Admit date and time

The Admit date and time for critical care designates the time the patient arrives on the unit, the one for medicine when the patient was accepted to the medicine service. IMPORTANT NOTE: The Admit date and time field is current used differently for Medicine and ICU. See below

We track Admit date and time for patients as part of our Minimal Data Set, i.e. this his high-priority data that needs to be collected ASAP. You will not be able to send any records (even correct ones) if it is not filled out for any patient.

Definition for Critical Care (ICU's)

• See Arrive DtTm field

This field designates the date/time the patient PHYSICALLY ARRIVES on the unit.

For the ICU's the most accurate place to find this information is where the nurse first charted first vital signs on admission to the unit.

• If the admission time is 24:00/midnight use 00:01 hours as the admit time. (This is a change from the previous rule of using 23:59 hours as the admit time. The change corresponds with the transition to TISS28 which does not have a 2 hour rule--change is effective 24:00 hours December 31, 2012) Mlaporte 13:39, 2012 December 9 (EST)
• see Transfer time rule for info on expected differences between admit and previous discharge times when transferring
• Has there been a decision about the arrive date/time for ICU patients who overflow outside their units?--Jpeterson 10:20, 2016 June 13 (CDT)
  • This is my understanding: If the patient never does arrive on your unit, then the arrive date and time will be the same time as the accept date and time. If the patient does arrive on your unit, then the arrive time will be the physical arrival on the unit, while the accept time will be when the service accepted care of the patient.-Mlagadi 15:18, 2016 June 14 (CDT)

Template:Discussion ICU

• I often have patients who are in PACU when accepted by SICU but have to stay in PACU as overflow. I had been told when oriented to consider the time accepted by SICU as the admit time & Arrive DtTm field in these cases. Should I be changing my practice to the time the patient actually comes to SICU, this sometimes never occurs as the bed space may never be found before the patient is discharged to the ward.--Jpeterson 11:19, 2012 December 10 (EST)
  • There apparently is a discrepancy between some of the data collectors for the discharge/admit time of a patient who has a code on the ward and then admitted to the ICU. After a discussion with Trish, the time of admission to the ICU should be when the patient arrives in the ICU after the code.--Jpeterson 13:03, 2016 May 13 (CDT)
    • That is the way I have always done it, usually first vital signs unless clear charting otherwise.GHall 13:44, 2016 May 13 (CDT)
      • now that we have an Accept DtTm field, in the EPR, if you are able to find documentation when an ICU service accepted the patient prior to arrival to your unit, then you can fill in this field. If there is no clear ICU acceptance date/time OR the patient stayed for example: in the PACU under ICU physican's care, but never moved into the ICU, then the Admit Data and time field + (Accept DtTm field + Arrive DtTm field will all be the SAME.--Trish Ostryzniuk 14:57, 2016 May 13 (CDT)
        • great input everyone!Trish Ostryzniuk 14:57, 2016 May 13 (CDT)

Definition for Medicine

This field designated the date/time that the patient was ACCEPTED TO the medicine physician service.

• see ER Wait to see where to enter Medicine ward actual physical arrival date/time.

Get the "accept to Medicine date/time" from one of the following in this order of preference:

1. physician's note accepting patient to their Service
2. from the hospital admission sheet (e.g the white admission separation?/triage sheet at HSC)
3. Often the actual time of admission is documented in the IPN (integrated progress note)) which is a hand written admission note by the nurse. We at HSC in medicine use this.--CMarks 08:10, 26 January 2012 (CST)

• • New form "Admission Request Form From Emergency Department" first line has Admit Order Written followed by date and time which is accurate.--CMarks 08:54, 2015 January 29 (CST)
    • is this form used across the region? If not, this info should go into HSC Medicine Collection Guide resp HSC General Collection Guide instead. Ttenbergen 16:41, 2015 January 29 (CST) Template:Discussion

• FOR THOSE PATIENTS ADMITTED FROM E.R: use the date and time from the "accepted to service" on the EPR orders. i.e. in the epr, click on orders, then highlight the order that says "admit to inpatient-medicine-medical service". Right click on that order. Scroll down to view, then across to history, then across to status. Click on status. Use the date and time as listed in the top "new" order. This is the date and time the patient is accepted to medical service.
• FOR THOSE PATIENTS ADMITTED FROM ANOTHER WARD: use the date and time plus five minutes from the discharge date and time of the sending ward. DPageNewton 15:17, 20 June 2011 (CDT)
• FROM ICU WITH A STOP IN DIALYSIS FOR TREATMENT: use the time they left ICU plus five minutes as the admit time to medicine. This was decided at the April 4,2013 task meeting.

Source for this information - STB Medicine

• For Acute Care Medicine patients at STB - use the Doctors orders on the EPR as date/time accepted to Medicine Service.
• for Non Acute Care (C service) medicine patients at STB - use EPR's registration tab/visit location/location history, for date/time accepted to medicine service.

For admissions from: ICU, ambulatory or other medicine wards

For patients admitted directly from an ICU, ambulatory care or other wards the admission date/time is the date/time that they actually arrive to the medicine ward.(exception is if they have dialysis see above) Also consider the Transfer time rule.

Template:CCMDB Data Integrity Checks

• Minimal_Data_Set#CCDMB_Data_Integrity_Checks

Date and time formats

see Date and Time Format

Data use

Among other things, the times are used to generate statistics about

• LOS
• Multiple Encounter
• Transfer Delay
• bed occupancy

See Also

• Admit date and time
• Discharge date and time
• Transfer Ready date and time

Legacy

This article was spun out from Interrelation between Admit, Discharge and Transfer Ready date and time, see that article for any history missing from here.