Definition of a Medicine Program Admission: Difference between revisions

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''For Critical Care, see [[Definition of an ICU_admission]]''
*''For Critical Care, see [[Definition of an ICU_admission]]''


The definition of a "Medicine patient" for the Regional Medicine Database is:  
*The following situations ARE included for the Regional Medicine Database:  
*admitted under a Medicine service attending physician.  If patient doesn't meet this definition then we don't collect data and enter into the Medicine database.
**Admitted under a Medicine service attending physician anywhere in the hospital (including, for example, if they are remaining in ED because there is no medicine ward bed yet).
**Admitted to a Medicine ward location but rather than being cared for by the regular ward team, the primary care service is Nephrology
***Once such a person is transferred out of the Medicine ward location, we no longer follow the patient.
**Admitted to a Medicine ward location but rather than being cared for by the regular ward team, he primary care service is Neurology.
***This includes "HSC Internal Med / Neurology" patients admitted to [[HSC HOBS]] -- once they are discharged/transferred out of HOBS, we no longer follow the patient.  (per Dan Roberts, see also [[HSC Medicine Collection Guide]])
***More generally, once such a person is transferred out of the Medicine ward location, we no longer follow the patient.
**Admitted to a Medicine ward location but rather than being cared for by the regular ward team, the primary care service is Oncology -- ''EXCEPT'' if admitted ONLY for chemotherapy
***A subtlety here is that if during the chemotherapy the patient has a complication and now is admitted for that complication (i.e. no long "only for chemotherapy") then we will include them in the Medicine database.
***Once such a person is transferred out of the Medicine ward location, we no longer follow the patient.
*As always, collection for internal medicine patients starts at [[Accept DtTm]] ie [[Accept_DtTm_field#Direct_Admissions.2FTransfers|possibly while in ER]], regardless of where they are, including if they are still in the ER (i.e. [[EMIP]]).


Collection for internal medicine patients starts at [[Accept DtTm]] ie [[Accept_DtTm_field#Direct_Admissions.2FTransfers|possibly while in ER]], regardless of where they are, including if they are still in the ER (i.e. [[EMIP]]).
{{DT | Clear out or reconcile [[EPR Reports]], [[Discharge Register]], [[Transfer Register]], [[Definition of a Medicine Service admission]], [[Definition of an ICU admission]]}}
__TOC__ 
=== Special cases - Inclusion of extra patients ===
{{DA |
* Allan to ask Nick Hajidiacos what he wants and why.
}}
{{DiscussTask |
* Allan to ask Nick Hajidiacos what he wants and why.
}}
This is about the inclusion of some pt not attended by Internal Medicine Attendings. Generally we only include pts under Internal Medicine Service, but the following are exceptions where we collect even though pt is under other physician:
* all '''"HSC Internal Med / Neurology" patients that are admitted to [[HSC HOBS]]''', once they are discharged/transferred out of HOBS, we no longer follow the patient.  (per Dan Roberts, see also [[HSC Medicine Collection Guide]])
* all '''nephrology patients'''
{{Discuss |
{{Discuss |
* many to D5 (Low [[Level of care hierarchy]]) under service of nephrology, neurology, oncology (ward being a non-teaching medicine but those services continue to care for their patient unless accepted by Dr Dowhanic or Arneja(who won't handle the HD population))
* many to D5 (Low [[Level of care hierarchy]]) under service of nephrology, neurology, oncology (ward being a non-teaching medicine but those services continue to care for their patient unless accepted by Dr Dowhanic or Arneja (who won't handle the HD population))
** ''not sure what that line means now with the new model; would collectors need to include any non-med-service patients for this? If not, what are we actually saying with it?  
** ''not sure what that line means now with the new model; would collectors need to include any non-med-service patients for this? If not, what are we actually saying with it?  
}}
}}

