Boarding Loc

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Projects
Active?: active
Program: CC and Med
Requestor: internal
Collection start: 2019-Sep-20
Collection end:

This isn't so much a project as way to track how patients physically move around the hospital. See Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry for information about it and why we needed to change it to this model.

This project tracks where and when a patient arrives into a new physical location.

Data Collection Instructions

How to enter this

You can use the "Make loc" button to generate and pre-populate these entries.

  • Use tmp fields:
    • Project: Boarding Loc
    • Enter start_dt: arrival date at physical location, under column E.
    • Enter start_tm: arrival time at physical location, under column M.
    • checkbox: not used for this project
    • Item:
      • no location entered is the default (that entry will not be allowed in a complete record)
        • change the original entry to the first location the patient was during the admission in this record, e.g. ER, specific medicine ward etc
        • for any physical move to another unit, enter an additional Boarding Loc entry:
      • for "home" locations or other locations where there is a specific entry listed in the dropdown (eg ER)
        • item: the actual ward, e.g. STB_B5 or HSC_MICU
        • comment: leave blank
  • CCMDB automatically populates the comment column with the local actual unit names. To make this blank, collectors have to remove the entry. Is there a good reason why it can't just stay in there? (emailed Julie)Ttenbergen 16:43, 2021 January 18 (CST)
    • Not sure I understand. do you mean when the item='STB CICU' then comment='STB CICU', when item='STB ER' then comment='STB ER', when item='STB ICU Boarding' then comment=the localunit say 'STB_CICU' or 'STB ACCU' or 'STB_*'. I think it is just OK if they stay in comment. no need to remove.
      • Yes, generally speaking the comments for boarding and covid would stay the same, just the comment for home locations would now be allowed to stay the same. Specifically, the values listed in "Boarding Loc" column of s_Cognos_unit would be used. Ttenbergen 10:14, 2021 January 19 (CST)
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      • for "boarding" and COVID Suspect locations
        • item: "<your site> - boarding" (eg. "HSC - boarding", resp. "HSC - ICU boarding")
        • comment: actual unit
      • for COVID Positive locations
        • item: "<your site> - COVID unit" (eg. "GRA - COVID unit")
        • comment: actual unit

GRA MICU

  • Grace Main ICU Choose Boarding Location and GRA_MICU
  • Grace Recovery Room (ICU) Choose boarding location and GRA-recovery and enter comment Covid+ICU.
  • For External(SDC/NFA) beds choose boarding loc and GRA-ICU boarding and enter exact location in comments.

Why do we use the actual unit start dttm rather than the time they became our pt on a unit

We decided to use the actual unit start dttm because as the start of the boarding loc entry for two reasons:

  • it is the actual time a pt arrived on that unit, so it's a more intuitive data point for someone not familiar with our data
  • it allows clean matching to Cognos entries so the various Cognos tools can identify if an entry has already been dealt with

Special Case - cross-program boarding

If a patient is accepted by your service but remains at a location of a different service for some time before moving to your service, you need to enter a Boarding Loc entry for that period.

For Critical Care collection, this could happen if the team runs a code on a patient and accepts care for that patient, but for a period of time hasn't yet moved the patient. For Critical Care, you would enter a generic "<Site>_Med" (ie GRA_Med, HSC_Med, STB_Med) for this patient so we don't have CC collectors keeping track of where regular, boarding or covid locations are. The generic "<Site>_Med" entry would only be available on CC laptops.

For Medicine laptops this isn't an issue because all CC locations are explicitly included in Boarding Loc.

Special Case - Parked

  • For patients who are Parked in ER, just follow usual instructions, a special entry is no longer needed, since the ER delay will take care of them.

Special Case - EMIP/ECIP

See 2020-10 EMIP changes

Special Case - COVID

Special Case - COVID status of unit changes while patient location and service remains same

  • If the unit a patient is on changes to be a COVID Designated Ward, or changes to no longer be a COVID unit, and the patient stays put and remains on your service, put a new boarding loc entry to reflect the new unit status:
    • If the unit a patient is on changes to be a COVID unit, enter a Boarding Loc entry of <your site> - COVID unit (e.g. "STB - COVID unit") for any admission to and time spent in a COVID unit
      • enter the actual location into the comment field, e.g. E6
    • If the unit a patient is on changes to no longer be a COVID unit, and the patient stays put, enter a Boarding Loc entry of the Service/Location, e.g. STB_E6_B

Special Case - Erroneous Unit information in Cognos EPR Report

Sometimes there are location entries in Cognos that are errors. EG. a patient may be listed as having gone to a weird unit for 5 minutes and then moved to a more reasonable one. They were probably never on that weird unit. For those cases, just exclude the location from your list so it doesn't clutter things, and don't enter this as a location.

