Previous Service field

The Previous_Service field contains information about the most recent "originating service" for those patient's who where already in a prior inpatient location before coming to their current service location.

Collection Instruction

For each patient,

• enter the option that most closely matches
  • for medicine ward-to-ward moves, code "medicine" as previous service
  • for ICU-to-ICU moves, code "Critical Care" if no other specific service is documented
  • for pt from ER, code "Emergency Medicine" unless a different service had accepted them and is handing them off to Medicine
• for pt direct from ambulatory care not via ER, code "not applicable"
• if the service is not listed, code "other (known but not on list)"
  • in these cases we don't care about the details; if we see too many others we may add additional options in future

From Cardiac Cath Lab

A patient goes to emergency, then is sent to the cardiac cath lab for an angiogram. The pt can't really go to the cath lab without a cardiologist involved, so sending service would be cardiology. (as discussed at 2016-06 team meeting)

from OR

If a patient comes from an OR/RR, code the responsible surgical service as previous service.

Nursing Home Wards (HSC/GRA)

We treat patients that went through the HSC/GRA Nursing Home as having been discharged. So, admission from there should be as if admitted from home, so put "not applicable" into the Previous Service field. This does not affect the Visit Admit DtTm field definition - remember, that is defined by EPR entry.

from EMIP via ER

The case of VIC ER to STB EMIP to VIC ER to VIC Ward is a bit tricky because STB EMIP signify being an inpatient under Medicine service before going to VIC ER. WIKI defines Previous Service as the "originating service" for those patient's who where already in a prior inpatient location. It would be easier to define the previous service if this is a case of direct transfer to VIC Medicine service and parked only in VIC ER. This is a good question - which to use, Emergency Medicine or Medicine? Since it is known that there is prior inpatient service, I am more on the second one 'Medicine'. This can be a similar case when the previous location is Operating or Recovery and the responsible surgical service is coded as previous service. If coming from home to another ER to own ER to own Ward, then previous service is clearly Emergency medicine.

Data Use

Patients with Previous Location field critical care must have Previous Service field critical care, and patients from medicine must have previous service medicine.

Used to be:

• ER_Wait#Reporting_and_Analysis
• Sending service to ICU will be reported to the Critical Care Director.

Template:CCMDB Data Integrity Checks

• Can't be empty.

• query check_previous_location_vs_service_inconsistent: patients with Previous Location field in medicine must have Previous Service field medicine; patients from ICU (except CCU) must have previous service "critical care".

Implementation

The field is populated with options from the s_previous_service table.

Legacy

For medicine this concept is related to ER Wait.

For critical care this concept is related to Service Sending to ICU.