Boarding Loc

Projects
Active?:	active
Program:	CC and Med
Requestor:	internal
Collection start:	2019-Sep-20
Collection end:

This isn't so much a project as way to track how patients physically move around the hospital. See Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry for information about it and why we needed to change it to this model.

This project tracks where and when a patient arrives into a new physical location.

Data Collection Instructions

How to enter this

• Use tmp fields:
  • Project: Boarding Loc
  • Enter start_dt: arrival date at physical location, under column E.
  • Enter start_tm: arrival time at physical location, under column M.
  • checkbox: not used for this project
  • Item: no location entered is the default (that entry will not be allowed in a complete record)
    • change the original entry to the first location the patient was during the admission in this record, e.g. ER, specific medicine ward etc
    • for any physical move to another unit, enter an additional Boarding Loc entry:
      • For "home" locations
        • item: the actual ward
        • comment: leave blank
      • For "boarding" locations
        • item: "<your site> - boarding" (eg. HSC - boarding)
        • comment: leave blank

FOR STB MEDICINE PROGRAM

• A6S (current covid suspect unit) enter as STB-boarding as well as for any additional covid suspect units with whichever Med service is applicable
• A6GY(current covid positive unit) enter as STB-COVID unit and for any additional covid positive units with whichever Med service is applicable
• B4NO unit currently in use for displaced E6B patients, enter as STB-boarding with Med B service
• For other boarding locations like A7S, A7W, etc. enter as STB-boarding with applicable Med service

APACHE

The APACHE elements time frame will start in the off-ward bed location.

Does it really start in ER? since that's now one off-ward location? In any case, we should really only link to the definition in APACHE from here so this doesn't become inconsistent. If someone knows where that's documented, can you please confirm and fix? Ttenbergen 00:36, 2020 October 16 (CDT) I haven't been able to find it on the Wiki, but I was told to get my values for my Apache from the previous location. So for example a patient getting admitted to the ward from ER, the Apache values would be the ones just prior to their Accept Dt/Tm. Think "this was their condition when they were accepted by medicine". If it's a transfer to the ward from ICU, I take the last values before they left. Surbanski 11:14, 2020 October 19 (CDT) To confirm for patients admitted from ER, Apache vital signs are taken from closest to but prior to Accept Date/time? For medicine yes. I don't know if ICU does anything different. If I've been doing it wrong I expect someone from medicine at the other sites will say something :) Surbanski 10:31, 2020 October 20 (CDT) Dose ICU start there APACHE and TISS from the ER accept time or ICU admit time. Currently we collect from the ER accept time only when the patient is boarded in the ER for greater than 2 hours. Gthomson2 10:43, 2020 October 20 (CDT)

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TISS

TISS starts from the off-ward bed.

This would now mean TISS starts in ER if the pt is in ER long enough. We discussed that a while ago and I can't remember the outcome. This might need to be updated to correspond to that. Or rather, this should only be a link to that so it doesn't go inconsistent in the future. If some one knows what was decided, can you please fix this? Ttenbergen 00:36, 2020 October 16 (CDT)

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Special Case - cross-program boarding

If a patient is accepted by your service but remains at a location of a different service for some time before moving to your service, you need to enter a Boarding Loc entry for that period.

For Critical Care collection, this could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med" for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are. The generic "<Site>_Med" entry would only be available on CC laptops.

For Medicine we were not able to imagine a circumstance where a medicine service patient would be cared for by medicine in the ICU, so we have not yet added a "<site>_CC" entry to medicine laptops. Please flag if one is needed.

Special Case - Parked

• For patients who are Parked in ER, just follow usual instructions, a special entry is no longer needed, since the ER delay will take care of them.

