Admit From & Discharged To: Difference between revisions

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The following guidelines will apply:

*When ER is indicated as the ''admit from'' location, this implies that the pt originated in the community.

*If a pt has been treated in one or more ER's PRIOR TO ICU or ward admit, the ADMIT FROM should be the ER the patient was in just PRIOR to ICU or ward admission.(reviewed by Task committee December 5,2012)[[User:GHall|GHall]] 17:21, 2012 December 5 (EST)-[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)

*If a pt has been treated at any hospital ward or ICU inside or outside the city or province, it is important to capture this information, even if the pt went to your unit via ER for assessment. Your hospital ER in this case is just a triage area and not the original place they presented. For example: if a pt has been on the ward in Selkirk and is transferred to HSC ER and then is sent to HSC MICU, the ''admit from'' is Selkirk Ward, even though it is not a direct transfer. -[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)

*If a pt was bounced around a lot, then use the last ward or ICU as the source.

*PARR and the OR at any location can be used as ''admit from'' sources. It is not necessary to put the previous hospital code for these patients.

*The OR can be used as a ''discharge to'' location only if the pt is not returning to your unit. (Discharge to a different inpatient location following surgery).

*ER and ACF cannot be used in the ''discharge to'' field. If the patient goes to these locations, then the place they go after this needs to be put in the ''discharge to'' field.

* The heart cath lab is never used as an admit from or discharge to location. Where the pt was before and after this procedure needs to be recorded in these fields.

~~{{discussion}}~~

*If it is unclear what type of unit the patient is transferred to or discharged to outside city or province, put unknown. Unknown is coded as "X". See table below.

** From a collection perspective, is it ever unclear '''''inside''''' the city where a pt came from. If not, we are good, but before the above was changed, it instructed to use *x even inside the city, and now it no longer has instructions for inside the city. Ttenbergen 11:50, 2012 November 15 (EST)

** within city hospitals "x" as second letter is not an options. Is that a problem? Ttenbergen 17:18, 2012 October 19 (CDT)

*** Yes, it will be a problem in the linking of admissions across hospitals for those who have more than one admission. After appending, we will know eventually the unit where the patient was transferred when doing the linking and therefore we want the unit to be specified at the entry level than do the changes later. In addition, for the Critical Care, the Directors are monitoring the inter and intra facility transfers in the region so we need to be specific (no unknowns). Also for Critical Care, the specific location the patient went within the region is needed to determine if the patient's next admission is a readmission or not. [[User:JMojica|JMojica]] 11:31, 2012 November 15 (EST)

****Of course we want the data if available, but would we rather have a guess or have the collector spend time pursuing. And, what I meant was, has it been a problem for collectors to not have the "unknown" option in town, i.e. is there ever a legitimate reason to loose track? Ttenbergen 18:15, 2013 April 8 (EDT) {{discussion}}

****Of course we want the data if available, but would we rather have a guess or have the collector spend time pursuing. And, what I meant was, has it been a problem for collectors to not have the "unknown" option in town, i.e. is there ever a legitimate reason to loose track? Ttenbergen 18:15, 2013 April 8 (EDT) {{discussion}}(never resolved...) Ttenbergen 15:26, 2014 January 26 (CST)

* All my out-of-town patients who are directed straight from those ER's (~~or Nursing Stations) come through our ER unless they go directly to the OR~~. ~~If I show all of these as HSC ER admissions, the other info will be lost~~. ~~Is this what you want? Also, they are bringing in patients from the field by direct helicopter to the airport~~. ~~I am only able to code these as admit from HSC ER~~, ~~is that what you want? <who, when?> {{Discussion}}~~

===Deceased (Expired) patients ===

'''Discharge-to''' must be left '''blank''' for patients who has expired.

*this includes [[Braindead]] [[Organ Donor]]s that go to operating room (OR) for organ donation.

==== [[Organ Donor]]/[[Braindead]] ====

Specific procedures apply, see [[Organ Donor]] article for details

===OR Admissions ===

To be admitted from an OR (i.e. admit from = *P), the primary admit diagnosis must be the procedure they were in the OR for. See [[Check ORDx]] for more info.

