Pre-admit Inpatient Institution field: Difference between revisions

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removed the "temproary" requirement
No longer just for temporary, and further answers as discussed in main office by Trish, Julie, Tina
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== Collection Instruction ==
== Collection Instruction ==
If the [[Previous Location field]] '''contains a "temporary" location''' like an ER, OR or Cath Lab you will need to enter this field. In that case, for each patient,  
For each patient,  
* enter the option that most closely matches
* enter the option that most closely matches
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if the situation is unknown, enter '''location missing/unknown'''
* if the situation is unknown, enter '''location missing/unknown'''


If the [[Previous Location field]] does '''not contain a "temporary" location'''
If the patient did not come from an inpatient location, enter "not applicable", for example if they came from home or a clinic. The ER is  '''not''' an inpatient location.
* enter "not applicable"


If you know how we code the location exactly, you can type it. Otherwise press the "magic wand" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
If you know how we code the location exactly, you can type it. Otherwise press the "magic wand" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
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===HSC ER to GGH ICU to GGH Ward===
===HSC ER to GGH ICU to GGH Ward===
*pt sent to GGH ICU from HSC ER  with order to transfer presumably because no critical care beds at HSC.  Not treated as an admission by ER standards, but clearly had to be admitted or would not have been sent to ICU.  Should this be treated as an inpatient admission for our purposes, so HSC ER would be entered as preadmit institution location?
*pt sent to GGH ICU from HSC ER  with order to transfer presumably because no critical care beds at HSC.  Not treated as an admission by ER standards, but clearly had to be admitted or would not have been sent to ICU.  Should this be treated as an inpatient admission for our purposes, so HSC ER would be entered as preadmit institution location?
** They were never an inpatient at HSC so the entry for [[Pre-admit Inpatient Institution field]] needs to be "not applicable". Ttenbergen 10:34, 2016 May 3 (CDT)


=== Unit name changes ===
* Can we change W3 to S3 as it is no longer called W3 (unit was expanded)?[[User:Mschaffer|Mschaffer]]
* Can we change W3 to S3 as it is no longer called W3 (unit was expanded)?[[User:Mschaffer|Mschaffer]]
** changed, Grace collecors, please delete when you have seen
** changed, Grace collecors, please delete when you have seen
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{{discussion}}
{{discussion}}
*When we have patients moving from ward to ward, we normally do not go back to their original admission date to gather data especially as some patients have been admitted for over a year. Will it be acceptable to continue this practice?--[[User:CMarks|CMarks]] 12:39, 2016 April 11 (CDT)
*When we have patients moving from ward to ward, we normally do not go back to their original admission date to gather data especially as some patients have been admitted for over a year. Will it be acceptable to continue this practice?--[[User:CMarks|CMarks]] 12:39, 2016 April 11 (CDT)
** For intra-hospital transfer, code Pre-admit Inpatient Institution field as "not applicable" (I still have to make that available) Ttenbergen 11:41, 2016 April 27 (CDT)
** For intra-hospital transfers of inpatient (excluding ER transfers), code the previous hospital location. Ttenbergen 10:34, 2016 May 3 (CDT)
 
===Readmission from Grace/HSC Nursing Home===
===Readmission from Grace/HSC Nursing Home===
*currently discharges to and admissions from Grace Nursing Home are treated as new admissions (with the exception of the Discharge Screening Tool which is labelled 'transferred form').  Technically, though, this is an interhospital transfer, and the hospital treats it as a continuous admission.  Will this require a previous Inpatient Institution entry? And will the visit admission date then be the original admission date, or the date transferred from one ward to the other? [[User:SCortilet|SCortilet]]
*currently discharges to and admissions from Grace Nursing Home are treated as new admissions (with the exception of the Discharge Screening Tool which is labelled 'transferred form').  Technically, though, this is an interhospital transfer, and the hospital treats it as a continuous admission.  Will this require a previous Inpatient Institution entry? And will the visit admission date then be the original admission date, or the date transferred from one ward to the other? [[User:SCortilet|SCortilet]]
**Good question.  The discharges to GRA or HSC nursing home will be treated as '''intra-hospital''' transfers. The pre-admit in-patient  institution is '''Not-Applicable'''. The Visit admission date is the same as the original admission date in EPR. This will be treated as a special case of readmission in the analysis and report. [[User:JMojica|JMojica]] 13:39, 2016 May 2 (CDT)
** We treat these nursing home wards as inpatient locations for at least some scenarios, so we will treat them as inpatient locations for this. So, code e.g. Grace Nursing Home as [[Previous Location field]] and code Grace Ward (or e.g. VIC_S5 if known) as [[Pre-admit Inpatient Institution field]].
 
=== Day Surgery ===
If a patient was a day-surgery patient and ends up on our unit directly, their day surgery would be treated and an inpatient experience.


== Data Use / Purpose ==
== Data Use / Purpose ==

Revision as of 10:34, 3 May 2016

This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear.

