CCMDB.mdb Change Log 2008

The CCMDB.mdb Change Log logs changes made to the CCMDB.mdb, including lock-downs when one person is making changes so that no one else makes changes at the same time. New entries should be made at the top to be immediately apparent. Discussions should be added at the level of individual changes if they correspond to a change, and at the end of the article if they relate to the change process in general. When a change is tested and rolled out it is also documented here.

Requested changes for the next version

Admit-from and discharge-to for ICU can't be current location

a. The admit From should never be the same as the Hospital and Location code (ex. FROM = HM, Hosp=HSC, Loc=MICU) b. The discharge To should never be the same as the Hospital and Location code (ex. Hosp=HSC, Loc=MICU, To = HM) As 8(b)

Ensure discharge time = 0:00 can't get through

to implement check mentioned in Admit, Transfer and Discharge date and time but not currently working

Before being able to use on the laptops

• automate the backup to the server
• automate a backup to the SD card
• automate checking for new front-end on every log in to the network

MI Data Integrity Check

If 102-10 you must not use any another 102 with a subcode. update Myocardial infarction when done.

ARF & CRF & ARI Integrity Check

• if CRF (351) in comorbid then ARF(350) or ARI (364) cannot be in admit or complication.
  • The 364 is new since the discussion about the cleaner. What is it about? Ttenbergen 15:55, 5 November 2008 (CST)
    • Yes, since I have been further reviewing patient profiles in more detail from the problems that SAS has generated, I see renal insufficiency (364)being coded in admit or complication DX slots for patients who have a comorbid condition of chronic renal failure (351).

The Change Log

4 Nov 2008

• adding values for the lab maximums. Ttenbergen 16:26, 4 November 2008 (CST)
• sent to Trish for testing Ttenbergen 16:51, 4 November 2008 (CST)

October 29, 2008

• s-alldiagnosis for CCMDB and Handibase.

*DX code updates/repairs/NEW:

• • 199-16 nosebleed added in brackets to be consistent with code label
  • 199-17 uncontrolled bleeding requires Transfus/OR (NEW CODE)
  • 777-5 & 777-6 spelling fix (Dilatation)
  • 794-27 TIPS - Transjugular Intrahepatic Portosystemic Stent (not a surgery, done in X-ray) (NEW CODE)

*Pathogen updates

• • pathogen subcode 93 -Syphilis-Treponema Pallidium
  • pathogen subcode 94-Lyme-Borrelia Burgdorferi

*changes made as per code guide, these are not new codes, just specific listings just like for the Hepatitis code.

• Menningoencephalitis codes: See neurological drop down DX list on your PDA
  • 77-65
  • 77-68
  • 77-74
  • 77-79
  • 77-92
  • 77-93
  • 77-95

• • • NOTE TO DATA COLLECTORS: Syphilis code now added. If neurosyphilis then use code 77-93 (as per Dr. Kumar).
• Copied to Master on Regional Server
• ROLLED OUT

TOstryzniuk 19:29, 29 October 2008 (CDT)

• • • • These new changes are not in our PDA? Where do the pathogen updates go re Syphilis treponema Pallidium and Lyme Borrelia Burgdorferi ? Shirley Kiesman.

• • • • • Should be on your PDA under Neurolgic dropdown DX list. 77-93 Menigoencehp-Syphilis.

the pathogen subcode used 93 which is labelled Syphilis-Treponema Pallidium. It is too long to list it under 77-73 with the full bug name. Let me know if you see it now. TOstryzniuk 16:28, 30 October 2008 (CDT)

• • • • • • Thank you Trish They are now in my PDA.
          • We must not have synced our PDA's. It is there! thanks

September 29, 2008

APACHE Glasgow Coma Scale (GCS) - MOTOR drop down list

• In ACCESS drop down list for MOTOR - had seven items. Should only be 6. item 2 "when spoken to" removed, and the two number 4's have be renumbered.
• Rolled out from MASTER todayTOstryzniuk 06:26, 29 September 2008 (CDT)

