2020 GRA COVID unit transition: Difference between revisions

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* Patients that were on 5N began moving to 2S on March 28. It was a staggered move, and because we're not going to the wards to review charts, I can't say for sure if there was a reason why that was. For example, one patient was admitted to 5N in February and was moved to 2S on March 28. Another was admitted Jan 14 and was moved April 7. EPR doesn't give any clues as to why they were staggered this way (if there was a medical reason why they stayed behind).
* Patients that were on 5N began moving to 2S on March 28. It was a staggered move, and because we're not going to the wards to review charts, I can't say for sure if there was a reason why that was. For example, one patient was admitted to 5N in February and was moved to 2S on March 28. Another was admitted Jan 14 and was moved April 7. EPR doesn't give any clues as to why they were staggered this way (if there was a medical reason why they stayed behind).
* We have confirmed with one of the doctors that 2S IS a non-teaching medicine ward with the 2 doctors that previously covered 5N. So yes, 2S is what 5N was pre-COVID.  
* We have confirmed with one of the doctors that 2S IS a non-teaching medicine ward with the 2 doctors that previously covered 5N. So yes, 2S is what 5N was pre-COVID.  
* I don't know what bed capacity 5N and 5S will have but I do know that everyone COVID SUS or COVID POS will default to 5N. If they have more than 2 POS admissions, they will open 5S. We're assuming if a COVID SUS is swabbed negative, they will be moved to 2S. Currently there is 1 admission on 5N that are not labelled COVID in EPR, so again, I don't know if there's another medical reason why they stayed behind.  [[User:Surbanski|Surbanski]] 09:09, 2020 April 15 (CDT)}}
* I don't know what bed capacity 5N and 5S will have but I do know that everyone COVID SUS or COVID POS will default to 5N. If they have more than 2 POS admissions, they will open 5S. We're assuming if a COVID SUS is swabbed negative, they will be moved to 2S. Currently there is 1 admission on 5N that are not labelled COVID in EPR, so again, I don't know if there's another medical reason why they stayed behind.
* The COVID POS patients are usually under the internist that admitted them unless they are coming from ICU (the patients on 5S are under internal medicine).  [[User:Surbanski|Surbanski]] 09:09, 2020 April 15 (CDT)}}


== Transition plan ==
== Transition plan ==

Revision as of 09:13, 15 April 2020

This page is about the transition of collection units at GRAto accommodate the new COVID unit.

Background

The dates are not yet finalized.

  • Monday?? April ??.20 – patients in GRA_N5 will be moving to GRA_2S
  • ?? April ?? .20 - 5S will be a new COVID-19 ward GRA_5S_C with ?? adult beds
  • Patients that were on 5N began moving to 2S on March 28. It was a staggered move, and because we're not going to the wards to review charts, I can't say for sure if there was a reason why that was. For example, one patient was admitted to 5N in February and was moved to 2S on March 28. Another was admitted Jan 14 and was moved April 7. EPR doesn't give any clues as to why they were staggered this way (if there was a medical reason why they stayed behind).
  • We have confirmed with one of the doctors that 2S IS a non-teaching medicine ward with the 2 doctors that previously covered 5N. So yes, 2S is what 5N was pre-COVID.
  • I don't know what bed capacity 5N and 5S will have but I do know that everyone COVID SUS or COVID POS will default to 5N. If they have more than 2 POS admissions, they will open 5S. We're assuming if a COVID SUS is swabbed negative, they will be moved to 2S. Currently there is 1 admission on 5N that are not labelled COVID in EPR, so again, I don't know if there's another medical reason why they stayed behind.
  • The COVID POS patients are usually under the internist that admitted them unless they are coming from ICU (the patients on 5S are under internal medicine). Surbanski 09:09, 2020 April 15 (CDT)
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Transition plan

  1. There is no transition plan for the new COVID ward GRA_5S_C which has already been added to the s_dispo table.
  2. This transition plan is only for the patients in N5 who were moved to 2S.

collector instructions

  1. change the Service/Location of the record to the new location (ie from GRA_N5 to GRA_2S )
  2. enter the actual location as part of Boarding Loc:
    • for patients who had no location borrowing during transition:
      • change the "no borrow" line to "GRA_N5" and enter the time the patient arrived in N5
      • add a line for "GRA - Home medicine ward" with the time that the patient was actually moved
    • if there were patients who actually were in a borrow location during the transition, let's talk about how we would enter those


