Transfer Ready date and time: Difference between revisions

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=== Medicine Special Case - OM(osteomylitis)requiring the 4-6week IV ABx treatment ===

Question:

{{discussion}}If a patient has OM(osteomylitis)requiring the 4-6week IV ABx treatment: can they ever be considered medically stable while in hospital? At present a consult is made to Community IV Program and a PICC is inserted-arrangements made and D/C with community management OR

If a patient has OM(osteomylitis)requiring the 4-6week IV ABx treatment: can they ever be considered medically stable while in hospital? At present a consult is made to Community IV Program and a PICC is inserted-arrangements made and D/C with community management OR

Patient is not suitable for CIVP d/t Hx of IV drug abuse/no home to go to/ antibiotic not stable enough to be given from alternate site if home due to its admixture etc so remains in hospital for their IV treatment and is often away on hospital day passes in between doses...

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I am unclear about this diagnostic code and Medically Stable determination...we get bad cellulitis/OM pts needing extensive IV AB Tx sent to D5 Non-teaching but not declared med stable D/T infection/s.

How do others feel re: this population?

How do others feel re: this population? --[[User:Llemoine|Llemoine]] 14:59, 2015 September 23 (CDT)

--[[User:Llemoine|Llemoine]] 14:59, 2015 September 23 ~~(CDT)~~

*I've wondered this as well. I would say they are not medically stable for discharge, and therefore in the case where the patient is transferred to a non-teaching ward, would have no transfer ready date. If they can be discharged home with the IV program, then I would assume the transfer ready date is the discharge to home order.[[User:Mlagadi|Mlagadi]] 07:49, 2015 September 24 (CDT)

*This has been my approach as well. [[User:Ppiche|Pamela Piche]] 08:16, 2015 September 24 (CDT)

*Does noncompliancy or a home care hold or all the reasons above change the fact that the pt is medically stable/ transfer ready would this be more of a discharge issue? (no place to go) The patient is ready to go home and for what ever reaons cant do CIVP Do we look at CIVP as a long term treatment like a foot ulcer? I guess I am saying is does the patient becomes Transfer ready once the acute phase of treatment is over and the pt is medically stable (no wbc elevation/ no temp/ vs stable ect )and treatment is no longer acute but chronic? ps just asking shirley

* not transfer ready:

** I've wondered this as well. I would say they are not medically stable for discharge, and therefore in the case where the patient is transferred to a non-teaching ward, would have no transfer ready date. If they can be discharged home with the IV program, then I would assume the transfer ready date is the discharge to home order.[[User:Mlagadi|Mlagadi]] 07:49, 2015 September 24 (CDT)

** This has been my approach as well. [[User:Ppiche|Pamela Piche]] 08:16, 2015 September 24 (CDT)

transfer ready when CIVP becomes only obstacle to discharge:

* I code the same as Pam and Michelle but know exactly what your talking about Shirley, because if CIVP could be arranged more quickly than the patient would be discharged, so it is a barrier to discharge [[User:Lkaita|Lisa Kaita]] 13:48, 2015 September 28 (CDT)

*Good points, a suggestion then is that for patients who are accepted to the CIVP program and are otherwise ready/able to discharge could be considered "CIVP holds" and the transfer ready date/time would be the date/time the patient was accepted to the CIVP as the barrier to discharge is systemic in origin (wait for service to be put in place).For patients who are accepted to the CIVP program but are unable to discharge due to patient based problems such as addictions, mental health or other active phsiological problems the transfer ready date/time would be the date/time of physician discharge order.[[User:Ppiche|Pamela Piche]] 07:33, 2015 September 29 (CDT)

* let's code as transfer ready

** Good points, a suggestion then is that for patients who are accepted to the CIVP program and are otherwise ready/able to discharge could be considered "CIVP holds" and the transfer ready date/time would be the date/time the patient was accepted to the CIVP as the barrier to discharge is systemic in origin (wait for service to be put in place).For patients who are accepted to the CIVP program but are unable to discharge due to patient based problems such as addictions, mental health or other active phsiological problems the transfer ready date/time would be the date/time of physician discharge order.[[User:Ppiche|Pamela Piche]] 07:33, 2015 September 29 (CDT)

