Accept DtTm field

This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear. 

The Accept DtTm field contains the date and time when the attending physician accepts a patient, i.e. the date/time a patient changes status from what is documented in Previous Service field to Service/Location field.

Collection Instruction

For all patients, if there is a record of the date/time that the service physician accepted the patient, enter this as the Accept DtTm. Collect this wherever available, but it is especially important for patients coming from ER. If the patient is accepted and arrives at the same time, or if there is no clear record of the accept date/time, enter the Arrive_DtTm field and then click the "set accept_DtTm to Arrive_DtTm" button to copy the DtTm across.

If the Accept DtTm > Arrive DtTm, make accept = arrive.

Possible documentation locations

• admission/separation registers
• Template:Discussion any others? Ttenbergen 11:52, 2016 May 5 (CDT)
• Physician Order sheet when being transferred ie: "May transfer to D5/ non-teaching" or in Progress note section MD may write transfer plan pending bed.--Llemoine 15:11, 2016 May 9 (CDT)
• For all the patients from ER and for PARR patients, the orders are a good source of data for this. For the other previous locations (wards and other hospital icu’s and wards) this is not a consistently accurate source. (Laura via email)

Questions

ward to ward

• When a pt moves from ward to ward do you want us enter the date & time the transfer order is written in the "Accept DtTM" or the time the pt actually arrived to the unit and comes under the care of the new unit? In ER, once an order is written for a pt to transfer to a ward the accepting service will care for the pt. in ER. Ward to ward transfers are different. When a pt transfers from ward to ward sometimes the service or physician will continue the care for the pt. on the new unit & sometimes they do not.
  • Template:Discussion Julie, Tina and Trish are still discussing this. Ttenbergen 16:52, 2016 May 16 (CDT)
  • A good example is a patient that is located in ICMS at STB who has been accepted by CCU attending during their stay in the ICU. When they get transferred to CCU, the CCU data collector would be tempted to put the accept time documented in the transfer orders, however the same service was covering the pt during their stay in the ICU so this is a problem. I did discuss this with Julie and she said that we already track these types of patients in the tmp by putting the CCU service entry so it would only be confusing and skew the purpose of the accept dttm to document the accept time in CCU as per the orders. She suggested just putting the same time as the arrive dttm to CCU in this example. --LKolesar 12:47, 2016 May 19 (CDT)

accept after arrive

• If the order that indicates acceptance is written after the patient arrives, I suggest that we just make the accept time and the arrive time the same to avoid confusion. --LKolesar 06:48, 2016 May 10 (CDT)
  • Template:Discussion Julie, Tina and Trish are still discussing this. Ttenbergen 16:52, 2016 May 16 (CDT)

delay between acceptance and arrival

• I don't think this is feasible. A patient can be accepted (ie - order written to transfer to D5) but cannot go until an actual bed is available which may take a number of days. In the meantime the original ward that the patient is on, is still collecting data.--CMarks 07:53, 2016 May 10 (CDT)
  • Template:Discussion Julie, Tina and Trish are still discussing this. Ttenbergen 16:52, 2016 May 16 (CDT)

Data Use

Many things, need to pull them together Ttenbergen 12:59, 2016 March 21 (CDT)

Template:CCMDB Data Integrity Checks

• Function Dispo Chronological

Legacy

This field is part of the 2016 Time and Place changes.

For medicine this concept is related to admit date and time (when pt is from ER). It does not simply replace the field, so this value still needs to be entered for patients not from ER.

For critical care this concept is related to Service Sending to ICU. (There is no comparable field in ICU for this in the old system).