2020 GRA COVID unit transition
This page is about the transition of collection units at GRAto accommodate the new COVID unit.
Background
The dates are not yet finalized.
- Saturday March 28.20 – start date patients in GRA_N5 move to GRA_2S but not all. Moves are are on staggered basis in April.
- ?? April ?? .20 - 5S will be a new COVID-19 ward GRA_5S_C with ?? adult beds
- 2020 Apr 14 - Grace ICU - PACU has now been converted to be ready for non covid ICU pts (15 beds) - ready to go but no admissions. The Current GRA ICU (10 beds) will become the covid ICU
Medicine Situation
Collection instruction summary for now
If in the documentation from ER it says that a COVID swab was sent and they do NOT indicate the result, we assume they were admitted to whichever ward as COVID SUS
- If they were admitted to 5N, service location= home ward location (3N, 3S or 2S), boarding loc in tmp= 5N
- If they’re admitted to their home ward, Service Location = home ward (3N, 3S, 2S), no boarding loc in tmp is necessary, unless they are transferred to 5N at some point during their stay
- If they’re swabbed positive, the initial profile will be discharged to 5S_C, and a new profile will be created Service Location= 5S_C, and if they’re physically anywhere other than 5S_C we will add a boarding loc entry.
- We do not follow surgery patients that are COVID suspect unless they are under the care of medicine
Random bits from crazy email stream, need to be integrated
Collection
- COVID POS: label with Service/Location of GRA_5S_C regardless of their physical location; enter physical location as Boarding Loc if not physically on 5S_C
- COVID SUS: on 3S as well but under a 3S doctor, not a 2S/5N doctor
- use GRA S3 profile, no tmp Boarding Loc is needed
- GRA N5 is a mix of GRA S3, GRA N3 and GRA 2S . So these will be entered with a Service location of S3, 2S or N3, also with tmp Boarding Loc = GRA_N5
Transition
- GRA_N5 patients discharged before April 15 remain GRA_N5
- GRA_N5 patients discharged after April 15:
- if pt is COVID POS change Service/Location to GRA_5S_C
- otherwise change Service/Location to GRA 2S regardless if they move physically there
- enter Boarding Loc=GRA_N5 for the time they were on that unit
Transition plan
- There is no transition plan for the new COVID ward GRA_5S_C which has already been added to the s_dispo table.
- This transition plan is only for the patients in N5 who were moved to 2S or who remained on N5 under the N5 physicians.
- GRA_2S needs to be added to the s_dispo table.
- GRA_N5 needs to be added to s_tmp of Project BoardingLoc
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collector instructions
- change the Service/Location of the record to the new location (ie from GRA_N5 to GRA_2S )
- enter the actual location as part of Boarding Loc:
- for patients who had no location borrowing during transition:
- change the "no borrow" line to "GRA_N5" and enter the time the patient arrived in N5
- add a line for "GRA - Home medicine ward" with the time that the patient was actually moved
- if there were patients who actually were in a borrow location during the transition, let's talk about how we would enter those
- for patients who had no location borrowing during transition:
N5 COVID suspect ward
This ward is a mix of different medicine patients ie. 3S, 2S, and 3N patients, therefore each data collector will enter their own patients
- the Service/Location will be your home ward location
- in the tmp the Boarding Loc will be N5
- if the patient's result is negative and they are moved back to their home ward then enter Boarding Loc GRA home medicine ward with the date and time they are transferred back
- if the patient's result is positive, create a new profile using S5 as Service/Location if they do not physically move to S5 and remain on N5 then enter Boarding Loc N5 with the date and time closest to the positive result, if or when they move to S5 enter Boarding Loc Gra home medicine ward with the date and time they are transferred to S5
Special Circumstances
When reviewing a chart in MR and you find a positive result that is dated after their discharge date and time.
We then need to split the profile into
- Before COVID positive (ie COVID suspect) with service_loc=home ward, boardingLoc if applicable, dispo_dttm=(swab sent date/time)
- Arrive date/time= swab sent date/time +5 minutes, service_loc=5S_C
Which serial numbers should be used
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Surbanski 09:10, 2020 April 16 (CDT)
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Outstanding issues
I have spoken with Richard Q the manager on the 5th floor today and this is what he has told me:
- As of right now, they still don't have confirmation on the designated COVID units, but at this time, 5N is being used for COVID SUS and 5S is being used for COVID POS admissions. Currently according to EPR there are 2 positive cases admitted to 5S.
- Over the past week, there has been a lot of movement from 5N to 2S, which in the past was where our boarders were moved to. When I asked Richard, he indicated that 2S has become the "clean" medicine unit. Again, this is all yet to be confirmed by GH and/or WRHA.
- Currently, there is 1 doctor who has taken on the COVID patients, but again, this could be temporary and may change over time depending on what the demand is.
- Unless they are labeled COVID POS in EPR, there is no way for us to know what the swab results return as. This information will only be gathered once the chart is available in Medical Records. If you would like to grant us the ability to go to eChart to review, I'll leave that to the powers that be to decide. My understanding is in this Data Collector role, we are no to review records in eChart.
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Surbanski 11:30, 2020 April 15 (CDT) |
ICU Situation
- The current Grace ICU will be the COVID unit. A new 15 bed ICU has been set up in the GRA_PACU area, this will be the clean ICU.
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Reporting
service location GRA_N5 before move date to GRA_2S and GRA_2S can be reported together.
Cross checks
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