  • To confirm: Julie, this means that if a pt was listed in Congos as some bogus unit for the first 6 hours of their stay, we would list their stay on our unit as starting 6 hours later. this would probably trigger some of Pagasa's cross checks, and give you 6 hours of missing occupancy. I still think it's the right way to deal with this error since messing with the times would break how entries are linked to Cognos, but I want to make sure we are all aware that this is a thing and how we approach it. Ttenbergen 13:29, 2020 November 9 (CST)
    • when does this phenomenon occur - at the beginning or in between transfers? (Julie)
      • It seems to be a matter of data entry errors, so I suppose it can occur at any time. Ttenbergen 11:00, 2020 November 18 (CST)
    • if at the beginning, then just exclude. (Julie)
      • If we ignore it if it happens at the beginning, it will mean Cognos lines that are not linked to anything. They will either clutter the screen as "not yet entered", or will need to be excluded manually by collectors. I think manually excluding them would get them off the list, but if a collector then tries to make sense of what they see the next day it will be confusing. Ttenbergen 11:00, 2020 November 18 (CST)
    • If in between transfers during an episode, is there a query done for that? Pagasa' query will crosschecks between records and not within episode. But if that happens, since only the arrived date is entered, I will always assume continuous stay defining the end date as the start date of the next boarding location. (julie)
      • Not sure what kind of query you have in mind. We only collect the unit starts, so there are no unit ends to cross check against. This means we should define how to enter these "bogus" units as either including them with the previous or including them with the next unit. I would prefer including them with previous because it doesn't break linking with Cognos for the next unit. Ttenbergen 11:00, 2020 November 18 (CST)


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Should be entered promptly

Occupancy per ward is being reported and/or requested. I have to change my program using the boarding loc info - have two fields arrival and departure per boarding location. It is very important that the location and dates arrived must be promptly entered so I can calculate occupancy accurately for the right physical location. --JMojica 09:38, 2020 October 14 (CDT)

Start/End Dates

  • Start: 2019-Sep-01: new admissions on and after this date.
  • End: there is no planned end date

Loose ends

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Which if any of Project_Borrow_arrive#Data_Integrity_Checks_.28SMW.29 will need to be moved over to this instead?

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  • inactivate legacy entry Home Medicine ward once last pt using it is discharged
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Data Integrity Checks (automatic list)

 AppStatus
Query check tmp ER Boarding Loc should exist if from ERCCMDB.accdbdeclined
Check if awaiting code is primary dx then Transfer Ready DtTm must be equal to Arrive DtTmCCMDB.accdbdeclined
Query s tmp check Boarding Loc and TransferReadyDtTm pairsCCMDB.accdbimplemented
Query check tmp 2 BL TR S same tmCCMDB.accdbimplemented
Query Check BL TR combiner nullCCMDB.accdbimplemented
Query check Transfer DtTm after paired BL and before later BLCCMDB.accdbimplemented
Query s tmp Boarding Loc ER delay reasonableCCMDB.accdbimplemented
Query check no consecutive same BL or ServiceCCMDB.accdbimplemented
Query check CCI TISS matching BoardingLoc timeCCMDB.accdbimplemented
Query check tmp Boarding Loc Service first sameCCMDB.accdbimplemented
Query s tmp check combined Boarding Loc and TransferReadyDtTmCCMDB.accdbimplemented
Query check transfer DtTm during admissionCCMDB.accdbimplemented
Query check tmp Service and Boarding Loc during admission timeframeCCMDB.accdbimplemented
Query check tmp service or location duplicateCCMDB.accdbimplemented
Query s tmp Boarding Loc date itemCCMDB.accdbimplemented
Query check minimal data set incompleteCCMDB.accdbimplemented
Query check tmp Transfer Ready not before Boarding LocCCMDB.accdbretired
Query s tmp check combined BL and TRDtTm nonsequentialCCMDB.accdbretired
Query check transfer ready tmp for each Boarding LocCCMDB.accdbretired
Query s tmp Boarding Loc no borrow but entryCCMDB.accdbretired

Data Use

Critical care and Medicine programs want to know this to better understand patient flow and bed utilization.

SAS Program

The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.

Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time
where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.

The SAS program is saved in X:\Julie\SAS_CFE\CFE_macros\Bed_Borrow.sas

Background

See Bed borrow as aggregator page for other boarding and borrow related concepts.

The concept is similar to EMIPs but we will keep the EMIP separate from this project. The current EMIP will stay the same.--JMojica 10:37, 2019 September 20 (CDT)

Related articles

Related articles:
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