Boarding Loc: Difference between revisions

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=== Special Case - Cross-program boarding ===
=== Special Case - Cross-program boarding ===
If a patient is accepted by a service, taken care of by that service but '''remains at a location of a different service where we collect for some time''' before moving to the new service, enter a [[Boarding Loc]] entry for that period. That originating and different service location becomes the first Boarding loc.
If a patient is accepted by one of our services, and is on an off-service ward, enter a [[Boarding Loc]] entry for that period.  
{{DL |
 
should the above say "before moving to a new ''ward''" or is "to the new service" right. the whole thing confuses me a bit...  
}}
'''For medicine pts boarding in ICU''' you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc.
'''For medicine pts boarding in ICU''' you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc.
{{DL|
{{DL|
what is this sentence telling me, can I not use the specific medicine entry? Why/how? What would a new collector need to know?  
what is this sentence telling me, can I not use the specific medicine entry? Why/how? What would a new collector need to know?  
* I have no idea, I suppose this can happen although I have not ever seen this at any of the facilities, I believe you were the original author of this so feel free to do what you want with this [[User:Lkaita|Lisa Kaita]] 13:46, 6 August 2025 (CDT)
}}
}}


'''For CC patients boarding on a Med ward where we collect''', enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only for [[Critical Care program]] admissions.  
'''For CC patients boarding on a Med ward where we collect''', enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only for [[Critical Care program]] admissions.  
{{DL | said laptop, but should be per admission; might be worth confirming that this isn't a lose end we missed from going to patientfollow. if all good, comment can be deleted. }}
 


{{Ex | This could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med"  "<Site>_Med" (ie [[GRA_Med]], [[HSC_Med]], [[STB_Med]]) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are.}}
{{Ex | This could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med"  "<Site>_Med" (ie [[GRA_Med]], [[HSC_Med]], [[STB_Med]]) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are.}}

Revision as of 13:46, 6 August 2025

Projects
Active?: active
Program: CC and Med
Requestor: internal
Collection start: 2019-Sep-20
Collection end:

This isn't so much a project as way to track how patients physically move around the hospital. See Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry for information about it and why we needed to change it to this model.

This project tracks where and when a patient arrives into a new physical location under the Medicine or ICU service.

Data Collection Instructions

Sources for Boarding Loc DtTm

CSS / Cognos2 Unit Starter

Usually the Cognos Unit start time from CSS or Cognos2 Unit Starter can be used as Boarding Loc.

  • sometimes the first Service tmp entry and first and second Boarding Locmay all have the same date and time. The date and time for these entries must be confirmed by looking at the chart, specifically orders, flowsheets, and progress notes

First set of vital signs for CC

ICU Curriculum: The first set of vital signs is used as Boarding Loc dttm for arrival on the unit for Critical Care program admissions, if it is different from the Cognos Unit Start DtTm.

Erroneous Unit information in CSS/Cognos2 Unit Starter

Sometimes the times are not when people really show up at a location. Use what you know to be correct from chart and your knowledge of your hospital.

How to enter

You can use the "make loc" button to generate and pre-populate these entries.

  • Use tmp fields:
    • Project: Boarding Loc
    • start_dt and start_tm:
    • checkbox: not used for this project
    • Item:
      • for the initial unit or ER and each physical move to another unit, enter the location by using the "make loc" button in Patient Viewer Tab Cognos ADT2
      • please note that if a boarding location appears in COGNOS but the patient does NOT move/arrive to that boarding location, do NOT enter that boarding location. We only capture boarding locations where the patient physically arrives
        • if the ward is not available in the dropdown, please notify Tina, Lisa, and Julie; Tina/Lisa will add the location to the dropdown and update the wiki as needed; Julie will note the change for her reports. eg. during the various COVID waves, many surgical wards were used for medicine overflow or COVID patients
        • leave what is in Cognos, the main office doesn't use this part for anything for home locations, but it can be used to crosscheck accuracy.
  • no location entered is the default
    • that entry will not be allowed in a complete record; it is automatically deleted when by Cognos Make Loc button, but needs to be removed before setting a record to complete if it is still present.

Combining Transfer Ready DtTm tmp entry and Boarding Loc records

Special Case - Can't have two Boarding Locs with same DtTm

  • No two different Boarding Loc recordss should have same start_dt and start_tm.
    • if two locations have the same Start_DtTm in CSS/Cognos2 Unit Starter this is an error. Change one to be off by one minute, put a note in Notes field to check boarding location to confirm the correct date and time for the boarding locations of concern.
  • The date and time for these entries must be confirmed by looking at the chart, specifically orders, flowsheets, and progress notes
Example:   
  • Example: Not infrequently, the COGNOS data for HSC_SICU patients coming from the ER will show the first service, first boarding location (ER) and the second boarding location (SICU) as all having the same start_DtTm. Our solution for this is to change the second boarding location (SICU) to be off by one minute.

