Swap Locations: Difference between revisions
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<quote>...because cognos Is often using the swing bed as a legitimate date and time, we are getting incorrect information. I find that more often than not (not necessarily every single time), the swing bed entry is usually when the patient is still physically located in er, and has not yet, actually physically been moved up to the ward. The er needs to use that location to admit another patient. Therefore, they will put a “swing bed” entry in. because the swing bed entry is listed right after the er entry, cognos picks that up, and uses that as the admit to unit start date and time. This date and time, is, in actual fact wrong. The actual ward unit start time, is the next entry in the location history that does not have the swing bed tag as the location. (Debbie)</quote> | <quote>...because cognos Is often using the swing bed as a legitimate date and time, we are getting incorrect information. I find that more often than not (not necessarily every single time), the swing bed entry is usually when the patient is still physically located in er, and has not yet, actually physically been moved up to the ward. The er needs to use that location to admit another patient. Therefore, they will put a “swing bed” entry in. because the swing bed entry is listed right after the er entry, cognos picks that up, and uses that as the admit to unit start date and time. This date and time, is, in actual fact wrong. The actual ward unit start time, is the next entry in the location history that does not have the swing bed tag as the location. (Debbie)</quote> | ||
Clarifications: | Clarifications: | ||
* The entry is picked up by Cognos ''"because the swing bed entry is listed right after the er entry"'', it is picked up because it is a unit entry during the timeframe of a service admission. | * The entry is '''not''' picked up by Cognos ''"because the swing bed entry is listed right after the er entry"'', it '''is''' picked up because it is a unit entry during the timeframe of a service admission. | ||
* The swing bed is associated with whichever location it is a swing bed for. So, if the ER uses a ward swing bed, then maybe the real problem is that they should be using an ER swing bed? If they did, the pt would be correctly still listed as an ER | * The swing bed is associated with whichever location it is a swing bed for. So, if the ER uses a ward swing bed, then maybe the real problem is that they should be using an ER swing bed? If they did, the pt would be correctly still listed as an ER | ||
** Not necessarily, swing bed entries are not specific to ER only, and ER occasionally uses ambiguous locations for swing bed entries that are picked up by cognos resulting in a false positive (exclusion patient) showing on cognos. | |||
*** Clarification: a swing bed will always be associated with a unit | |||
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{{Discuss | | {{Discuss | | ||
* Debbie: When you say ''"the next entry in the location history"'', you mean the history on the EPR, right? [[User:Ttenbergen|Ttenbergen]] 09:26, 2020 December 3 (CST)Yes, the location history in the epr. Each scenario with a swing bed entry can be different, and needs to be reviewed to ascertain the true and correct information. [[User:DPageNewton|DPageNewton]] 09:45, 2020 December 3 (CST) | * Debbie: When you say ''"the next entry in the location history"'', you mean the history on the EPR, right? [[User:Ttenbergen|Ttenbergen]] 09:26, 2020 December 3 (CST)Yes, the location history in the epr. Each scenario with a swing bed entry can be different, and needs to be reviewed to ascertain the true and correct information. [[User:DPageNewton|DPageNewton]] 09:45, 2020 December 3 (CST) | ||
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{{Discuss | Is there ever "room for interpretation" where both collectors would still consider the pt on their unit, or where both would consider them already/still on the other unit? If not, how and why? | {{Discuss | | ||
* another question here : | * Is there ever "room for interpretation" where both collectors would still consider the pt on their unit, or where both would consider them already/still on the other unit? If not, how and why? | ||
** another question here : | |||
I supposed this swing bed is already happening in the past, before we have this COGNOS admitter. How it is handle? 1) is it included – such that the accept date is taken from that line of swing bed or 2) excluded and the next line where the Accommodation has an entry is the one chosen? I think we need to decide first if to include or not before solving the exclusion process. who to ask? --[[User:JMojica|JMojica]] 16:02, 2020 December 2 (CST) | I supposed this swing bed is already happening in the past, before we have this COGNOS admitter. How it is handle? 1) is it included – such that the accept date is taken from that line of swing bed or 2) excluded and the next line where the Accommodation has an entry is the one chosen? I think we need to decide first if to include or not before solving the exclusion process. who to ask? --[[User:JMojica|JMojica]] 16:02, 2020 December 2 (CST) | ||
*** Absolutely agreed, Julie. But there is also an element of us reporting info different than maybe what other, EPR based reports would show. [[#"Swing beds" at STB]] shows the list of swing bed locations that show up in the Cognos data. They all are associated by name and data to the ward locations. So anyone generating data from EPR/Cognos would associate these with the units, not the previous location. We would be the only place associating them with still being in the ER. I just reviewed the raw Cognos data, and we get the bed, but not the bed start and end dttm. If we could get that we would be able to figure out what percentage of total LOS is affected by this, but it probably has the biggest impact on ER wait times - It sounds like anyone just looking at Cognos data would underestimate that time because pts look like they are on unit already. [[User:Ttenbergen|Ttenbergen]] 09:56, 2020 December 3 (CST) | |||
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The use of swap or swing locations makes it hard to follow patients in [[Cognos Report Integrator]], so we need to find out more about how these are used. | The use of swap or swing locations makes it hard to follow patients in [[Cognos Report Integrator]], so we need to find out more about how these are used. | ||
=== possible solution: exclude by filter === | === possible solution: exclude by filter === | ||
Revision as of 10:56, 3 December 2020
Some sites use swap locations as entries in EPR.
