EMIP

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Revision as of 12:53, 2020 September 23 by Ttenbergen (talk | contribs) (→‎For EMIP entry: shouldn't have separate number pool any more)
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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 one of the medicine services we follow in the ER (emergency department). We are tracking this as VIC_EMIP, GRA_EMIP, STB_EMIP and HSC_EMIP.

Definition of EMIP

  1. Pt has an order or some entry that medicine has accepted the patient while still in ER.
  2. The patient is discharged/transferred from ER to either
    • home or
    • any other out of hospital location or
    • the patient is transferred within the hospital to any service because Medicine decides that they will not take the pt but the patient needs different care.
  • Do we include ED Death after arrival in our EMIP collection?
  • When reviewing the Cognos EPR Report I came across a few entries that were "ED Death after Arrival" (4 across sites between 2020-03-16 - 29) . Our current definition would exclude these from EMIP collection. Do we include or exclude them in practice? Is that intentional or have we just never thought about them?
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  • Do we include AMA in our EMIP Collection? Ttenbergen 12:47, 2020 September 22 (CDT)
  • When reviewing the Cognos EPR Report I came across a few entries that were "ED Reg/Triaged/Assess LAMA" (6 across sites between 2020-03-16 - 29) . Our current definition would exclude these from EMIP collection. Do we include or exclude them in practice? Is that intentional or have we just never thought about them?
    • In both of these cases we would capture these patients if they were accepted by the medicine service prior to them dying or leaving AMA, it would show up on the discharge register, if they were not accepted by medicine then we do not include them as they were never under the care of the medicine service.
      • Yes they would show up. What I want to be sure about is whether we would collect them when we see them show up. If so, then we need one more bullet above, or we need to add the AMA option to the Home option, since they are kind of the same thing. As it stands now, if someone strictly follows the instructions they would exclude AMAs because they are not on our list.
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Collection Instructions

See site specific collection guides for details on the collection process, papers, binders.

Identifying EMIPs in Cognos Admitter

Laptops in the PatientFollow Project

EMIPs show up in Cognos Admitter and are filtered by the "Mine! Mine!" button to limit to the subset collected on a laptop. Because they don't have a Unit Arrive DtTm they filter to the end of the list when sorted by date.

laptops still collecting by location

EMIPs show up in Cognos Admitter and can be filtered for with the "EMIP" button.

Identifying patients (old way, in EPR)

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

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".

Patients transferred to other locations

Collection includes patients who are discharged to a non-medicine location in the hospital.

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).

EMIP to ICU

A patient who is accepted by medicine while in the ER, but who then goes to ICU without ever going to a medicine location or Boarding Loc should be collected as an EMIP.

Template:Guideline CAU vs Boarding Loc vs EMIP For STB_CAU, HSC_CAU, STB_CAU.

Patients in ER admitted under other services

Our definition of EMIP includes only patients that were followed by one of our medicine services. So, patients who were followed by Family Medicine or Trauma while still in the ER are not EMIPs. This means patients in Concordia ER or Oaks ER can not become EMIPs. Code them as regular ER patients.

No ICU counterpart

see ECIP for more info

Serial numbers used

Patients in EMIP have their own serial numbers starting at number 150.

Related Articles

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