Comfort Care: Difference between revisions

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This article is about collecting the "Comfort care" ([[ACP C]], palliation) temp entry.
This article is about collecting the "Comfort care" ([[ACP C]], palliation) temp entry.


===Data Use and Purpose===
== Data Use and Purpose ==
The purpose is to specifically identify and tag '''only''' those ICU and Medicine patients for whom the '''initial goal of care right from the start of a unit admission''' is comfort care, [[ACP C]], palliation.
The purpose is to specifically identify and tag '''only''' those ICU and Medicine patients for whom the '''initial goal of care right from the start of a unit admission''' is comfort care, [[ACP C]], palliation.


Line 8: Line 8:
Palliation, palliative care, comfort care, '''does not require [[Palliative Service]]''', but can include it.
Palliation, palliative care, comfort care, '''does not require [[Palliative Service]]''', but can include it.


==Start and stop date==
Select Comfort Care only if '''any''' of the following are true: 
*Start Date: 2013-Nov-11
*(a) the patient had an ACP-C ''prior to'' admission to that unit/ward
*Stop Date: none
*(b) the patient had an ACP-C order implemented as ''part of'' the admission orders to that unit/ward
*(c) the ''initial admission note'' of the unit/ward attending physician and/or the H&P written by the house officer identifies that the patient was admitted for any of: 
**(i) comfort care,
**(ii) palliation
**(iii) palliative care
**(iv) or end-of-life care 
***Note that none of items (i)-(iii) require that the patient was ACP-C or that the Palliative Care Service be involved in care.   
'''Intent''' of care is clear right '''from the beginning''' of a ward admission'' that it is for comfort care, ACP C, palliation, end of life care. This does not preclude having some medical treatments like treating an pneumonia or infection, pain, dehydration and anything else that would ease suffering.


=== Collection Instructions for Medicine and ICU===
Don't need to mark check box in column B if comfort care Project and Item are selected in TMP. Redundant step. [[User:TOstryzniuk|Trish Ostryzniuk]] 20:11, 2013 November 27 (CST) 


*Where: ccmdb '''TMP''' [[L_TmpV2]]:
**PROJECT: Select from dropdown list : Comfort Care
**ITEM: Select from dropdown list: Comfort Care
#Select Comfort Care only if '''any''' of the following are true: 
#*(a) the patient had an ACP-C ''prior to'' admission to that unit/ward
#*(b) the patient had an ACP-C order implemented as ''part of'' the admission orders to that unit/ward
#*(c) the ''initial admission note'' of the unit/ward attending physician and/or the H&P written by the house officer identifies that the patient was admitted for any of: 
#**(i) comfort care,
#**(ii) palliation
#**(iii) palliative care
#**(iv) or end-of-life care 
#***Note that none of items (i)-(iii) require that the patient was ACP-C or that the Palliative Care Service be involved in care.   
* None of the other fields in tmp are used for this project, ie no dates etc.


Admit DX's would use the same process as we always do. Most significant Medical problem in admit 1, 2, 3 etc.
=== Coding Instructions for Medicine and ICU===
If the patient meets the above criteria then code as:
*In [[CCMDB.mdb]] '''TMP''' tab add:
**PROJECT: Comfort Care
**ITEM: Comfort Care
**Checkbox, dates, numbers: Don't need to fill, not used for this project


''INTENT of care is clear right '''from the beginning''' of a ward admission'' that it is for comfort care, ACP C, palliation, end of life care. This does not preclude having some medical treatments like treating an pneumonia or infection, pain, dehydration and anything else that would ease suffering.
==Start and stop date==
*Start Date: 2013-Nov-11
*Stop Date: none


====Example====
== {{CCMDB Data Integrity Checks}} ==
Patient comes to CTU/S4 with a Dr.'s note/order stated intent of care is for comfort care/ACP C. Pt has Dx of CVA, CAP, cancer. 
Only one entry allowed per patient. Uses query ''s_tmp_comfort_care_gt_one''.
*Admit DX would be:  1. CVA 2. CAP, 3 CA  which ever one is the primary problem first.  Could be CAP because had CVA last week.
*TMP
**Project: Comfort Care
**Item: Comfort Care


== Data use / Reporting and Analysis ==
== Data use / Reporting and Analysis ==
I will populate this when I finally catch the report... Ttenbergen 15:06, 2014 September 19 (CDT)
The data is used to exclude patients from analysis for [[:Category:OverstayProject | Project Overstay]].
The data is used to exclude patients from analysis for [[:Category:OverstayProject | Project Overstay]].


Revision as of 15:15, 2015 April 29

This article is about collecting the "Comfort care" (ACP C, palliation) temp entry.

Data Use and Purpose

The purpose is to specifically identify and tag only those ICU and Medicine patients for whom the initial goal of care right from the start of a unit admission is comfort care, ACP C, palliation.

We do not want to track patients for whom comfort care is ordered after admission.

Palliation, palliative care, comfort care, does not require Palliative Service, but can include it.

Select Comfort Care only if any of the following are true:

  • (a) the patient had an ACP-C prior to admission to that unit/ward
  • (b) the patient had an ACP-C order implemented as part of the admission orders to that unit/ward
  • (c) the initial admission note of the unit/ward attending physician and/or the H&P written by the house officer identifies that the patient was admitted for any of:
    • (i) comfort care,
    • (ii) palliation
    • (iii) palliative care
    • (iv) or end-of-life care
      • Note that none of items (i)-(iii) require that the patient was ACP-C or that the Palliative Care Service be involved in care.

Intent of care is clear right from the beginning of a ward admission that it is for comfort care, ACP C, palliation, end of life care. This does not preclude having some medical treatments like treating an pneumonia or infection, pain, dehydration and anything else that would ease suffering.


Coding Instructions for Medicine and ICU

If the patient meets the above criteria then code as:

  • In CCMDB.mdb TMP tab add:
    • PROJECT: Comfort Care
    • ITEM: Comfort Care
    • Checkbox, dates, numbers: Don't need to fill, not used for this project

Start and stop date

  • Start Date: 2013-Nov-11
  • Stop Date: none

Template:CCMDB Data Integrity Checks

Only one entry allowed per patient. Uses query s_tmp_comfort_care_gt_one.

Data use / Reporting and Analysis

The data is used to exclude patients from analysis for Project Overstay.

The data is used to exclude patients in the analysis of the ALERT scale in the Quarterly report and Annual report.

Retrieved from "https://ccmdb.kuality.ca/index.php?title=Comfort_Care&oldid=43382"