Processes around changing a PatientFollow assignment

Patients are assigned to collectors using the PatientFollow Project. This page explains what needs to happen when an assignment is changed. The collector/laptop that used to collect a number needs to phase out that number, the collector/laptop who gains that number needs to start them, and we need to be sure that Julie will report on them continuously. We need a process where the time frame for the transition is limited.

Since PatientFollow Project assignments are based on the Service Start DtTm (collected as Service tmp entry), the transition is based on of the Service Start/Change dttms.

Process for the collector who will no longer be collecting the chart number ending

• patients with a service start DtTm after the transition date will no longer show up in Cognos Admitter/Cognos2 Service Starter on the laptops that are no longer collecting them (they will show up on the new laptop, see next section)
• If the next service or unit change would lead to a discharge from the affected laptop's, do a regular discharge.
• If the next service or unit change would not lead to a discharge from the affected laptop's (ie would just lead to another Service tmp entry or Boarding Loc entry), then discharge the patient to the Dispo location appropriate for their next unit (ie use the Dispo that someone from another site would use if they sent a pt there). This might mean that you are setting Dispo to the same value as Service/Location.

I do not understand this instruction, it is not clear, in particular "ie use the dispo that someone from another site would use if they sent a pt there". The last instruction that was talked about during the Microsoft team meeting on Monday, November 23rd was to enter dispo location as St. B med. This wasn't signed but I assume this was written by a STB med collector. So, in your case, you would be sending this to another STB Med laptop and so would enter STB Med. But these instructions need to be written so they will also be true for e.g. the similar change that is happening to STB CC. So, the instruction needs to be written so it is not specific to your situation. That means, you will use the same dispo entry as would anyone who sends a patient to the receiving laptop. If an HSC Med collector sent a pt to STB E6, they would enter STB Med in their dispo, right? If you can write this better above, then please do, it just needs to be general rather than specific to your situation. Ttenbergen 22:02, 2020 November 26 (CST)

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• enter Comorbid Diagnoses, Admit Diagnoses,Acquired Diagnoses and Admit Procedures,Acquired Procedures that happen before the transition dttm

Process for the collector who will now be collecting the chart number ending

• patients with a chart ending that is no longer collected on a laptop and who have a service start DtTm after the transition date will not show up in Cognos Admitter/Cognos2 Service Starter, even if their record was started on a different laptop

The above statement is not clear, will patients with transfers to other medicine units on/after transition date show up on receiving collector laptops? yes From below this statement is not clear: for Previous Location, Previous Service, Pre-admit Inpatient Institution use what someone from another site/program would use if they received this patient Does this statement mean to enter the specific unit for previous location and pre admit in-patient institution? Please clarify No, as above I was trying to phrase this generally so it applies to any change in allocation we make, not just to you. In your case, these would be STB Med because if these patients were moved to e.g. HSC Med, the HSC Med collector would use STB_Med for previous etc. If you can think of a better way to word this generally, please do, it just needs to be general rather than specific to your situation. Ttenbergen 22:02, 2020 November 26 (CST)

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• enter these patients through Cognos Admitter/Cognos2 Service Starter, which will add the Visit Admit DtTm field of the original entry on the other laptop
• only enter the unit or service changes that happen after admission to your unit, since the ones before will be on the other laptop already
• for Previous Location, Previous Service, Pre-admit Inpatient Institution use what someone from another site/program would use if they received this patient
• enter Acquired Diagnoses and Acquired Procedures that happen after the transition dttm

Cross-threshold records that persist for a long time

A change in unit or service will trigger a re-assignment, but a patient could remain on the same unit and service for a long time after a PatientFollow change. If the change was just done for workload re-distribution reasons this may not matter and collection can continue on the original laptop. If the re-assingment was done to wind down a laptop entirely the the remaining records should be discussed with main office on a regular basis to decide if collection should continue on that laptop, or if the record should be moved to the new laptop (ie. manually re-entered there, and deleted from old laptop). This will be a case-by-case decision.

What needs to be changed in CCMDB.mdb every time there are assignment changes

The S PatientFollow distribution table needs to be updated to set an ending time for the earlier laptop. A new line needs to be added for the later laptop, with the same start DtTm as the end DtTm for the earlier one.

Process Julie uses to re-connect the data

If we use teh Visit Admit DtTm field to define Hospital stays, and the Boarding Locs and Service tmp entry instead of old Service/Location etc, then e.g. LOS and Bed occupancy would be the same, whether they come from one laptop or several.

We discussed this today and you would need to make changes to how you derive these markers. A number of them probably need to be re-defined and revised after all the changes we have made because they would still be based around the old concepts of Accept DtTm, Arrive DtTm etc that should really not be used any longer for calculations. What would it take, and where are these things documented? Ttenbergen 16:50, 2020 November 23 (CST)

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To Do

Fix the cross checks so this can work; one way would be to exempt records with a visit admit dttm before follow-ending and a dispo (or now) after a follow-ending; messy query for messy times.

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