The Pre-admit Inpatient Institution field identifies the previous inpatient location of patients who were already inpatients elsewhere before coming to our unit. This does not include patients who just arrived at an ER elsewhere and were not admitted as inpatient there.

For example, a patient arriving from Selkirk Hospital via the local ER would have the ER coded in the Previous Location field and Selkirk coded in the Pre-admit Inpatient Institution field.

Collection Instruction

For each patient,

  • enter the option that most closely matches
  • if you know the situation but nothing on the list matches closely, enter other - known but not listed
  • if the situation is unknown, enter location missing/unknown

If the patient did not come from an inpatient location, enter "not applicable", for example if they came from home or a clinic. The ER is not an inpatient location.

If you know how we code the location exactly, you can type it. Otherwise press the "magic wand" button to take you to the S dispo chooser‎ to help filter options if desired.

Where to find this information

If patient came from a different Winnipeg hospital this will be recorded in the “Visit History” on the EPR.

Example

  • ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC.
    • The PrevInptLocation field is: VIC_Ward

Questions

how about nursing stations?

  • We used to collect nursing stations in hospital previous but would not include them under the new scheme because they are not inpatient locations.

We are planning a meeting with Randy Martin to discuss. For now you can't enter nursing stations here, so, don't. Ttenbergen 18:16, 2016 April 28 (CDT)

ER -> cath lab -> ward scenario

  • If the previous location is the heart cath lab (which is a temporary location), then I should add a pre-admit inpatient institution. However, if the patient comes to the cath lab from ER, I cannot put this location because it also is a temporary location. Currently we do not put in the heart cath lab as a place to admit from, instead we use where they were located just prior to the cath lab (ER in this example). I thought that Julie tracked Winnipeg hospital use of ER's for Randy so if we will no longer be able to put that the pt came from ER in this setting, then this will be entirely missed. Just checking! --LKolesar 14:21, 2016 April 14 (CDT)
    • A scenario of patient who went ICU elsewhere --> Ward elsewhere --> ER1 --> ER2 --> Cath Lab --> ICU/Ward will enter the pre-admit inpatient Institution as Ward elsewhere according to Allan Garland. JMojica 13:28, 2016 May 2 (CDT)

are EMIPs inpatients?

  • GRA_emip is not a pre admit location
    • Or are they? their name would suggest they are. Emailing Julie for answer. Ttenbergen 18:16, 2016 April 28 (CDT)
    • Good question. I would consider EMIPS as in-patient and therefore STB, VIC and GRA ER should be included in the downlist of PRE-admit location (not HSC,CON,OAK ER). JMojica 10:01, 2016 April 29 (CDT)

Grace changes requested

  • Missing from Grace: S2, S4, S5 (unless we just put GRA_ward for all units that we currently don't collect on)
    • changed, Grace collecors, please delete when you have seen

HSC ER to GGH ICU to GGH Ward

  • pt sent to GGH ICU from HSC ER with order to transfer presumably because no critical care beds at HSC. Not treated as an admission by ER standards, but clearly had to be admitted or would not have been sent to ICU. Should this be treated as an inpatient admission for our purposes, so HSC ER would be entered as preadmit institution location?

Unit name changes

  • Can we change W3 to S3 as it is no longer called W3 (unit was expanded)?Mschaffer
    • changed, Grace collecors, please delete when you have seen

intra-hospital transfers

Template:Discussion

  • When we have patients moving from ward to ward, we normally do not go back to their original admission date to gather data especially as some patients have been admitted for over a year. Will it be acceptable to continue this practice?--CMarks 12:39, 2016 April 11 (CDT)
    • For intra-hospital transfers of inpatient (excluding ER transfers), code the previous hospital location. Ttenbergen 10:34, 2016 May 3 (CDT)

Readmission from Grace/HSC Nursing Home

  • currently discharges to and admissions from Grace Nursing Home are treated as new admissions (with the exception of the Discharge Screening Tool which is labelled 'transferred form'). Technically, though, this is an interhospital transfer, and the hospital treats it as a continuous admission. Will this require a previous Inpatient Institution entry? And will the visit admission date then be the original admission date, or the date transferred from one ward to the other? SCortilet

Day Surgery

If a patient was a day-surgery patient and ends up on our unit directly, their day surgery would be treated and an inpatient experience.

Data Use / Purpose

To document where those patients who were inpatients immediately before arriving on our ward/unit came from.

The detailed information will allow us also to distinguish between patients who were or were not inpatients before arrival. This is relevant to a patient's risk of bad outcomes.

The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.

Template:CCMDB Data Integrity Checks

Not yet implemented Ttenbergen 14:11, 2015 May 27 (CDT)

  • Template:Discussion do these make sense? (old q from Tina)
    • YES. if these are done, you may delete the ones I wrote above. JMojica 12:31, 2015 May 28 (CDT)

Reports

Template:Discussion Which reports will this be on? Ttenbergen 10:33, 2016 March 22 (CDT)

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes and did not previously exist.

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