Special Case - EMIP/ECIP

See 2020-10 EMIP changes

Special Case - COVID

See 2020-10 COVID unit collection.

earlier info

During the COVID-19 pandemic there were a lot of movements of entire wards (see Category:2020 COVID unit transition for related pages). The Boarding Loc project was a convenient place to store this information, so we added some specific locations for this purpose: HSC_D4_P HSC_D5 HSC_D5_p HSC_H4H STB_E6_B GRA_5N

Start/End Dates

• Start: 2019-Sep-01: new admissions on and after this date.
• End: there is no planned end date

Loose ends

we have two entries "GRA_ER" and "GRA - ER". The "- ER" one is same format as the STB and HSC ones. We should probably consolidate the GRA_ER entry into GRA - ER. For now, collectors please use "GRA - ER", and when the last "GRA_ER" is gone I will get rid of the option and we can consolidate them. Ttenbergen 19:26, 2020 October 15 (CDT) we have two 5N entries as well: GRA - N5 and GRA_5N. As previously discussed we've been using GRA - N5 but let us know if that changes Surbanski 08:23, 2020 October 16 (CDT) Please use GRA - N5 as you have been. If neither of you has an GRA_5N on your laptop now I can inactivate that one. Ttenbergen 08:26, 2020 October 16 (CDT) I can confirm that our Boarding Loc entries are GRA - N5 and GRA - ER. You can remove the duplicates for both. Surbanski 08:49, 2020 October 16 (CDT)

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Query ''check ER Delay not too big'' needs to be changed to include the new Boarding Loc schema .

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Which if any of Project_Borrow_arrive#Data_Integrity_Checks_.28SMW.29 will need to be moved over to this instead?

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inactivate legacy entry Home Medicine ward once last pt using it is discharged

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Data Integrity Checks (automatic list)

	App	Status
Check if awaiting code is primary dx then Transfer Ready DtTm must be equal to Arrive DtTm	CCMDB.accdb	declined
Query check_tmp_ER_Boarding_Loc_should_exist_if_from_ER	CCMDB.accdb	declined
Query check minimal data set incomplete	CCMDB.accdb	implemented
Query check tmp 2 BL TR S same tm	CCMDB.accdb	implemented
Query Check BL TR combiner null	CCMDB.accdb	implemented
Query check Transfer DtTm after paired BL and before later BL	CCMDB.accdb	implemented
Query s tmp Boarding Loc ER delay reasonable	CCMDB.accdb	implemented
Query check no consecutive same BL or Service	CCMDB.accdb	implemented
Query check CCI TISS matching BoardingLoc time	CCMDB.accdb	implemented
Query check tmp Boarding Loc Service first same	CCMDB.accdb	implemented
Query s tmp check Boarding Loc and TransferReadyDtTm pairs	CCMDB.accdb	implemented
Query s tmp check combined Boarding Loc and TransferReadyDtTm	CCMDB.accdb	implemented
Query check transfer DtTm during admission	CCMDB.accdb	implemented
Query check tmp Service and Boarding Loc during admission timeframe	CCMDB.accdb	implemented
Query check tmp service or location duplicate	CCMDB.accdb	implemented
Query s tmp Boarding Loc date item	CCMDB.accdb	implemented
Query Check_VADT_too_close_to_first_boarding_loc	CCMDB.accdb	needs review
Query check tmp Transfer Ready not before Boarding Loc	CCMDB.accdb	retired
Query s tmp check combined BL and TRDtTm nonsequential	CCMDB.accdb	retired
Query check transfer ready tmp for each Boarding Loc	CCMDB.accdb	retired
Query s tmp Boarding Loc no borrow but entry	CCMDB.accdb	retired

Data Use

Critical care and Medicine programs want to know this to better understand patient flow and bed utilization.

SAS Program

The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.

Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time

where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.

The SAS program is saved in X:\Julie\SAS_CFE\CFE_macros\Bed_Borrow.sas

Background

See Bed borrow as aggregator page for other boarding and borrow related concepts.

The concept is similar to EMIPs but we will keep the EMIP separate from this project. The current EMIP will stay the same.--JMojica 10:37, 2019 September 20 (CDT)

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