case.

Homeless patients

If a homeless patient is discharged, either to a place like Siloam Mission or even without a specific plan, then code them as discharged to home. Consider whether they might have left AMA.

Prison / Jail / Correctional Institution

If a patient is discharged to prison, jail or a correctional institution, code this as a Institution NOS.

• Pre acute living situation field should be coded as: Jail/correctional institution.

Discharged to ER or Urgent Care

If you discharge a patient to the ER or Urgent Care, you can't enter this in the dispo field. The reason is that this should not happen. If it really does happen:

• enter Other Continents - unknown/other (this is a very rare entry so when we see it, we can question it. Put a note in to the Notes field so Pagasa can check there first.)
• email Pagasa so she can enter your ER / Urgent Care location as dispo.

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.

These patients might become Parked in ER at the next location.

Deceased patients

• for patients who expire, see Deceased patients for more info. Enter one of
  • "Died - Organ Donor"
  • "Died - NOT Organ Donor"

See also: Deceased patients#General instructions for deceased patients

Data Use

• Mortality Rate
• Intra or Inter Transfer Rate
• Discharges out of hospital
• Organ donor rate
• AMA Rate
• Linking admissions

Data Integrity Checks (automatic list)

	App	Status
Check pre acute consistent	CCMDB.accdb	declined
Function Validate Dispo	CCMDB.accdb	implemented
Check function location NE dispo	CCMDB.accdb	implemented
Query check ICD10 dx implying death must have appropriate dispo	CCMDB.accdb	implemented
Query check dispo lower acuity than location	CCMDB.accdb	retired
Link suspect dead then alive query	Centralized data front end.accdb	implemented
Link suspect mismatch to ours incomplete query	Centralized data front end.accdb	implemented
Link suspect not same visitAdmitDtTm query	Centralized data front end.accdb	implemented
Query cardiac arrest throughout admission	Centralized data front end.accdb	needs review

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

• Discharge To
• Var 2 - Discharge-to Ward
• ICU Var 6 - AMA
• Survive / Expired

Data from these fields has been back-populated to the this field so data is available from the beginning of the database.

Related articles:

• Organ Donor/Braindead

Very early missing Discharge-tos

There were 6762 very old ICU records who are listed as survived but didn’t have a discharge-to. This is from HSC-only days when there simply were no checks.

When data was brought across from the old discharge to field the dispo fields of these records were set to 'survive(Legacy)'.