September 17, 2008

Modifiying the program to permit direct entry of data. Ttenbergen 12:39, 17 September 2008 (CDT)

August 6, 2008 18:05

• Numbers allowed in name field FIXED. Tested.
• rolled out Master today.
• log showed that all sites updated TOstryzniuk 18:06, 6 August 2008 (CDT)

July 30 - update to master file only

• Deleted the contents of the L_tmp_V2 table because they were causing send errors at HSC.
• Rolled out from "Master". Ttenbergen 09:34, 30 July 2008 (CDT)

Was this to HSC only? Didn't seem to make it to other sites?

• • tested after COPYING from MASTER. Can still put numbers in NAME field and ACCESS doesn't complain.
  • I put my copy in TRISH TEST.

TOstryzniuk 18:08, 30 July 2008 (CDT)

July 28 2008 15:45

Added check that First name and Last Name are not entirely numerical. Note: it will only catch names that are all numbers, e.g. if someone accidentally put the PHIN in the name. A fair bit of coding would be necessary to track individual numbers in strings, and I did not implement it.

Copied to Test_Trish.Ttenbergen 15:43, 28 July 2008 (CDT)

July 25. 2008 12:10

• Problem:
  • 1. lab item Voluven not showing up on peripheral PDA's after being synch'd.

• Findings:
  • a. Handibase has two lab tables: s_labs & s_allLabs. Apparently the table that the PDA is using is the s_allLabs table. Voluven was added to s_labs instead of s_allLabs and this is why sites cannot find this item on their PDA Lab drop down list.
  • b. HSC_MICU folder on regional server was relabelled to HSC_MICU1 after Crash July 11.08 and updateALL batch file was not updated along with this change.
  • c. Problem after adding the lab item Voluven. When you log into CCMDB and tried EDITING you would get an OVERFLOW error message.

• Solution:
  • a. Blank out the s_labs table, not used. Add Voluven to the s_AllLab table only. DONE
    • extra blank rows and second troponin code in s_allLABS. Clean out. DONE
  • b. Fix HSC_MICU to HSC_MICU1 in the updateall batch file and other clean up DONE.
  • c. ACCESS - EDIT - OVERFLOW problem labs. Voluven upper limit amount automatically set to 9999 when you add it to the s-alllab table. Should only be 999. Fix DONE.

• • When PDA is synch'd Voluven is now visible on lab drop down list.

• • rolled out from "MASTER" July 25.08 @ 17:15 hrs.
• TOstryzniuk 16:34, 25 July 2008 (CDT)

July 24, 2008

• ICU Var 2 option - code OBS (observation unit - Telemetry CON) removed. It was in both Var 1 & 2. Now only available in Var 1.
• s_varoption in ACCESS on s_var2opt in Handibase were both edited.
• s_Handibase VIEW option for this table was also fixed. The CC CON view was deleted.
• s_labs: Voluven added to ACCESS and Handibase lab table. (Lab item #142 in master database)
  • Copied to Master on twister and rolled out to all sites. TOstryzniuk, 24 July 2008 (CDT)

Jul 2, 2008

• fix for Var1/Var2 problem at StB - (problem was that if you copy past L-files from Handibase into ACCESS you could not check off complete tab. Had to delete Var 1, 2 & 5, then retype into ACCESS before you can check off completed (this is according to Elaine Nagy, who is not clear what the fix was, but was aware of the above described problem).-Tina Tenbergen
• LTV (long term Vent) added to ACCESS and email sent out with a requirement for email response that LTV has been added to the FILTER dropdown list on every PDA.
• roll-out July 2,2008 @ 1430 hrs.TOstryzniuk 00:02, 2 July 2008 (CDT)

Changes rolled out at unknown date before Jul 2

19 June 2008

• add WarnMaxCount column to s_Labs
• add WarnMaxDoses and WarnMinDoses columns to s_drugs
• add code to give warnings when these values are exceeded.

