Previous Location field

The Previous Location field contains the most recent previous physical location of a patient before arriving at the collection location. (exception, see #EMIP, bed borrow)

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 you know the location exactly, you can type it. Otherwise press the "?" button to take you to the S dispo chooser‎ to help filter options if desired.

For wards where we don't collect, enter e.g. HSC_ward. For wards where we do collect enter the actual ward as available in the dropdown.

Example

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.

Where to find this information

If patient came from a different Winnipeg hospital this should be recorded in the “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.

direct transfer

For patients who get parked in the ER during a inter-facility transfer, enter the previous ward in Pre-admit Inpatient Institution field and enter your ER in Previous Location field. (In the past you would have entered the hospital and ward as the "admit from".)

EMIP/Bed borrow

see those articles

from psych unit

Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.

Data collection units that have a mix of different physician serve types

We have a few units in the Region that have a mix of 2 different services (internal medicine, surgical, family medicine etc).

• VIC_S3 - is a mix of family medicine and internal medicine patients
• HSC_B3 - is a mix of day surgery & internal medicine patients
• any others?

For patients on these units:

• If patient is an internal medicine patient: enter the unit name (eg. VIC_S3)
• If patient is not a internal medicine patient, enter the generic hospital ward (e.g. VIC Ward); this will allow you to enter the Previous Service field with a physician service other than "Medicine".

Example: transfer from out-of-town ER

Pt was examined & treated in the Selkirk ER (but not admitted as an in pt.) & then sent as a direct admit to HSC but stopped in HSC ER & was treated there till a ward bed was ready. Code as

• Previous Location field: HSC ER
• Previous Service field: Emergency Medicine
• Pre-admit Inpatient Institution field: NA / not applicable
• yes, the Selkirk ER would not be reflected in collection

See also

• Operating room visits

Question: from day surgery or From Family Medicine

• Just wondering what people are selecting in the previous location field for patients who come from a day surgery unit (ex. B3 day surgery at HSC)... Right now we only have ambulatory care or interventional radiology to choose from. Do we need to add a "day surgery" option in the drop down menu? Or "other ward"?--Jvelasco 12:07, 2016 August 2 (CDT)
  • Previous Location - HSC Ward.
  • Previous Service - General Surgery (or other surgical service listed in drop down.
    • I have struggled with this as well, but usually my same day patients are coming directly from the OR, or Recovery Room, so I just enter this in my previous location field, and put n/a for my pre-admit inpatient institution. If they came from a same day surgical area, then I would probably enter "ambulatory care" for my previous location.Mlagadi 09:20, 2016 August 3
    • I am trying to complete a profile that was sent to MICU from S3 at the VIC, and it won’t let me check off “complete” for my registration section. The problem seems to be that the system wants me to enter medicine as a sending service, but in reality this patient is on S3 under family medicine. My only other option would be to check off the more generic “Vic ward” instead of “VIC S3”. This patient is not on the S3 data base, because we don’t admit any of the patients on S3 that are under family medicine. Let me know if you want to change things on your end, or if you want me to change my previous location.Mlagadi 2016 Sept 19.
      • In this case, even though the patient is physically in S3, she should enter the generic VIC Ward as previous location. We would like to be specific in the ward for previous location and dispo fields when it is the Med ward we are collecting or when these wards are of interest to the users (e.g. step down wards, long term vent wards). Put Family Medicine as previous service. Putting VIC S3 as previous location will only create a question ‘why there is no record of this patient in VIC S3 ?” Julie Mojica 2016-Sept-19

Data Use

This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.

Template:CCMDB Data Integrity Checks

Implemented:

• Can not be blank
• previous_NE_Location() - Previous Location field can't be same as Service/Location field
• Patients with Previous Location field critical care must have Previous Service field critical care, and patients from medicine must have previous service medicine.

• query check_prev_pre-admit_consistent: for inpatient transfers within the region, Previous Location field and Pre-admit Inpatient Institution field should be same.

• query check_previous_location_vs_service_inconsistent: patients with Previous Location field in medicine must have Previous Service field medicine; patients from ICU (except CCU) must have previous service "critical care".

Following might still need to be implemented:

• Check ORDx; or not? Would have to be done for ICD10, so can it wait? Ttenbergen 16:26, 2016 May 25 (CDT)
  • discussing with Julie, she seems open to waiting, told her I am starting Category:ICD10 and Template:ICD10 for stuff like this. Ttenbergen 10:56, 2016 June 2 (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.

It a combination of our previous

• Admit from
• Hospital previous
• Var 1 - Admit-from Ward