EMIP
EMIP stands for Emergency Medicine "IN" patient and is used as a Service/Location field in the Medicine database. It is used for patients who are admitted to our internal medicine service and spend their entire admission under the medicine service in the ER (emergency department). We are tracking this as VIC_EMIP, GRA_EMIP, STB_EMIP and HSC_EMIP.
Definition of EMIP
- Pt has an order or some entry that medicine has accepted the patient while still in ER.
- The patient either is discharged from ER to home or any other out of hospital location
OR.... the patient is transferred within the hospital directly to a different service because Medicine decides that they will not take the pt but the patient needs different care. Examples: Palliative care take over the care; ICMS takes over the care; Surgery takes over the care; Gynecology takes over care; etc.
- These patients are only under medicine while they reside in ER. Once they leave ER they are either going out of hospital or going to a different service within the hospital.
Collection Instructions
See site specific collection guides for details on the collection process, papers, binders.
identifying patients
EMIPs will show up under:
- the Transfer Register if they are sent to non-medicine units in your hospital.
- EMIP's in this list will be those under the medicine or internal medicine service that subsequently changed service before leaving ER and were transferred out of ER to a local hospital ward or unit. (not a medicine ward).
- see instructions for Off ward field to also identify some EMIP patients. See this under the title "how to identify off-ward patients" in that article.
- the Discharge Register if they leave the hospital
- When reviewing the discharge list generated by the instructions, the EMIP's are those that have medicine or internal medicine under the "service" heading.
- Run these reports at least once a week if possible.
For EMIP entry
- There is a separate paper log sheet that has its' own sequential numbers.
Entering patients in dispo tab fields
- Service/Location field - your EMIP (e.g. GRA_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, and medicine accepted the patient from them -in order for a pt to be an EMIP they must have been accepted by Medicine for admission otherwise they would just be an Emergency patient
- Accept DtTm field - the time Medicine accepted them, i.e. the time they became an EMIP
- Arrive DtTm field - same as Accept DtTm field
- Previous Location field - use normal instructions
- Dispo field - For EMIP pts, you cannot put discharge to an ER, so if that is where they went, put the place they went after ER (usually a ward).
- Transfer Ready DtTm -only use this if the pt is going home. Otherwise use "not transfer ready".
- See Overstay_Predictor_Project_Collection_Instructions#Possible_Scenario_-_EMIP_patient_that_never_made_it_to_the_ward for how to code overstay for these patients.
Patients transferred to other locations
Collection includes patients who are discharged to a non-medicine location in the hospital. So, if an EMIP patient is transferred to an ICU, that ICU would use e.g. GRA_EMIP as Previous Location. If a pt who starts out on the EMIP track turns into a medicine off ward patient, collect them as you would any other off-ward patient.
EMIP scenario
- In ER under Medicine service and left your hospital to Home or died in ER
- In ER under Medicine service and transferred to other locations under different service in your hospital
- In ER under Medicine service and discharged to other locations in another hospital
NOT an EMIP
- In ER under Medicine service and then moved to a Medicine service ward (i.e. a regular Medicine admission)
- In ER under Medicine service and then moved to other ward but under Medicine service (i.e. a case of off ward patients).
HSC Community and Clinical Decision Unit (CCDU)
Template:Discussion Are there ever EMIPs in HSC Community and Clinical Decision Unit (CCDU)? Would we catch them? Ttenbergen 11:27, 2016 December 29 (CST)
- In early February, I ran the reports for HSC for overflows to look at this issue. I ran one week only (Feb 1-8). It showed 5 patients that went to GH6 ward as medical overflows. It also showed 8 patients that went to CCDU under medicine during this week. I am unsure if these are already captured or should be captured or not. I just did this as requested by Trish. Just letting you know my findings. --LKolesar 07:20, 2017 February 27 (CST)
- I ran the same dates. I had 6 Neurology pts that went directly to H6...these pts are not normally collected because we have not had instructions to do so. We only collect Neuro pts that are admitted to Hobs or the medicine wards we collect on. One H medicine pt went directly to H6. This pt was missed, again because we are not aware of any A, D, or H Medicine pts admitted on wards not covered by data collectors. Lastly 6 CCDU pts under "HSC Medicine/Clinical Decision" which we do not collect. They do not belong to a medicine service. They are emergency pts.--CMarks 14:24, 2017 March 2 (CST)
No ICU counterpart
see ECIP for more info
Serial numbers used
Patients in EMIP have their own serial numbers starting at number 150.