Dispo field
Data Element (edit) | |
Field Name: | dispo |
CCMDB Label: | Dispo |
CCMDB tab: | not stated |
Table: | L_Log table |
Data type: | integer |
Length: | long |
Program: | Med and CC |
Created/Raw: | Raw |
Start Date: | 2016-07-01 |
End Date: | 2300-01-01 |
Sort Index: | 41 |
The Dispo field contains information about what happens to the patient at the end of their admission.
Collection Instruction
If you know the location exactly, you can type it. Otherwise press the "?" button to take you to the S dispo chooser to help filter options if desired.
surviving patients
For each patient,
- enter the location that most closely matches
- for wards where we don't collect, enter e.g. HSC_ward
- for wards where we do collect enter the actual ward as available in the dropdown
- consider bed borrows
AMA
Enter "AMA (left against medical advice)" for patients who leave against medical advice (type "AMA" to open up drop down).
AMA is used as follows:
- AMA is being excluded in the calculation of Readmission rate.
- AMA is being counted as HOME in reporting for the location the patient went after discharge.
- AMA as itself for specific request.
AMA should be entered whether the patient follows the WRHA AMA process (signing form etc) or just goes AWOL. This will lead to proper reporting for the first two points, and it will allow a chart review to exclude AWOL person depending on the data requirements in the third case.
Homeless patients
If a homeless patient is discharged, either to a place like Siloam Mission or even without a specific plan, then code them as discharged to home. Consider whether they might have left AMA.
Prison / Jail / Correctional Institution
If a patient is discharged to prison, jail or a correctional institution, code this as a discharge to home.
- Pre acute living situation field should be coded as: Jail/correctional institution.
Discharged to ER or Urgent Care
If you discharge a patient to the ER or Urgent Care, you can't enter this in the dispo field. The reason is that this should not happen. If it really does happen:
- enter Other Continents - unknown/other (this is a very rare entry so when we see it, we can question it. Put a note in to the Notes field so Pagasa can check there first.)
- email Pagasa so she can enter your ER / Urgent Care location as dispo.
We don't want ER to be available in the dropdown because it had been mistakenly entered a number of times. If it turns out there are a lot of legitimate discharges to ER we will make the option available.
These patients might become Parked in ER at the next location.
Operating room visits
deceased patients
- for patients who expire, one of
- "Died - Organ Donor" (follow definitions in that article)
- "Died - NOT Organ Donor"
Data Use
- Mortality Rate
- Intra or Inter Transfer Rate
- Discharges out of hospital
- Organ donor rate
- AMA Rate
- Linking admissions
Template:CCMDB Data Integrity Checks
- cannot use: not applicable
- location_NE_dispo() - Service/Location field can't be same as Dispo field
Following might still need to be implemented:
- Check organ donors must be dead - this is a dx cross check - can it wait for ICD10? Template:ICD10 Actually, I don't think this dx will be available in ICD10, since it's not a diagnosis. So, likely it will only be coded in dispo field once ICD10 is in place, at which point this comment could go. Ttenbergen 09:56, 2016 June 16 (CDT)
- In ICD10 Template:ICD10 Organ donor (organ/tissue donation by the donor) doesn't imply death, but there is Sudden cardiac death (and died), Brain death, whatever will be the code for old Medical Assistance In Dying.
Template:Discussion are there others? Ttenbergen 22:55, 2017 November 13 (CST)
Implementation
The field is populated with options from the s dispo table.
Related Articles
Legacy
This field is part of the 2016 Time and Place changes.
It a combination of our previous
Data from these fields has been back-populated to the this field so data is available from the beginning of the database.
Related articles:
Very early missing Discharge-tos
There were 6762 very old ICU records who are listed as survived but didn’t have a discharge-to. This is from HSC-only days when there simply were no checks.
When data was brought across from the old discharge to field the dispo fields of these records were set to 'survive(Legacy)'.