Task Team Meeting - Rolling Agenda and Minutes 2019
List of items to bring to task meeting
Add to this by adding the following to the article where the problem is documented:
{{DiscussTask | explanation}}
| Question | Modification date"Modification date" is a predefined property that corresponds to the date of the last modification of a subject and is provided by Semantic MediaWiki. | |
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| Decubitus Stage not indicated Details |
| 8 October 2025 01:25:23 |
| Dispo field | If this is actually done then why don't we just make the nursing stations available? We already have s_dispo table entries for them. 35 entries since 2016, 6 in the last 12 months. Are there other things for which this entry is used? Checked for reasons for this decision but they don't appear documented Ttenbergen 19:42, 13 March 2025 (CDT) JALT I thought we had decided at JALT to collect this as presented by EPR... do I remember this wrong? I had already added it in CCMDB.accdb Change Log 2025#2025-03-11-1. Ttenbergen 22:52, 11 March 2025 (CDT)
| 8 September 2025 15:31:26 |
| pre_acute_living_situation field | JALT should we be including Misericordia TCU here? Lisa Kaita 11:57, 5 June 2025 (CDT) | 3 October 2025 15:28:45 |
See Task Team Meeting - Rolling Agenda and Minutes 2018 for previous year's minutes.
ICU Database Task Group Meeting – January 24, 2019
- Present: Allan, Con, Joanna, Julie, Tina, Trish
- Absent: Laura
- Minutes prepared by: AG
- Action items in BOLD
1. There is still concern about the extra workload of ICD10/CCI. We will continue to monitor this and seek pithy suggestions for reducing the workload with minimal loss of content/value.
2. Consideration of adding chemotherapy to the CCI list This CCI picklist code would be 1.ZZ.35.HA-M0. At the Dec 7, 2018 task meeting we decided to eliminate it, though that item doesn’t explain why. We’ll reconsider at the next task.
3. Consideration of adding a specific ICD10 code for IVDA -- There is no ICD10 code for IVDA. The drug abuse codes go by the drug, not the route. If we decide we really need/want this, we can add a custom code. At the next meeting we’ll discuss this.
4. After discussion of whether we want to code CMV(+) status for organ transplants, we decided that we do not.
5. FFP does not have stickers that come with it from Blood Services. This led to a question of how to quantify FFP.
- Allan called the Winnipeg office of Canadian Blood Services and was told that for full units (approx. 250 mL) they do have stickers, but when they send half units that those do not have stickers. A solution appears to be to count the stickers, which should be there for whole units, but for half units, count them manually -- as 0.5 of a unit. We’ll discuss this more at the next Task meeting.
6. Question arose of how to code Factor V Leiden mutation. Allan will look into this ---> DONE, as the Wiki page indicates this is covered in Primary hypercoagulability (thrombophilia).
7. A complex question was raised about coding/counting CCI admit procedures that are done prior to admission, especially if done in a procedure suite on the way from one hospital ward or ICU to another hospital ward or ICU.
- Our current criteria are listed in CCI Collection and that works fine when the patient comes to out ICU/ward from the ED or another location where we do not collect.
- But, it’s complicated by the fact that is a patient goes from one to another of our collecting locations, that they might be counted in each place. Furthermore, a person being transferred from location A to location B may, in between, go to a procedure suite and get admit-type procedures.
- We agreed to make 4 general rules for procedures:
- (i) Transfer from collecting location A to collecting location B without any stop in between where procedures might occur -- all procedures done before leaving location A will be collected by location A only
- (ii) Transfer from collecting location A to collecting location B WITH a stop in between where procedures occur -- all procedures done before leaving location A will be collected by location A only, while procedures done at the stop in between will be coded by location B only.
- (iii) Transfer from noncollecting location A (which includes ED) to collecting location B without any stop in between where procedures might occur -- any qualifying admit procedures done before leaving location A will be collected by location B
- (iv) Transfer from noncollecting location A (which included ED) to collecting location B WITH a stop in between where procedures occur -- all procedures done before leaving location A or during the stop in between will be coded by location B only.