17 June 2008

• added checker to set maximum lab count
• added checker to set maximum pharmacy doses
• removed "Cefotaxime IV 1G" from s_drugs because it was a duplicate
• added checker for admit/discharge locations vs. Var1/2 in medicine
• added GRA_GM to s_moveto
• rolled outTOstryzniuk 17:26, 17 June 2008 (CDT)

29 May 2008

Added checks:

• no discharge to ER

Still to do:

• admit from same hospital needs a Var1
• discharge to same hospital needs a Var 2

Not rolled out yet

27 May 2008 cont'd

Tina has the CCMDB on her desktop to implement further checks.

27 May 2008

Added check to prevent midnight/empty admit time from being sent. Changed minimum value for WBC to 0.02 be consistent with Ed's program's checks. Rolled out.

Import of earlier change log

Tina's Log

Enter at the top from now on

May 2 - checking that Data-Cleaning Items are checked already.

Apr 2 - re-added "changed Smartpump checks to allow Vic to enter date/time" which was overwritten by a later change, I assume.

Mar 13 - changed Smartpump checks to allow Vic to enter date/time

Mar 10 - fixed error checking for smartpump to actually prevent send on error instead of just giving message. Sent to Test_trish for testing.

Feb 8 - starting changes for checks after chat with Pagasa, and processing for Smartpump study starting March 1. - at HSC anything but a single move to <r_location> for someone admitted via ER will be flagged - if two moves have the same move-date-time, they will be flagged There will be further changes out of the meeting with Pagasa, but I wanted to get a version with the smartpumo updates into testing for now.

Feb 4 - updated tmpV2 checker to stop checking transfusions against packed cells; file now with Trish for testing.

Jan 28 - Updated Moves checker to flag moves <= admit and >= discharge (was < and >); copied to Trish_Test for testing

Jan 15 File is still down for HanDBase testing. Also did a correction to coding for discharge-to fields that are legitimately empty. Rolled out, but still on hold.

Jan 10 Stephanie asked me to add GRA_W4 to s_tmp and that she had discussed with Trish, so I did

Jan 9 added fields for Handbase synching to all tables, r*_...

Dec 18 Made and reverted changes for decubitus ulcer and to start writing to TmpV2_1 because the original got corrupted. Returned file to Trish several times since last update, but forgot to update log.

Dec 11-12 Adding Chart Number isnumeric check Adding Decubitus ulcer study and checks.

---

old records in whatever order...

Nov 10 @ 9:30 Made changes to file sending so StB ICU (old Access) and all other sites can use the same ccmdb.mdb

Nov 14 @11:00 Changed sort order for Var1 and Var2 and deleted ICUs from that list.

Nov 15 @13:30 Changed Pagasa Output to show discharge dates even if there is no discharge time. Wasn't doing that before...

--- Didn't enter into here while Trish was away, will start again now. ---

Sep 25 @10:00 Fixed the Moves Checker, it was giving an error for move-time out of admit-discharge time, but it was not locking out. Does now.

Sep 25 @13:30 Taking down the master file for updates: - Make AutoRanker for Labs and Pharm from Cost Data - Change Var1-6 on the PDA to dropdowns - Make an error checker to reject no moves for people admitted from ER in Tmp

Dec 5 @2:07 Changing output to tmpV2 to only send moves when complete advised trish to go ahead and change s_tmp so that euro score will only be sent once when complete.

Trish's Log

Nov 8, 2006 @ 1500 Trish playing with latest version of CCMDB on desk top. Trying to sort the ACCESS s_admitdischarge table by code. Tina had fixed ACCESS so that it catches NO VALUES for ADL. Works

Nov 8, 2006 @ 1710 hrs - roll out to all sites from Master. Trish along with Tina, sorted the ADMIT from and discharge to table in ACCESS. Trish added STB ambulatory care to admit from or discharge to. We excluded the option of BLANK in the ADMIT from table. Copied to MASTER on twister Rolled out to all site.

