Overstay Predictor Project Collection Instructions

Changes coming July 31 2017 - stay tuned here........ 

Instructions for admissions starting Jul 31 2017

This article documents what data collectors need to do to collect information for the Overstay Predictor Project.

This project is one of the Vacation and staff shortage collection priorities!

No entries are required in the TMP section. (AutoEntry of DPST form in tmp will disappear.)

• • • Trish & Tina...At the task meeting it was mentioned that we are to generate a new colour with every ward move but I don't see instructions reflecting this.--CMarks 12:49, 2017 July 20 (CDT)
    • in discussion.

Participating Medicine sites

• STB
• HSC
• GRA
• VIC - up to Oct 2.17 midnight

In addition to Minimal Data Set

The following items need to be entered before the generation of the chart colour in the next step because the algorithm uses this data:

• Date of Birth
• Province
• Accept DtTm if used, else Arrive DtTm
• Pre-admit Inpatient Institution
• ADL
• Glasgow Coma Scale
• important: List of diagnoses affecting Overstay Project

Generate colour

Once the required information has been entered click the "Overstay" button on the patient viewer screen next to the Notes field and it will turn a colour based on an algorithm.

The program will ask you if this is the final colour you will submit. If so, it will be stored and sent. The colour will also be automatically added to the beginning of the Notes field, since most collectors were manually putting it there anyways.

• RED - significant risk for discharge delays
  • automatic generation of email to notify unit manager
  • put red stick on chart
• YELLOW - anyone who is not red
  • no email to manager
  • no sticker on chart
• GRAY - if some needed data is missing you will not be able to generate a colour; there will be a specific error, please act on it; there are no gray stickers, gray is just a colour the laptop will give when it gets bad data for the algorithm.

Red Chart Stickers

If the colour is red place a 3/4" red round sticker on the spine of the patient chart.

RED DOT stickers needed or not?

• who needs 3/4" red dots stickers?

Yes

• • DPN - STB E5 (ward clerks would order)
  • VP - HSC H4

No

• • LL - HSC B3/D5 (has from previous)
  • SK - VIC - N5, S4, S5 (ward clerk would order as per SK)
  • LK - GGH - 5N, 3S, 3N (we order from grand and toy)
  • EN - STB E6-5B (can get from ward, knows where they keep them)

are there Other coloured dots on charts?

There is currently a small red dot used to indicate long term chart. Template:Discussion

• Are these small red dots used at all sites? Ttenbergen 14:44, 2017 July 18 (CDT)
  • we don't use them at GGH Lisa Kaita 07:33, 2017 July 20 (CDT)
    • I haven't ever seen small red dots being used at the VIC.Mlagadi 15:11, 2017 July 19 (CDT)
• Is there any risk of someone confusing these small red dots with our overstay ones? Ttenbergen 14:44, 2017 July 18 (CDT)
  • Are you talking about the small dots that the ward staff use on the addressograghs?--CMarks 12:56, 2013 July 30 (CDT)
    • any dots that might be confused with ours, eg by new staff misunderstanding training. Do you think those might be? Ttenbergen 09:44, 2017 July 19 (CDT)

even at STB? - YES

• At STB at this time the data collectors do not travel to the ward to review charts as they are able to retrieve all their information from EPR. Once this change is implemented, do they need to go to the ward every day to put stickers on the charts? Who will be looking at these stickers which are put on the charts here at STB? Are all sticker colors essential on the chart spine? If the unit manager is being notified of red ones perhaps this email notification is sufficient for the purposes of the overstay project? (instead of red sticker). Just checking to make sure we all understand this new change. --LKolesar 07:37, 2017 July 19 (CDT)
  • At this time the plan would be for all (incl STB) medicine collectors to put dots on physical charts. We discussed only notifying the manager by email with the requestor of the project, but they really want the dots. One thing we considered was the possibility of putting something equivalent to the red dot onto Medworxx. I am looking into that. Ttenbergen 09:44, 2017 July 19 (CDT)

DPST form - STOP July 31.17

Collectors will no longer:

• collect any information from the DPST forms or be responsible for them (tmp file for the questions will be gone)
• post information in the Transition Coordinator binders or
• notify and assign allied Health.

Collectors can ignore the form and just collect the minimal data set outlined above to generate a colour.

• wards may continue to fill out the DPST form at admission For their own purposes.

Transition Coordinator Binder - Stop July 31.17

Collectors will no longer:

• post any kind of information in the Transition Coordinator binder
• notify and assign reds to allied Health team

Notifying the Unit Manager

If a patient is identified as red, collector must send an email to the unit manager.

