AcceptDateSource

This is a temporary project to track source collectors use for Accept DtTm to help us assess quality and consistency of this data.

Collection instructions

For each patient admitted from the ER, enter one or more lines for this project.

Enter one line for each document you came across that you could have used as source for the Accept DtTm, enter the source/document:

• TMP tab on laptop in CCMDB.mdb
• Project: AcceptDateSource
• Item: select the document from #Options for "Item"
• checkbox/column B: check if this is the document you used for the Accept DtTm
• Date/column E: enter the date if different from the one you used.
• Time/column M: enter the time if different from the one you used.
  • If time is not documented leave it blank and enter "no time documentation" into the comment field.
  • If multiple times are documented in a given Item (say Dr Order), enter the earliest time and no need to enter the other times of the same Item. JMojica 10:29, 2017 January 31 (CST)
• coment/column Q': comment if item is "Guess" or "Other"

Direct Admissions / Transfers who stop in ER

• See: Accept_DtTm_field#Direct_Admissions.2FTransfers
• For direct admits but stop in ER and Accept_DtTm recorded, choose the option 'Other' and write in the Comment 'Triage sheet'.

Options for "Item"

Use one of the following for the "Item":

item	description	sort order
ER form-Request for Admit to inpatient unit		1
Inpatient Summary Sheet	whatever colour, white at HSC or pink at Conc, Gra	2
Dr. order	written order that our service physician order accepting the patient	3
Standard Order Sheet	ICU or Medicine	4
Admission Notes	ICU or Medicine	5
Consult Form	only consult to ICU or Medicine Services	6
HX & Physic note		7
ER Dr note	note that ICU/med service accepted the patient	8
EPR - see wiki for field to use	see #location of accept dttm in EPR	9
Inpatient Demographic Sheet		9.5
Guess - no documentation		10
Other	enter in comment what it is	11

standard vs drs orders

• ... However any standard order sheet should really be considered a "Dr's order" unless we are trying to establish a consistent source across all facilities where we can determine accept time, with the exception of SBGH of course.
  • good point. We are trying to find out how things are documented though, so for now let's treat them differently, but thanks for letting us know that we can combine them. (discussed w Tina and Julie) Trish Ostryzniuk 14:02, 2017 February 7 (CST)

ICU vs Medicine

• We are also putting consults for screening medicine under other as the current dropdown allows only for ICU consult, could that be changed to say consult? Lisa Kaita 11:11, 2017 February 7 (CST)
  • We have changed anything that was specific to ICU so it could be medicine as well. Thanks, good point! Trish Ostryzniuk 14:02, 2017 February 7 (CST)

Preliminary documentation info

As we are trying to find out what to collect, we found the following.

"ER Department - Request for Admission to Inpatient Unit" form

At HSC, Director of Medical Records states that there should be a white form on chart - ER Department - Request for Admission to Inpatient Unit. (Trish asked them to fax her copy). Hospitals using this:

• HSC
• VIC
• CON - has this form but is not a permanent part of the chart,it is tossed in confidential waste.
• SOGH
• Grace-the request for admission form filled out in the ER is a part of the permanent chart. The time on this form is taken from the orders when the "Admit to Medicine" order is written, so the time is ideally the same on both forms, however some differences in time have been noted. This is also the same time entered on the Pink Admission Summary form.

HSC Pink Sheets

HSC's pink sheet is only seen rarely. Usually I've only seen it for patients who came in for a same day procedure and then ended up needing to be admitted to medicine. We use the white sheet where the physician requests a bed for the patient. This time is usually the same time as the doctors orders.--CMarks 13:10, 2017 January 18 (CST)

location of accept dttm in EPR

• At STB we always take the accept date and time from the Dr orders. This applies to medicine and ICU. There are no exceptions that I know of. Do we still have to go through the motions of entering this information on every profile? I realize that all other hospitals do not have orders yet in their EPR and I understand why you are seeking this information for them. Just want to know if we have to do this or if it can be automatically filled in for STB??--LKolesar 09:34, 2017 January 27 (CST)

Where in EPR, what is the field name? There was talk about us not having rights to the correct field. Do none of the collectors? We discussed at Task meeting what will need to happen to fix this.

• There is no "field name" for accept date and time. The source for this is the Dr. orders under "transfers/care directives" category under the Orders TAB. --LKolesar 09:40, 2017 January 27 (CST)
• at GGH, the accept time can be taken from the Admission Register from EPR Report Lists; this time=time on Request for admission generated in ER=admit time on pink sheet=time order written "admit to"

Dates

Start Date

Target: 2017-Feb-1

End Date

2017-Mar-31

Background

Operation Planning - Patient Flow. Region Managers and Director are monitoring and tracking patient flow from the emergency department to their unit. The data helps support any changes needed to improve patient flow from ER to unit.