Nov 10.2006 trish Added M3 to variable 1 & 2 drop down table (RNVAR form ) in ACCESS and in S-variables 1 & 2. Forgot how to sort so that M3 code is not at the bottom Tina........could you do this? (Tina sorted).

Also, I see MICU, SICU, also CCU and IICU listed a number of times in Var 1 or 2 drop down. These should not be there. Not sure if I can take them out of here? please advise. (Tina fixed ICU's taken out of this list).

Nov 15.06 @ 1855 Pm Rollout batch file ran. All sites updated.

Nov 22.06 ACCESS drop down list is missing infection code 80 spinal ABCESS Drainage. seems that in the DX column there is no YES or NO. YES applied. Rolled out to all sites successfully.

Nov 27.06 1220 PM Address with Tina Nov 23. Data collectors are able to send patient file in with MISSING DX green sheets. If they do not ADD a page for green sheets, ACCESS will allowing sending blank pages and it shows up in greensheet.mdb as missing. Waiting for Tina to fix.

- also: serial number sequence order. Collector as accidentatly assigning a wrong serial number. For example: Galye B5 Serial sequence is 2630-2680, yet for one patient she assigned a serial number of 3640 which is way off.

Tina - anyway to catch numbers that are way out of range from sequence that are sent in?

April 11 7 12.2007 Trish - added code 831-9, and 542. Fixed 884 so that it can be used in both main Dx & comorbid. Rolled out to all sites.

September 24,2007- Oct 12.2007 ROLLED OUT Oct 12.07 Code 763-sub code 01,02,20,21 word clarification Thrombolytic infusion: 763-01 Thrombolytic infusion Regional (PVD & plugged catheters) 763-02 Thrombolytic infusion Strokes 763-20 Thrombolytic infusion Cardiac 763-21 Thrombolytic infusion Pulmonary Embolus

Corretion to s-all DX s spelling: Myeglobinemia

NEW CODE- as per Dr. Roberts: 763-38 Line insertion ONLY as primary reason for admission

Tina working on FILTERS for MOVES for Med database

New CODE Lung transplant 805-04 Cadaver Donor 805-05 Living Donor

Nov 22.07 Trish s_tmp MOVES VIC -N2 removed (surgery on 4th floor will be know as S2) VIC -SS2 changed to S2. SS2 is an error. Rolled out

Nov 27.07 1850 hrs ACCESS s_admitdischarge table is missing code GA - vic ambulatory care. It is in the handibase admitdischarge table. updated ACCESS in Master and rolled out.

Dec 6.07 1655 hrs ACCESS s_tmp - Tina fixed so that move data is only sent once when complete. Euroscore set so that data in only sent once. Rolled out

Dec 13.07 issues with TMV2 crashing & locking up. Problem started Dec 11 or 12. Tina not sure of the cause. tina replaced with Tmpv2_1 and will merge tmpv2 data with tmpv2_1. Because of this problem people could not send. CSV file would arrive but moves and tasks would not. Tested - able to sent out with out crashing. ROLLED OUT

Dec 17.2007 Decubitus Ulcer items added, but decided that it is labor intensive and not cost effective to enter into tmpv2_1, so it has been deleted. Tested -all items related to decubitus deleted including s_tmp for handibase Tina has fixed up. Tested - able to send out without any problems. Jan and Pagasa checked. ROLLED OUT

Jan 4.08 Code 875 Radio Active Iodine TX code added. Rolled out

Jan 10.08 Trish aware of GRACE-W4 added to tmp file for MOVES. Tina has added to MASTER and rolled out. Trish copied latest to her desktop

Jan 21.08 Tina rolled out a CCMDB: PC transfusion audit crosschecking with lab PC count.

Jan 22.08 STB reported sending problems. Tina fixed tmpv2 PC transfusion checking with lab PC count. Rolled out before Regional server crashed. Regional server is up and down last 2 days.