When patients need to switch locations due to medical reasons, patient swap locations can be performed in the ADT EPR. For example, patient A and patient B need to switch locations. Patient A is in a private room and patient B is in a semi-private room. Both patients could be transferred into the swap location or non-census location, freeing up both of the unit beds. Then both Patient A and Patient B can be transferred into the correct unit and room/bed.
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A patient was in a swing bed from 0243 until 0405 that is the actual arrival time to the unit. The patient remained in ER until 0405 but MR staff had to electronically enter/place the patient somewhere. |
The problem
Swing or swap locations are not real locations. While listed as in a swap location, the pt might still be in the old location or already be in a new location that gets entered after. Collectors seem to review the chart, make sense of what actually happened, and enter accordingly.
<quote>...because cognos Is often using the swing bed as a legitimate date and time, we are getting incorrect information. I find that more often than not (not necessarily every single time), the swing bed entry is usually when the patient is still physically located in er, and has not yet, actually physically been moved up to the ward. The er needs to use that location to admit another patient. Therefore, they will put a “swing bed” entry in. because the swing bed entry is listed right after the er entry, cognos picks that up, and uses that as the admit to unit start date and time. This date and time, is, in actual fact wrong. The actual ward unit start time, is the next entry in the location history that does not have the swing bed tag as the location. (Debbie)</quote> Clarifications:
- The entry is not picked up by Cognos "because the swing bed entry is listed right after the er entry", it is picked up because it is a unit entry during the timeframe of a service admission.
- The swing bed is associated with whichever location it is a swing bed for. So, if the ER uses a ward swing bed, then maybe the real problem is that they should be using an ER swing bed? If they did, the pt would be correctly still listed as an ER
- Not necessarily, swing bed entries are not specific to ER only, and ER occasionally uses ambiguous locations for swing bed entries that are picked up by cognos resulting in a false positive (exclusion patient) showing on cognos.
- Clarification: a swing bed will always be associated with a unit
- Not necessarily, swing bed entries are not specific to ER only, and ER occasionally uses ambiguous locations for swing bed entries that are picked up by cognos resulting in a false positive (exclusion patient) showing on cognos.
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I supposed this swing bed is already happening in the past, before we have this COGNOS admitter. How it is handle? 1) is it included – such that the accept date is taken from that line of swing bed or 2) excluded and the next line where the Accommodation has an entry is the one chosen? I think we need to decide first if to include or not before solving the exclusion process. who to ask? --JMojica 16:02, 2020 December 2 (CST)
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The use of swap or swing locations makes it hard to follow patients in Cognos Report Integrator, so we need to find out more about how these are used.
possible solution: exclude by filter
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One problem with filtering these out would be that, I think, the unit record for a swap location might be the same as the unit record for a successive stay in that unit; ie. the bed entry chagnes, but the unit remains the same. So, the unit start dttm and unit end dttm don't care if part of the unit stay was in a swap location. Is that not true? If it is true, then how would we filter these out? if I eliminate every line that has a swap/swing bed (which I can do) then we will not get any line for those pts who never get into a real bed on that unit (which may be good), but we would still get the same line with unit start and end times including the swap/swing time for patients who eventually get into a bed on that unit. Ttenbergen 12:07, 2020 December 2 (CST) |
For these reasons all swing bed entries should be filtered out if possible.
possible solution: exclude by manual exclude
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This will not exclude the record from Cognos2 Ender since that is based on service rather than unit.
Location specific info
"Swing beds" at STB
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Are the following the STB ones? AsgnBed_Current
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??? at HSC
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"Swap locations" at GRA
These show up in the AsgnBed_Current as:
- GH-SWAP Location
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