=== from out-of-town via ER ===

*If a pt has been treated in one or more ER's PRIOR TO ICU or ward admit, the ADMIT FROM should be the ER the patient was in just PRIOR to ICU or ward admission.(reviewed by Task committee December 5,2012)[[User:GHall|GHall]] 17:21, 2012 December 5 (EST)-[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)

*If a pt has been treated at any hospital ward or ICU inside or outside the city or province, it is important to capture this information, even if the pt went to your unit via ER for assessment. Your hospital ER in this case is just a triage area and not the original place they presented. For example: if a pt has been on the ward in Selkirk and is transferred to HSC ER and then is sent to HSC MICU, the ''admit from'' is Selkirk Ward, even though it is not a direct transfer. -[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)

All my out-of-town patients who are directed straight from those ER's (or Nursing Stations) come through our ER unless they go directly to the OR. If I show all of these as HSC ER admissions, the other info will be lost. Is this what you want? Also, they are bringing in patients from the field by direct helicopter to the airport. I am only able to code these as admit from HSC ER, is that what you want? <who, when?> {{Discussion}}

=== Internal Discharge-To locations we don't code ===

The following internal discharge-to locations cannot be used. If the patient goes to these locations, then code where they go afterward as ''discharge to'' field.

* ER

* ACF

* the heart cath lab; see also [[#From other hospital via Angio]]

=== STEMIs at St Boniface ===

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If a patient is sent to ER from ambulatory care to be assessed by Medicine Service in ER to see if he should or should not be admitted to a med ward bed, then this is not a direct admission to medicine. Admit from is HE.