- Allan will make changes to the “Moved Patients” segment of Admit procedure to reflect this -- DONE.
8. Tina raised the issue of the possibility of the following true timing of events: First patient accepted for admission; Second patient deemed transfer ready to a lower level of care; Last is patient arrives. It’s an issue because the current cross-check does not allow Transfer Ready D/T to occur prior to Arrival D/T. After discussion (which unfortunately Tina was not present for), we agreed that the rule should be that Transfer Ready D/T can only be coded at or after Arrival D/T. The rationale has to do with the main desire for avoidable days to refer to actual bed occupancy days avoidable.
9. Discussion about coding Bacteremia. Although this is a finding and not an actual disease, because of it’s importance, we agreed that even though the general role is that coding findings/signs/symptoms is optional when the underlying cause is known, that for bacteremia we should ALWAYS code it when present. Furthermore, that at the discretion of the data collector, it can be linked to another presumed infection (e.g. Klebsiella pneumonia linked to Klebsiella bacteremia), but if it’s not completely clear that they’re related, to leave the bacteremia as “free standing”. Allan will modify the wiki page for Bacteremia, the sepsis template -- DONE.
Next Task Group Meeting: February 6, 2019 at 11am
ICU Database Task Group Meeting – January 9, 2019
- Present: Allan, Con, Joanna, Julie, Tina, Trish
- Absent: Laura
- Minutes prepared by: AG
- Action items in BOLD
1. Through discussion it became clear that there’s a need to modify the Kidney, renal tubular acidosis (RTA, all types) wiki page to clarify that by definition it is not an RTA if renal failure (acute or chronic) is present. Said another way, an RTA is a metabolic acidosis due to an inability of the renal tubules to excrete hydrogen ions in the presence of a normal creatinine clearance, as indicated usually by a normal creatinine. Allan will add this to the wiki article -- DONE.
2. There was substantial concern voiced by Con and Joanna about how long the new system is taking to code. At this point it’s as much as 4-fold longer than before. We discussed possible reasons, which include:
- ICD10 coding, though this is possibly less burdensome than is CCI coding.
- The biggest single issue raised was that among the 5 CCI Collection Modes:
- Collecting "CCI collect each" items
- Collecting "CCI collect count each" items
- Collecting "CCI collect count days" items
- Collecting "CCI collect count units" items
- Collecting "CCI collect first" items
- We recognized that we probably could downgrade most of ‘1’ to be one of the others
- And that for at least some of ‘2’, '3' and '4' we could downgrade to ‘5’
- We decided today to do that for HD, PD, CRRT and ICP monitoring (Done - Tina)
- Allan will take a look at the entire list, especially CCI Picklist, and consider further items that can be downgraded.
- Other options for reducing workload for CCI include: (i) compressing the number of body parts, (ii) reducing and/or compressing the number of “what was done to the body part” items.
- We’ll discuss all this at next Task meeting.
3. Julie raised the question of Charlson items -- specifically that previously most such items were allowed to be listed either as Admit Diagnosis or Comorbid Diagnosis. (See also Controlling Dx Type for ICD10 codes) The question is what do we want to do now about this. Allan will review both Charlson’s original description, and Quan’s administrative data implementation to see what THEY did regarding this --> DONE. The intention of this coding is to identify conditions that are present prior to admission. Thus, we should include admit and even acquired (post-admit) diagnoses for those Charlson items where it's pretty clear that the condition was almost certainly present prior to admission, even if that wasn't recognized, i.e. the following ones:
- Peripheral vascular disease
- Dementia
- Chronic pulmonary disease
- Rheumatic disease
- Mild liver disease
- Moderate or severe liver disease
- Diabetes without chronic complications
- Diabetes with chronic complications
- Any malignancy, including lymphoma and leukemia, except of skin
- Metastatic solid tumor
- AIDS (disease due to HIV)
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Charlson Admit Como - I have put several related pages on your list that start with the same words as this one. We need to update them to make sense with any change to this. Some still had other questions in them anyway. |
4. It was noted that the Template:ICD10 Guideline Como vs Admit is very confusing. Allan will work on it. (Template was added to Allan's list)