Service Sending to ICU

 Go to: Previous Service field for the most updated instructions & also post questions there.  That article will be the new name for this field in the Dispo tab in CCMDB.

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 patients's who where already in a prior inpatient location before coming to the ICU. (refer to Task Meeting Minutes April 13,2015). Note: This is different to the "service of the attending" during the patient's stay in ICU.

Data Collection Instructions

When you enter a new ICU patient a "Srv to ICU" will be automatically generated with item zz_enter. Before you can check the tmp checkbox this item has to be changed to one of the following:

• one of the sending services as per dropdown if applicable
• z_not an inpatient - if the patient was not an inpatient, eg came from home, usually only happens in CCU e.g. if STB cardiologist admits based on phone call; this is not for pts coming from angio, these would be from service cardiology
• z_not applicable' - pt moving from one ICU to another (including from CCU, don't use cardiology for this)
• z_other - any others such as EENT surgery at STB
• z_unknown - if unknown service for patients coming from ward or OR or RR
• - the entry automatically put in for new CC patients, not accepted as final entry when checking tmp checkbox

The other tmp fields are not used (except in "not applicable" scenario)

special case - ER -> OR -> ICU

• Scenario: 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.
• Collection: 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 code Service Sending with the specific service.

Template:Discussion Would pt ever go to OR without having been accepted? Ttenbergen 17:39, 2016 March 21 (CDT)

• A pt has to be accepted by a surgical service before going to the OR for surgery. --LKolesar 06:38, 2016 April 27 (CDT)

How to determine?

Go and find out. Ask on the ward. Talk to people. 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.

Start/End Dates

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

Template:CCMDB Data Integrity Checks

When you enter a new ICU patient a "Srv to ICU" will be automatically generated.

• If that record is missing, you can't checkbox tmp
• If that record has "enter" or "" as item, you can't checkbox tmp

currently impossible

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

• 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

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 Pre-admit Inpatient Institution field. I will take that check out for now. Ttenbergen 11:50, 2015 June 24 (CDT) Template:Discussion

SAS Program

• The data is saved in table L_TmpV2 under project "Srv to ICU" of the centralized_data.mdb
• The SAS program that reads the data is in X:\Julie\SAS_CFE\CFE_macros\CFE_ServiceSendingtoICU.sas

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)
    • need to look into Ttenbergen 16:58, 2016 March 21 (CDT)

why a STB CC topic?

Template:Discussion why would this be in the STB Critical Care category specifically? Or the Site Specific Collection Guide? If not answered by next review I will remove category. Ttenbergen 16:58, 2016 March 21 (CDT)