EMIP
EMIP stands for Emergency Medicine "IN" patient and is used as a location / in the Medicine database. It is used to as location for patients who are admitted to the medicine service and spend their entire hospital admission in the ER (emergency department) while under the care of Medicine Service attending physician. This sort of thing happens at the Victoria General Hospital and the Grace General Hospital
Collection Instructions
- Service/Location field - your EMIP
- Previous Service field - likely emergency medicine, unless some other service accepted them prior to medicine, and was never able to get them out of the ER either;
- Template:Discussion actually are those EMIPs? Ttenbergen 08:36, 2016 May 11 (CDT)
- Accept DtTm field - the time Medicine accepted them, i.e. the time they became an EMIP
- Arrive DtTm field - time patient physically arrived in the ER
- Previous Location field - use normal instructions
do EMIPs have arrive times?
(as moved from other article)
- EMIP pts will not have an arrive date or time as they do not physically leave the ER.
- They do have arrive times, they arrived in the ER, right? CCMDB won't let you check registry complete if you leave it out. I am moving this discussion to the EMIP article, Steph please delete this discussion once you have seen it. Ttenbergen 08:36, 2016 May 11 (CDT)
- I am thinking that the arrive and accept date/times should be the same, much like transfers from ICU to Medicine, or between medical units, the visit admit time will capture the time they arrived to the ER ie. the triage time. I don't think the arrive time should precede the accept time, thoughts? Lisa Kaita 09:38, 2016 May 11 (CDT)
- I see what you mean. Maybe we wait for Julie to get back next week. In the meantime, there are no cross checks that would prevent an accept before or after arrive. Ttenbergen 13:04, 2016 May 11 (CDT)
- I am thinking that the arrive and accept date/times should be the same, much like transfers from ICU to Medicine, or between medical units, the visit admit time will capture the time they arrived to the ER ie. the triage time. I don't think the arrive time should precede the accept time, thoughts? Lisa Kaita 09:38, 2016 May 11 (CDT)
- They do have arrive times, they arrived in the ER, right? CCMDB won't let you check registry complete if you leave it out. I am moving this discussion to the EMIP article, Steph please delete this discussion once you have seen it. Ttenbergen 08:36, 2016 May 11 (CDT)
EMIP as previous location for ICU
Template:Discussion What if EMIP patient doesn't come to medicine ward (making them no longer EMIP) but deteriorates and is admitted to ICU? Do you collect these as EMIPs? Do you omit them from collection? Discussed with Trish but we did not know what collectors do with these. The answer to this will also define whether or not "***_EMIP" needs to be available as in Previous Location field. Ttenbergen 17:34, 2016 May 9 (CDT)
- EMIPs are by definition Emergency Medicine Inpatients and never leave the Emergency Department until discharge. Their entire LOS is in the ER. They are not entered into the database until they have been discharged. If they are moved to any other unit, they are no longer EMIPs but are entered into the database for Medicine or ICU as appropriate. EMIP cannot be a previous location.
- The Previous Location field is the most recent physical location of a patient before they arrived at the collection location. EMIP is not a physical location. This patient would be admitted from a previous location of ER.
- Sending Service is the service that the patient was under the care of "prior to" being sent to collection location. Main office will review if patient is an EMIP then goes to ICU, does ICU reports want to note sending service to be Medicine Service in these circumstances? Will let you know.
- when a medicine patient deteriorates in the ER and is then admitted to ICU, we do not enter them as an EMIP patient for two reasons,; they are no longer.by definition an EMIP patient, and the patient will be captured by ICU data collection Lisa Kaita 22:14, 2016 May 9 (CDT)
- I concur with Lisa --LKolesar 06:42, 2016 May 10 (CDT)
Do these happen for ICU?
- When the ICU doctors see a pt in ER and accept them while they are still there, the accept date and time will reflect this. They will then be transported to the ICU at some point and therefore we do not use the EMIP designation as it becomes an ICU admission. --LKolesar 10:36, 2016 May 11 (CDT)
Template:Discussion Do these ever happen for ICU? If they don't, then we should change the instructions to no longer say Medicine only because it's irrelevant. If they do happen, then we should likely include them in collection, no? Is there any reason to have different instructions? Ttenbergen 08:36, 2016 May 11 (CDT)
Locations
VIC EMIP
See VIC_Medicine_Collection_Guide#Identifying_OVER_and_EMIP_patients.
GRA EMIP
- start date: November, 2010
- see GRA_Medicine_Collection_Guide#EMIPs_at_the_Grace for how these are identified at the Grace.
STB_EMIP
See STB_Medicine_Collection_Guide#Process_for_identifying_Overflow_and_EMIP_patients
Serial numbers used
Patients in EMIP have their own serial numbers starting at number 1.