Special Case - GRA MICU boarding in GH-Emergency

This is a case of Patients who appear to transfer from in-patient situation to Emergency Room, see there for more info.

  • Grace ICU boarding in ER choose Boarding Location GH-Emergency
  • Grace Main ICU choose Boarding Location and GH-Intensive Care
  • Grace Recovery Room (ICU) choose Boarding Location and GH-Recovery Room and enter comment Covid+ICU
  • For External(SDC/NFA) ICU beds choose Boarding Loc and GH-External ICU and enter exact location in comments

Special Case - Cross-program boarding

If a patient is accepted by one of our services, and is on an off-service ward, enter a Boarding Loc entry for that period.

For medicine pts boarding in ICU you can use the explicit ICU entry that applies because all CC locations are explicitly included in Boarding Loc.

what is this sentence telling me, can I not use the specific medicine entry? Why/how? What would a new collector need to know?

  • I have no idea, I suppose this can happen although I have not ever seen this at any of the facilities, I believe you were the original author of this so feel free to do what you want with this Lisa Kaita 13:46, 6 August 2025 (CDT)
  • SMW


  • Cargo


  • Categories

For CC patients boarding on a Med ward where we collect, enter "GRA_Med"/"HSC_Med"/"STB_Med" as applicable. We added these boarding loc options specifically for this scenario, and they are available only for Critical Care program admissions.


Example:   
This could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med"  "<Site>_Med" (ie GRA_Med, HSC_Med, STB_Med) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are.

Special Case - Visits to temporary locations that happen to be Boarding Locs

Occasionally a patient may be transferred to a location that is normally a Boarding Loc that we would enter or discharge to, however that location may be used as a temporary boarding location for a procedure. If after reading through the chart this is in fact the case, that Boarding Loc should not be entered, as it should be regarded as though the patient were going for any procedure and then back to their home ward location.

Example:   

Medicine patient is transferred to ICMS for a scope and is not admitted under critical care -> don't enter a Boarding Loc for ICMS

Special Case - parked in ER

For further information please see

Instructions that apply to both Boarding Loc and Service tmp entry

Special Case - Cognos data has different times for first Boarding Loc and Service tmp entry

See DtTm for First Boarding Loc and First Service

Start/End Dates of collection

Data Integrity Checks (automatic list)

 AppStatus
Check if awaiting code is primary dx then Transfer Ready DtTm must be equal to Arrive DtTmCCMDB.accdbdeclined
Query check_tmp_ER_Boarding_Loc_should_exist_if_from_ERCCMDB.accdbdeclined
Query check minimal data set incompleteCCMDB.accdbimplemented
Query check tmp 2 BL TR S same tmCCMDB.accdbimplemented
Query Check BL TR combiner nullCCMDB.accdbimplemented
Query check Transfer DtTm after paired BL and before later BLCCMDB.accdbimplemented
Query s tmp Boarding Loc ER delay reasonableCCMDB.accdbimplemented
Query check no consecutive same BL or ServiceCCMDB.accdbimplemented
Query check CCI TISS matching BoardingLoc timeCCMDB.accdbimplemented
Query check tmp Boarding Loc Service first sameCCMDB.accdbimplemented
Query s tmp check Boarding Loc and TransferReadyDtTm pairsCCMDB.accdbimplemented
Query s tmp check combined Boarding Loc and TransferReadyDtTmCCMDB.accdbimplemented
Query check transfer DtTm during admissionCCMDB.accdbimplemented
Query check tmp Service and Boarding Loc during admission timeframeCCMDB.accdbimplemented
Query check tmp service or location duplicateCCMDB.accdbimplemented
Query s tmp Boarding Loc date itemCCMDB.accdbimplemented
Query Check_VADT_too_close_to_first_boarding_locCCMDB.accdbneeds review
Query check tmp Transfer Ready not before Boarding LocCCMDB.accdbretired
Query s tmp check combined BL and TRDtTm nonsequentialCCMDB.accdbretired
Query check transfer ready tmp for each Boarding LocCCMDB.accdbretired
Query s tmp Boarding Loc no borrow but entryCCMDB.accdbretired

Data Use

Critical care and Medicine programs want to know this to better understand patient flow and bed utilization.

SAS Program

The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.

Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time
where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.

The SAS program is saved in S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas.

  • the specific macros are %BoardingLoc, %ACCUBorrow, %ICUOtherService

Background

See Bed borrow as aggregator page for other boarding and borrow related concepts.

The concept of EMIPs which was similar from Bed borrow and collected separately before are now collected as part of Boarding Loc. See EMIP#Legacy information information for how they were collected before/

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