Deceased patients

This page ties together the different types of information we collect about deceased patients. Additional info might be in but not integrated here yet.

Dispo needs to be tweaked to Death - to OR Death - to other ICU Death - to morgue

• SMW

• Cargo

• Categories

What about the tiss score sheet, it extends beyond LOS then in these cases? There are significant interventions done by the nurses after braindeath, hopefully we can complete the tiss to the end of bed occupancy? Just checking.--LKolesar 14:06, 2019 May 2 (CDT) AKA Query TISS Errors NrTISSDays NE LOS; Query TISS Errors missing days; Query TISS Errors TISS date out of admission

• SMW

• Cargo

• Categories

New Rules (as of April 2019) Regarding Brain death and Organ Donation

• For a patient who develops Brain death in location A, and then transfers to location B for further evaluation for organ donation
  • In location A the patient will have an acquired diagnosis of Brain death, and their dispo will be Death with transfer to another ICU. The LOS in location A will be time from admit to Brain death. Any time spent in location A after Brain death will be counted towards occupancy but not LOS.
  • In location B the patient will have admit diagnosis of Brain death, and their dispo will be Death with transfer to OR for organ donation IF they go for donation and Death with transfer to morgue if not. While all of this time will be included in occupancy, none of it will be included in LOS (since the person was not alive).
  • In the unusual situation where the patient goes directly from location A (an ICU) to the OR of another/different hospital for organ harvesting, the dispo for location A will be Death with transfer to OR for organ donation
  • Regarding death rates in these records
    • It’s necessary to avoid double counting the death in location A and location B.
• For a patient who is not yet brain dead in location A and then transfers to location B with expectation of near-future Brain death or Donation after Cardiac Death (DCD)
  • In location A the dispo will be transfer to location B. The record in location B will have admit diagnoses of whatever is present. IF that person develops Brain death in location B, then that will be coded as an acquired diagnosis.
  • If the patient develops Brain death in location B, then the LOS in location B will only be the time from admit to Brain death. For calculating this patient’s total LOS, it will be the entire time in location A + the time in location B until Brain death.
• For a patient who is in one location (e.g. MICU), where he develops Brain death, and then stays in that location to be evaluated/optimized for being an organ donor
  • Brain death will be an acquired diagnosis. LOS will only be the time from admit to Brain death. Time after Brain death will be counted towards occupancy but not LOS.
  • The dispo will be Death with transfer to OR for organ donation IF they go for donation and Death with transfer to morgue if not.

General instructions for deceased patients

• there might or might not be one of the Category:Diagnosis implying death

Diagnosis implying death codes:

Brain death Medical Assistance In Dying

• 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: "Death - to morgue"
• Dispo DtTm: time of death

organ donor

See Guideline for coding organ donation after death

Data prior to death (even if pt did not die on our ward)

Decisions about end of life care

• ACP C

End of life care

• Comfort Care
• DC Treatment
• Hospice
• Palliative care

MAID

• Medical Assistance In Dying (MAID)

Data about patients who did die

• APACHE physiological variable collection#Patient DIED shortly after arriving in unit

Not organ donors

• Dispo DtTm field
• Dispo field

Organ donors

• see Guideline for coding organ donation after death

Category:Diagnosis implying death

Diagnosis implying death codes:

Brain death Medical Assistance In Dying

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

Legacy info

click expand to see legacy info

ACP Status collection in ICU Palliative Service Medical Assistance In Dying (old) Organ Donor