Previous Location field

Data Element (edit)
Field Name:	Previous_Location
CCMDB Label:	Previous Location
CCMDB tab:	Dispo
Table:	L_Log table
Data type:	number
Length:	long integer
Program:	Med and CC
Created/Raw:	Raw
Start Date:	2016-07-01
End Date:	2300-01-01
Sort Index:	37

The most recent previous physical location (with #exceptions) of a patient before arriving at the collection location.

• SMW

Legacy implementation right in the table

• Cargo

• Categories

• Forms

Collection Instruction

For each patient,

• enter the option that most closely matches:
  • for places where we collect, use the Service/Location used by the counterpart laptop: <site>_Med, GH-CC, HSC MICU , HSC SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU
  • for wards where we don't collect: <site>_Ward or other external entry e.g. home
• if you know the situation but nothing on the list matches closely, enter other - known but not listed
• if the situation is unknown, enter Not known
• if the patient is in ER under a service we do not collect ie. cardiology, surgery etc use <site>_ER

If you know the location exactly, you can type it, otherwise click on the dropdown button to view the options

Borrowed Bed Or Pt Boarding On Other Unit

For direct transfers within the Winnipeg region, should we enter the Last Boarding Location as the Previous Location ? No because these are only temporary location. Use the service taking care of the patient : <site>_Med, GH-CC, HSC_MICU, HSC_SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU.

To clarify for LAU inpatients ie. Oak, Conc, Vic, etc. often will be transferred to the facility UC for stabilization and sometimes be returned to originating unit in the LAU facility or will transfer out to STB ER for further assessment or as a direct to STB ER or a STB med unit. In the direct scenarios is the previous location coded as the LAU inpatient unit or the LAU UC? Thanks! ```` Does LUA mean Lower Acuity Unit? It is not specifically listed in the dispo table - can we consider it as generic <site> ward? If LAU is an inpatient location, maybe the choice for preadmit inpt location is <site> Ward and the previous location is STB ER if transfer out to STB ER or STB Med if direct transfer to STB Med or <site> ward if returning back to the LAU facility. --JMojica 11:38, 2024 February 26 (CST) Yes Julie the LAU locations include VIC_ward, CON_ward, etc. and yes, is the entry for the preadmit inpatient Institution. These patients almost always transfer to the facility UC area for advanced assessment and treatment then sometimes transfer back to the LAU unit in which case is not for the data base. What I'm asking is whether the previous location should be entered the same as the preadmit inpatient Institution ie. site_ward or should the entry be site_UC. Since UC/ER is not an inpatient unit but rather a temporary location should the previous location be site_ward to be congruent with the instructions above that state: Yes to simplify depending on the temporary location, for this case previous location can be <site> ward. For direct transfers within the Winnipeg region, should we enter the Last Boarding Location as the Previous Location ? No because these are only temporary location. Use the service taking care of the patient : <site>_Med, GH-CC, HSC_MICU, HSC_SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU. Should the examples include generic site_ward? Thanks, Pamela Piche 11:56, 2024 February 26 (CST) yes, you are correct, we should use the service taking care of the patient as previous location. When will generic ward be used - if the origin of the patient is not from the ward we are collecting. --JMojica 14:41, 2024 February 26 (CST) If direct transfers between facilities that stop by receiving ER the dispo for the sending facility is not ER but the receiving service and direct transfers between facilities that stop by the sending ER the dispo is not the ER but the receiving service. Should this concept extend to all direct transfers that stop by an ER at either sending or receiving facility? So for the direct VIC_ward patient that stops by VIC UC should the previous location be coded as VIC_ward or VIC UC? If UC is used does this appear as a VIC "EMIP"? Is previous location of VIC_ward more accurate in this scenario? There is a direct MICU patient from Thompson ICU that stopped by Thompson ER. Should the previous location be coded as Thompson ER or Thompson ICU? If coded as Thompson ER does this appear as a Thompson ECIP? Is the previous location code of Thompson ICU more accurate in this scenario? I am seeking clarification as to the correct coding in these scenarios. Thank you, Pamela Piche 07:10, 2024 February 27 (CST) We have 2 direct transfers - 1. from outside Winnipeg facilities - whether inpt or not, if they went to <own site> ER (e.g. STB ER) for triage, previous location is <own site> ER (e.g. STB ER). If they just stop by only at <own site> ER, then previous location is the outside facility service - it does not matter if from ICU (e.g. Thompson ICU) or ER (e.g. Thompson ER) service of that outside facility as long as the pre-admit inpt has been filled up correctly (e.g. Thompson ICU) , then in TMP Boarding, put <own site> ER (e.g. STB ER) as first boarding loc. 2. within WPG facilities - since we are linking all admissions of all hospitals we are collecting, we need to be specific for the sending and receiving service. For those we no longer collect sites CON/OAK/VIC - inpatients from CON, OAK, VIC who are directly transferred to HSC/STB/GRA, then the pre-admit inpt will not be N/A and the previous location is the same as the pre-admit inpt. If not yet an inpt from CON/OAK/VIC and transfers only from their UC triage, then previous location is the CON/OAK/VIC UC. For transfers among HSC/STB/GRA - if already inpatients, and no in-between procedures, pre-admit inpt is the same as previous location. if there is temporary location in-between, then previous location is equal to the temporary location (e.g. ER, OR, RR, Cath Lab, Dialysis, Radiology). If not yet an inpt and coming from <other site> ER then previous location is <other site> ER. --JMojica 10:02, 2024 February 27 (CST)

