ACP Status Collection for LAU

Projects
Active?:	active
Program:	CC and Med
Requestor:	Dr. Dan Roberts
Collection start:	2025-03-15
Collection end:	2025-04-13

This dataset contains data in support of the LAU Collection Project and regular data collection for both ICU and medicine programs.

ACP status affects care decisions (and sometimes indecision) and therefore Length Of Stay and also outflow pathways.

similar dataset ACP Status Collection in ICU

Data Collection

• For any record collected, enter
• The first documented ACP status
• The last documented ACP status
• Do not collect multiple changes in the ACP status during the course of their hospitalization only as directed above.

Data Entry Instructions

For every LAU Collection Project, a line with Project = "ACP first" and item = "not entered" will automatically be entered. Update that line to one of the following:

• Project:
  • ACP first
  • ACP last
• Items:
  • ACP-C
  • ACP-M
  • ACP-R
  • not documented
• Date/Time: dttm of the status decision
  • if decision was made before admission, use the first service/admit dttm
  • if a time is not available, enter 12:00
  • if the ACP last status is the same as the ACP first status, enter the same ACP status as the first, and use the same dttm as the first ACP.
  • if the ACP last status is different than ACP first status, enter the last documented ACP Status and the dttm that it was changed, you do not need another ACP last entry.
• Checkbox, Integer, Real, Comment: not used

• • Use the earliest documented ACP first status that is part of the current admission
  • If there are multiple ACP status changes/family discussions that are affecting the LOS or seem unusual, leave this as a comment in the "Q" column, NOT the notes section

many patients are deemed comfort care, with no official change in their status except in the notes and orders, can we use the dttm in orders or notes to reflect ACP last status? I would think yes based on ACP-C and Palliative care criteria? Lisa Kaita 09:53, 11 June 2025 (CDT) Interesting. It would depend on the purpose of this field, to some degree. Also, we discussed today that there has been category creep in those over time: ACP-C content I think was really only ever intended as page intro for what is essentially an index page to make sure we keep in mind all places where the concept is used. APC-C setting qualifies for Transfer Ready DtTm tmp entry Having ACP-C status qualifies for Palliative care dx, but other things do as well, so not interchangeable. The page explicitly says they are not the same. I think we are actually looking for properly completed and documented advanced care plans, specifically, but will confirm. Ttenbergen 16:30, 11 June 2025 (CDT) "note indicating that there was a discussion with patient or care team", a definition similar to that ...

• SMW

• Cargo

• Categories

if date/time is not documented, is a date/time required? would it be date of first service and 1200? that might put it before the first service start dttm, which (and needs to) trigger the cross check. The DtTm is important since we will look at this in the context of delays, so even a best guess would be better than a not-filled. So I would say enter best guess. If it is clear the discussion was on the unit and after admission, and there really is no way to figure out when, we could have some sort of standard, eg xhrs after admission. I will confirm. Ttenbergen 16:30, 11 June 2025 (CDT)

• SMW

• Cargo

• Categories

• if status is documented as "presumed", is this what we should use?
  • then you enter "not documented" (but maybe we need to fine-tune the wording)

• but if there is no documented ACP status?
  • then you enter "not documented"
    • yes, but using date & time of first service, date & time of current boarding location service or one of these dates & 12:00?

Sources

• ACP form
• Admission sheets
• Progress notes
• If a patient arrives from another facility, or transferred from another ward/service with an ACP status already documented use that as the first ACP status and the dttm would be the same as the first service dttm

About the data

• Every patient in our sample had a ACP done by the end of their stay. This was confirmed with the data collector. Likely related to these patients being elderly. There might be a policy at the sites, we have not investigated this.

Data Use

This data is being collected as a current state for LAU Collection Project.

Consistency Checks

Data Integrity Checks (automatic list)

	App	Status
Query check ACP Status Collection	CCMDB.accdb	implemented

Log

• 2025-06-10 opening up collection for all medicine and ICU admissions
• 2025-03-15 - 2025-04-13: collection of data for LAUs as part of LAU Collection Project
• 2025-03-06 - discussed with DR if we should use the same dataset and definitions as for ACP Status Collection in ICU ; we don't need the source or the M+/- distinction, but we do want the first and last ACP as we did for that project.
• 2025-06-10 added to S tmp table for regular data collection

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