Dispo field

Data Element (edit)
Field Name:	dispo
CCMDB Label:	Dispo
CCMDB tab:	Dispo
Table:	L Log table
Data type:	number
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.

• SMW

Legacy implementation right in the table

• Cargo

• Categories

• Forms

Transition to PatientFollow Project

Use the new method for patients with a Dispo DtTm after the PatientFollow_Project#Transition_dates, even for patients who were accepted before the transition date.

For other components of PatientFollow, the new instructions are based on a patient's Accept DtTm. The change to using e.g. "HSC_Med" in Dispo needs to be based on the Dispo DtTm because otherwise the old entries won't link up to the new entries when Pagasa does the Linking. Ttenbergen 16:50, 2020 October 23 (CDT)

Collection instructions

surviving patients

• Enter:
  • for places where we collect, use the Service/Location used by the counterpart laptop: <site>_Med, GH-CC, HSC MICU , HSC SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU
  • for wards where we don't collect: <site>_Ward or other external entry e.g. home

so if a patient is taken to the OR direct from your unit (either from medicine or ICU) the dispo loc will still be <site>_ward? Check Visits to temporary locations this may answer your question (copied from further down below in this article)

• SMW

• Cargo

• Categories

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:

1. AMA is being excluded in the calculation of Readmission rate.
2. AMA is being counted as HOME in reporting for the location the patient went after discharge.
3. 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 Institution NOS.

• 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.

Deceased patients

See

• Deceased patients#General instructions for deceased patients
• Guideline for coding organ donation after death
• Visits to temporary locations

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

query of what is currently available

SQL

SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo FROM s_dispo WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));

Query of what is currently used

query z_s_dispo_inactivatable

is there any chance we can have the Dispo list cleaned up if we're using the above options? There are still +++ inpatient options for the hospitals? I guess this would also apply to the Previous Location and Pre-Admit lists as well. yes, needs to happen and is discussed in template:Location dropdown cleanup, please discuss further there since this affects other fields/pages as well.

• SMW

• Cargo

• Categories

Data Use

• ICU Mortality
• Intra or Inter Transfer Rate
• Discharges out of hospital
• Organ donor rate
• AMA Rate
• Linking admissions

Data Integrity Checks (automatic list)

	App	Status
Check pre acute consistent	CCMDB.accdb	declined
Function Validate Dispo	CCMDB.accdb	implemented
Check function location NE dispo	CCMDB.accdb	implemented
Query check ICD10 dx implying death must have appropriate dispo	CCMDB.accdb	implemented
Query check dispo lower acuity than location	CCMDB.accdb	retired
Link suspect dead then alive query	Centralized data front end.accdb	implemented
Link suspect mismatch to ours incomplete query	Centralized data front end.accdb	implemented
Link suspect not same visitAdmitDtTm query	Centralized data front end.accdb	implemented
Query cardiac arrest throughout admission	Centralized data front end.accdb	needs review

Implementation

The field is populated with options from the s dispo table.

Legacy

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

It a combination of our previous

• Discharge To
• Var 2 - Discharge-to Ward
• ICU Var 6 - AMA
• Survive / Expired

Data from these fields has been back-populated to the this field so data is available from the beginning of the database.

Related articles:

• Organ Donor/Braindead

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)'.