This page is about the May transition of collection units at HSC to accommodate the new COVID unit. See 2020-03 HSC COVID unit transition, 2020-04 HSC COVID unit transition about earlier transitions.
Background
Dates
- May 12.20 - HSC D2 C will now be ortho patients.
- ?? .20 - H7 (H7 and H733 old CCU) will be additional 17 beds for ICU (HSC_MICU and/or HSC_SICU)
- it is not yet clear if this ward is allocated for MICU only or SICU only or both - waiting for the decision.
- ?? .20 - A7 will be additional 14 beds for ICU (HSC_MICU and/or HSC_SICU)
- it is not yet clear if this ward is allocated for MICU only or SICU only or both - waiting for the decision.
Medicine specifics
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- Julie wrote - We should have a cut-off date for the additional covid ward D2 and MS3. As I understand these new wards are for covid positives. Once dates are confirmed, then we start collecting at D2 and MS3.
- Currently D2 is still a suspect ward, D4 is still our only COVID + ward Lisa Kaita 17:01, 2020 April 16 (CDT)
- May 12.20 D2 C is no longer suspect ward. will now be ortho pts. D4 will house both suspect and +ve covid
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If all the covid wards are operational, how to handle the case where the patient stayed in 2 official covid wards consecutively - 1) separate records or 2)one continuous record? I think we should consider (2) as continuous.
ICU specifics
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Related to ICU, how will the patient originally at HSC_MICU then move to either H7 or A7 under the care of MICU be collected - will the move to H7/A7 be a new record or continuation?
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- April 2020 HSC_MICU will admitted both SICU and MICU physician Service patients that are either suspect or confirmed COVID patients. No suspect or positive covid will be admitted to HSC SICU. Though MICU is a close unit the SICU patient in this unit will be under the SICU attending service physician. Depending on skill set required, sometime may be a SICU nurse or just MICU nurse. The nurse bit we will not be able to track. We need to ask Randy and Bojan how they want this tracked in Database in terms of service occupancy. Put service Loc as HSC SICU and tag in TMP as boarding location? Julie would some of the logic applied to bed board apply to how we tag this.
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Wards involved:
originals:
Service Locations
Tmp entries
- The following should be added to Tmp entries :
- HSC_D5_P
- HSC_D4_P
- HSC_H4H
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- Does that mean all those should be removed as s_dispo table entries? If we keep them in both linking will mess up.
- are you using the tmp entries in linking? I use the s_dispo when I do linking. I use the tmp entries to calculate time spent in each boarding loc and home ward. --JMojica 11:03, 2020 April 15 (CDT)
- No, not using tmp entries for linking, but if info is kept in tmp instead of new record added then the dispo entry in previous record or previous entry in next record may not match with the service location.
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Transition plan
- There is no transition plan for the new COVID wards and the additional ICUs. Just need to add in the s_dispo table
- This transition plan is only for the patients in H4H who were moved to HSC_B2
- "HSC_H4H" needs to be added to s_tmp of Project BoardingLoc
collector instructions
- change the Service/Location of the record to the new location (ie from HSC_H4H to HSC_B2 )
- Multi DC are collecting the H4H patients
- HSC_H4H_a to HSC_B2
- HSC_H4H_b to HSC_B2
- HSC_H4H_d to HSC_B2
- HSC_H4H_h to HSC_B2
- the new ward B2 does not need a subscript anymore because the Laptop identifier replaces it.
- enter the actual location as part of Boarding Loc:
- for patients who had no location borrowing during transition:
- change the "no borrow" line to "HSC_H4H" and enter the time the patient arrived in H4H
- add a line for "HSC - Home medicine ward" with the time that the patient was actually moved
- if there were patients who actually were in a borrow location during the transition, let's talk about how we would enter those
- The move from H4H to B2 happened April 14th.
D2 COVID Suspect Ward HSC_D2_C
- Stopped May 12.20. will be Ortho.
This ward is a mix of different medicine patients ie. H, D, A, unkknown, and nephrology patients, therefore each data collector will enter their own patients
- the Service/Location will be your home ward location
- in the tmp the Boarding Loc will be generic boarding and in Q column enter D2
- if the patient's result is negative and they are moved back to their home ward then enter Boarding Loc HSC home medicine ward with the date and time they are transferred back
- if the patient's result is positive, create a new profile using D4_C or whichever COVID + ward they are transferred to, if they remain on D2 no changes are required
Special Circumstances
When Reviewing a chart in MR and you find a COVID positive or COVID suspect patient that occurred BEFORE the new COVID positive/suspect wards were opened, use Service Location home ward location and use the appropriate COVID-19 (SARS-COV-2) or Observation for suspected infection NOS code.
When reviewing a chart in MR and you find a COVID suspect patient on your home ward and the patient is transferred to another location where the diagnosis of COVID positive is made, check the date/time the swab was sent. If it was sent less than 48 hours after admission code this as an Admit Diagnosis, if the swab was sent greater than 48 hours after admission code this as an Acquired Diagnosis
Serial Number
- For transition units ie. D5 to WRS3, D4 to D5, H4H to B2, use your continuous serial numbers
- For D4_C start with serial number 150
data processor instructions
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Depending on how we do this with tmp vs service location we may end up with linking issues and orphans; need to review.
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Reporting
Cross checks
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- Have not yet checked how this will impact CFE Data Integrity Checks. Pagasa, of the top of your head which would be impacted and how?
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