Template:Discussion We are going to automate that process at least partially, using something similar to the email buttons you already have. Details to come. Ttenbergen 14:44, 2017 July 18 (CDT)

• tina is working on it for this week.

Possible Scenarios

Possible Scenario - Patient transferred from other ward - admit ward was participating ward

If the patient was admitted from a another medicine ward at the same location, and if that ward also participates in the Overstay project, then the original Yellow/Red designation is retained. Ensure that these charts have the appropriate colour dot on them. If they were pre-determined to be a "red" then the name and date of the patient transferred in should be written in the transition coordinator binder, indicating that they are a transfer in from another ward.

The completed form, with colour written on it, should arrive on the new unit with the patient. The designated colour should be written on the form.

If the patient is admitted to a participating ward, then transferred to a non-participating ward, and finally back to a participating ward, then use the colour on the original ward.

Template:Discussion Need to discuss with Julie how this will work. There will no longer be a form to travel along. What would happen if we just generated the colour again and stripped out values for transferred pts later? Ttenbergen 14:44, 2017 July 18 (CDT)

• If generating the color every time will simplify the instructions to the DC, this is fine with me. In the analysis, I will only use the color of the first ward admission and not the succeeding transfers. --JMojica 16:15, 2017 July 18 (CDT)
  • OK, will take out these instructions when I clean up since it will now be simply matter of generating a colour in every case. Ttenbergen 09:59, 2017 July 19 (CDT)

• Tina, is it possible to have an article in WIKI about the Overstay model and the cut-off value that designate color? Thanks. --JMojica 16:15, 2017 July 18 (CDT)
  • added: Overstay Predictor Project Algorithm Ttenbergen 09:59, 2017 July 19 (CDT)

Possible Scenario - Patient transferred from other ward - admit ward was NON-participating ward

If the patient is transferred either from or via any unit not participating in the Overstay project (e.g. an ICU) generate a colour.

Possible Scenario - colour change due to data entry error

After 24 hours all information required to make the assessment as to if the patient is at risk should be available (or not known to the nurse within the first 24 hours and thus considered a risk). The only case where the colour should be changed is if the data-collector knew they had made an error on data entry. In that case, click the button again and answer "yes" to the question whether this is the final entry; this will overwrite the previous entry in the tmp table, and it will add the new entry to the beginning of the Notes field. This means you may have multiple colours in notes, the first one being the current one. It is not be necessary to document when a sticker colour changes. Just change the colour.

• Tina, how are these color changes being handled when sending the data - which color appears in the table L_TmpV2? Can we assume that the last color entry is the final color? JMojica 11:33, 2015 April 30 (CDT) Template:Discussion
  • I will need to review in the CCMDB.mdb... Ttenbergen 11:33, 2015 May 1 (CDT)
    • I still need to review... Ttenbergen 14:44, 2017 July 18 (CDT)

Possible Scenario - Patient died/discharged before data collection

Enter anyway and generate colour. Do not contact Unit Manager.

Possible Scenario - EMIP patient that never made it to the ward

Enter anyway and generate colour. Do not contact Unit Manager.

Possible Scenario - Off ward patients

For patients with Off ward field = true, Enter anyway and generate colour. Template:Discussion Which unit manager do we contact? Ttenbergen 14:44, 2017 July 18 (CDT)

• email to MALynch. Trish Ostryzniuk
  • MAL only wants overstay from first ward patient was admitted to and not subsequent once if color changes. It will be up to collectors to makes sure that red dot follow patient on chart to unit they are transferred to. Unit manager from wards we are collecting on will be notified and if patient overflow to off ward, collector will follow as we do now until discharge from service. MAL said it is up to manager to notify off service ward manager. She want to keep this process simple.

Chart binders - what happens with chart binders when pt moves from one war to another at your site?

• HSC-Med- Con M-binder goes to receiving unit and traded for empty one
• Gra_-Med - Allyson - binder goes to receiving unit and traded for empty one
  • Gra-ICU - keeps binder and only send paper from chart.
• STB-Med - Debbie - keeps binder and only send paper from chart. (sending ward keeps their charts)
  • STB-MICU - keep binder and only send paper from chart.
• VIC-MED - Shirley-binder goes to receiving unit and traded for empty one
  • VIC-ICU - Michelle-binder goes to receiving unit and traded for empty one

Instructions admissions before Jul 30 2017

see Pre-2017-07-30 Overstay Predictor Project Collection Instructions