  • 5North is NOT a boarding location. It's still a regular sub acute medicine ward. Yes the patients are Covid suspects we think due to being Exposed but this is not confirmed. No boarders here Mcrawley 15:15, 2020 April 14 (CDT)
    • Are there new patients admitted at N5 (primarily as COVID suspects)? --JMojica 16:01, 2020 April 14 (CDT)
      • On closer inspection the new people being admitted to this ward are all Covid suspects, was hard to tell at first because patients that stayed on this ward were 5 North patients. So it looks like the new patients on the ward are boardersMcrawley 08:01, 2020 April 15 (CDT)
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Outstanding issues

I have spoken with Richard Q the manager on the 5th floor today and this is what he has told me:

  • As of right now, they still don't have confirmation on the designated COVID units, but at this time, 5N is being used for COVID SUS and 5S is being used for COVID POS admissions. Currently according to EPR there are 2 positive cases admitted to 5S.
  • Over the past week, there has been a lot of movement from 5N to 2S, which in the past was where our boarders were moved to. When I asked Richard, he indicated that 2S has become the "clean" medicine unit. Again, this is all yet to be confirmed by GH and/or WRHA.
  • Currently, there is 1 doctor who has taken on the COVID patients, but again, this could be temporary and may change over time depending on what the demand is.
  • Unless they are labeled COVID POS in EPR, there is no way for us to know what the swab results return as. This information will only be gathered once the chart is available in Medical Records. If you would like to grant us the ability to go to eChart to review, I'll leave that to the powers that be to decide. My understanding is in this Data Collector role, we are no to review records in eChart.
  • For the patients who have been moved from GRA N5 to GRA 2S - I have been tracking these as boarders. Do you want me to continue in this manner? Surbanski 14:42, 2020 April 8 (CDT)
    • Julie? Ttenbergen 14:59, 2020 April 14 (CDT)
      • refer to the transition instruction. --JMojica 16:02, 2020 April 14 (CDT)
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  • For the POS patients who have moved from 5N to 5S - How do we want to track these? There is a dispo location to this unit, but I don't yet see a Service Location for this unit (unless Tina/Julie are still working on this step and it is yet to come). Surbanski 14:42, 2020 April 8 (CDT)
    • Made GRA_5S_C available for collection now. Sorry, I missed a step earlier for this. If you van now enter this please delete the question, otherwise put a comment that this is still an issue. Ttenbergen 14:59, 2020 April 14 (CDT)
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  • I would like some direction on how to proceed - I didn't know that my medicine unit (5N) was transitioned into a COVID floor. I've been entering and tracking the 5N admissions and 2S boarders. I know it's difficult to make decisions when no one really knows what's going on, but before I get too deep in COVID I'd like to have some direction to avoid duplication of work (i.e. having a profile for a 5N admission and a second profile for a 5S admission if we decide to track them).Surbanski 14:42, 2020 April 8 (CDT)
    • do you mean both N5 and 5S are COVID wards, please confirm because we need to distinguish the N5 as acute med unit vs N5 as covid ward. Covid ward(s) will be reported separately from the other med wards. thanks. --JMojica 16:23, 2020 April 14 (CDT)
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  • I have another question - currently I am recording data and admissions on 5N (as per the current process), which we are assuming is the COVID SUS ward. Some of these patients are discharged from the ward after a couple of days once (I assume) their swab results are back negative. If we're not interested in collecting for COVID SUS, then we need to change the process for data entry on this unit. Technically, my 5N medicine patients are admitted on 2S, which are now all being labelled as "Boarders". I'm not sure what that would look like but I'm open to a discussion with whoever it would be who would decide this. Surbanski 08:57, 2020 April 9 (CDT)
    • are these covid suspects under the medicine service? this will be a bit tricky if being taken care by medicine service. should it be considered as 2S medicine service borrowing bed at 5N, so it will not be missed? --JMojica 16:30, 2020 April 14 (CDT)
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Reporting

service location GRA_N5 before ?? and GRA_2S can be reported together.

Cross checks

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  • Have not yet checked how this will impact CFE Data Integrity Checks. Pagasa, of the top of your head which would be impacted and how?
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Related articles

Related articles:
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