EMIP: Difference between revisions

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(as discussed with Julie and Trish)
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EMIP stands for '''E'''mergency '''M'''edicine "'''IN'''" patient and is used as a [[Location field|location]] / in the Medicine database. It is used to as location for patients who are admitted to the medicine service and spend their entire hospital admission in the ER (emergency department) while under the care of Medicine Service attending physician.  
EMIP stands for '''E'''mergency '''M'''edicine "'''IN'''" patient and is used as a [[Location field|location]] / in the Medicine database. It is used to as location for patients who are admitted to the medicine service and spend their entire '''admission under the medicine service''' in the ER (emergency department).  
This sort of thing happens at the '''Victoria General Hospital''' and the '''Grace General Hospital'''
We are tracking this at VIC, GRA, STB.


== Collection Instructions ==
== Collection Instructions ==
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* [[Previous Location field]] - use normal instructions
* [[Previous Location field]] - use normal instructions


== EMIP as previous location for ICU ==
=== Patients discharged to other locations in hospital ===
{{discussion}}
Collection includes patients who are discharged to other locations in the hospital. Should have been like this all along, but the definition said otherwise. Please collect as this going forward, as discussed with Trish and Julie. Ttenbergen 11:18, 2016 May 16 (CDT)
What if EMIP patient doesn't come to medicine ward (making them no longer EMIP) but deteriorates and is admitted to ICU? Do you collect these as EMIPs? Do you omit them from collection? Discussed with Trish but we did not know what collectors do with these.
*if a pt is admitted to anywhere other than ER they automatically are not an EMIP-EMIPs spend their entire LOS in hospital in the ER; if they are accepted by Medicine and never leave the ER they are EMIPs, if they are admitted to ICU they become part of the ICU database, and if they are sent to a Medicine ward they are part of the Medicine database. EMIPs are identified as EMIP when they show up on the Admission Summary but never show up on one of the Medicine wards; they are tracked until they either show up on a Medicine ward or are discharged at which point they can be designated an EMIP; they will never be entered into the EMIP database until after discharge
The answer to this will also define whether or not "***_EMIP" needs to be available as in [[Previous Location field]]. Ttenbergen 17:34, 2016 May 9 (CDT)
*EMIPs are by definition Emergency Medicine Inpatients and never leave the Emergency Department until discharge. Their entire LOS is in the ER. They are not entered into the database until they have been discharged.  If they are moved to any other unit, they are no longer EMIPs but are entered into the database for Medicine or ICU as appropriate. EMIP cannot be a previous location. 
**The [[Previous Location field]] is the most recent physical location of a patient before they arrived at the collection location. EMIP is not a physical location. This patient would be admitted from a previous location of ER. 
**[[Service Sending to ICU | Sending Service]] is the service that the patient was under the care of "prior to" being sent to collection location.  Main office will review if patient is an EMIP then goes to ICU, does ICU reports want to note sending service to be ''Medicine Service'' in these circumstances?  Will let you know.
*when a medicine patient deteriorates in the ER  and is then admitted to ICU, we do not enter them as an EMIP patient for two reasons,; they are no longer.by definition an EMIP patient, and the patient will be captured by ICU data collection  [[User:Lkaita|Lisa Kaita]] 22:14, 2016 May 9 (CDT)
* I concur with Lisa --[[User:LKolesar|LKolesar]] 06:42, 2016 May 10 (CDT)


== Do these happen for ICU? ==
== Do these happen for ICU? ==
*When the ICU doctors see a pt in ER and accept them while they are still there, the accept date and time will reflect this.  They will then be transported to the ICU at some point and therefore we do not use the EMIP designation as it becomes an ICU admission. --[[User:LKolesar|LKolesar]] 10:36, 2016 May 11 (CDT)
While these do, in theory, happen in ICU, we will not collect them.  
** What if pt dies after acceptance and before move? That would make them EMIP. Would hopefully be rare, but it would mean we don't need special case between ICU and medicine for this. Ttenbergen 14:11, 2016 May 11 (CDT)


{{discussion}} Do these ever happen for ICU? If they don't, then we should change the instructions to no longer say Medicine only because it's irrelevant. If they '''do''' happen, then we should likely include them in collection, no? Is there any reason to have different instructions? Ttenbergen 08:36, 2016 May 11 (CDT)
{{discussion}}
Collecting them would also be not feasible as long as the "ignore pt who was in ICU for less than 30 minutes" rule is in effect. Where is that documented? Could not find it in [[Definition of an ICU admission]] or by search for "30 minutes". Ttenbergen 11:18, 2016 May 16 (CDT)


== Locations ==
== Locations ==

Revision as of 11:18, 2016 May 16

EMIP stands for Emergency Medicine "IN" patient and is used as a location / in the Medicine database. It is used to as location for patients who are admitted to the medicine service and spend their entire admission under the medicine service in the ER (emergency department). We are tracking this at VIC, GRA, STB.

Collection Instructions

Patients discharged to other locations in hospital

Collection includes patients who are discharged to other locations in the hospital. Should have been like this all along, but the definition said otherwise. Please collect as this going forward, as discussed with Trish and Julie. Ttenbergen 11:18, 2016 May 16 (CDT)

Do these happen for ICU?

While these do, in theory, happen in ICU, we will not collect them.

Template:Discussion Collecting them would also be not feasible as long as the "ignore pt who was in ICU for less than 30 minutes" rule is in effect. Where is that documented? Could not find it in Definition of an ICU admission or by search for "30 minutes". Ttenbergen 11:18, 2016 May 16 (CDT)

Locations

VIC EMIP

See VIC_Medicine_Collection_Guide#Identifying_OVER_and_EMIP_patients.

GRA EMIP

Template:Discussion should all EMIPs be coded as overflow since they spend their entire LOS in the ER not the ward?

STB_EMIP

See STB_Medicine_Collection_Guide#Process_for_identifying_Overflow_and_EMIP_patients

Serial numbers used

Patients in EMIP have their own serial numbers starting at number 1.

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