Intended1stSrvc: Difference between revisions

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**e.g. patient admitted from ED ventilated with severe pneumonia, should go to MICU but it is full, so goes to SICU and is taken care of by the SICU service. Here [[Service/Location]] is SICU and [[Intended1stSrvc]] is MICU

**e.g. patient in ED at Grace and should go to Grace ICU but it's full, so goes to HSC MICU. Here [[Service/Location]] is MICU and [[Intended1stSrvc]] is Grace ICU. This example shows that the [[Intended1stSrvc]] can be at a different hospital altogether.

*This variable should be left BLANK when the ICU service the patient is on is the one they should be on -- i.e. only fill it in when there is an [[Intended1stSrvc]] that is different from the first service they are actually on (i.e. what's in [[Service/Location]]

*This variable should be left BLANK when the ICU service the patient is on is the one they should be on -- i.e. only fill it in when there is an [[Intended1stSrvc]] that is different from the first service they are actually on (i.e. what's in [[Service/Location]])

*Along with [[Boarding Loc]], [[Service Location]]

*Along with [[Boarding Loc]], [[Service Location]] and [[Intended1stSrvc]] allow clear identification of all types of ICU boarding

*As part of this alteration in collection, we will no longer collect [[Service tmp entry]]

**those downloaded entries do not actually correspond the the true 6 ICU services that exist (as of 2025) and so are confusing, as they are things like "HSC Critical Care/Medicine A" or "HSC Critical Care/Plastics"

**as [[Service tmp entry]] is downloaded from Cognos, this will no longer occur

*As we create a new ICU profile (record) when the ICU service changes, each time a new ICU profile is created, collectors will need to consider [[Intended1stSrvc]] anew

**although we considered carrying over the prior value of [[Intended1stSrvc]] when a patient is transferred ICU-to-ICU, we decided against this as it creates other ambiguities

~~contains information about patients who are '''taken care~~ of by a ~~critical care service other then~~ the ~~one that normally would have taken~~ care ~~of them'''~~, ~~generally~~ due to ~~capacity limitations. The actual~~ service ~~taking care of~~ the patient is ~~encoded in [[Service tmp entry]],~~ this ~~variable encodes which~~ service ~~should have taken care of~~ a patient ~~initially upon admission~~, but ~~did not. Along with [[Boarding Loc]] and [[Service tmp entry]]~~, this ~~data allows keeping track of every type of boarding (also~~ called ~~bed borrowing) and~~ "~~double-boarding~~" ~~bed-days reported.~~

*Here is the most complex subtlety of this issue of what service a patient "should be on"

**It can change during the course of the episode of ICU care (across ICUs, or within a single ICU). Sometimes such a change might be clearcut (e.g. due to occurrence of a surgical procedure) but other times the fact that the service the patient should be on changes is just within the heads of the attending physicians. Because of this uncertainty we explicitly decided NOT to try and track the service a patient should be on as time goes by, but only upon initiation of an ICU profile, which is why this variable is called "Intended1stSrvc"

== Data Collection Instructions ==

@@ Line 17: / Line 17: @@
 **e.g. patient admitted from ED ventilated with severe pneumonia, should go to MICU but it is full, so goes to SICU and is taken care of by the SICU service.  Here [[Service/Location]] is SICU and [[Intended1stSrvc]] is MICU
 **e.g. patient in ED at Grace and should go to Grace ICU but it's full, so goes to HSC MICU.  Here [[Service/Location]] is MICU and [[Intended1stSrvc]] is Grace ICU.  This example shows that the [[Intended1stSrvc]] can be at a different hospital altogether.
-*This variable should be left BLANK when the ICU service the patient is on is the one they should be on -- i.e. only fill it in when there is an [[Intended1stSrvc]] that is different from the first service they are actually on (i.e. what's in [[Service/Location]]
+*This variable should be left BLANK when the ICU service the patient is on is the one they should be on -- i.e. only fill it in when there is an [[Intended1stSrvc]] that is different from the first service they are actually on (i.e. what's in [[Service/Location]])
-*Along with [[Boarding Loc]], [[Service Location]]
+*Along with [[Boarding Loc]], [[Service Location]] and [[Intended1stSrvc]] allow clear identification of all types of ICU boarding
 *As part of this alteration in collection, we will no longer collect [[Service tmp entry]]
+**those downloaded entries do not actually correspond the the true 6 ICU services that exist (as of 2025) and so are confusing, as they are things like "HSC Critical Care/Medicine A" or "HSC Critical Care/Plastics"
 **as [[Service tmp entry]] is downloaded from Cognos, this will no longer occur
+*As we create a new ICU profile (record) when the ICU service changes, each time a new ICU profile is created, collectors will need to consider [[Intended1stSrvc]] anew
+**although we considered carrying over the prior value of [[Intended1stSrvc]] when a patient is transferred ICU-to-ICU, we decided against this as it creates other ambiguities
-contains information about patients who are '''taken care of by a critical care service other then the one that normally would have taken care of them''', generally due to capacity limitations. The actual service taking care of the patient is encoded in [[Service tmp entry]], this variable encodes which service should have taken care of a patient initially upon admission, but did not. Along with [[Boarding Loc]] and [[Service tmp entry]], this data allows keeping track of every type of boarding (also called bed borrowing) and "double-boarding" bed-days reported.
+*Here is the most complex subtlety of this issue of what service a patient "should be on"
+**It can change during the course of the episode of ICU care (across ICUs, or within a single ICU).  Sometimes such a change might be clearcut (e.g. due to occurrence of a surgical procedure) but other times the fact that the service the patient should be on changes is just within the heads of the attending physicians.  Because of this uncertainty we explicitly decided NOT to try and track the service a patient should be on as time goes by, but only upon initiation of an ICU profile, which is why this variable is called "Intended1stSrvc"
 == Data Collection Instructions ==