~~=== [[Organ Donor]]/[[Braindead]] ===~~

~~Specific procedures apply, see [[Organ Donor]] article for details~~

== {{CCMDB Data Integrity Checks}} ==

@@ Line 6: / Line 6: @@
 The following guidelines will apply:
 *When ER is indicated as the ''admit from'' location, this implies that the pt originated in the community.
-*If a pt has been treated in one or more ER's PRIOR TO ICU or ward admit, the ADMIT FROM should be the ER the patient was in just PRIOR to ICU or ward admission.(reviewed by Task committee December 5,2012)[[User:GHall|GHall]] 17:21, 2012 December 5 (EST)-[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)
-*If a pt has been treated at any hospital ward or ICU inside or outside the city or province, it is important to capture this information, even if the pt went to your unit via ER for assessment.  Your hospital ER in this case is just a triage area and not the original place they presented.  For example:  if a pt has been on the ward in Selkirk and is transferred to HSC ER and then is sent to HSC MICU, the ''admit from'' is Selkirk Ward, even though it is not a direct transfer. -[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)
 *If a pt was bounced around a lot, then use the last ward or ICU as the source.
 *PARR and the OR at any location can be used as ''admit from'' sources.  It is not necessary to put the previous hospital code for these patients.
 *The OR can  be used as a ''discharge to'' location only if the pt is not returning to your unit. (Discharge to a different inpatient location following surgery).
-*ER and ACF cannot be used in the ''discharge to'' field.  If the patient goes to these locations, then the place they go after this needs to be put in the ''discharge to'' field.
-* The heart cath lab is never used as an admit from or discharge to location.  Where the pt was before and after this procedure needs to be recorded in these fields.
-{{discussion}}
 *If it is unclear what type of unit the patient is transferred to or discharged to outside city or province, put unknown. Unknown is coded as "X". See table below.
 ** From a collection perspective, is it ever unclear '''''inside''''' the city where a pt came from. If not, we are good, but before the above was changed, it instructed to use *x even inside the city, and now it no longer has instructions for inside the city. Ttenbergen 11:50, 2012 November 15 (EST)
 ** within city hospitals "x" as second letter is not an options. Is that a problem? Ttenbergen 17:18, 2012 October 19 (CDT)
 *** Yes, it will be a problem in the linking of admissions across hospitals for those who have more than one admission.  After appending, we will know eventually the unit where the patient was transferred when doing the linking and therefore we want the unit to be specified at the entry level than do the changes later. In addition, for the Critical Care, the Directors are monitoring the inter and intra facility transfers in the region so we need to be specific (no unknowns). Also for Critical Care, the specific location the patient went within the region is needed to determine if the patient's next admission is a readmission or not. [[User:JMojica|JMojica]] 11:31, 2012 November 15 (EST)
-****Of course we want the data if available, but would we rather have a guess or have the collector spend time pursuing. And, what I meant was, has it been a problem for collectors to not have the "unknown" option in town, i.e. is there ever a legitimate reason to loose track? Ttenbergen 18:15, 2013 April 8 (EDT) {{discussion}}
+****Of course we want the data if available, but would we rather have a guess or have the collector spend time pursuing. And, what I meant was, has it been a problem for collectors to not have the "unknown" option in town, i.e. is there ever a legitimate reason to loose track? Ttenbergen 18:15, 2013 April 8 (EDT) {{discussion}}(never resolved...) Ttenbergen 15:26, 2014 January 26 (CST)
-* All my out-of-town patients who are directed straight from those ER's (or Nursing Stations) come through our ER unless they go directly to the OR.  If I show all of these as HSC ER admissions, the other info will be lost.  Is this what you want?  Also, they are bringing in patients from the field by direct helicopter to the airport.  I am only able to code these as admit from HSC ER, is that what you want? <who, when?> {{Discussion}}
 ===Deceased (Expired) patients ===
 '''Discharge-to''' must be left '''blank''' for patients who has expired.
 *this includes [[Braindead]] [[Organ Donor]]s that go to operating room (OR) for organ donation.
+==== [[Organ Donor]]/[[Braindead]] ====
+Specific procedures apply, see [[Organ Donor]] article for details
 ===OR Admissions ===
 To be admitted from an OR (i.e. admit from = *P), the primary admit diagnosis must be the procedure they were in the OR for. See [[Check ORDx]] for more info.
+=== from out-of-town via ER ===
+*If a pt has been treated in one or more ER's PRIOR TO ICU or ward admit, the ADMIT FROM should be the ER the patient was in just PRIOR to ICU or ward admission.(reviewed by Task committee December 5,2012)[[User:GHall|GHall]] 17:21, 2012 December 5 (EST)-[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)
+*If a pt has been treated at any hospital ward or ICU inside or outside the city or province, it is important to capture this information, even if the pt went to your unit via ER for assessment.  Your hospital ER in this case is just a triage area and not the original place they presented.  For example:  if a pt has been on the ward in Selkirk and is transferred to HSC ER and then is sent to HSC MICU, the ''admit from'' is Selkirk Ward, even though it is not a direct transfer. -[[User:TOstryzniuk|Trish Ostryzniuk]] 12:03, 2013 October 3 (CDT)
+All my out-of-town patients who are directed straight from those ER's (or Nursing Stations) come through our ER unless they go directly to the OR.  If I show all of these as HSC ER admissions, the other info will be lost.  Is this what you want?  Also, they are bringing in patients from the field by direct helicopter to the airport.  I am only able to code these as admit from HSC ER, is that what you want? <who, when?> {{Discussion}}
+=== Internal Discharge-To locations we don't code ===
+The following internal discharge-to locations cannot be used. If the patient goes to these locations, then code where they go afterward as ''discharge to'' field.
+* ER
+* ACF
+* the heart cath lab; see also [[#From other hospital via Angio]]
 === STEMIs at St Boniface ===
@@ Line 48: / Line 56: @@
 If a patient is sent to ER from ambulatory care to be assessed by Medicine Service in ER to see if he should or should not be admitted to a med ward bed, then this is not a direct admission to medicine.  Admit from is HE.
-=== [[Organ Donor]]/[[Braindead]] ===
-Specific procedures apply, see [[Organ Donor]] article for details
 == {{CCMDB Data Integrity Checks}} ==