EMIP

EMIP stands for Emergency Medicine "IN" patient and is used as a Service/Location field in the Medicine database. It is used for patients who are admitted to our internal medicine service and spend their entire admission under the medicine service in the ER (emergency department). We are tracking this as VIC_EMIP, GRA_EMIP, STB_EMIP and HSC_EMIP.

Definition of EMIP

1. Pt has an order or some entry that medicine has accepted the patient while still in ER.
2. The patient either is discharged from ER to home or any other out of hospital location

• OR....
• the patient is transferred within the hospital directly to a different service because Medicine decides that they will not take the pt but the patient needs different care. Examples: Palliative care take over the care; ICMS takes over the care; Surgery takes over the care; Gynecology takes over care; etc.
  • These patients are only under medicine while they reside in ER. Once they leave ER they are either going out of hospital or going to a different service within the hospital.

Collection Instructions

See site specific collection guides for details on the collection process, papers, binders.

identifying patients

EMIPs will show up under:

• the Transfer Register if they are sent to non-medicine units in your hospital.
• EMIP's in this list will be those under the medicine or internal medicine service that subsequently changed service before leaving ER and were transferred out of ER to a local hospital ward or unit. (not a medicine ward).
  • see instructions for Off ward field to also identify some EMIP patients. See this under the title "how to identify off-ward patients" in that article.

• the Discharge Register if they leave the hospital
  • When reviewing the discharge list generated by the instructions, the EMIP's are those that have medicine or internal medicine under the "service" heading.

• • Run these reports at least once a week if possible.

For EMIP entry

• There is a separate paper log sheet that has its' own sequential numbers.

Entering patients in dispo tab fields

• Service/Location field - your EMIP (e.g. GRA_EMIP)
• Previous Service field - likely emergency medicine, unless some other service accepted them prior to medicine, and was never able to get them out of the ER either, and medicine accepted the patient from them -in order for a pt to be an EMIP they must have been accepted by Medicine for admission otherwise they would just be an Emergency patient
• Accept DtTm field - the time Medicine accepted them, i.e. the time they became an EMIP
• Arrive DtTm field - same as Accept DtTm field
• Previous Location field - use normal instructions
• Dispo field - For EMIP pts, you cannot put discharge to an ER, so if that is where they went, put the place they went after ER (usually a ward).
• Transfer Ready DtTm -only use this if the pt is going home. Otherwise use "not transfer ready".
• See Overstay_Predictor_Project_Collection_Instructions#Possible_Scenario_-_EMIP_patient_that_never_made_it_to_the_ward for how to code overstay for these patients.

Patients transferred to other locations

Collection includes patients who are discharged to a non-medicine location in the hospital. So, if an EMIP patient is transferred to an ICU, that ICU would use e.g. GRA_EMIP as Previous Location. If a pt who starts out on the EMIP track turns into a medicine off ward patient, collect them as you would any other off-ward patient.

EMIP scenario

• In ER under Medicine service and left your hospital to Home or died in ER
• In ER under Medicine service and transferred to other locations under different service in your hospital
• In ER under Medicine service and discharged to other locations in another hospital

NOT an EMIP

• In ER under Medicine service and then moved to a Medicine service ward (i.e. a regular Medicine admission)
• In ER under Medicine service and then moved to other ward but under Medicine service (i.e. a case of off ward patients).

HSC Community and Clinical Decision Unit (CCDU)

Template:Discussion How about EMIPs that only were on here? Ttenbergen 13:21, 2017 September 19 (CDT)

EMIPs at non-medicine sites

• Are you interested in an EMIP from the Oaks being admitted to medicine at STB or should we just put from Oaks ER? Currently the option of EMIP at Oaks is not available for the pre-admit inpatient institution or the admitted from location. It would be a rarity to be able to determine if a patient is an EMIP at the Oaks because they do not have EPR physician orders available on line yet. However, we have found one case by means of notes sent with the pt that determined that the pt was admitted to the Oaks as an inpatient but remained in their ER and later sent to STB E5 medicine. Just checking if you want these and if so, we would need to allow this option. Eventually we will not have an ER at the Oaks at all and it will only be urgent care at some point so this is a consideration as well. (For now we will just use Oaks ER.) (from email from Laura)
  • We don’t collect Med in Oaks so Oak ER is just fine. However, if the patient is an inpatient from OAKs, just enter ‘OAK Ward’ in the inpatient institution. (from Julie)
    • Our definition of EMIP doesn’t seem to explicitly restrict to “a medicine service we collect”. It just says “entire admission under the medicine service”. Can we fix that to “entire admission under a medicine service we collect”.

This might also mean that some of our collectors would include patients accepted by e.g. H6 doctors, while others would not. Change would fix that as well. Should we change the wording of the definition above? If so then this discussion can go. If not, it should probably be summarized... Ttenbergen 18:55, 2017 September 21 (CDT)

No ICU counterpart

see ECIP for more info

Serial numbers used

Patients in EMIP have their own serial numbers starting at number 150.

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