Intended1stSrvc: Difference between revisions
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'''<mark>This project is not live yet, do not follow the instructions to stop the old collection yet. | '''<mark> | ||
* This project is not live yet, do not follow the instructions to stop the old collection yet. | |||
* Planned go-live is 2025-01-01 | |||
* For now, continue to use the instructions in [[ICUotherService]] | |||
</mark> | |||
== Background == | == Background == | ||
This project encodes when an admission "''should have been''" with a different Critical Care service than where it actually ended up. | |||
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== Left to resolve == | == Left to resolve == | ||
=== need to resolve before we can start collecting === | === need to resolve before we can start collecting === | ||
{{DL | | {{DL | | ||
* Could you confirm that there are no changes required to the following pages? We discussed that details about them might change as part of all this. [[User:Ttenbergen|Ttenbergen]] 14:44, 23 December 2025 (CST) | * Could you confirm that there are no changes required to the following pages? We discussed that details about them might change as part of all this. [[User:Ttenbergen|Ttenbergen]] 14:44, 23 December 2025 (CST) | ||
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** [[Service tmp entry]] | ** [[Service tmp entry]] | ||
}} | }} | ||
=== can be left until later but may complicate analysis or degrade data === | === can be left until later but may complicate analysis or degrade data === | ||
{{DJ | | {{DJ | | ||
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{{Discuss | | {{Discuss | | ||
* Can these only be at the same site as the record? If so that may be a relevant cross-check. | * Can these only be at the same site as the record? If so that may be a relevant cross-check. | ||
}} | |||
{{DJ | | |||
* We need to confirm that the change is properly indexed and contextualized on [[2025-05 Revision of concept around ICUotherService]]. | |||
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* just for tracking | * just for tracking | ||
** TT reviewed "what links here" for [[ICUotherService]] | ** TT reviewed "what links here" for [[ICUotherService]] | ||
== Data Use == | |||
* see [[ICU Service Location Discrepancy]] | |||
== Log == | == Log == | ||
Revision as of 16:20, 23 December 2025
| Projects | |
| Active?: | planned |
| Program: | CC |
| Requestor: | Bojan Paunovic |
| Collection start: | |
| Collection end: | |
- This project is not live yet, do not follow the instructions to stop the old collection yet.
- Planned go-live is 2025-01-01
- For now, continue to use the instructions in ICUotherService
Background
This project encodes when an admission "should have been" with a different Critical Care service than where it actually ended up.
- It is to be used when the ICU service a patient is actually on (MICU, SICU, IICU, ICMS, CICU, Grace ICU) is different from the service the patients should be on. This most common reason for this to happen is bed capacity issues.
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- This variable should be left BLANK when the ICU service the patient is on is the one they should be on -- i.e. only fill it in when there is an Intended1stSrvc that is different from the first service they are actually on (i.e. what's in Service/Location)
- Along with Boarding Loc, Service Location and Intended1stSrvc allow clear identification of all types of ICU boarding
- those downloaded entries do not actually correspond the the true 6 ICU services that exist (as of 2025) and so are confusing, as they are things like "HSC Critical Care/Medicine A" or "HSC Critical Care/Plastics"
- as Service tmp entry is downloaded from Cognos, this will no longer occur
- As we create a new ICU profile (record) when the ICU service changes, each time a new ICU profile is created, collectors will need to consider Intended1stSrvc anew
- although we considered carrying over the prior value of Intended1stSrvc when a patient is transferred ICU-to-ICU, we decided against this as it creates other ambiguities
- Here is the most complex subtlety of this issue of what service a patient "should be on"
- It can change during the course of the episode of ICU care (across ICUs, or within a single ICU). Sometimes such a change might be clearcut (e.g. due to occurrence of a surgical procedure) but other times the fact that the service the patient should be on changes is just within the heads of the attending physicians. Because of this uncertainty we explicitly decided NOT to try and track the service a patient should be on as time goes by, but only upon initiation of an ICU profile, which is why this variable is called "Intended1stSrvc"
Data Collection Instructions
- Code it as the ICU service that the patient SHOULD HAVE BEEN under upon initial admission to the ICU Service in this hospital, i.e. at the start of this record
- Leave it blank if the very first day in ICU in that hospital, the patient was, in fact under the "correct" ICU service, i.e. the service that should have been taking care of the patient -- and as this is the majority of all ICU records, this variable will usually be left blank.
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Transfer to Another ICU Service
- This is important regarding this variable as a new ICU database record is created when a patient goes from one ICU service to another, but not if the patient goes from one ICU Boarding Loc to another while staying under the same service.
Things to resolve
{{Discuss| Things we need to resolve:
- We need to review anything that links to ICUotherService, and anything that page lists to. The "anything that links there" can be accessed by expanding the "related articles (expand)" at the bottom of ICUotherService. Ttenbergen 10:59, 25 September 2025 (CDT)
- I have reviewed the links to ICUotherService and changed what needs changing. Ttenbergen 15:05, 26 September 2025 (CDT)
Data collection
Data Entry Instructions
- Use tmp fields:
- Project: Intended1stSrvc
- Item: one of (HSC-MICU, HSC-SICU, HSC-IICU, STB-MICU, STB-CICU, STB-ACCU, GH-CC)
- all other fields are not used for this project
Special Cases
Service admissions where the situation changes part way through the record
- Definition of a Critical Care Program Admission lays out when a new record should be created
- How does that play into this?
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Data Integrity Checks (automatic list)
none found
Background
- A similar concept used to be collected in ICUotherService; see 2025-05 Revision of concept around ICUotherService for details
- We recognize that the drop-downs we chose are different from the standardized terms in EPR; it was decided that this is OK because the perception is that our terms are what leadership actually wants
Left to resolve
need to resolve before we can start collecting
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can be left until later but may complicate analysis or degrade data
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can be safely left until later
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resolved
- just for tracking
- TT reviewed "what links here" for ICUotherService
Data Use
Log
- -> 2026-01-01 - this entry essentially replaces ICUotherService
- 2025-12-18 JALT - decision that dropdown listings for this should be the same as for Boarding Loc
- 2025-12-23 - broke out ICU Service Location Discrepancy to document how indicators and metrics will be derived from this
- 2025-09-25 - change of ICUotherService to this way of coding the concept was first discussed, page generated for Allan to update.
- See 2025-05 Revision of concept around ICUotherService for decisions leading up to implementation