Deceased patients: Difference between revisions
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Ttenbergen (talk | contribs) moved discussion about dispo for organ donors here from Check dx implying death must be dispo deceased since it is really more general than that check. |
Ttenbergen (talk | contribs) |
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* Is that really what you want? It will give occupancy but miss actual time of death. }} | * Is that really what you want? It will give occupancy but miss actual time of death. }} | ||
==== discussion about organ donor collection === | ==== discussion about organ donor collection ==== | ||
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* presumably organ donation always happens in an OR. So, pt would always have [[Dispo]] OR when sent for organ donation. But if that's true, then when do we ever use [[Dispo]] = "Died - organ donor"? The way I read [[Dispo_field#deceased_patients]] we would not code the OR/ICU, but the desire for this cross-check makes me wonder if we are all on the same page about this. Collectors, do you ever code OR/ICU as dispo for a brain dead organ donor? Julie, do you ''expect'' to see them coded as that? (emailed Julie and collectors) Ttenbergen 16:45, 2018 November 24 (CST)}} | * presumably organ donation always happens in an OR. So, pt would always have [[Dispo]] OR when sent for organ donation. But if that's true, then when do we ever use [[Dispo]] = "Died - organ donor"? The way I read [[Dispo_field#deceased_patients]] we would not code the OR/ICU, but the desire for this cross-check makes me wonder if we are all on the same page about this. Collectors, do you ever code OR/ICU as dispo for a brain dead organ donor? Julie, do you ''expect'' to see them coded as that? (emailed Julie and collectors) Ttenbergen 16:45, 2018 November 24 (CST)}} | ||
*When there is a braindead patient waiting for transplant we always put dispo to OR once they go there. Putting the time of death as the time of braindeath will not work because we continue to look after the patient for quite a while after the pronouncement of braindeath (even for 1 or 2 days or more). The tiss extends longer and there are interventions that we code after braindeath. If we put died: organ donor for these patients, what time would we put there as the actual time of death?? --[[User:LKolesar|LKolesar]] 05:31, 2018 November 26 (CST) | *When there is a braindead patient waiting for transplant we always put dispo to OR once they go there. Putting the time of death as the time of braindeath will not work because we continue to look after the patient for quite a while after the pronouncement of braindeath (even for 1 or 2 days or more). The tiss extends longer and there are interventions that we code after braindeath. If we put died: organ donor for these patients, what time would we put there as the actual time of death?? --[[User:LKolesar|LKolesar]] 05:31, 2018 November 26 (CST) | ||
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* I also use the dispo location "died - organ donor" when pt leaves to OR using that time as time of death. Pts can be in ICU for days after brain death is declared. --[[User:Llovell|Llovell]] 11:03, 2018 November 26 (CST) | * I also use the dispo location "died - organ donor" when pt leaves to OR using that time as time of death. Pts can be in ICU for days after brain death is declared. --[[User:Llovell|Llovell]] 11:03, 2018 November 26 (CST) | ||
* We don't often see this at the Grace because they are transferred out to another facility if they are an organ donor, but I do not code the braindeath as the time of disposition, I would code it as a complication and the disposition date and time would be the transfer to another facility [[User:Lkaita|Lisa Kaita]] 10:15, 2018 November 27 (CST)ing death | * We don't often see this at the Grace because they are transferred out to another facility if they are an organ donor, but I do not code the braindeath as the time of disposition, I would code it as a complication and the disposition date and time would be the transfer to another facility [[User:Lkaita|Lisa Kaita]] 10:15, 2018 November 27 (CST)ing death | ||
== Data prior to death (even if pt did not die on our ward) == | == Data prior to death (even if pt did not die on our ward) == | ||
Revision as of 11:20, 28 November 2018
This page ties together the different types of information we collect about deceased patients. Additional info might be in but not integrated here yet.
Palliative question
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Julie asks: how to add a code for palliative care/ comfort care at discharge and/or change dx palliative service. |
General instructions for deceased patients
- there might or might not be one of the Category:Diagnosis implying death
| Diagnosis implying death codes: |
- the patient might become a Organ donor (organ/tissue donation by the donor)
- if the patient had been sent to a temporary location and was expected to return to the unit after the procedure, then the dispo is death. If the person was NOT expected to return to the unit after the procedure, then the dispo is transfer to the procedure area, resp the next ward.
NOT organ donor
- Dispo: "Died - NOT organ donor"
- Dispo DtTm: time of death
organ donor
- Dispo: "Died - organ donor"
- ie don't code that pt was discharged to the OR or another ICU
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- Dispo DtTm: sent from ICU to the operating room or to another ICU
- ie don't code the time of death
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discussion about organ donor collection
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- When there is a braindead patient waiting for transplant we always put dispo to OR once they go there. Putting the time of death as the time of braindeath will not work because we continue to look after the patient for quite a while after the pronouncement of braindeath (even for 1 or 2 days or more). The tiss extends longer and there are interventions that we code after braindeath. If we put died: organ donor for these patients, what time would we put there as the actual time of death?? --LKolesar 05:31, 2018 November 26 (CST)
- I have been following the instruction on the Organ Donor page, so the dispo location is "died - organ donor" and the date/time is when the patient leaves to the OR. For these patients I don't put the actual time of death, but in ICD10 we can put the date for Brain death and Sudden cardiac death (and died) --Jvelasco 08:29, 2018 November 26 (CST)
- I also use the dispo location "died - organ donor" when pt leaves to OR using that time as time of death. Pts can be in ICU for days after brain death is declared. --Llovell 11:03, 2018 November 26 (CST)
- We don't often see this at the Grace because they are transferred out to another facility if they are an organ donor, but I do not code the braindeath as the time of disposition, I would code it as a complication and the disposition date and time would be the transfer to another facility Lisa Kaita 10:15, 2018 November 27 (CST)ing death
Data prior to death (even if pt did not die on our ward)
Decisions about end of life care
- ACP C
- (legacy) ACP Status collection in ICU
End of life care
MAID
Data about patients who did die
- APACHE physiological variable collection#Patient DIED shortly after arriving in unit
- Dispo DtTm field
- Dispo field
Organ Donation
Category:Diagnosis implying death
| Diagnosis implying death codes: |
Data Integrity Checks (automatic list)
| App | Status | |
|---|---|---|
| Query check ICD10 dx implying death must have appropriate dispo | CCMDB.accdb | implemented |
| Link suspect dead then alive query | Centralized data front end.accdb | implemented |
| Query NDC dx implying death across encounters | Centralized data front end.accdb | implemented |