Intended1stSrvc

Projects
Active?:	proposed"proposed" is not in the list (active, planned, legacy, aborted in planning) of allowed values for the "ProjectActive" property.
Program:	CC
Requestor:
Collection start:
Collection end:

This project is not live yet, do not follow the instructions to stop the old collection yet. I hope to have this set up to start collecting with the new instructions Oct 1. For now, continue to use the instructions in ICUotherService. Ttenbergen 14:27, 26 September 2025 (CDT)

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Background

The Critical Care Program Quality Indicator Report

is that the right report? I have added this new data to that report's dependencies. If it's the wrong one it will need to be taken out of there. If other reports also use this, it will need to be added to them. If only that report you can remove this comment. Ttenbergen 15:20, 26 September 2025 (CDT)

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• This variable essentially replaces ICUotherService
• It is to be used when the ICU service a patients is actually on (MICU, SICU, IICU, ICMS, CICU, Grace ICU) is different from the service the patients should be on. This most common reason for this to happen is bed capacity issues.
  • e.g. patient admitted from ED ventilated with severe pneumonia, should go to MICU but it is full, so goes to SICU and is taken care of by the SICU service. Here Service/Location is SICU and Intended1stSrvc is MICU
  • e.g. patient in ED at Grace and should go to Grace ICU but it's full, so goes to HSC MICU. Here Service/Location is MICU and Intended1stSrvc is Grace ICU. This example shows that the Intended1stSrvc can be at a different hospital altogether.
• This variable should be left BLANK when the ICU service the patient is on is the one they should be on -- i.e. only fill it in when there is an Intended1stSrvc that is different from the first service they are actually on (i.e. what's in Service/Location)
• Along with Boarding Loc, Service Location and Intended1stSrvc allow clear identification of all types of ICU boarding
• As part of this alteration in collection, we will no longer collect Service tmp entry
  • those downloaded entries do not actually correspond the the true 6 ICU services that exist (as of 2025) and so are confusing, as they are things like "HSC Critical Care/Medicine A" or "HSC Critical Care/Plastics"
  • as Service tmp entry is downloaded from Cognos, this will no longer occur
• As we create a new ICU profile (record) when the ICU service changes, each time a new ICU profile is created, collectors will need to consider Intended1stSrvc anew
  • although we considered carrying over the prior value of Intended1stSrvc when a patient is transferred ICU-to-ICU, we decided against this as it creates other ambiguities
• Here is the most complex subtlety of this issue of what service a patient "should be on"
  • It can change during the course of the episode of ICU care (across ICUs, or within a single ICU). Sometimes such a change might be clearcut (e.g. due to occurrence of a surgical procedure) but other times the fact that the service the patient should be on changes is just within the heads of the attending physicians. Because of this uncertainty we explicitly decided NOT to try and track the service a patient should be on as time goes by, but only upon initiation of an ICU profile, which is why this variable is called "Intended1stSrvc"

Data Collection Instructions

• Code it as the ICU service that the patient SHOULD HAVE BEEN under upon initial admission to the ICU Service in this hospital, i.e. at the start of this record
  • Leave it blank if the very first day in ICU in that hospital, the patient was, in fact under the "correct" ICU service, i.e. the service that should have been taking care of the patient -- and as this is the majority of all ICU records, this variable will usually be left blank.

Example:

Patient with acute MI admitted via ED. He should have been under the ACCU service in ACCU but ACCU was full. So he was admitted to ICMS instead under the ICMS Service. Thus here Intended1stSrvc = ACCU.

Transfer to Another ICU Service

• This is important regarding this variable as a new ICU database record is created when a patient goes from one ICU service to another, but not if the patient goes from one ICU Boarding Loc to another while staying under the same service.

• Use tmp fields:
• Project: Intended1stSrvc
• Item:

JALT How do we want to do this, we could use the currently active entries for CC in s_dispo table: HSC_IICU HSC_MICU HSC_SICU STB_ACCU STB_CICU STB_MICU or the full possible names under the CC services in S Cognos Services table that we actually use (in the last 2 months we had): Item GH Critical Care / ACSS GH Critical Care / General GH Critical Care / General ICU HSC Critical Care - MICU HSC Critical Care / A Medicine HSC Critical Care / A Non Teaching Med HSC Critical Care / D Medicine HSC Critical Care / D Non Teaching Med HSC Critical Care / General HSC Critical Care / H Medicine HSC Critical Care / H Non Teaching Med HSC Critical Care / Intermediate HSC Critical Care / Medicine HSC Critical Care / Neurosurgery HSC Critical Care / Obstetrics HSC Critical Care / Orthopedics HSC Critical Care / Otolaryngology HSC Critical Care / Plastics HSC Critical Care / Respiratory HSC Critical Care / Trauma HSC Critical Care / Vascular HSC Surgery / Neurosurgery SBGH Cardiac / Cardiac Surgery SBGH Cardiac / Crit Care Cardiology SBGH Critical Care / Acute Care Surgery SBGH Critical Care / B Service SBGH Critical Care / C Service SBGH Critical Care / Cardiac Surgery SBGH Critical Care / Crit Care Cardiology SBGH Critical Care / General SBGH Critical Care / Medicine or we could use only the part before the "/" for the CC services in S Cognos Services table: GH Critical Care HSC Critical Care / Intermediate (this wouldn't be captured without the post-/ part) HSC Critical Care (but what would actually signify SICU, or would we again still need Service/Location for that? SBGH Cardiac SBGH Critical Care SBGH Cardiac / Cardiac Surgery (this wouldn't be captured without the post-/ part) SBGH Cardiac / Crit Care Cardiology (this wouldn't be captured without the post-/ part)

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Things to resolve

Things we need to resolve: We need to review anything that links to ICUotherService, and anything that page lists to. The "anything that links there" can be accessed by expanding the "related articles (expand)" at the bottom of ICUotherService. Ttenbergen 10:59, 25 September 2025 (CDT) I have reviewed the links to ICUotherService and changed what needs changing. Ttenbergen 15:05, 26 September 2025 (CDT) We need to move the change-related parts of what Allan wrote in Intended1stSrvc to 2025-05 Revision of concept around ICUotherService to keep this page on target and keep the explanation in one place. Ttenbergen 15:05, 26 September 2025 (CDT) I think I have done that, mostly, but someone should have a look at 2025-05 Revision of concept around ICUotherService to confirm that the change is explained fully enough to make sense of the before and after data Ttenbergen 23:03, 28 September 2025 (CDT).

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Log

• 2025-09-25 - change of ICUotherService to this way of coding the concept was first discussed, page generated for Allan to update.
• See 2025-05 Revision of concept around ICUotherService for decisions leading up to implementation

Data Integrity Checks (automatic list)

none found

I don't think any checks are possible for this, or can someone think of one?

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