PatientFollow Project: Difference between revisions
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=== Viewing the numbers assigned to a given laptop === | === Viewing the numbers assigned to a given laptop === | ||
The assignment is a matter of laptop, chart number ending and the date at which point a specific distribution started. We don't want to store it here on the wiki because it is kind of messy and hard to keep updated. Use [["Show PatientFollow allocation" button]] to see which numbers are assigned to the laptop you are working on during which timeframe. | The assignment is a matter of laptop, chart number ending and the date at which point a specific distribution started. We don't want to store it here on the wiki because it is kind of messy and hard to keep updated. Use [["Show PatientFollow allocation" button]] to see which numbers are assigned to the laptop you are working on during which timeframe. | ||
=== Assignment changes === | |||
See [[Processes around changing a PatientFollow assignment]] | |||
== Entering into the laptop == | == Entering into the laptop == |
Revision as of 15:15, 2020 November 23
Our database collects patient ward stays, which means the data of a patient may be processed by several collectors during the admission. This leads to extra, wasted work of different collectors familiarizing themselves with the same patient. We are looking at ways to reduce this waste.
Specifically, we are looking into having a single collector/laptop follow a patient for their whole admission, and how our processes would need to change to accommodate this, and what extra tools we might need.
Identifying admissions / Starting collection
Currently patients are assigned to collectors/laptops based on where they are admitted. To change to the new system, we would need to identify patients who enter a given site and then assign them to the collector pool equitably. We are planning on a process based on the last two digits of the chart number. We are currently developing the EPR Reports Integrator that will help facilitate this (aside from making dealing with reports easier in the first place).
What would be the process for picking up new patients
See Using Cognos Report Integrator to keep track of patients; there would be a filter to limit the list to your location.
If we split by chart number, how do we ensure no pts are missed or duplicated?
- duplication - there could only be duplication if you enter a chart number that is someone else's; your Cognos Admitter resp Cognos2 Service Starter will only show your patients, so you would not duplicate someone else's, and any risk of duplicating your own is no higher than it was with the old process.
- missing a patient - we have been testing the Cognos EPR Report to make sure patients are not missed from it; for PatientFollow we will simply filter that list, so if all patients were on it, they should still all be on the split list
- main office can run a check between Cognos Data and our data for the first few weeks to make sure all Cognos data is also in our data
Medical Records requests
Shelf split based on Laptop identifier, see HSC Medical Records requests for details.
Actual chart number split per site and per laptop
The split is automatically reflected in Cognos Admitter, no additional filtering needed.
Viewing the numbers assigned to a given laptop
The assignment is a matter of laptop, chart number ending and the date at which point a specific distribution started. We don't want to store it here on the wiki because it is kind of messy and hard to keep updated. Use "Show PatientFollow allocation" button to see which numbers are assigned to the laptop you are working on during which timeframe.
Assignment changes
See Processes around changing a PatientFollow assignment
Entering into the laptop
The initial ward would need to be entered as usual. For stays on subsequent wards, Cognos Admitter/Patient Viewer Tab Cognos ADT and if need be the Patient copier button can be used to create the next record.
Use Using_Cognos_Report_Integrator_to_keep_track_of_patients#Downtime_procedure
Follow between medicine/critical care or just within one program
For now we are testing this just following patients within the same program, eg if a patient were admitted to a medicine ward, then ICU, and then back to the same medicine ward, then the medicine collector would get the two med admissions, and the CC collector would collect the ICU stay. This may change in the future but would require fairly significant changes to CCMDB.accdb Data Integrity Checks and other settings in CCMDB.accdb.
Programming that would need to be updated to be able to use a laptop across programs
- cross checks have been checked as part of previous project, should work
- Generupdate / query check_tmp_generate_allowed
- Hider
- Converter functions Hosp, Loc, Prog
old process and questions that were addressed | ||||
Would the LOS have any impact on this sharing plan?
EMIPsEMIP's will be distributed to collectors/laptops in the same way as we collect ward patients, using the assigned MRN's, so over time, they should have an equal distribution based on your EFT. Further, there will no longer be special collection instructions for EMIPs under Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry. How was the distribution initially defined and validated?We would essentially take the sum EFTs per program/site and consider them as 100%, and then assign the chart numbers based on that percentage. For example, if a site has 3 collectors that are each a .5EFT, each collector would get 33% of that site's new admissions, so collector A might get charts ending in 00-33, collector B 34-66, and collector C 67-99.
Process to identify Medicine patients from EPR at STB
Breakdown per unit:
Simply looking at and entering patients from lists is not enough, list entries may require further analysis: On the transfer list for example there may be entries made in error that patient A was admitted to a unit. The error is usually followed by a “transfer to another unit” a few minutes later. My understanding is that when an entry error is made by MR staff once entered, the entry cannot be deleted, so to reconcile the error another entry is made to “transfer” the patient to the correct unit location. Additionally, sites and units may have certain “idiosyncrasies” for example chemo only admissions for STB E6 are not included in the data base. This can only be ascertained by entering the profile and taking a closer look at the information contained within to determine whether the patient should/should not be included in the database. Simply looking at/using entries found on a list is not always sufficient or indeed accurate. The issue would be exacerbated by a random chart number assignment for no information at all can be gleaned from a record number. In fact, there is a fair amount of “investigative” work involved in data collection such as running and reconciling 4 EPR lists per unit, and follow up of patient list entries as necessary to ascertain “true/legitimate” patient admissions so as to avoid entry error, duplication, or missing patients.
concerns about patient follow due to this complicated processThe process to identify patients for collection in our database is currently ill defined, complex and different between collectors and sites.
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Background
We needed to implement PatientFollow Project in order to be able to streamline collection. Doing it by location meant multiple records per admission, Coordination of data between collectors, and other issues. Also, it prevented flexible re-allocation of workload according to differing collector EFTs - under the new scheme we can split patient load according to EFT.
Transition dates
Transition dates |
Patient Follow one record one episode model GRAGRA Med & GRA_CC
HSCHSC Med & HSC CC (MICU) (SICU)
STBSTB Med
STB ICU's
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