Overstay Predictor Project: Difference between revisions

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== Instructions ==

For every '''medicine''' patient at the ~~'''~~Grace~~''' hospital~~, '''as soon as possible''', but definitely '''within 48 business hrs of admission''':

For every '''medicine''' patient admitted to the Grace 5N, '''as soon as possible''', but definitely '''within 48 business hrs of admission''':

#Find the new '''"~~Overstay~~" ~~form''' on the chart~~

#Find the new white '''"Nursing_Discharge_Screening_Tool"[[Media:Nursing_Discharge_Screening_Tool Nursing_Discharge_Screening_Tool.pdf]] form''' on the chart. It will be with the admission documentation.

~~#*Latest '''form''' Go to:~~[[Media:Nursing_Discharge_Screening_Tool Nursing_Discharge_Screening_Tool.pdf]]~~--[[User:LHathout|Linda Hathout]] 21:38, 2012 July 5 (CDT)~~

#*the form is to be dated and time stamped

#*the form is to be dated and ~~timed~~

#*For the first 6 check boxes on the form, create a record for each in tmp entries and check the check box if the answer is Yes. (one to one from the form, no interpretation necessary)indicated if no answer is provided.

#*For the first 6 check boxes on the form, create a record for each in tmp entries and check the ~~checkbox~~ if the answer is Yes. (one to one from the form, no interpretation necessary)

#*re question 4 (managing independently), if any of the boxes within question 4 are checked "no" or "x", the answer to question 4 will also should be checked "no"; all boxes within the question must be unmarked or given a check mark in order for question 4 to be checked "yes"

#*re question 4 (managing independently), if any of the boxes within question 4 are checked "no", the answer to question 4 will also be checked "no"; all boxes within the question must be ~~unchecked~~ in order for question 4 to be checked "yes"

#the form is to be completed within 24 hours of admission; if it is not possible at time of admission, the admitting nurse will pass the responsibility for completion to the next duty nurse

#*~~Linda will check to see what should be done if there are changes to~~ the form~~, answers etc.~~ within the first 24 hours ~~post~~ admission

#*The nurse can update the form within the first 24 hours after admission if, for example they receive information from the patients family that contradicts the patients answers. It is possible that depending on when you review that document these changes are not captured. This a know risk that has to be accepted.

~~#**this complicates~~ the ~~life of~~ the ~~collector as it means multiple checks of the form must~~ be ~~completed and will delay the assignment of the Transition Coordinator~~

#*If the form is '''not completed''' within the first 24 hours the data collector is to check with the bedside nurse and remind them to complete it?

#***what happens if the form is '''not completed''' within the first 24 hours? ~~- [[User: SCortilet | Stephanie]]. {{Discussion}}~~

*The information used in the predictor calculation is based on the minimal data set plus a handful of diagnostic codes that need to be checked for within the first 24 hours. The following as part of minimal data set:

*~~Also, enter at least all~~ the following as part of minimal ~~dataset~~

#'''DOB'''

#'''Admit Date'''

#'''ADL'''

#~~??''whether there was any~~ '''CVA''' or '''Dementia''' as ~~a '''comorbid'''??? {{Discussion}} CVA in~~ comorbid~~?? Is this correct''? {{Discussion}}~~

#'''CVA''' know or speculated as the admitting

#''whether there was a [[Overstay Predictor Diagnosis Code Used | permanent & severe neurological or spinal]] insult as an ~~'''admit''' or '''complication'''~~ diagnosis~~?? Is this correct''? {{Discussion}}~~

#'''Dementia''' as an admitting reason or comorbid

#''whether there was a [[Overstay Predictor Diagnosis Code Used | permanent & severe neurological or spinal]] insult as an admitting diagnosis

* Click the new “Overstay” button on the patient viewer form next to the notes field and it will turn a colour (~~colors~~ based on an underlying algorithm too complicated to get into here, but based on tmp entries, age, comorbids, admit dxs and ADLs):

Once this information has been entered click the new “Overstay” button on the patient viewer form next to the notes field and it will turn a colour (colours based on an underlying algorithm too complicated to get into here, but based on tmp entries, age, comorbids, admit dxs and ADLs):

** GREEN - low/no risk for discharge issues

** YELLOW - some risk for discharge issues

** RED - significant risk for discharge issues.

** RED - significant risk for discharge issues assign a transition coordinator.

** GRAY - if some needed data is missing

* ~~If the chart already has a sticker the '''same''' colour then you are done~~

* Based on the color displayed put that colored sticker on the patients chart. Stickers will be located adjacent to the transition coordinator binder at the unit clerk desk.

* if the colour in the program is different from the one on the ~~chart~~ put ~~a sticker of the program colour over the~~ sticker on the chart. Stickers will be ~~supplied~~. ~~(permanent location of stickers on the ward has yet to be determined)~~

*if the patient has been designated as "red" for purposes of overstay prediction, the data collector will assign a Transition Coordinator by placing the patients name beside the transition coordinator on call for the time period of the patients admission. The transition coordinators will be assigned to cover between Friday to Monday, the next shift will go to Wednesday, the last will be Wednesday to Friday. If the designation is made after 1500 on the day of entry, the assignment will be deferred to the next day's coordinator. The rotation of Coordinators is made up of Home Care, Social Work, Physio, And OTs. After assignment, that service is responsible for following that patient throughout their hospital stay.

*if the patient has been designated a "red" for purposes of overstay prediction, the data collector will assign a Transition Coordinator in the ~~book at~~ the ~~desk~~. ~~Assignment is by rotation~~. If the designation is made after 1500 on the day of entry, the assignment will be deferred to the next day's coordinator. The rotation of ~~Coodinators~~ is made up of Home Care, Social Work, Physio, And OTs. After assignment, that service is responsible for following that patient throughout their hospital stay.