== Sources ==

@@ Line 60: / Line 60: @@
 === Medicine Special Case - OM(osteomylitis)requiring the 4-6week IV ABx treatment ===
+Question:
-{{discussion}}If a patient has OM(osteomylitis)requiring the 4-6week IV ABx treatment: can they ever be considered medically stable while in hospital? At present a consult is made to Community IV Program and a PICC is inserted-arrangements made and D/C with community management OR
+{{discussion}}
+If a patient has OM(osteomylitis)requiring the 4-6week IV ABx treatment: can they ever be considered medically stable while in hospital? At present a consult is made to Community IV Program and a PICC is inserted-arrangements made and D/C with community management OR
 Patient is not suitable for CIVP d/t Hx of IV drug abuse/no home to go to/ antibiotic not stable enough to be given from alternate site if  home due to its admixture etc so remains in hospital for their IV treatment and is often away on hospital day passes in between doses...
@@ Line 68: / Line 69: @@
 I am unclear about this diagnostic code and Medically Stable determination...we get bad cellulitis/OM pts needing extensive IV AB Tx sent to D5 Non-teaching but not declared med stable D/T infection/s.
-How do others feel re: this population?
+How do others feel re: this population? --[[User:Llemoine|Llemoine]] 14:59, 2015 September 23 (CDT)
---[[User:Llemoine|Llemoine]] 14:59, 2015 September 23 (CDT)
-*I've wondered this as well. I would say they are not medically stable for discharge, and therefore in the case where the patient is transferred to a non-teaching ward, would have no transfer ready date. If they can be discharged home with the IV program, then I would assume the transfer ready date is the discharge to home order.[[User:Mlagadi|Mlagadi]] 07:49, 2015 September 24 (CDT)
-*This has been my approach as well. [[User:Ppiche|Pamela Piche]] 08:16, 2015 September 24 (CDT)
 *Does noncompliancy or a home care hold or all the reasons above change the fact that the pt is medically stable/ transfer ready would this be more of a discharge issue? (no place to go) The patient is ready to go home and for what ever reaons cant do CIVP  Do we look at CIVP  as a long term treatment  like a foot ulcer? I guess I am saying is does the patient  becomes Transfer ready once the acute phase of treatment is over and the pt is medically stable (no wbc elevation/ no temp/ vs stable ect )and treatment is no longer acute but chronic?  ps just asking shirley
+* not transfer ready:
+** I've wondered this as well. I would say they are not medically stable for discharge, and therefore in the case where the patient is transferred to a non-teaching ward, would have no transfer ready date. If they can be discharged home with the IV program, then I would assume the transfer ready date is the discharge to home order.[[User:Mlagadi|Mlagadi]] 07:49, 2015 September 24 (CDT)
+** This has been my approach as well. [[User:Ppiche|Pamela Piche]] 08:16, 2015 September 24 (CDT)
+transfer ready when CIVP becomes only obstacle to discharge:
 * I code the same as Pam and Michelle but know exactly what your talking about Shirley, because if CIVP could be arranged more quickly than the patient would be discharged, so it is a barrier to discharge [[User:Lkaita|Lisa Kaita]] 13:48, 2015 September 28 (CDT)
- *Good points, a suggestion then is that for patients who are accepted to the CIVP program and are otherwise ready/able to discharge could be considered "CIVP holds" and the transfer ready  date/time  would be the date/time the patient was accepted to the CIVP as the barrier to discharge is systemic in origin (wait for service to be put in place).For patients who are accepted to the CIVP program but are unable to discharge due to patient based problems such as addictions, mental health or other active phsiological problems the transfer ready date/time would be the date/time of physician discharge order.[[User:Ppiche|Pamela Piche]] 07:33, 2015 September 29 (CDT)
+* let's code as transfer ready
+** Good points, a suggestion then is that for patients who are accepted to the CIVP program and are otherwise ready/able to discharge could be considered "CIVP holds" and the transfer ready  date/time  would be the date/time the patient was accepted to the CIVP as the barrier to discharge is systemic in origin (wait for service to be put in place).For patients who are accepted to the CIVP program but are unable to discharge due to patient based problems such as addictions, mental health or other active phsiological problems the transfer ready date/time would be the date/time of physician discharge order.[[User:Ppiche|Pamela Piche]] 07:33, 2015 September 29 (CDT)
 == Sources ==