Previous Location field
| Data Element (edit) | |
| Field Name: | Previous_Location |
| CCMDB Label: | Previous Location |
| CCMDB tab: | Dispo |
| Table: | L_Log |
| Data type: | number |
| Length: | long integer |
| Program: | Med and CC |
| Created/Raw: | Raw |
| Start Date: | 2016-07-01 |
| End Date: | 2300-01-01 |
| Sort Index: | 37 |
The most recent previous physical location of a patient before arriving at the collection location.
For exceptions, see
Collection Instruction
For each patient,
- enter the option that most closely matches
- if you know the situation but nothing on the list matches closely, enter 'other - known but not listed
- if the situation is unknown, enter location missing/unknown
If you know the location exactly, you can type it. Otherwise press the "?" button to take you to the S dispo chooser to help filter options if desired.
For wards where we don't collect, enter e.g. HSC_ward. For wards where we do collect enter the actual ward as available in the dropdown.
Example
For example, a patient arriving from Selkirk Hospital via the local ER would have the ER coded in the Previous Location field and Selkirk coded in the Pre-admit Inpatient Institution field.
Where to find this information
If patient came from a different Winnipeg hospital this should be recorded in the “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.
direct transfer
For patients who get parked in the ER during a inter-facility transfer, enter the previous ward in Pre-admit Inpatient Institution field and enter your ER in Previous Location field. (In the past you would have entered the hospital and ward as the "admit from".)
from psych unit
Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.
Question about Dialysis unit as previous location
- Since now we have the Dialysis unit as an option for previous location, should we always be using this even if the pt is a ward patient that just happens to be transferred from the dialysis unit to the ICU as the last place they were located having their treatment? I thought that was what was wanted. Just checking because at the team meeting there was some discussion about a pt having gone to dialysis between transfers and that affecting their EPR arrival time on a given ward. This can apply to Previous location and to dispo. If we use the option of Dialysis unit it is still clear that they were a ward patient because you would still enter the ward in the previous inpatient location field. Using dialysis unit as a place would make transfers much more accurate so I think that this would prevent any problem using EPR times regarding transfers when dialysis is done before or after a transfer. Just bringing this up because of the question that was brought up in the team meeting so we can clarify this. Thanks.--LKolesar 07:37, 2017 March 13 (CDT)
- Yes the location Dialysis Unit will be used in the Previous Location and Dispo if applicable, similar to 'Cardiac Cath Lab'. If already an inpatient, enter the location in the Pre-admit Inpatient Institution. JMojica 13:47, 2017 March 14 (CDT)
- This is not presently an option at HSC-with medicine transfers-the transferring ward /medicine group continues to manage patient until they arrive on the next unit-then orders etc are processed and admission is completed.Our arrival to ward time then becomes our coordinated transfer time/s.--Llemoine 08:02, 2017 March 15 (CDT)
- Yes the location Dialysis Unit will be used in the Previous Location and Dispo if applicable, similar to 'Cardiac Cath Lab'. If already an inpatient, enter the location in the Pre-admit Inpatient Institution. JMojica 13:47, 2017 March 14 (CDT)
Question about Heart Cath Lab as previous location
- When a valve replacement is done in the cath lab (TAVI) should we put the CATH lab in previous location or OR? Do we have to put all surgical procedures from the OR? Just making sure this will not conflict with anything. Just checking because Lois had this question.
- yes this will affect the score of the APACHE II Diagnosis categories where the nonoperative and operative patients have to be defined by using the previous location (i.e. operative if coming from OR/RR). Can we keep the previous location = Operating Room until we move to ICD10 coding which will consequently require the changing of the program for the APACHE II Diagnosis categories. JMojica 14:26, 2017 March 14 (CDT)
Data collection units that have a mix of different physician serve types
We have a few units in the Region that have a mix of 2 different services (internal medicine, surgical, family medicine etc).
- VIC_S3 - is a mix of family medicine and internal medicine patients
- HSC_B3 - is a mix of day surgery & internal medicine patients
- any others?
For patients from these units:
- If patient is an internal medicine patient: enter the unit name (eg. VIC_S3)
- If patient is not a internal medicine patient, enter the generic hospital ward (e.g. VIC Ward); this will allow you to enter the Previous Service field with a physician service other than "Medicine".
Patients from day surgery
For patients admitted from day surgery units, enter:
- Previous Location - <your hospital> Ward, e.g. HSC Ward
- Previous Service - General Surgery (or other surgical service listed in drop down.
Data Use
This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.
Template:CCMDB Data Integrity Checks
Implemented:
- Can not be blank
- previous_NE_Location() - Previous Location field can't be same as Service/Location field
- Patients with Previous Location field critical care must have Previous Service field critical care, and patients from medicine must have previous service medicine.
- query check_prev_pre-admit_consistent: for inpatient transfers within the region, Previous Location field and Pre-admit Inpatient Institution field should be same.
- query check_previous_location_vs_service_inconsistent: patients with Previous Location field in medicine must have Previous Service field medicine; patients from ICU (except CCU) must have previous service "critical care".
Following might still need to be implemented:
- Check ORDx; or not? Would have to be done for ICD10, so can it wait? Ttenbergen 16:26, 2016 May 25 (CDT)
- discussing with Julie, she seems open to waiting, told her I am starting Category:ICD10 and Template:ICD10 for stuff like this. Ttenbergen 10:56, 2016 June 2 (CDT)
Implementation
The field is populated with options from the s_dispo table.
Legacy
This field is part of the 2016 Time and Place changes.
It a combination of our previous