IICU consult

Projects
Active?:	planned
Program:	CC
Requestor:	Bojan P / Jodi / Adrian
Collection start:
Collection end:

• current error when date and time for both requested and accept is entered, unable to send. Error message...email sent with screenshot.-Joanna Velasco
• observations: requests are in IICU book, so they are recorded. When beds opens, then the IICU service reviews the all the requested listed and chooses those that meet criteria for IICU admission. It is observed that patients seem to only be "accepted" when a bed opens up in IICU, but there is often no documentation in the chart of the "Accept" date and time. - Joanna Velasco.

Purpose

To capture the number of patient days waiting for transfer from acute ICU bed to IICU bed

Data Collection

For every Critical Care patient who has a consult to IICU, obtain the date and time order was written by ICU requesting IICU consult.

How to code

requested

• Project: IICU consult
• Item: consult request written
• Date (Column E): consult dt
• Time (Column M): consult tm
• Checkbox: dt and/or time missing
• Comment: (example):
  • No documented request
• Integer: not used
• Real: not used

accepted

• Project: IICU consult
• Item:
  • consult accepted by IICU
  • consult rejected by IICU
  • consult unknown
• Date (Column E): response dt
• Time (Column M): response tm
• Checkbox: dt and/or time missing
• Comment: any observation (some examples):
  • consult was only accepted when bed was available
  • no documented reply & pt went to off ward bed (RR)
  • no documented reply & pt died waiting
• Integer: not used
• Real: not used

Consult Unknown

If you can't find any record of a consult, enter "consult unknown" and check the checkbox for dt missing.

Background: Especially at STB, given it is mostly EPR, he IICU docs rarely, if ever, write into EPR. We are not so much looking to track when consults filled as much as what pt disposition is ultimately.

IICU Consulted but pt deteriorates before transfer

If IICU has been consulted and accepted but then the patient's condition deteriorates prior to getting a bed in IICU and is no longer a candidate for IICU then leave original consult & accept date and use the Notes field to provide further info.

Sources

• physician orders
• consult form
• IPN (integrated progress notes)

Out of province patients

• HSC IICU collectors - when a patient comes from another site outside province, would you be able to see in chart when consult was requested by the other ICU and when IICU service accepted? Trish Ostryzniuk 11:35, 2018 November 14 (CST)
  • I have never had this case before, but I think it all depends on what is photocopied and sent with the patient from the referring facility.--Jvelasco 12:13, 2018 November 14 (CST)

Why not put this in Transfer Ready DtTm?

• Why do we need a project to determine the patient days waiting for transfer when we already put in the Transfer Ready DtTm? I suggest we just put another option in the drop down for transfer ready which would read "waiting for IICU bed" and then you would have the information you need without a new tmp item. --LKolesar 07:59, 2018 November 6 (CST)
  • The definition for Transfer Ready DtTm says to enter the first time they are transfer ready. This may not be the first time. Also, we prefer not to add temporary data to existing fields because it would change their definition with special cases, and mess with cross-checks that are based on those fields. Ttenbergen 10:52, 2018 November 6 (CST)

how about the date/time responded

We do not need the date when IICU doc answered consult at this time.

Data use

validating resource use and need.

Study Run Times

• start date: 2018-11-12
• projected end date: 2019-06-30

Data Integrity Checks (automatic list)

	App	Status
Query s tmp IICU consult dispo to IICU but no tmp	CCMDB.accdb	implemented
Query s tmp IICU consult DtTm	CCMDB.accdb	retired

Related articles

Polling for ease of ID'ing Date and Time of consult

Can the collectors easily find in the chart when a consult for IICU or order for IICU consult is made?Trish Ostryzniuk 18:43, 2018 October 31 (CDT)

• would you be able to find DATE and TIME consult was ordered? Trish Ostryzniuk 11:35, 2018 November 2 (CDT)
  • OAK: I have not seen a consult at Oaks for IICU but it would be easily identified in the consults, notes and or orders;
  • GRA: it is easily identified in the orders, consult and or notes Lisa Kaita 21:06, 2018 October 31 (CDT)
  • STB: the orders including consults are all electronic so it would be easy to obtain this data. --LKolesar 18:30, 2018 November 1 (CDT)
  • HSC: we can usually find something in the orders, consults and/or IPN about the intention to send someone to IICU.