Revision as of 12:55, 2 December 2020

  • The following situations ARE included for the Regional Medicine Database:
    • Admitted under a Medicine service attending physician anywhere in the hospital (including, for example, if they are remaining in ED because there is no medicine ward bed yet).
    • Admitted to a Medicine ward location but rather than being cared for by the regular ward team, the primary care service is Nephrology
      • Once such a person is transferred out of the Medicine ward location, we no longer follow the patient.
    • Admitted to a Medicine ward location but rather than being cared for by the regular ward team, he primary care service is Neurology.
      • This includes "HSC Internal Med / Neurology" patients admitted to HSC HOBS -- once they are discharged/transferred out of HOBS, we no longer follow the patient. (per Dan Roberts, see also HSC Medicine Collection Guide)
      • More generally, once such a person is transferred out of the Medicine ward location, we no longer follow the patient.
    • Admitted to a Medicine ward location but rather than being cared for by the regular ward team, the primary care service is Oncology -- EXCEPT if admitted ONLY for chemotherapy
      • A subtlety here is that if during the chemotherapy the patient has a complication and now is admitted for that complication (i.e. no long "only for chemotherapy") then we will include them in the Medicine database.
      • Once such a person is transferred out of the Medicine ward location, we no longer follow the patient.
  • As always, collection for internal medicine patients starts at Accept DtTm ie possibly while in ER, regardless of where they are, including if they are still in the ER (i.e. EMIP).
  • many to D5 (Low Level of care hierarchy) under service of nephrology, neurology, oncology (ward being a non-teaching medicine but those services continue to care for their patient unless accepted by Dr Dowhanic or Arneja (who won't handle the HD population))
    • not sure what that line means now with the new model; would collectors need to include any non-med-service patients for this? If not, what are we actually saying with it?
  • SMW


  • Cargo


  • Categories
  • At STB patients admitted under SBGH Internal Med/Nephrology are collected and included in the database.

Special cases - Exclusion STB Oncology patients

We don't collect Oncology patients at STB that are admitted only for chemotherapy. These are short stay patients with only nursing IPN entries. If these patients develop complications they are transferred to Internal medicine service for the duration of hospital stay. Task_Team_Meeting_-_Rolling_Agenda_and_Minutes_2020#ICU_Database_Task_Group_Meeting_.E2.80.93_November_18.2C_2020 Confirmed at Task Meeting.

These are excluded by excluding the following services from our Cognos Report Integrator:

  • "SBGH Internal Med / Oncology"
  • Not excluding HSC counterparts for now although they were listed here also. Can HSC tell if they should come off the list?
    • "HSC Oncology / Radiation"
    • "HSC Oncology / Medicine"
  • SMW


  • Cargo


  • Categories

Special cases - Exclusion STB Interventional Radiology patients

  • STB_Med - interventional radiology will admit a patient for an overnight procedure, we are not following these
  • This is correct, we do NOT follow interventional radiology patients who stay overnight for procedures. Your first clue that it's not an internal medicine is the attending physician. The attending physician will be an interventional radiologist, not an internal medicine doc. DPageNewton 08:11, 2020 November 19 (CST)
  • In Cognos I don't see a service that makes me think interventional radiology, but it might just be a service not included in the dump. Collectors: Do these patients show up in Cognos, and if so, how do you decide that this is what they are and they should be excluded? Ttenbergen 16:39, 2020 November 2 (CST)
  • At this point I have not come across an interventional radiology patient in cognos admitter. See above for how we determine if it's an interventional radiology patient. If there is a way to definitely exclude them from the admitter that would be helpful. There are enough other exclusion patients in there already. DPageNewton 08:11, 2020 November 19 (CST)


  • SMW


  • Cargo


  • Categories

Special cases - Exclusion HSC H6 patients

  • patients admitted to HSC_H6 under "HSC Internal Med / Respiratory" or "HSC Internal Med / Neurology"
    • H6 is also a medicine contingency ward, so we do follow some patients on H6 Lisa Kaita 10:59, 2020 November 4 (CST)

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