Level of care hierarchy: Difference between revisions

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* ward outside WRHA

* PCH or home

=== When to use the Levels of Care ===

When the intent is to move the patient from a higher level of care to a lower level of care, transfer ready date and time has to be entered corresponding to the physical location where the decision was made. The entries are done following the guidelines in the [[Boarding Loc]] and [[Transfer Ready DtTm tmp entry]].

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~~=== Actual listing of care levels for different [[Boarding Loc]]s ===~~

~~The [[s_level_of_care table]] in [[CCMDB.accdb]] (and automatically linked into [[CFE]] contains a mapping of our Boarding Locs to their level of care.~~

=== Hierarchy and Transfer Ready Dt/Tm Entries ===

A Transfer Ready Dt/Tm is entered when a patient has been declared medically stable and/or ready to be transferred to a lower level of care (for example, a patient has been made ACP-C, deemed stable and ready for discharge home/to PCH, ready to be transferred from ICU to medicine, etc). For patients who present to ER and then are admitted to the medicine ward, they do NOT need a Transfer Ready date and time entry leaving ER because they are not going to a lower level of care (even though listed above indicates ER is a higher level of care). The care they will be receiving on medicine is considered to be equivalent to the level of care they received in ER. The line still needs to be entered/associated with the ER Boarding Loc, but follow the direction used when the patient is moved with a Transfer Ready date and time that is not available, or if they were not transfer ready.

=== Actual listing of care levels for different [[Boarding Loc]]s ===

The [[s_level_of_care table]] in [[CCMDB.accdb]] (and automatically linked into [[CFE]] contains a mapping of our Boarding Locs to their level of care.

{{Discuss| Should Special case - ER, OR and PACU entry (see above) and what is written directly above need to be somehow be better reconciled? Otherwise apt to differing interpretation(s) for example, if ER is to be considered a "higher" level of care than a medicine unit a collector could enter a comment of "not available" as the patient did transfer to a "lower" level of care so theoretically was "transfer ready" based on special case above (as appears to be an exception) but a date/time was not available, or alternatively enter a comment of "not transfer ready" as the transfer to a medicine unit is not a lower level of care unless indicated otherwise while the patient is in ER (ie. change to ACP C). If left as is, would this be confusing to a new collector? }}

@@ Line 11: / Line 11: @@
 * ward outside WRHA
 * PCH or home
 === When to use the Levels of Care ===
 When the intent is to move the patient from a higher level of care to a lower level of care, transfer ready date and time has to be entered corresponding to the physical location  where the decision was made.  The entries are done following the guidelines in the [[Boarding Loc]] and [[Transfer Ready DtTm tmp entry]].
@@ Line 20: / Line 21: @@
 <!-- as per meeting with Allan 2020-10-27 -->
-=== Actual listing of care levels for different [[Boarding Loc]]s ===
-The [[s_level_of_care table]] in [[CCMDB.accdb]] (and automatically linked into [[CFE]] contains a mapping of our Boarding Locs to their level of care.
 === Hierarchy and Transfer Ready Dt/Tm Entries ===
 A Transfer Ready Dt/Tm is entered when a patient has been declared medically stable and/or ready to be transferred to a lower level of care (for example, a patient has been made ACP-C, deemed stable and ready for discharge home/to PCH, ready to be transferred from ICU to medicine, etc). For patients who present to ER and then are admitted to the medicine ward, they do NOT need a Transfer Ready date and time entry leaving ER because they are not going to a lower level of care (even though listed above indicates ER is a higher level of care). The care they will be receiving on medicine is considered to be equivalent to the level of care they received in ER. The line still needs to be entered/associated with the ER Boarding Loc, but follow the direction used when the patient is moved with a Transfer Ready date and time that is not available, or if they were not transfer ready.
+=== Actual listing of care levels for different [[Boarding Loc]]s ===
+The [[s_level_of_care table]] in [[CCMDB.accdb]] (and automatically linked into [[CFE]] contains a mapping of our Boarding Locs to their level of care.
 {{Discuss| Should Special case - ER, OR and PACU entry (see above) and what is written directly above need to be somehow be better reconciled? Otherwise apt to differing interpretation(s) for example, if ER is to be considered a "higher" level of care than a medicine unit a collector could enter a comment of "not available" as the patient did transfer to a "lower" level of care so theoretically was "transfer ready" based on special case above (as appears to be an exception) but a date/time was not available, or alternatively enter a comment of "not transfer ready" as the transfer to a medicine unit is not a lower level of care unless indicated otherwise while the patient is in ER (ie. change to ACP C). If left as is, would this be confusing to a new collector? }}