BedHeldEnd DtTm

Projects
Active?:	planned
Program:	CC and Med
Requestor:	???
Collection start:	2023-01-01
Collection end:

Data Collection

Collect for all patients where beds are held due to AMA or procedure at other sites. This will only be recorded in the situations when:

• patient leaves AMA and the bed is held for a bit hoping they come back (but they never do so) (ie this doesn't apply to AMAs who sign out and we know they won't return)
• patient goes elsewhere for a procedure expecting them to return so bed is held but they never do come back.

Collection Instructions

• Project :BedHeldEnd DtTm
• Items: AMA or Procedure
• Date (field E): Discharge date as per ADT (ie when the bed was released)
• Time (field M): Discharge time as per ADT (ie when the bed was released)
• Not used: Integer, Real, Checkbox, Comment

Sources

Use the discharge dttm as per Cognos2 Ender/ADT.

Background

As discussed at JALT, the frequency of people leaving AMA (esp from ward) is not low. And, per Lisa, most of these are without notice. Thus it is not a trivial issue that there is a nontrivial difference between when the patient actually stops being under care vs. when the bed is released for reassignment.

Our previous instructions were to note in the Dispo DtTm field when the person left AMA, or was noted to be gone and assumed AMA. If a bed is "held" and the patient indeed returns, goes back into that bed without being readmitted (because the bed was held), then this isn't to be considered to be an AMA. This follows the same kind of reasoning as Visits to temporary locations. This meant we had no way to report bed times lost to AMA.

We then realized that this issue is the same for bed times lost to beds held when a patient is sent to another hospital for a procedure, expecting to return (so the bed from the sending site is held) but then does not return.

These 2 situations are easy for the DCs to identify and they always do so anyway, so we decided to track this to allow us to report on this more meaningfully.

So we will distinguish between:

• (a) Actual time under care, which is from Admit DtTm to the patient's Dispo DtTm -- we'll call this the patient's length of stay **use for indicators LOS Per Record or LOS per Service
• (b) What we'll call "Bed Assigned Time", i.e. from Admit DtTm to the time when the bed is released for reassignment, which we will call "BedHeldEndTime". This latter is generally available from Cognos (ADT)
  • Use for indicator Bed occupancy

Collection parameters

• End Date: planned as continuous collection without an end date

Data Use

• LOS Per Record
• LOS per Service
• Bed occupancy

Consistency Checks

We should likely add one for complete and undeleted records such that if AMA is entered for this, Dispo must be AMA. Converse is not true in case of AMA who signs out. BedHeld will not be entered if pt signs out AMA following WRHA process. Do we want to add a counterpart so we can cross-check that the entry wasn't just forgotten if there is an AMA entry in Dispo? Could we consider adding two different dispo options, ie AMA (AWOL) and AMA WRHA protocol? or something like that? Lisa Kaita 15:35, 2022 December 8 (CST) I think that would be good. Can you always see that from chart? And,should "WRHA" be in there or is it a shared health protocol these days? Could just call it "AMA (protocol)". However, would a "protocol" case ever result in the delay we are tracking here? Wouldn't they have Dispo DtTm EQ AMA time? Ttenbergen 10:47, 2022 December 14 (CST)

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Data Integrity Checks (automatic list)

	App	Status
Query check tmp BedHeld	CCMDB.accdb	implemented

To do

make CCMDB changes edit any related AMA content on wiki

added: 2022-12-08 action: 2022-12-08

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Log

• 2022-12-08 made page to validate