Jan 23.08 Code 361 & 805 Main Dx label clarification. Instead of both being Renal Transplant: 361 Renal Transplant Problems & 805 Renal Transplant Surgery. Updated in s-alldiagnosis for ACCESS and Handibase. Ed also fixed ICU and Medicine ICU database labels. Trish copied to Master. Rolled out to all sites.

Jan 25.08 ACCESS and Handibase table updates. 1. s_tmp MOVE-updated to inlcude GRA S2 (orthopedics ward) 2. s_ADMITDISCH -update to include St Amant center. Code AW.

Rolled out

Jan 29.08 ACCESS & Handibase changes 1. s-pathogen table updated with subcode 95 West Nile. ACCESS changes 2. Move before ADMIT or AFTER discharge - trapping in ACCESS so data collector can't send in with this type of error. 3. Tina fixed so that a NAME is not allowed in the chart number slot. 4. Date and time at the top of the ACCESS screen (beside chart number), this date is now the admission date and time not the file creation date and time.

Rolled out

Jan 31.08 1800 hrs ACCESS - s-admitdischarge missing St Amant center code AW. Not sure what happen. Copy on desktop prior to making change had the change in it. Fixed Copy to MASTER

Rolled out

Feb 4.08@ 1425 hrs Transfusion study stopped Jan 31.08. Tina DISABLED the cross checking in ACCESS of # of transfusions in tmp vs # PC in Lab. (cross check was so PC in labs = # of transfusion in tmp before sending allowed).

Rolled out

Feb 12.08 1700 hrs Testing latest updates to CCMDB - PUMP AUDIT for March 1.08 with numbers 1-8 for comment options. Problem with ACCESS blocking admit from HA or BA with a move. HA or BA may or may not have a move. If there is a move, then comment "ER", must be included.

Plan to roll out February 25.08 when TINA returns for vacation. Reminder in Outlook.

Feb 13.08 1200 hrs. Tina blocked the out the MOVE from HA check. Will work on testing move checks when she returns on February 25.08

Current verion I have copied to desk top and will continue to test. If okay will roll out after February 25.08

Feb 14.08 Feb 4.08 Version in MASTER updated DX NEW CODE 763-39 ECHMO Updated s-allDX in MASTER CCMDB and s-all DX for handibase. rolled out

Feb 25.08 1310 hrs Tested. This is the Feb 13.08 version (feb 13 note above). Changes: Some moves, Colleague Pump audit for March 3 to 23 Problems with pump audit found. Copied to Master & rolled out with bugs.

Feb 26.08 1800 hrs. Tina fixed and applied following rules in ACCESS:

1. If Guardian Software used then: -check mark YES - no integer variable should be allowed -manually typed it comments not needed.

2. If Guardian software not used then: -check mark NO -an integer variable code required (1 to 7) -manually typed in comment not needed

3. If Guardian software not used then: -check mark NO -integer variable code 8 is used -a manually typed in comment is needed

4. Julie- 1 to7 int_var should be converted A to G as agreed by Julie and Tina. This is to keep comment codes consistent to last audit. Tested Copied to Master Rolled out 1910

March 7.08 1045 763-39 missing from S_allDiagnosis in ACCESS. Not sure why. back up copy on Trish Desktop show code and this was the version copied into MASTER, as per note above. Re-inputted it into s_ALLDX in MASTER. Rolled out to all sites.

Mar 10 1520 hrs Tina fixed error checking for smartpump to actually prevent send on error instead of just giving message. Tested - trap is working not allowing to SEND if there are still errors in smart pump. Copied to Master. Rolled out to site.

Mar 13.08 1430 hrs. Tina changed Smartpump checks to allow VIC to enter date/time in DtTm_var field. this is an exception for VIC. When VIC sends in Data, Pagasa to copy and paste DtTM_var field to collection dt/time field. Update copied up to VIC medicine ONLY