Service Sending to ICU

for tracking which service is taking care of a patient in STB CCU, see CCU Service Tracking instead

Purpose

To identify the "sending service" or "originating service" for those who came to ICU from a prior inpatient location (refer to Task Meeting Minutes April 13,2015). This is different to the "service of the attending" during the patient's stay in ICU.

Data Collection Instructions

For each patient who meets the following conditions:

• critical care patient
• was an inpatient before coming to ICU (even if arrived via temp location such as ER, procedure suite, OR or RR)
• doesn't arrive from another ICU (i.e. not an inter or intra transfer)

• The service is consulted in emergency, an OR or procedure is planned and an ICU stay is planned post-op but the patient was not on an inpatient ward.We need to know are we including patients from emergency or not in these cases? Collectors are doing this differently so we need to know.
  • If the patient had been accepted to a service, ie admitted and therefore now an inpatient, even if they were still physically in the ER, then 'yes, do code Service Sending.
  • Otherwise, 'no, do not code Service Sending.

add a single tmp entry with the following:

• project: Srv to ICU
• item: the sending service, in case of OR, the service of the OR physician:
  • Medicine
  • Cardiology
  • Psych
  • Ob/Gyne
  • Family Medicine (only relevant at sites that have family medicine)
    • collectors, if your site has family medicine please list wards here, if not, please state Template:Discussion
      • HSC
      • STB
      • VIC
      • CON
      • OAK
      • GRA
  • General surgery (including ACSS and Trauma surgery)
  • Cardiac surgery
  • Thoracic surgery
  • Urologic surgery
  • Ortho surgery
  • Neurosurgery
  • Vascular surgery
  • Plastic surgery
  • z_other - any others such as EENT surgery at STB
  • z_not applicable - in this case an entry to the comment field in tmp will be required. (z_ to sort to bottom)
• the other tmp fields are not used (except in "not applicable" scenario)

How to determine?

We want to know what service the physician who sent the patient worked for at the time. Some physicians wear multiple hats, so name of physician is no good. Some locations have patients from multiple services, so location is no good. Template:Discussion

• How are collectors determining this? How often would you be not sure which service is sending a patient - Ttenbergen 14:54, 2015 June 25 (CDT) Ttenbergen 16:52, 2015 July 13 (CDT)
  • I have not been looking at the service information on a regular basis, but do know that the initial service for the SICU admission may be changed very soon after admission to the unit.--Jpeterson 09:57, 2015 July 15 (CDT)
    • hasn't been a problem thus far, in EPR there is a pt provider section that shows what service(s) the pt has been under, as well there is often an indication of service change in the EPR orders section Lisa Kaita 12:22, 2015 July 15 (CDT)
      • Is it always the service where a patient was most recently that is the "sending" one? IE, are there scenarios where a "consultant from other service" of some sort is called to the ward where a patient is, and that consultant sends to ICU. In that case, do we want the ward where the pt was, or the consultant? Ttenbergen 11:46, 2015 July 16 (CDT)

Start/End Dates

• Start: 2015-06-22
• End: there is no planned end date

Template:CCMDB Data Integrity Checks

• Query s_tmp_Service_Sending_to_ICU - Error if:
  • not admitted from inpatient location ((S AdmitDischarge.inpatient = true)) but has "Srv to ICU" entry
  • admitted from inpatient location and one of
    • no "Srv to ICU" entry
    • has "Srv to ICU" = "z_not applicable" and no comment

Template:Discussion Right now our consistency check would not allow someone from other hosp via ER. We won't be able to do this check until we have PrevInptLocation field. I will take that check out for now. Ttenbergen 11:50, 2015 June 24 (CDT)

• Query s_tmp_Service_Sending_to_ICU_duplicate - error if more than one entry per patient Ttenbergen 15:35, 2015 June 22 (CDT)

See also

• STB Cardiac Care patients
• Registry Patient Type

to do before go live

• Registry_Patient_Type#C-Cardiac_Type - awaiting confirmation
  • "Once this tmp study section is active we can go back to making the pt type relate to the type of diagnosis." (Laura K)