Off ward field: Difference between revisions

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=== Parked in ER ===

[[Parked in ER]] is before [[Arrive DtTm]], so they are not "off ward". Don't check the field.

# find patients as per [[off ward field]] article

# Write down a list of these patients with their chart numbers on a paper.

# Place this list on the bulletin board in the medicine office so that both medicine data collectors are aware that there are medicine service patients on off-service wards in the hospital.

==== generated list for [[overflow]]s also includes EMIP patients ====

**When reviewing the list of patients generated by the above method, you can also identify some [[EMIP]] patients. The patients that were accepted by medicine while in ER and subsequently were transferred to a different service while still in ER are actually EMIP patients. For example, the pt was under medicine while in ER but later (while still in ER) are taken over by surgery, palliative, critical care, etc. These are EMIP patients. --[[User:Malcudia|Malcudia]] 07:46, 2017 February 10 (CST)

==== Entering Overflow patients ====

* If these patients ultimately get transferred to one of the medicine wards (E5, E6 or B5), then the data collector that does that ward will enter those patients on their laptop, reflecting their entire stay from the admission from ER. In the dispo tab the [[Off ward field]] must be ticked off as they were off ward for part of their stay.

* If these patients get discharged from the off service ward to home or out of hospital location, then these are considered overflows that must be entered on the E5 laptop.

*This patient list is posted on the bulletin board of the medicine office. If they are admitted to one of the medicine wards, then that data collector will cross that person off the list. Once a week check if the pt is still in the hospital, if they have left and were never admitted to one of the medicine wards, then the E5 data collector will enter them on her laptop. --[[User:LKolesar|LKolesar]] 06:48, 2017 February 1 (CST)

===Patients who are on off service wards part of their stay only===

*When a pt comes to E5, E6 or B5 from an off-service ward (this includes 6AS), the data collector must go to the original presentation of the pt to see if this pt was accepted to medicine on the off-service ward prior to their arrival on their own ward. If you see that the pt was looked after by internal medicine prior to their arrival from the other ward, make sure you start your profile on the original date that medicine accepted them (usually in ER).

*On occasion medicine patients are transferred to off service wards, but are still admitted under the internal medicine service. ie. patient transferred from E6 to 7AS (surgical ward) but still admitted under internal medicine. The attending may be different than the admitting service but it is still an internal medicine attending. Please continue to follow these patients (new profile is '''not''' required) until they are discharged or transferred to an off service ward under family medicine or any other service other than internal med. Please note the location in the RECORD box to indicate where the pt is currently located.

==How to determine when a patient is no longer under an internal medicine service==

In the EPR the patient list will show the "provider" which should identify which service the attending physicians is from. However, because this is not always consistently kept up to date when services change, the following checks can help to determine if a patient remains under internal medicine or switches to another service.

1. In EPR,Check the orders under transfers/care directives, to see if there has been an order to switch from internal medicine to another service. Use the time transfered to the other ward as the discharge time or use the time in the order when the other service took over care if the pt remains on the off-service ward.

2. In EPR, go to the patient info tab, select care providers from the left hand column, a list should come up with providers and their discipline with a date. If you see that the most recent attending is no longer an internal medicine physician then there has likely been a change of service. You may be able to confirm this by checking under the documents tab, sort by discipline, and then check the medicine notes that correspond to the date found in the care providers list. The progress notes from different services will be identified as such in the notes section. If you determine that they are in fact now under a new service (with no corresponding order), use the date and time of the attending switch in the care provider list as your discharge date and time.

== Data Use ==

@@ Line 79: / Line 79: @@
 === Parked in ER ===
 [[Parked in ER]] is before [[Arrive DtTm]], so they are not "off ward".  Don't check the field.
+# find patients as per [[off ward field]] article
+# Write down a list of these patients with their chart numbers on a paper.
+# Place this list on the bulletin board in the medicine office so that both medicine data collectors are aware that there are medicine service patients on off-service wards in the hospital.
+==== generated list for [[overflow]]s also includes EMIP patients ====
+**When reviewing the list of patients generated by the above method, you can also identify some [[EMIP]] patients.  The patients that were accepted by medicine while in ER and subsequently were transferred to a different service while still in ER are actually EMIP patients.  For example, the pt was under medicine while in ER but later (while still in ER) are taken over by surgery, palliative, critical care, etc.  These are EMIP patients.   --[[User:Malcudia|Malcudia]] 07:46, 2017 February 10 (CST)
+==== Entering Overflow patients ====
+* If these patients ultimately get transferred to one of the medicine wards (E5, E6 or B5),  then the data collector that does that ward will enter those patients on their laptop, reflecting their entire stay from the admission from ER. In the dispo tab the [[Off ward field]] must be ticked off as they were off ward for part of their stay.
+* If these patients get discharged from the off service ward to home or out of hospital location, then these are considered overflows that must be entered on the E5 laptop.
+*This patient list is posted on the bulletin board of the medicine office.  If they are admitted to one of the medicine wards, then that data collector will cross that person off the list.  Once a week check if the pt is still in the hospital,  if they have left and were never admitted to one of the medicine wards, then the E5 data collector will enter them on her laptop.  --[[User:LKolesar|LKolesar]] 06:48, 2017 February 1 (CST)
+===Patients who are on off service wards part of their stay only===
+*When a pt comes to E5, E6 or B5 from an off-service ward (this includes 6AS), the data collector must go to the original presentation of the pt to see if this pt was accepted to medicine on the off-service ward prior to their arrival on their own ward.  If you see that the pt was looked after by internal medicine prior to their arrival from the other ward, make sure you start your profile on the original date that medicine accepted them (usually in ER).
+*On occasion medicine patients are transferred to off service wards, but are still admitted under the internal medicine service.  ie. patient transferred from E6 to 7AS (surgical ward) but still admitted under internal medicine.  The attending may be different than the admitting service but it is still an internal medicine attending.  Please continue to follow these patients (new profile is '''not''' required) until they are discharged or transferred to an off service ward under family medicine or any other service other than internal med.   Please note the location in the RECORD box to indicate where the pt is currently located.
+==How to determine when a patient is no longer under an internal medicine service==
+In the EPR the patient list will show the "provider" which should identify which service the attending physicians is from.  However, because this is not always consistently kept up to date when services change, the following checks can help to determine if a patient remains under internal medicine or switches to another service.
+. In EPR,Check the orders under transfers/care directives, to see if there has been an order to switch from internal medicine to another service.  Use the time transfered to the other ward as the discharge time or use the time in the order when the other service took over care if the pt remains on the off-service ward.
+. In EPR, go to the patient info tab, select care providers from the left hand column, a list should come up with providers and their discipline with a date.  If you see that the most recent attending is no longer an internal medicine physician then there has likely been a change of service.  You may be able to confirm this by checking under the documents tab, sort by discipline, and then check the medicine notes that correspond to the date found in the care providers list. The progress notes from different services will be identified as such in the notes section. If you determine that they are in fact now under a new service (with no corresponding order), use the date and time of the attending switch in the care provider list as your discharge date and time.
 == Data Use ==