Definition of a Critical Care Laptop Admission

The definition of an "ICU patient" for the Regional ICU Database is:

• EXCEPT for the exceptions immediately below, a patient admitted under Critical Care service, regardless of their physical location, even if it is a Boarding Loc such as PACU or ER. If patient doesn't meet this definition then we don't collect data and enter into the ICU database. What this DOES mean is that this begins at the time when the ICU service takes over primary care of the patient (see Service tmp entry)
• Exception HSC SICU: As SICU patients remain under the primary care of the surgical service, they do not fall under the rule directly above. Instead a SICU patient becomes an ICU laptop patient at the earlier of (a) actual arrival in SICU or (b) the patient is not yet in SICU (e.g. is in PACU, or ED or boarding elsewhere) but the SICU service has accepted them to come to SICU when there's a bed in SICU.
• Exception STB : STB_CICU, STB_MICU & STB_ACCU Admissions start at Arrive_DtTm unless the Cognos data is within a reasonable time frame. EPR times are unreliable as they are ofter entered long before the pt is actually in the unit or are entered when the pt is in a swing bed location; EPR times are reflected in the Cognos data.
• Exception PACU: pts in PACU are to be included if they are under critical care, but not if they are under surgery

• Special case: Pts in ICU for procedures only: as per Bed borrow exclude patients brought into ICUs for procedures only; these would likely not show up in the Cognos reports because the service does not change to ICU for them

Entry of Admission Date to Critical Care Service and Reporting

Since the definition varies from site and unit, for the Statistician to get the correct admission date time to the ICU which is to be used to calculate Length of Stay (ICU Report), the admission date and time must be entered in the Service Tmp entry as its first service entry Start date and time. It would be hit and miss to get the correct date and time information to the first Boarding Loc because the first physical location may not be the unit but just a boarding location and by definition does not necessarily imply that the patient is already being taken over by the ICU service. Neither getting the correct admission date time to the succeeding boarding location which can also be a boarding location. The purpose of the Service tmp is to define the start dates the service takes over and the first start date time is the beginning date when the Critical Care service takes over regardless of the location it started (e.g. own ICU, other ICU unit, Off service unit, ER, RR, or other locations).