[[File:Transition_coordinator4.gif]]

== [[Overstay Predictor Diagnosis Code Used]] ==

@@ Line 25: / Line 25: @@
 == Instructions ==
-For every '''medicine''' patient at the '''Grace''' hospital, '''as soon as possible''', but definitely '''within 48 business hrs of admission''':
+For every '''medicine''' patient admitted to the Grace 5N, '''as soon as possible''', but definitely '''within 48 business hrs of admission''':
-#Find the new '''"Overstay" form''' on the chart
+#Find the new white '''"Nursing_Discharge_Screening_Tool"[[Media:Nursing_Discharge_Screening_Tool Nursing_Discharge_Screening_Tool.pdf]] form''' on the chart. It will be with the admission documentation.
-#*Latest '''form''' Go to:[[Media:Nursing_Discharge_Screening_Tool Nursing_Discharge_Screening_Tool.pdf]]--[[User:LHathout|Linda Hathout]] 21:38, 2012 July 5 (CDT)
+#*the form is to be dated and time stamped
-#*the form is to be dated and timed
+#*For the first 6 check boxes on the form, create a record for each in tmp entries and check the check box if the answer is Yes.  (one to one from the form, no interpretation necessary)indicated if no answer is provided.
-#*For the first 6 check boxes on the form, create a record for each in tmp entries and check the checkbox if the answer is Yes.  (one to one from the form, no interpretation necessary)
+#*re question 4 (managing independently), if any of the boxes within question 4 are checked "no" or "x", the answer to question 4 will also should be checked "no"; all boxes within the question must be unmarked or given a check mark in order for question 4 to be checked "yes"
-#*re question 4 (managing independently), if any of the boxes within question 4 are checked "no", the answer to question 4 will also be checked "no"; all boxes within the question must be unchecked in order for question 4 to be checked "yes"
 #the form is to be completed within 24 hours of admission; if it is not possible at time of admission, the admitting nurse will pass the responsibility for completion to the next duty nurse
-#*Linda will check to see what should be done if there are changes to the form, answers etc. within the first 24 hours post admission
+#*The nurse can update the form within the first 24 hours after admission if, for example they receive information from the patients family that contradicts the patients answers. It is possible that depending on when you review that document these changes are not captured. This a know risk that has to be accepted.
-#**this complicates the life of the collector as it means multiple checks of the form must be completed and will delay the assignment of the Transition Coordinator
+#*If the form is '''not completed''' within the first 24 hours the data collector is to check with the bedside nurse and remind them to complete it?
-#***what happens if the form is '''not completed''' within the first 24 hours? - [[User: SCortilet | Stephanie]]. {{Discussion}}
+*The information used in the predictor calculation is based on the minimal data set plus a handful of diagnostic codes that need to be checked for within the first 24 hours. The following as part of minimal data set:
-*Also, enter at least all the following as part of minimal dataset
 #'''DOB'''
 #'''Admit Date'''
 #'''ADL'''
-#??''whether there was any '''CVA''' or '''Dementia''' as a '''comorbid'''???  {{Discussion}} CVA in comorbid??  Is this correct''? {{Discussion}}
+#'''CVA''' know or speculated as the admitting
-#''whether there was a [[Overstay Predictor Diagnosis Code Used | permanent & severe neurological or spinal]] insult as an '''admit'''  or '''complication''' diagnosis??  Is this correct''?  {{Discussion}}
+#'''Dementia''' as an admitting reason or comorbid
+#''whether there was a [[Overstay Predictor Diagnosis Code Used | permanent & severe neurological or spinal]] insult as an admitting diagnosis
-* Click the new “Overstay” button on the patient viewer form next to the notes field and it will turn a colour (colors based on an underlying algorithm too complicated to get into here, but based on tmp entries, age, comorbids, admit dxs and ADLs):
+Once this information has been entered click the new “Overstay” button on the patient viewer form next to the notes field and it will turn a colour (colours based on an underlying algorithm too complicated to get into here, but based on tmp entries, age, comorbids, admit dxs and ADLs):
 ** GREEN - low/no risk for discharge issues
 ** YELLOW - some risk for discharge issues
-** RED - significant risk for discharge issues.
+** RED - significant risk for discharge issues assign a transition coordinator.
 ** GRAY - if some needed data is missing
-* If the chart already has a sticker the '''same''' colour then you are done
+* Based on the color displayed put that colored sticker on the patients chart. Stickers will be located adjacent to the transition coordinator binder at the unit clerk desk.
-* if the colour in the program is different from the one on the chart put a sticker of the program colour over the sticker on the chart. Stickers will be supplied. (permanent location of stickers on the ward has yet to be determined)
+*if the patient has been designated as "red" for purposes of overstay prediction, the data collector will assign a Transition Coordinator by placing the patients name beside the transition coordinator on call for the time period of the patients admission. The transition coordinators will be assigned to cover between Friday to Monday, the next shift will go to Wednesday, the last will be Wednesday to Friday. If the designation is made after 1500 on the day of entry, the assignment will be deferred to the next day's coordinator. The rotation of Coordinators is made up of Home Care, Social Work, Physio, And OTs.  After assignment, that service is responsible for following that patient throughout their hospital stay.
-*if the patient has been designated a "red" for purposes of overstay prediction, the data collector will assign a Transition Coordinator in the book at the desk.  Assignment is by rotation.  If the designation is made after 1500 on the day of entry, the assignment will be deferred to the next day's coordinator.  The rotation of Coodinators is made up of Home Care, Social Work, Physio, And OTs.  After assignment, that service is responsible for following that patient throughout their hospital stay.
+[[File:Transition_coordinator4.gif]]
 == [[Overstay Predictor Diagnosis Code Used]] ==