• SMW

• Cargo

• Categories

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

query of what is currently available

SQL

SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo FROM s_dispo WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));

Query of what is currently used

query z_s_dispo_inactivatable

Where to find this information

If patient came from a different Winnipeg hospital this should be recorded in the “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.

Exceptions

Data collection units that have a mix of different physician serve types

We have a few units in the Region that have a mix of different services (internal medicine, surgical, family medicine etc).

• HSC_B3 - is a mix of day surgery & internal medicine patients
• any others?

For patients from these units:

• If patient was an internal medicine there, enter <site>_Med
• If not a internal medicine patient, enter the <site>_Ward

from HSC psych unit

Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.

Dialysis unit as previous location

For patient from Dialysis unit, use that unit as previous location. Pre acute living situation field would be the unit they came from right before, if applicable.

Heart Cath Lab vs OR as previous location

When a procedure (e.g valve replacement) is done in the cath lab before the pt arrives on your unit, enter Cath Lab if done in Cath Lab and put OR if done in OR.

Patients from day surgery

For patients admitted from day surgery units, enter:

• Previous Location - <site>_Ward, e.g. HSC Ward

Homeless Patients

If a homeless patient is admitted directly then code them as admitted from home. Usually they would be via ER, of course, and you'd code them as that.

Prison / Jail / Correctional Institution

If a patient is admitted from prison, jail or a correctional institution, code this as an admission from "Institution NOS".

See Prison / Jail / Correctional Institution for additional info.

Data Use

This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.

Data Integrity Checks (automatic list)

	App	Status
Check pre acute consistent	CCMDB.accdb	declined
Query check tmp ER Boarding Loc should exist if from ER	CCMDB.accdb	declined
Function Validate Previous Location	CCMDB.accdb	implemented
Query check prev pre-admit consistent	CCMDB.accdb	implemented
Check function previous NE Location	CCMDB.accdb	implemented
Query check CCI from OR no CCI	CCMDB.accdb	implemented
Query check pt from ER	CCMDB.accdb	implemented
Query check previous location vs service inconsistent	CCMDB.accdb	retired
Check Accept Loc Park	CCMDB.accdb	retired
Query check VAP admit must be from ICU	CCMDB.accdb	retired
Link suspect mismatch from ours incomplete query	Centralized data front end.accdb	implemented
Link suspect not same visitAdmitDtTm query	Centralized data front end.accdb	implemented
Query cardiac arrest throughout admission	Centralized data front end.accdb	needs review

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes.

It a combination of our previous

• Admit from
• Hospital previous
• Var 1 - Admit-from Ward